Exploring the Impact of ACE Inhibition in Immunity and Disease

Angiotensin-converting enzyme (ACE) is a zinc-dependent dipeptidyl carboxypeptidase and is crucial in the renin-angiotensin-aldosterone system (RAAS) but also implicated in immune regulation. Intrinsic ACE has been detected in several immune cell populations, including macrophages and neutrophils, w...

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Main Authors: Delia Oosthuizen, Edward D. Sturrock
Format: Article
Language:English
Published: SAGE Publications 2022-08-01
Series:Journal of the Renin-Angiotensin-Aldosterone System
Online Access:https://doi.org/10.1155/2022/9028969
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author Delia Oosthuizen
Edward D. Sturrock
author_facet Delia Oosthuizen
Edward D. Sturrock
author_sort Delia Oosthuizen
collection DOAJ
description Angiotensin-converting enzyme (ACE) is a zinc-dependent dipeptidyl carboxypeptidase and is crucial in the renin-angiotensin-aldosterone system (RAAS) but also implicated in immune regulation. Intrinsic ACE has been detected in several immune cell populations, including macrophages and neutrophils, where its overexpression results in enhanced bactericidal and antitumour responses, independent of angiotensin II. With roles in antigen presentation and inflammation, the impact of ACE inhibitors must be explored to understand how ACE inhibition may impact our ability to clear infections or malignancy, particularly in the wake of the coronavirus (SARS-CoV2) pandemic and as antibiotic resistance grows. Patients using ACE inhibitors may be more at risk of postsurgical complications as ACE inhibition in human neutrophils results in decreased ROS and phagocytosis whilst angiotensin receptor blockers (ARBs) have no effect. In contrast, ACE is also elevated in certain autoimmune diseases such as rheumatoid arthritis and lupus, and its inhibition benefits patient outcome where inflammatory immune cells are overactive. Although the ACE autoimmune landscape is changing, some studies have conflicting results and require further input. This review seeks to highlight the need for further research covering ACE inhibitor therapeutics and their potential role in improving autoimmune conditions, cancer, or how they may contribute to immunocompromise during infection and neurodegenerative diseases. Understanding ACE inhibition in immune cells is a developing field that will alter how ACE inhibitors are designed in future and aid in developing therapeutic interventions.
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spelling doaj.art-ecb209a41a9847849f92042c12cc185a2024-03-06T19:05:54ZengSAGE PublicationsJournal of the Renin-Angiotensin-Aldosterone System1470-32031752-89762022-08-01202210.1155/2022/9028969Exploring the Impact of ACE Inhibition in Immunity and DiseaseDelia Oosthuizen0Edward D. Sturrock1 Angiotensin-converting enzyme (ACE) is a zinc-dependent dipeptidyl carboxypeptidase and is crucial in the renin-angiotensin-aldosterone system (RAAS) but also implicated in immune regulation. Intrinsic ACE has been detected in several immune cell populations, including macrophages and neutrophils, where its overexpression results in enhanced bactericidal and antitumour responses, independent of angiotensin II. With roles in antigen presentation and inflammation, the impact of ACE inhibitors must be explored to understand how ACE inhibition may impact our ability to clear infections or malignancy, particularly in the wake of the coronavirus (SARS-CoV2) pandemic and as antibiotic resistance grows. Patients using ACE inhibitors may be more at risk of postsurgical complications as ACE inhibition in human neutrophils results in decreased ROS and phagocytosis whilst angiotensin receptor blockers (ARBs) have no effect. In contrast, ACE is also elevated in certain autoimmune diseases such as rheumatoid arthritis and lupus, and its inhibition benefits patient outcome where inflammatory immune cells are overactive. Although the ACE autoimmune landscape is changing, some studies have conflicting results and require further input. This review seeks to highlight the need for further research covering ACE inhibitor therapeutics and their potential role in improving autoimmune conditions, cancer, or how they may contribute to immunocompromise during infection and neurodegenerative diseases. Understanding ACE inhibition in immune cells is a developing field that will alter how ACE inhibitors are designed in future and aid in developing therapeutic interventions.https://doi.org/10.1155/2022/9028969
spellingShingle Delia Oosthuizen
Edward D. Sturrock
Exploring the Impact of ACE Inhibition in Immunity and Disease
Journal of the Renin-Angiotensin-Aldosterone System
title Exploring the Impact of ACE Inhibition in Immunity and Disease
title_full Exploring the Impact of ACE Inhibition in Immunity and Disease
title_fullStr Exploring the Impact of ACE Inhibition in Immunity and Disease
title_full_unstemmed Exploring the Impact of ACE Inhibition in Immunity and Disease
title_short Exploring the Impact of ACE Inhibition in Immunity and Disease
title_sort exploring the impact of ace inhibition in immunity and disease
url https://doi.org/10.1155/2022/9028969
work_keys_str_mv AT deliaoosthuizen exploringtheimpactofaceinhibitioninimmunityanddisease
AT edwarddsturrock exploringtheimpactofaceinhibitioninimmunityanddisease