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Relationship between angiotensin-converting enzyme gene polymorphism (insertion/deletion) and the clinical condition of sepsis

Introduction

It has been postulated that genetic predisposition may influence the susceptibility to infection and disease outcome. The D allele of the angiotensin-converting enzyme (ACE) gene is associated with many diseases. However, there are only few reports available about infection. We have investigated the association between ACE I/D polymorphism and sepsis, its clinical features such as shock, acute respiratory distress syndrome (ARDS), multiorgan dysfunction syndrome (MODS) and mortality.

Methods

Ninety-eight patients who had been diagnosed with sepsis and 100 healthy individuals were included. The patients were divided into groups based on the presence of shock, ARDS, MODS and mortality. The ACE gene polymorphism was analyzed by PCR.

Results

There was no statistical difference between the controls' and patients' genotype (P = 0.29). No evidence emerged regarding the association of the ACE I/D polymorphism with MODS, but there was evidence of an association with sepsis-related hypotension, mortality and ARDS. While the I/I genotype was observed to increase the sepsis-related mortality risk 11.5-fold (P = 0.008), it increased the risk for hypotension 9.5-fold (P < 0.001). On the other hand, it was found that carrying D/D genotypes increased the risk of the having ARDS 4.5-fold (0R = 4.5, 95% CI 1.15–19.6) (P = 0.028). Meanwhile, in multivariate logistic analysis, shock is the only factor associated with mortality.

Conclusion

The insertion polymorphism in angiotensin-converting enzyme gene is associated with an increase in the risk of sepsis-related mortality and shock, but the deletion polymorphism is associated with an increase in the risk of sepsis-related ARDS.

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Yildizdas, R. Relationship between angiotensin-converting enzyme gene polymorphism (insertion/deletion) and the clinical condition of sepsis. Crit Care 12, P466 (2008). https://doi.org/10.1186/cc6687

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Keywords

  • Healthy Individual
  • Emergency Medicine
  • Gene Polymorphism
  • Mortality Risk
  • Acute Respiratory Distress Syndrome