Elevated Serum Angiotensin-Converting Enzyme in Systemic Lupus Erythematosus: A Biomarker for Lupus Nephritis Severity and Disease Activity

Document Type : New and original researches in the field of Microbiology.

Authors

1 Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Sohag University, Egypt

2 Department of Dermatology, Venerology and Andrology, Faculty of Medicine, Sohag University, Egypt

Abstract

Background: Angiotensin-converting enzyme (ACE) plays a crucial role in blood pressure regulation and fluid balance. Beyond its traditional role in cardiovascular physiology, ACE has been implicated in immune regulation and inflammation. Objectives: This study aims to explore the serum levels of ACE in patients with systemic lupus erythrematosus (SLE), examining whether there are significant alterations in ACE levels compared to healthy individuals. Methodology: This cross-sectional study investigated serum levels of ACE, in 50 patients with SLE, including 25 with lupus nephritis (LN), and 25 age- and sex-matched healthy individuals. Results: The median ACE level was significantly higher in patients with SLE (40.5) than control group (19) (p <0.001). Moreover, serum ACE was higher in patients with LN (61.68 ± 29.5) compared with those without renal manifestations (30.28 ± 14.5), and was significantly higher in patients with advanced stages of LN. Regarding diagnostic performance of serum ACE biomarkers for prediction of SLE, a Cut-off value of 15 had a sensitivity of 86% and specificity of 74%. In addition, the diagnostic performance of serum ACE biomarkers for predicting LN was calculated, with a Cut-off value of 40, yielding a sensitivity of 76% and specificity of 80%. Conclusion: There was a potential association of serum ACE with LN severity. A noteworthy correlation was established between serum ACE and serum creatinine, suggesting ACE as an indicator for lupus activity and LN, and proposing ACE inhibitors as prophylaxis for SLE patients lacking LN.

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