Impact of ACE polymorphism on renal allograft function, blood pressure, and proteinuria under ACE inhibition

Suwelack, Barbara; Kempkes-Koch, M; Kobelt, Viola; Hillebrand, Uta; Matzkies, F; Gerhardt, Ulf; Hohage, Helge

doi:10.1016/s0041-1345(02)03058-0

Cited by 13 publications

(7 citation statements)

References 19 publications

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“…The effects of equivalent doses of ACEI on hypertension and proteinuria in humans show interindividual variability, which may be explained by ACE gene polymorphism (Ruggenenti et al. , 2000; Suwelack et al. , 2002).…”

Section: Effect Of Acei On the Progression Of Renal Diseasesmentioning

confidence: 99%

Angiotensin‐converting enzyme inhibitors in the therapy of renal diseases

Lefebvre

Toutain

2004

Vet Pharm & Therapeutics

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Renal diseases, especially chronic renal failure (CRF), are common in canine and feline medicine. The renin-angiotensin-aldosterone system (RAAS) plays a pivotal role in these conditions in the development of renal lesions and the progression of kidney dysfunction. Angiotensin-converting enzyme inhibitors (ACEI) are currently considered as the most efficient agents in therapeutic strategies. The benefit of an ACEI treatment can be explained by at least three mechanisms: ACEI limit systemic and glomerular capillary hypertension, have an antiproteinuric effect, and retard the development of glomerulosclerosis and tubulointerstitial lesions. These effects have been studied in dogs and cats, and there is now some evidence to support the recommendation of ACEI therapy in dogs and cats with CRF. Nevertheless the prescription of ACEI in such patients should take into account the potential influence of renal impairment on ACEI disposition, and adverse effects on the renal function itself (especially hypotension and acute reductions in glomerular filtration rate). The risk of drug interaction with diuretics, nonsteroidal anti-inflammatory drugs and anesthetics, should not be overestimated. Furthermore, hypotension may occur in patients on a low sodium diet.

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Section: Effect Of Acei On the Progression Of Renal Diseasesmentioning

confidence: 99%

Angiotensin‐converting enzyme inhibitors in the therapy of renal diseases

Lefebvre

Toutain

2004

Vet Pharm & Therapeutics

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“…The two trials scrutinizing the effects of enalapril produced disparate resultsFTodd et al [1995] found no differences among ACE I/D genotypes, whereas Haas et al [1998] found II/ID subjects responded more favorably. Both imidipril and quinapril caused more favorable responses in the ACE II genotype [Ohmichi et al, 1997;Suwelack et al, 2002], whereas benazepril and fosinopril caused more favorable responses in the DD genotype [Li et al, 2003;Stavroulakis et al, 2000]. Lisinopril showed no differential responses with respect to ACE I/D [Dudley et al, 1996;O'Toole et al, 1998] or AGT M235T [Dudley et al, 1996].…”

Section: Renin-angiotensin-aldosterone System Drugs Ace Inhibitorsmentioning

confidence: 99%

Pharmacogenetics of antihypertensive treatment

Arnett

Claas

2004

Drug Development Research

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Hypertension is a common disorder associated with increased cardiovascular morbidity and mortality. Unfortunately, in the United States, only about one third of those who are aware of their hypertensive status successfully control their blood pressure. One reason for this is the variable and unpredictable response individuals have to pharmacologic treatment. Clinicians often resort to a trial-anderror approach to match patients with effective drug treatment. It is the goal of hypertension pharmacogenetics to apply knowledge of genetic predictors of treatment response to drugs that lower blood pressure and to translate this knowledge into clinical practice. To date, more than 30 studies have investigated associations between specific genetic polymorphisms and response to particular antihypertensive drugs. Angiotensin-converting enzyme inhibitors have been most frequently studied, followed by diuretics, beta-blockers, angiotensin II blockers, adrenergic alpha-agonists, and calcium channel blockers. Renin-angiotensin-aldosterone system genes have been the most widely studied, with the angiotensinconverting enzyme I/D variant being typed in about one third of all hypertension pharmacogenetic studies to date. In a number of cases, significant and potentially promising associations between genes and drug treatments have been reported. However, taken in sum, the literature suggests that the path from genedrug-outcome association studies to clinically useful knowledge may be neither short nor direct. In the future, carefully designed studies must acknowledge that hypertension is caused by multiple genes and environmental factors that act in concert. These considerations, along with a better understanding of the complexities of the biology of hypertension, open the next set of opportunities for hypertension pharmacogenetics research. Drug Dev.

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“…However, several inconsistencies are evident in the findings of some hypertension, left ventricular hypertrophy and cardiomyopathy studies, and consequently the extent of the modification effect of this polymorphism remains unclear [46][47][48][49][50]. A meta-analysis assessed the possibility of an association between the ACE I/D polymorphism and the response to ACE inhibitors among 4 previously published pharmacogenetic reports that included a total of 925 patients.…”

Section: Ace Polymorphisms and Ace Inhibitor Drug Responsementioning

confidence: 99%

Pharmacogenetically Tailored Treatments for Heart Disease

Vafiadaki¹,

Arvanitis²,

Kranias³

et al. 2010

CPD

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Heart disease represents the primary cause of death worldwide, with mortality rates being predicted to remain constant within the next couple of decades. Cardiac disease treatment currently includes the administration of drugs, predominantly aiming at improving heart performance, through controlling heart rhythm, blood pressure, as well as reducing cholesterol and blood clotting. Despite, however, the medical advances that have lead towards a better understanding of heart disease pathophysiology and the development of new therapeutic approaches, the degree of success of the available drug therapies varies among patients. The existence of polymorphisms in a number of genes has been shown to result in differences in pharmacokinetics, pharmacodynamics and drug metabolism and have therefore been associated with response to drug treatment. The occurrence of adverse drug reactions that may lead to drug-induced toxicity represents another factor influencing outcome of therapeutic treatment. While the influence of genetic polymorphisms in patient's response to heart disease drugs is being unveiled, the rapidly evolving field of pharmacogenetics is promising to aid clinicians in choosing the best suited drug/dose for each patient and the pharmaceutical companies in the design of better targeted, more effective new chemical compounds. In the near future individualized, targeted therapy will become part of clinical care routine maximizing patient therapeutic benefits and minimizing risks of adverse effects.

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Impact of ACE polymorphism on renal allograft function, blood pressure, and proteinuria under ACE inhibition

Cited by 13 publications

References 19 publications

Angiotensin‐converting enzyme inhibitors in the therapy of renal diseases

Angiotensin‐converting enzyme inhibitors in the therapy of renal diseases

Pharmacogenetics of antihypertensive treatment

Pharmacogenetically Tailored Treatments for Heart Disease

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