From the Guidelines
There is no direct evidence to suggest a relationship between high angiotensin-converting enzyme (ACE) levels and Interleukin-1 beta (IL-1β) and Interleukin-18 (IL-18) based on the provided study from 2024 1.
Inflammatory Pathways
The study primarily focuses on the diagnosis and management of Still's disease, comprising systemic juvenile idiopathic arthritis and adult-onset Still's disease, and discusses various biomarkers for the disease, including IL-18 and S100 proteins 1.
- IL-18 is mentioned as a proinflammatory cytokine produced by inflammasome activation, which drives IFNγ overproduction.
- S100 proteins, such as S100 A8/A9 (also called serum calprotectin) and S100 A12, are produced by innate immunity cells (monocytes and neutrophils) and act as danger-associated molecular patterns to amplify inflammation. However, there is no mention of ACE levels or their potential relationship with IL-1β and IL-18 in this study.
Clinical Relevance
In clinical practice, understanding the relationship between different inflammatory markers is crucial for diagnosing and managing conditions characterized by chronic inflammation.
- The study highlights the importance of considering alternative diagnoses, such as malignancies, infectious diseases, or other immune-mediated inflammatory diseases, when diagnosing Still's disease 1.
- It also emphasizes the need for validated biomarkers and therapeutic strategies for patients with Still's disease, particularly those with inadequate response to IL-1 and IL-6 inhibitors 1. Despite the lack of direct evidence, the interconnected nature of inflammatory processes suggests that further research into the relationship between ACE levels and various interleukins could provide valuable insights into the pathophysiology of inflammatory diseases.
From the Research
Relationship between ACE level and Interleukin-1 beta (IL-1β) and Interleukin-18 (IL-18)
- There is limited direct evidence on the relationship between high angiotensin-converting enzyme (ACE) level and Interleukin-1 beta (IL-1β) and Interleukin-18 (IL-18) in the provided studies.
- However, one study 2 mentions that high-dose ACE inhibitors can reduce various neurohormonal measurements, including interleukin-6 levels, but does not specifically mention IL-1β and IL-18.
- The other studies 3, 4, 5, 6 focus on the role of ACE in hypertension, its inhibitors, and related diseases, but do not provide direct evidence on the relationship between ACE level and IL-1β and IL-18.
- Therefore, based on the provided studies, there is no clear evidence to establish a direct relationship between high ACE level and IL-1β and IL-18.