The Relationship of Serum Angiotensin Converting Enzyme(ACE), Angiotensin II and Clinical Markers in the Idiopathic Interstitial Pneumonia

특발성 간질성 폐렴 환자에서 임상적 지표와 혈청 Angiotensin Converting Enzyme(ACE) 및 Angiotensin II와의 관계

  • Kyung, Sung-Young (Division of Pulmonary Medicine, Gachon Medical School Medical Center) ;
  • Hahn, Hye-Sook (Division of Pulmonary Medicine, Gachon Medical School Medical Center) ;
  • Song, Suk-Ho (Division of Pulmonary Medicine, Gachon Medical School Medical Center) ;
  • Hwang, Jun-Kyu (Division of Pulmonary Medicine, Gachon Medical School Medical Center) ;
  • Lim, Young-Hee (Division of Pulmonary Medicine, Gachon Medical School Medical Center) ;
  • An, Chang-Hyeok (Division of Pulmonary Medicine, Gachon Medical School Medical Center) ;
  • Park, Gye-Young (Division of Pulmonary Medicine, Gachon Medical School Medical Center) ;
  • Park, Jung-Woong (Division of Pulmonary Medicine, Gachon Medical School Medical Center) ;
  • Jeong, Seong-Hwan (Division of Pulmonary Medicine, Gachon Medical School Medical Center) ;
  • Ha, Seung-Yeon (Department of International Medicine, Pathology, Gachon Medical School Medical Center) ;
  • Lee, Jae-Woong (Department of International Medicine, Thoracic surgery, Gachon Medical School Medical Center)
  • 경선영 (가천의과대학교 길병원 내과학교실 호흡기내과) ;
  • 한혜숙 (가천의과대학교 길병원 내과학교실 호흡기내과) ;
  • 송석호 (가천의과대학교 길병원 내과학교실 호흡기내과) ;
  • 황준규 (가천의과대학교 길병원 내과학교실 호흡기내과) ;
  • 임영희 (가천의과학대학교 길병원 내과학교실 호흡기내과) ;
  • 안창혁 (가천의과학대학교 길병원 내과학교실 호흡기내과) ;
  • 박계영 (가천의과학대학교 길병원 내과학교실 호흡기내과) ;
  • 박정웅 (가천의과학대학교 길병원 내과학교실 호흡기내과) ;
  • 정성환 (가천의과대학교 길병원 내과학교실 호흡기내과) ;
  • 하승연 (가천의과학대학교 길병원 내과학교실 병리과) ;
  • 이재웅 (가천의과대학교 길병원 내과학교실 흉부외과)
  • Published : 2002.05.30

Abstract

Background : There have been several studies showing that angiotensin II and the angiotensin converting enzyme (ACE) contribute to the activation of fibroblast including the pulmonary fibrosis, and apoptosis of the alveolar epithelium in idiopathic intersititial pneumonia. This study was performed to identify the relationship between the serum angiotensin II, ACE and the pulmonary function test (PFT), the dyspnea score, and the cell fraction of the bronchoalveolar lavage fluid(BALF). Materials and Methods : Twenty three patients with idiopathic interstitial pneumonia from March, 1999 to October, 2001 at Gachon medical school were enrolled in this study. They were divided into IPF(UIP) (16) and NSIP (7) groups. Twelve of the idiopathic interstitial pneumonia patients (UIP : 5, NSIP : 7) were diagnosed by an open lung biopsy, 11 of IPF patients were diagnosed by the American Thoracic Society (ATS) diagnostic criteria. The PFT values, dyspnea score, serum ACE and angiotensin II were measured, and a bronchoscopy was performed to obtain the BALF. Results : Of all the patients, 7 were in the normal range and 14 showed an increase in the serum level of angiotensin II. In terms of the serum ACE level, 14 patients had an increased level. The DLCO% of the angiotensin II in increased group was significantly lower than the not-increased group (p=0.021). Other factors did not correlate with the serum ACE or the angiotensin II increased group and not-increased group. Conclusion : These results suggest that an increased angiotensin II serum level may be associated with increase in the of alveolar capillary block in the progression of pulmonary fibrosis in idiopathic interstitial pneumonia.