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A GWAS of ACE Inhibitor-Induced Angioedema in a South African Population.

medRxiv

September 2024

Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7625, Western Cape, South Africa.

Background: Angiotensin-converting enzyme inhibitor-induced angioedema (AE-ACEI) is a life-threatening adverse event and, globally, the commonest cause of emergency presentations with angioedema. Several large genome-wide association studies (GWAS) have found genomic associations with AE-ACEI. However, despite African Americans having a 5-fold increased risk of AE-ACEI, there are no published GWAS from Africa.

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Five-Membered Nitrogen Heterocycles Angiotensin-Converting Enzyme (ACE) Inhibitors Induced Angioedema: An Underdiagnosed Condition.

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Angiotensin-converting enzyme (ACE) inhibitors are used primarily in the treatment of hypertension, heart failure, and in the acute phase of myocardial infarction. Lisinopril [N-[(1S)-1-car-boxy-3-phenylpropyl]-L-lysyl-L-proline], enalapril [(S)-1-[N-[1-(ethoxycarbonyl)-3-phenylpropyl]-L-alanyl]-L-proline] and ramipril [2-aza-bicyclo-[3.3.

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Meta-analysis of ACE inhibitor-induced angioedema identifies novel risk locus.

J Allergy Clin Immunol

April 2024

Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany; Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany. Electronic address:

Article Synopsis
  • Angioedema is a serious reaction linked to ACE inhibitors, and its causes include genetic and non-genetic factors; recent studies have begun to uncover genetic risk factors but not the full underlying mechanisms.!* -
  • Researchers analyzed data from over 1,000 European patients, discovering three significant genetic risk loci associated with ACEi-induced angioedema, one of which has not been previously noted.!* -
  • The findings underscored the role of bradykinin signaling and coagulation pathways while suggesting new genetic candidates involved in angioedema, highlighting similar genetic effects in both European and African-American patients.!*
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Angioedema is a rare but known side effect of angiotensin-converting enzyme (ACE) inhibitor therapy. The most common presentations of ACE inhibitor-induced angioedema describe swellings in the oropharyngeal and periorbital regions. We describe a rare case of a 58-year-old female with a history of type 2 diabetes and hypertension taking lisinopril for the past three years and presented with recurrent episodes of abdominal pain, nausea, and vomiting around the same time she started taking the drug.

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