J. Cole et al., Lack of angiotensin II-facilitated erythropoiesis causes anemia in angiotensin-converting enzyme-deficient mice, J CLIN INV, 106(11), 2000, pp. 1391-1398
While nephrologists often observe reduced hematocrit associated with inhibi
tors of angiotensin-converting enzyme (ACE), the basis for this effect is n
ot well understood. We now report that two strains of ACE knockout mice hav
e a normocytic anemia associated with elevated plasma erythropoietin levels
. Cr-51 labeling of red cells showed that the knockout mice have a normal t
otal blood volume but a reduced red cell mass. ACE knockout mice, which lac
k tissue ACE, are anemic despite having normal renal function. These mice h
ave increased plasma levels of the peptide acetyl-SDKP, a possible stem cel
l suppressor. However, they also show low plasma levels of angiotensin II.
Infusion of angiotensin II for 2 weeks increased hematocrit to near normal
levels. These data suggest that angiotensin II facilitates erythropoiesis,
a conclusion with implications for the management of chronically ill patien
ts on inhibitors of the renin-angiotensin system.