Serum angiotensin-converting enzyme in multiple sclerosis
C. S. Constantinescu, D. B. Goodman, R. I. Grossman, L. J. Mannon and J. A. Cohen
Department of Neurology, University of Pennsylvania, Philadelphia 19104-4283, USA.
OBJECTIVE: To determine the extent and significance of serum
angiotensin-converting enzyme (ACE) elevation in multiple sclerosis (MS)
and the correlation between serum ACE activity and clinical and magnetic
resonance imaging (MRI) indicators of disease activity. DESIGN: A
retrospective cross-sectional study of 45 consecutive patients with
clinically definite MS and a longitudinal study of 30 additional patients
with clinically definite MS involved in a long-term study of neurologic
function and MRI in MS. SETTING: Comprehensive MS center of a tertiary care
university hospital. SUBJECTS: A total of 75 patients with clinically
definite MS and 31 healthy controls. METHODS: Serum ACE activity was
measured using a spectrophotometric assay and correlated with clinical
indicators of disease activity and with total cerebral MS lesion volume
measured by MRI. RESULTS: An elevated ACE activity was found in 17 (23%) of
75 patients with MS as compared with 2 (6%) of 31 healthy controls. Changes
in serum ACE activity correlated with changes in total plaque volume on
MRI. CONCLUSIONS: Serum ACE activity may be an indicator of disease
activity in longitudinal analysis. Also, elevated ACE activity in a patient
with otherwise typical MS need not raise suspicions of alternative
diagnoses.
