ANGIOTENSIN I-CONVERTING ENZYME INSERTION DELETION POLYMORPHISM - POTENTIAL SIGNIFICANCE IN NEPHROLOGY/

Angiotensin I-converting enzyme (ACE) plays a pivotal role in cardiova scular homeostasis and by activating angiotensin I into angiotensin II and inactivating bradykinin. These two peptides play antagonistic rol es on the cardiovascular system by regulating vascular tone and vascul ar smooth muscle cell proliferation. Identification of the ACE gene as a genetic marker for various forms of cardiovascular disease is a rec ent result of the progress made in molecular biology and genetics. The insertion/deletion (ID) polymorphism of the ACE gene defined by the p resence or absence of the 287 base pair Alu sequence situated in intro n 16 has been investigated as a possible genetic marker for a variety of cardiovascular disease including myocardial infarction, essential h ypertension, cardiomyopathy, and diabetic vascular complications. This paper reviews prior reports and briefly describes our recent study on the association of the ACE I/D polymorphism and antiproteinuric effec t of ACE inhibitors in patients with proteinuria.