Document Detail

Angiotensin-converting enzyme activity in serum and bronchoalveolar lavage fluid after damage to the alveolo-capillary barrier in the human lung.
MedLine Citation:
PMID:  8270718     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Angiotensin-converting enzyme (ACE) is considered as a possible marker for endothelial cell damage in serum or bronchoalveolar lavage fluid. This hypothesis was tested during cardiac surgery and during the adult respiratory distress syndrome. DESIGN: We used patients with an expected different degree of endothelial cell damage. ACE levels in serum and bronchoalveolar lavage fluid were compared with indirect markers of alveolo-capillary barrier integrity. SETTING: Interdisciplinary team in a university hospital. METHODS: 13 Cardiac surgery patients received no glucocorticoids and 13 others received 2 g methylprednisolone before extracorporeal circulation. Thirteen patients were used as controls and 15 patients had nonseptic adult respiratory distress syndrome. All underwent bronchoalveolar lavage for ACE determination. RESULTS: At different times during surgery serum angiotensin-converting enzyme levels were not significantly different between the two groups. In post-operative bronchoalveolar lavage fluid, angiotensin-converting enzyme levels were significantly higher in patients who received corticoids (27.8 +/- 1.7 U/l, mean +/- SEM), compared to patients without corticoids (19.8 +/- 1.4 U/l), control patients (18.2 +/- 1.3 U/l) or patients with full blown non-septic adult respiratory distress syndrome (18.8 +/- 1.1 U/l). There were no correlations between lavage angiotensin-converting enzyme and other parameters for alveolo-capillary membrane integrity in the lavage fluid such as the number of neutrophil cells, albumin or protein concentration, and between lavage angiotensin-converting enzyme and PaO2/FIO2 ratio during lavage. CONCLUSION: Angiotensin-converting enzyme activity in serum or bronchoalveolar lavage fluid does not reflect damage of endothelial cells or damage of alveolocapillary integrity in acute pulmonary disease.
R F De Jongh; W A De Backer; R Mohan; P G Jorens; F J van Overveld
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Intensive care medicine     Volume:  19     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  1993  
Date Detail:
Created Date:  1994-02-01     Completed Date:  1994-02-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  390-4     Citation Subset:  IM    
Department of Anesthesiology, Sint Jansziekenhuis, Genk, Belgium.
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MeSH Terms
Biological Markers
Bronchoalveolar Lavage Fluid*
Cardiac Surgical Procedures
Glucocorticoids / therapeutic use
Intraoperative Period
Methylprednisolone / therapeutic use
Middle Aged
Peptidyl-Dipeptidase A / blood*
Respiratory Distress Syndrome, Adult / enzymology*
Reg. No./Substance:
0/Biological Markers; 0/Glucocorticoids; 83-43-2/Methylprednisolone; EC A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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