Association between Insertion/Deletion Polymorphism in Angiotensin-Converting Enzyme Gene and Acute Lung Injury/Acute Respiratory Distress Syndrome in Adults: A Meta-Analysis_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

GaoFei , DongLiang ,  YanJie

Intensive Care Unit, Wuxi People's Hospital Afiliated to Nanjing Medical University, Wuxi, Jiangsu, 214023, China;

Corresponding author：

YanJie, Email: yjeast@163.com

Keywords：

Angiotensin-converting enzyme; Acute lung injury; Acute respiratory distress syndrome; Meta-analysis

DOI：

10.7507/1671-6205.2016011

Video：

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Objective To assesse the association of an insertion/deletion (I/D) polymorphism in the angiotensin-converting enzyme gene (ACE) with the risk and the mortality of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). Methods We searched electronic databases through April 2014 for the terms "angiotensin-converting enzyme gene", "acute lung injury" and "acute respiratory distress syndrome", and reviewed all studies that reported the relationship of the I/D polymorphism in ACE with ALI/ARDS in adults. Eight studies met the inclusion criteria, comprising 498 ALI/ARDS patients, 3220 healthy controls and 1137 patients without ALI/ARDS. Three genetic models were used: the allele, dominant and recessive models. The meta-analysis was performed with RevMan 5.2 software. Results The ACE I/D polymorphism was not associated with susceptibility to ALI/ARDS compared with the healthy controls and the patient controls for any genetic model. The ACE I/D polymorphism was associated with the mortality risk of ALI/ARDS in Asian subjects, and OR was 2.99 (95% CI 1.87-4.76, P < 0.05), 0.36 (95% CI 0.20-0.67, P < 0.05), 4.62 (95% CI 1.71-12.45, P < 0.05) for allele I/D, genotype II/II+ID and genotype DD/II+ID, respectively. Conclusion There is a possible association between the ACE I/D polymorphism genotype and the mortality risk of ALI/ARDS in Asians.

Citation： GaoFei, DongLiang, YanJie. Association between Insertion/Deletion Polymorphism in Angiotensin-Converting Enzyme Gene and Acute Lung Injury/Acute Respiratory Distress Syndrome in Adults: A Meta-Analysis. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(1): 43-48. doi: 10.7507/1671-6205.2016011 Copy

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2.	Ware LB, Herridge M. Acute lung injury. Semin Respir Crit Care Med, 2013, 34:439-440.
3.	Azevedo ZM, Moore DB, Lima FC, et al. Tumor necrosis factor (TNF) and lymphotoxin-alpha (LTA) single nucleotide polymorphisms:importance in ARDS in septic pediatric critically ill patients. Hum Immunol, 2012, 73:661-667.
4.	Wacharasint P, Nakada TA, Boyd JH, et al. AA genotype of IL-8-251A/T is associated with low PaO(2)/FiO(2) in critically ill patients and with increased IL-8 expression. Respirology, 2012, 17:1253-1260.
5.	陈光建, 邱海波, 陆晓旻, 等.ACE基因I/D多态性与急性肺损伤发生及预后的关系.临床麻醉学杂志, 2009, 25:806-808.
6.	Tsantes AE, Kopterides P, Bonovas S, et al. Effect of angiotensin converting enzyme gene I/D polymorphism and its expression on clinical outcome in acute respiratory distress syndrome. Minerva Anestesiol, 2013, 79:861-870.
7.	Rigat B, Hubert C, Alhenc-Gelas F, et al. An insertion/deletion polymorphism in the angiotensinⅠ-converting enzyme gene accounting for half the variance of serum enzyme levels. J Clin Invest, 1990, 86:1343-1346.
8.	Tiret L, Rigat B, Visvikis S, et al. Evidence, from combined segregation and linkage analysis, that a variant of the angiotensinⅠ-converting enzyme (ACE) gene controls plasma ACE levels. Am J Hum Genet, 1992, 51:197-205.
9.	Marshall RP, Webb S, Bellingan GJ, et al. Angiotensin converting enzyme insertion/deletion polymorphism is associated with susceptibility and outcome in acute respiratory distress syndrome. Am J Respir Crit Care Med, 2002, 166:646-650.
10.	Jerng JS, Yu CJ, Wang HC, et al. Polymorphism of the angiotensin-converting enzyme gene affects the outcome of acute respiratory distress syndrome. Crit Care Med, 2006, 34:1001-1006.
11.	Adamzik M, Frey U, Sixt S, et al. ACE I/D but not AGT (-6)A/G polymorphism is a risk factor for mortality in ARDS. Eur Respir J, 2007, 29:482-488.
12.	Chan KC, Tang NL, Hui DS, et al. Absence of association between angiotensin converting enzyme polymorphism and development of adult respiratory distress syndrome in patients with severe acute respiratory syndrome:a case control study. BMC Infect Dis, 2005, 9:26.
13.	Villar J, Flores C, Pérez-Méndez L, et al. Angiotensin-converting enzyme insertion/deletion polymorphism is not associated with susceptibility and outcome in sepsis and acute respiratory distress syndrome. Intensive Care Med, 2008, 34:488-495.
14.	Cardinal-Fernández P, Ferruelo A, El-Assar M, et al. Genetic predisposition to acute respiratory distress syndrome in patients with severe sepsis. Shock, 2013, 39:255-260.
15.	Yamamoto T, Wang L, Shimakura K, et al. AngiotensinⅡ-induced pulmonary edema in a rabbit model. Jpn J Pharmacol, 1997, 73:33-40.
16.	Yokoyama T, Sekiguchi K, Tanaka T, et al. AngiotensinⅡand mechanical stretch induce production of tumor necrosis factor in cardiac fibroblasts. Am J Physiol, 1999, 276:H1968-1976.
17.	IgiĆ R, Behnia R. Properties and distribution of angiotensinⅠconverting enzyme. Curr Pharm Des, 2003, 9:697-706.
18.	Hu Z, Jin X, Kang Y, et al. Angiotensin-converting enzyme insertion/deletion polymorphism associated with acute respiratory distress syndrome among Caucasians. J Int Med Res, 2010, 38:415-422.
19.	Matsuda A, Kishi T, Jacob A, et al. Association between insertion/deletion polymorphism in angiotensin-converting enzyme gene and acute lung injury/acute respiratory distress syndrome:a meta-analysis. BMC Med Genet, 2012, 31:76.
20.	Hagiwara S, Iwasaka H, Matumoto S, et al. Effects of an angiotensin-converting enzyme inhibitor on the inflammatory response in in vivo and in vitro models. Crit Care Med, 2009, 37:626-633.
21.	Xiong J, Cheng G, Tang H, et al. Ardipusilloside I induces apoptosis in human glioblastoma cells through a caspase-8-independent FasL/Fas-signaling pathway. Environ Toxicol Pharmacol, 2009, 27:264-270.
22.	He X, Han B, Mura M, et al. Angiotensin-converting enzyme inhibitor captopril prevents oleic acid-induced severe acute lung injury in rats. Shock, 2007, 28:106-111.
23.	Sawcer S. Bayes factors in complex genetics. Eur J Hum Genet, 2010, 18:746-750.
24.	卢善翃, 李俊辉, 欧阳莎, 等.重症病毒性肺炎合并急性呼吸窘迫综合征的预后危险因素分析.中国呼吸与危重监护杂志, 2014, 13:560-564.

1. Ware LB. Pathophysiology of acute lung injury and the acute respiratory distress syndrome. Semin Respir Crit Care Med, 2006, 27:337-349.
2. Ware LB, Herridge M. Acute lung injury. Semin Respir Crit Care Med, 2013, 34:439-440.
3. Azevedo ZM, Moore DB, Lima FC, et al. Tumor necrosis factor (TNF) and lymphotoxin-alpha (LTA) single nucleotide polymorphisms:importance in ARDS in septic pediatric critically ill patients. Hum Immunol, 2012, 73:661-667.
4. Wacharasint P, Nakada TA, Boyd JH, et al. AA genotype of IL-8-251A/T is associated with low PaO(2)/FiO(2) in critically ill patients and with increased IL-8 expression. Respirology, 2012, 17:1253-1260.
5. 陈光建, 邱海波, 陆晓旻, 等.ACE基因I/D多态性与急性肺损伤发生及预后的关系.临床麻醉学杂志, 2009, 25:806-808.
6. Tsantes AE, Kopterides P, Bonovas S, et al. Effect of angiotensin converting enzyme gene I/D polymorphism and its expression on clinical outcome in acute respiratory distress syndrome. Minerva Anestesiol, 2013, 79:861-870.
7. Rigat B, Hubert C, Alhenc-Gelas F, et al. An insertion/deletion polymorphism in the angiotensinⅠ-converting enzyme gene accounting for half the variance of serum enzyme levels. J Clin Invest, 1990, 86:1343-1346.
8. Tiret L, Rigat B, Visvikis S, et al. Evidence, from combined segregation and linkage analysis, that a variant of the angiotensinⅠ-converting enzyme (ACE) gene controls plasma ACE levels. Am J Hum Genet, 1992, 51:197-205.
9. Marshall RP, Webb S, Bellingan GJ, et al. Angiotensin converting enzyme insertion/deletion polymorphism is associated with susceptibility and outcome in acute respiratory distress syndrome. Am J Respir Crit Care Med, 2002, 166:646-650.
10. Jerng JS, Yu CJ, Wang HC, et al. Polymorphism of the angiotensin-converting enzyme gene affects the outcome of acute respiratory distress syndrome. Crit Care Med, 2006, 34:1001-1006.
11. Adamzik M, Frey U, Sixt S, et al. ACE I/D but not AGT (-6)A/G polymorphism is a risk factor for mortality in ARDS. Eur Respir J, 2007, 29:482-488.
12. Chan KC, Tang NL, Hui DS, et al. Absence of association between angiotensin converting enzyme polymorphism and development of adult respiratory distress syndrome in patients with severe acute respiratory syndrome:a case control study. BMC Infect Dis, 2005, 9:26.
13. Villar J, Flores C, Pérez-Méndez L, et al. Angiotensin-converting enzyme insertion/deletion polymorphism is not associated with susceptibility and outcome in sepsis and acute respiratory distress syndrome. Intensive Care Med, 2008, 34:488-495.
14. Cardinal-Fernández P, Ferruelo A, El-Assar M, et al. Genetic predisposition to acute respiratory distress syndrome in patients with severe sepsis. Shock, 2013, 39:255-260.
15. Yamamoto T, Wang L, Shimakura K, et al. AngiotensinⅡ-induced pulmonary edema in a rabbit model. Jpn J Pharmacol, 1997, 73:33-40.
16. Yokoyama T, Sekiguchi K, Tanaka T, et al. AngiotensinⅡand mechanical stretch induce production of tumor necrosis factor in cardiac fibroblasts. Am J Physiol, 1999, 276:H1968-1976.
17. IgiĆ R, Behnia R. Properties and distribution of angiotensinⅠconverting enzyme. Curr Pharm Des, 2003, 9:697-706.
18. Hu Z, Jin X, Kang Y, et al. Angiotensin-converting enzyme insertion/deletion polymorphism associated with acute respiratory distress syndrome among Caucasians. J Int Med Res, 2010, 38:415-422.
19. Matsuda A, Kishi T, Jacob A, et al. Association between insertion/deletion polymorphism in angiotensin-converting enzyme gene and acute lung injury/acute respiratory distress syndrome:a meta-analysis. BMC Med Genet, 2012, 31:76.
20. Hagiwara S, Iwasaka H, Matumoto S, et al. Effects of an angiotensin-converting enzyme inhibitor on the inflammatory response in in vivo and in vitro models. Crit Care Med, 2009, 37:626-633.
21. Xiong J, Cheng G, Tang H, et al. Ardipusilloside I induces apoptosis in human glioblastoma cells through a caspase-8-independent FasL/Fas-signaling pathway. Environ Toxicol Pharmacol, 2009, 27:264-270.
22. He X, Han B, Mura M, et al. Angiotensin-converting enzyme inhibitor captopril prevents oleic acid-induced severe acute lung injury in rats. Shock, 2007, 28:106-111.
23. Sawcer S. Bayes factors in complex genetics. Eur J Hum Genet, 2010, 18:746-750.
24. 卢善翃, 李俊辉, 欧阳莎, 等.重症病毒性肺炎合并急性呼吸窘迫综合征的预后危险因素分析.中国呼吸与危重监护杂志, 2014, 13:560-564.

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Association between Insertion/Deletion Polymorphism in Angiotensin-Converting Enzyme Gene and Acute Lung Injury/Acute Respiratory Distress Syndrome in Adults: A Meta-Analysis

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