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Clinical Investigations: COUGH |

Is There an Association Between Angiotensin-Converting Enzyme Gene Variants and Chronic Nonproductive Cough?*

Lorcan P. A. McGarvey, MD; David A. Savage, D Phil; Susan A. Feeney, BSc; Liam G. Heaney, MD; Madeleine Ennis, PhD,; Joseph MacMahon, MB; A. Peter Maxwell, MD
Author and Funding Information

*From the Department of Respiratory Medicine (Drs. McGarvey and Heaney, and Mr. MacMahon) and Regional Nephrology Unit (Dr. Maxwell), Belfast City Hospital; and Departments of Medical Genetics (Dr. Savage and Ms. Feeney) and Clinical Biochemistry (Dr. Ennis), The Queen’s University of Belfast, Belfast, Northern Ireland.

Correspondence to: Lorcan P. A. McGarvey, MD, Department of Respiratory Medicine, Level 8, Belfast City Hospital, Lisburn Rd, Belfast BT9 7AB, Northern Ireland; e-mail: lpamcgarvey@hotmail.com



Chest. 2000;118(4):1091-1094. doi:10.1378/chest.118.4.1091
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Background: It is unclear why some patients develop a chronic nonproductive cough. Angiotensin-converting enzyme (ACE) inactivates tussive peptides in the airways such as bradykinin and tachykinins. An insertion/deletion polymorphism in the ACE gene accounts for variation in ACE levels, and patients with the II genotype have lowest serum ACE levels compared with ID and DD genotypes. We hypothesized that the II genotype would be associated with increased risk of developing a chronic cough.

Materials and methods: We recruited 47 patients (33 women), referred for evaluation of cough (median cough duration, 24 months; range, 2 to 240 months). Cough patients were evaluated using a comprehensive diagnostic protocol, and cough reflex sensitivity was measured using a capsaicin inhalation challenge. ACE genotyping was performed on DNA samples from patients using the polymerase chain reaction followed by agarose gel electrophoresis. ACE genotypes in patients with chronic cough were compared with those in 199 healthy control subjects. Serum ACE levels were determined using a colorimetric assay.

Results: Genotype frequencies for the ACE gene were similar between patients and control subjects. There was no correlation between capsaicin sensitivity and ACE genotypes or serum ACE levels.

Conclusion: Susceptibility to develop chronic cough is not associated with ACE genotype.


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