Angiotensin‐converting enzyme inhibitor and visceral angio‐oedema

Chuah, Hun Sheng; O’Donnell, Daniel

doi:10.1111/j.1742-6723.2011.01529.x

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…29,97 The development of intestinal angioedema caused by ACE inhibitors such as lisinopril is also very well documented in the literature. [98][99][100][101] 3.3 Possible mechanisms 3.3.1 Opioids. The analgesic actions of AngII may be possibly mediated directly through endogenous opioids in the body.…”

Section: Clinical Studiesmentioning

confidence: 99%

Renin–angiotensin system in pain: Existing in a double life?

Bali

Singh

Jaggi

2014

J Renin Angiotensin Aldosterone Syst

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Apart from the well-documented role of the renin-angiotensin-aldosterone system (RAAS) in regulating the blood pressure and other related parameters, its role in modulating different physiological/pathological functions, including pain, has also been described. Like its dual role in regulating stress-related anxiety and cognitive functions, its dual role has also been documented in pain modulation in different disease states. Drugs blocking the RAAS activation, viz., renin inhibitors, angiotensin converting enzyme (ACE) inhibitors, AT 1 receptor antagonists and aldosterone antagonists, have been shown to produce beneficial effects in migraine and neuropathic and nociceptive pain. Their beneficial effects have been mainly attributed to inhibition of the inflammatory cascade of reactions by inhibiting the generation of key cytokines, including tumor necrosis factor (TNF)-α. On the contrary, clinical as well as preclinical studies have also shown the paininducing actions of renin-angiotensin system (RAS) blocking drugs. Furthermore, the pain-relieving actions of angiotensin II (AngII) and pain-inducing actions of AT 1 blockers have also been described. The pain-inducing actions of ACE inhibitors have been mainly attributed to interference with metabolism of bradykinin and substance P, while the analgesic actions of AngII have been mainly related to activation of brain localized AT 2 receptors and release of endogenous opioids. The present review describes the dual role of the RAAS in different states of pain.

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Section: Clinical Studiesmentioning

confidence: 99%

Renin–angiotensin system in pain: Existing in a double life?

Bali

Singh

Jaggi

2014

J Renin Angiotensin Aldosterone Syst

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“…1 , 2 , 3 , 12 Symptoms usually begin 72 h after starting ACE inhibitor, 8 , 13 , 14 , 15 but there are reports of angioedema that developed after weeks 10 , 16 or years of therapy. 2 , 10 , 17 , 18 Typically symptoms resolve 48 h after ACE inhibitor suspension. 3 , 4 …”

Section: Discussionmentioning

confidence: 99%

Visceral Angioedema Induced by Angiotensin Converting Enzyme Inhibitor: Case Report

Frutuoso

Esteves

Silva

et al. 2016

GE Portuguese Journal of Gastroenterology

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IntroductionIntestinal angioedema is a rare adverse effect of angiotensin converting enzyme inhibitors.Clinical caseA 42-year old woman presented to the Emergency Department complaining of diffuse abdominal pain, predominantly in the right quadrants, with no other associated symptoms.She had been started on perindopril plus indapamide 72 h before the admission for arterial hypertension. There was no other relevant background.Physical examination suggested peritoneal irritation on the lower quadrants of the abdomen and right flank.Laboratory tests were relevant for mild leukocytosis. Abdomen ultrasound and contrast-enhanced computed tomography scan showed moderate amount of fluid in the pelvic excavation and small intestine wall thickening. She was admitted for observation. Once the hypothesis of intestinal angioedema was admitted, angiotensin converting enzyme inhibitor was withheld and no other-directed therapy was instituted. Within 24 h she showed clinical, analytic and imaging improvement, thus supporting this diagnosis.ConclusionThe diagnosis of intestinal angioedema induced by angiotensin converting enzyme inhibitor can be challenging and time consuming due to its rarity and nonspecific symptoms, which may lead to underdiagnosis of this entity.

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“…Therefore, ACE inhibitors (ACEi) have become the preferred agents for the therapies of patients with concurrent secondary diseases 10 . Many synthetic ACEi drugs such as captopril, benazepril and enlapril are currently widely used in hypertension and heart failure treatment, whereas, these classic ACEi exert side effects 11 – 14 , there will be a huge commercial interest in new, safe chemicals with ACE-inhibiting efficiency. Most recently, many groups have reported the discovery of natural ACEi agents in various natural sources 15 – 18 , in particular TCMs.…”

Section: Introductionmentioning

confidence: 99%

Bioactivity-Guided Fractionation of Pine Needle Reveals Catechin as an Anti-hypertension Agent via Inhibiting Angiotensin-Converting Enzyme

2017

Sci Rep

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Hypertension has been recognized as one of the highest risk factors for cardiovascular diseases. Anti-hypertension agent screening and development has been recognized as a pharmaceutical therapy approach for the cardiovascular diseases treatment. Many kinds of traditional Chinese medicines, such as pine needle, have been used for the treatment of hypertension for a long time, but the bioactive ingredients which responsible for their therapeutic effectiveness are remain unclear. Therefore, screening bioactive chemicals in natural sources is still the most straightforward strategy for novel Angiotensin-converting enzyme inhibitor (ACEi)-based anti-hypertension agents discovery. In this study, we demonstrated a bioactivity-guided fractionation strategy for identifying bioactive fractions and chemicals from pine needle based on LC/MS assay as well as elucidating their mechanisms of pharmacological activity. And we found out the compound in pine needle extracts being ACE-inhibitory active is catechin. When ACE activity was assayed in rat tissue membranes, it was observed that catechin demonstrate ACE inhibition in kidney, lung and testes tissue. All these presents catechin in pine needle could be a potential cardiovascular medicine.

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Angiotensin‐converting enzyme inhibitor and visceral angio‐oedema

Cited by 3 publications

References 7 publications

Renin–angiotensin system in pain: Existing in a double life?

Renin–angiotensin system in pain: Existing in a double life?

Visceral Angioedema Induced by Angiotensin Converting Enzyme Inhibitor: Case Report

Bioactivity-Guided Fractionation of Pine Needle Reveals Catechin as an Anti-hypertension Agent via Inhibiting Angiotensin-Converting Enzyme

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