251. Can ACE Inhibitors Promote Detrimental Vascular Effects After Percutaneous Injury?
- Author
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Eugenio Uslenghi, Giuseppe Matullo, Alberto Piazza, Valeria Ferrero, Flavio Ribichini, and William Wijns
- Subjects
medicine.medical_specialty ,Vascular smooth muscle ,Angiotensin-Converting Enzyme Inhibitors ,Peptidyl-Dipeptidase A ,Endothelial NOS ,Receptor, Angiotensin, Type 1 ,Internal medicine ,Internal Medicine ,Perindopril ,Medicine ,Humans ,Receptor ,Angiotensin II receptor type 1 ,Receptors, Angiotensin ,biology ,business.industry ,Graft Occlusion, Vascular ,Angiotensin-converting enzyme ,Angiotensin II ,Nitric oxide synthase ,Radiography ,Endocrinology ,biology.protein ,Stents ,business ,medicine.drug - Abstract
To the Editor: Zhuo et al1 reported interesting observations in vivo about the effects of angiotensin-converting enzyme (ACE) inhibition with perindopril on plasma ACE levels and cellular expression of ACE, AT1 receptors, and nitric oxide synthase (NOS) isoforms in human blood vessels. Oral ACE inhibition at conventional doses (perindopril 4 mg/d) decreased plasma ACE activity by 70% and vascular ACE immunoactivity to 65% of control subjects detected by immunocytochemistry, and increased endothelial NOS (eNOS) and inducible NOS (iNOS) expression in the vascular wall. However, the authors also observed a dramatic 80% increment of the AT1 receptor binding in vascular smooth muscle cells, which might increase the potential of these receptors to counterbalance the beneficial effects of suppressed angiotensin II formation if AT1 receptors were activated by alternative sources of angiotensin II. Whether the overexpression of AT1 receptors may somehow limit, or even reverse, the beneficial effects of ACE inhibitors in specific clinical situations of vascular disease has stimulated the following comments. So far, mostly beneficial vascular effects have been reported in patients treated with ACE inhibitors.2,3 However, 2 recent publications have shown that oral administration …
- Published
- 2002