Am. J. Respir. Crit. Care Med., Volume 156, Number 1, July 1997, 255-259

Polymorphism in the Angiotensin-Converting Enzyme (ACE) Gene and Sarcoidosis

HIROSHI TOMITA, YASUTAKA INA, YOSHIKI SUGIURA, SHIGEKI SATO, HARUHIKO KAWAGUCHI, MUNEHIKO MORISHITA, MASAHIKO YAMAMOTO, and RYUZO UEDA

Second Department of Internal Medicine, Nagoya City University Medical School, Nagoya, Japan; Second Department of Internal Medicine, Aichi Medical University, Nagakute, Japan; and Nagoya Medical Examination Center, Postal Life Insurance Corporation, Nagoya, Japan

It has recently been shown that an insertion (I)/deletion (D) polymorphism exists in the angiotensin-converting enzyme (ACE) gene, and that this polymorphism affects the serum ACE level. There are three genotypes: DD, DI, and II, with the ACE level highest in DD, intermediate in DI, and lowest in II. In the present investigation of the possible significance of the polymorphism for sarcoidosis, a total of 207 patients and 314 normal control subjects were examined. There were no significant differences in the I/D ratio and the genotype distribution between the two groups, and no significant variation in organ involvement (i.e., eye, skin, and heart) was noted among the three genotypes. To determine any prognostic influence of the polymorphism, we examined the disappearance ratio of abnormal shadow on chest radiography over 3 and 5 yr. No significant difference among the three genotypes was observed. New normal ranges of serum ACE level were determined for each genotype, and found to be 22% more sensitive overall than the conventional normal range and 39% more so for II type, suggesting an advantage for diagnosis and assessment of the disease activity of sarcoidosis.

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