Can elevated levels of most interleukins (IL) cause a high Angiotensin-Converting Enzyme (ACE) test?

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Last updated: April 7, 2025View editorial policy

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From the Guidelines

High levels of most interleukins can potentially cause elevated ACE test results, as evidenced by the complex interactions between inflammatory responses and cardiovascular disease, including the activation of macrophages and the release of pro-inflammatory cytokines, such as IL-6, IL-1, and TNF-alpha, as seen in patients with COVID-19 and ARDS 1.

Key Points to Consider

  • Interleukins play a crucial role in the immune system's inflammatory response, and high levels of IL-1, IL-6, and TNF-alpha can trigger granuloma formation and activate macrophages, which are the primary producers of ACE.
  • The relationship between elevated interleukins and increased ACE activity is often seen in inflammatory conditions, especially granulomatous diseases like sarcoidosis, as well as in patients with COVID-19 and ARDS, where the innate and adaptive immune responses are complex and may differentially influence therapeutic considerations 1.
  • ACE test results should be interpreted in the clinical context, considering other laboratory findings and the patient's symptoms, as the relationship between interleukins and ACE levels is not always direct or predictable.
  • A comprehensive evaluation by a healthcare provider is necessary to determine the underlying cause of elevated ACE levels, taking into account the potential effects of interleukins on the renin-angiotensin system and cardiovascular disease.

Clinical Implications

  • The use of ACE inhibitors, ARBs, or ARNI may be beneficial in reducing morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF), as evidenced by large RCTs, although the choice of therapy should be individualized based on patient characteristics and clinical context 1.
  • The complex interactions between inflammatory responses, cardiovascular disease, and the renin-angiotensin system highlight the need for a comprehensive approach to patient care, considering the potential effects of interleukins on ACE levels and cardiovascular disease.

From the Research

Interleukins and ACE Test

  • High levels of most interleukins can have various effects on the body, including inflammation and immune responses 2.
  • However, there is no direct evidence to suggest that high levels of interleukins can cause a high ACE test.
  • ACE (Angiotensin-Converting Enzyme) is an enzyme that plays a role in blood pressure regulation and is not directly related to interleukin levels 3, 4.
  • Some studies have investigated the relationship between ACE inhibitors and cytokine responses, including interleukins, but these studies do not provide evidence for a direct link between interleukin levels and ACE test results 5, 4.
  • One study found that ACE inhibitors can modulate cytokine responses, including increasing IL-10 production, but this does not necessarily imply a direct effect on ACE test results 4.
  • Another study found that IL-37, a type of interleukin, can be a biomarker for mortality risk in patients with sepsis, but this is not related to ACE test results 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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