Correlation between angiotensin-converting enzyme (ACE) inhibitor induced dry cough and ACE gene insertion/deletion (I/D) polymorphism

Hyeong Kim Je Hyeong Kim, Cheol Jeong Hye Cheol Jeong, Kyu Kim Kyung Kyu Kim, Yong Lee Sung Yong Lee, Hwan Kwon Young Hwan Kwon, Ra Lee So Ra Lee, Youb Lee Sang Youb Lee, Hyung Lee Sin Hyung Lee, Ryong Cha Dae Ryong Cha, Youn Cho Jae Youn Cho, Jeong Shim Jae Jeong Shim, Yong Cho Won Yong Cho, Ho Kang Kyung Ho Kang, Kyu Kim Hyoung Kyu Kim, Hwa Yoo Se Hwa Yoo, Ho In Kwang Ho In

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Abstract

Background: Persistent nonproductive cough is a major adverse effect encountered with ACE inhibitor treatment and the most frequent reason for withdrawal of the drug. The mechanism of cough was postulated to be associated with accumulation of bronchial irritants which are substrates of ACE. It has been speculated that occurrence of this adverse effect is genetically predetermined; in particular, variants of the genes encoding ACE. To investigate this relationship, we determined ACE gene Insertion/Deletion polymorphism in subjects with and without a history of ACE inhibitor-induced cough. Methods: Among the 339 patients with ACE inhibitor treatment, subjects who developed cough that resolved when not taking medication were designated to cough group and other subjects who did not complain cough were designated to non-cough group. Clinical characteristics of the patients were collected by review of medical records. ACE genotypes were determined by PCR amplification of DNA from peripheral blood and agarose gel electrophoresis. Results: 37 patients complained of dry cough(cough group) and 302 patients did not complained of cough (non-cough group). The incidence of ACE inhibitor induced dry cough was 10.9%. There was a preponderance of females in the cough group (M : F=24.3% : 75.7%) compared to the non-cough group (M : F=49.7% : 50.3%, p=0.004). There was no significant difference in mean age, underlying diseases, and kinds and frequencies of ACE inhibitors and their mean dosage between the both groups. ACE genotypic frequencies were I/I : I/D : D/D=16.2% : 18.9% : 64.9% in the cough group and 18.9% : 18.2% : 62.9% in the non-cough group which showed no significant difference between the both groups (p=0.926). Allelic frequencies were I : D = 25.7% : 74.3% and 28.0% : 72.0% in the cough and non-cough group respectively and the difference was not significant (p = 0.676). Conclusion: The incidence of ACE inhibitor- induced cough are 10.9%, and women are more susceptible to ACE inhibitor- induced cough. ACE inhibitor-induced dry cough is not associated with ACE gene Insertion/Deletion polymorphism.

Original languageEnglish
Pages (from-to)241-250
Number of pages10
JournalTuberculosis and Respiratory Diseases
Volume46
Issue number2
DOIs
Publication statusPublished - 1999

Keywords

  • ACE gene polymorphism
  • ACE inhibitor
  • Cough

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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    Je Hyeong Kim, H. K., Hye Cheol Jeong, C. J., Kyung Kyu Kim, K. K., Sung Yong Lee, Y. L., Young Hwan Kwon, H. K., So Ra Lee, R. L., Sang Youb Lee, Y. L., Sin Hyung Lee, H. L., Dae Ryong Cha, R. C., Jae Youn Cho, Y. C., Jae Jeong Shim, J. S., Won Yong Cho, Y. C., Kyung Ho Kang, H. K., Hyoung Kyu Kim, K. K., Se Hwa Yoo, H. Y., & Kwang Ho In, H. I. (1999). Correlation between angiotensin-converting enzyme (ACE) inhibitor induced dry cough and ACE gene insertion/deletion (I/D) polymorphism. Tuberculosis and Respiratory Diseases, 46(2), 241-250. https://doi.org/10.4046/trd.1999.46.2.241