TITLE:
Study of angiotensin converting enzyme and genotype among Egyptian preeclampsia patients
AUTHORS:
Hassan A. Alsokary, Mostafa A. Kamel, Sameh S. Sadek, Nermine H. Zakaria, Iman A. Abdel Fatah
KEYWORDS:
ACE: Angiotensin Converting Enzyme; Preeclampsia; Polymorphism; Doppler
JOURNAL NAME:
American Journal of Molecular Biology,
Vol.4 No.1,
January
15,
2014
ABSTRACT: Preeclampsia is a frequent disorder with reported incidence in pregnancies. In Egypt, it complicates
6%-8% of pregnancies and reaches 15%
in referral centers. The
renin-angiotensin system activation during the early stages of Preeclampsia
proved to be a direct cause. Women carrying the D allele of the ACE-I/D polymorphism have higher
measures of uterine artery resistance, which is a marker for development of
intrauterine growth retardation and preeclampsia. The maternal syndrome of
preeclampsia (PE) during the latter half of pregnancy is believed to result from
impaired placentation in early gestation and a failure to develop low
resistance uteroplacental circulation. Aim:
The aim of this study was to evaluate the association with angiotensin
converting enzyme gene polymorphism and changes in its enzyme serum level in
preeclamptic patients compared to non preeclamptic control group together with
studying the changes in umbilical artery and uterine artery Doppler. Subjects: The study was conducted on 180
pregnant women allocated into two groups having the same inclusion and
exclusion criteria except for hypertension and proteinuria; each group
comprised of 90 pregnant women with matched age. Methods: Doppler study of umbilical and uterine arteries
and the detection of Angiotensin converting gene polymorphism by PCR with
Estimation of serum ACE in serum by ELISA technique. Results: The distribution of the ACE-I/D genotypes and allelic
frequencies in the present study of polymorphism was 37.8% for the DD, 48.9%
for the ID, 13.3% for the II in preeclampsia group while it was 33.3% for the
DD, 46.7% for the ID, and 20% for the II in the control group. There was no
significant difference between cases and controls regarding the cumulative D
effect. Conclusions: No
existence of a relation between preeclampsia and ACE gene polymorphism
considering different modes of inheritance whether is dominance or recessiveness. No effect of ACE gene polymorphism is on ACE serum level. Positive correlation between ACE gene polymorphism
and the uterine artery Doppler changes gives strong evidence that ACE gene may
have a role in the histopathological changes taking place in these vessels, therefore affecting maternal prognosis. It is unclear to explain this
mismatched ACE genetic influence on the incidence of preeclampsia, but
the multifactorial pathogenesis of the development and complication in
preeclampsia and also physician’s intervention may contribute to the pregnancy
outcome. Recommendations: International collaborations, particularly among countries with
a high incidence of preeclampsia, may help to include participants with
different cultural and genetic backgrounds, which can provide further insight
into the etiology of the disease both genetic and environmental.