Editing Angiotensin-converting enzyme (section)

== Disease relevance ==
ACE inhibitors are widely used as pharmaceutical drugs in the treatment of conditions such as [[arterial hypertension|high blood pressure]], [[heart failure]], [[diabetic nephropathy]], and [[type 2 diabetes mellitus]].

ACE inhibitors inhibit ACE competitively.<ref>{{cite web | url = http://www.bhsoc.org/pdfs/therapeutics/Angiotensin%20Converting%20Enzyme%20(ACE)%20Inhibitors.pdf | archive-url = https://web.archive.org/web/20171118145458/http://www.bhsoc.org/pdfs/therapeutics/Angiotensin%20Converting%20Enzyme%20(ACE)%20Inhibitors.pdf | url-status = dead | archive-date = 18 November 2017 | title = Angiotensin converting enzyme (ace) inhibitors | website = British Hypertension Society }}</ref> That results in the decreased formation of angiotensin II and decreased metabolism of [[bradykinin]], which leads to systematic dilation of the arteries and veins and a decrease in arterial blood pressure. In addition, inhibiting angiotensin II formation diminishes angiotensin II-mediated [[aldosterone]] secretion from the [[adrenal cortex]], leading to a decrease in water and sodium reabsorption and a reduction in [[extracellular]] volume.<ref name="urlACE-inhibitors">{{cite web | url = http://www.cvpharmacology.com/vasodilator/ACE.htm | title = ACE-inhibitors | author = Klabunde RE | work = Cardiovascular Pharmacology Concepts | publisher = cvpharmacology.com | access-date = 26 March 2009 | archive-date = 2 February 2009 | archive-url = https://web.archive.org/web/20090202035338/http://cvpharmacology.com/vasodilator/ACE.htm | url-status = live }}</ref>

ACE's effect on Alzheimer's disease is still highly debated. Alzheimer patients usually show higher ACE levels in their brain. Some studies suggest that ACE inhibitors that are able to pass the blood-brain-barrier (BBB) could enhance the activity of major amyloid-beta peptide degrading enzymes like [[neprilysin]] in the brain resulting in a slower development of Alzheimer's disease.<ref>{{cite web | url = http://www.medscape.org/viewarticle/493130_7 | title = The Importance of Treating the Blood Pressure: ACE Inhibitors May Slow Alzheimer's Disease | date = 2004 | website = Medscape | publisher = Medscape Cardiology | access-date = 1 March 2016 | archive-date = 31 August 2016 | archive-url = https://web.archive.org/web/20160831005411/http://www.medscape.org/viewarticle/493130_7 | url-status = live }}</ref> More recent research suggests that ACE inhibitors can reduce risk of Alzheimer's disease in the absence of [[Apolipoprotein E|apolipoprotein E4 alleles (ApoE4)]], but will have no effect in ApoE4- carriers.<ref>{{cite journal | vauthors = Qiu WQ, Mwamburi M, Besser LM, Zhu H, Li H, Wallack M, Phillips L, Qiao L, Budson AE, Stern R, Kowall N | display-authors = 6 | title = Angiotensin converting enzyme inhibitors and the reduced risk of Alzheimer's disease in the absence of apolipoprotein E4 allele | journal = Journal of Alzheimer's Disease | volume = 37 | issue = 2 | pages = 421–428 | date = 1 January 2013 | pmid = 23948883 | pmc = 3972060 | doi = 10.3233/JAD-130716 }}</ref> Another more recent hypothesis is that higher levels of ACE can prevent Alzheimer's. It is assumed that ACE can degrade beta-amyloid in brain blood vessels and therefore help prevent the progression of the disease.<ref>{{cite web | url = http://www.science20.com/news_articles/ace_enzyme_may_enhance_immune_responses_and_prevent_alzheimers-128947 | title = ACE Enzyme May Enhance Immune Responses And Prevent Alzheimer's | website = Science 2.0 | date = 27 August 2014 | access-date = 1 March 2016 | archive-date = 7 March 2016 | archive-url = https://web.archive.org/web/20160307081505/http://www.science20.com/news_articles/ace_enzyme_may_enhance_immune_responses_and_prevent_alzheimers-128947 | url-status = live }}</ref>

A negative correlation between the ACE1 D-allele [[Allele frequency|frequency]] and the prevalence and mortality of [[COVID-19]] has been established.<ref>{{cite journal | vauthors = Delanghe JR, Speeckaert MM, De Buyzere ML | title = The host's angiotensin-converting enzyme polymorphism may explain epidemiological findings in COVID-19 infections | journal = Clinica Chimica Acta; International Journal of Clinical Chemistry | volume = 505 | pages = 192–193 | date = June 2020 | pmid = 32220422 | pmc = 7102561 | doi = 10.1016/j.cca.2020.03.031 }}</ref>