ELEVATION OF THE BRONCHOALVEOLAR CONCENTRATION OF ANGIOTENSIN-I CONVERTING ENZYME IN SARCOIDOSIS

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Abstract
The concentration of angiotensin converting enzyme (ACE) and that of albumin (Alb) were assayed in the serum (SACE SAlb) and in bronchoalveolar lavage fluid (LACE, LAlb). Three groups of patients were studied as follows: 14 healthy volunteers (group I), 45 patients with active sarcoidosis (group II), and 7 patients with sarcoidosis in remission (group III). The SACE in group II (4466 .+-. 2202 U/100 ml .hivin.x .+-. SD) was higher (P < 0.001) than in group I (2470 .+-. 547 .+-./100 ml) or in group III (2640 .+-. 610 U/100 ml); LACE was higher in group II (65.2 .+-. 48.4 U/100 ml, P < 0.001) than in group I (21.1 .+-. 14.7 U/100 ml), or in group III (25.7 .+-. 14.6 U/100 ml). The SAlb was, respectively, 3908 .+-. 385 mg/100 ml, 3982 .+-. 965 mg/100 ml and 3613 .+-. 222 mg/100 ml in groups I, II and III. The LAlb in group II (8.2 .+-. 6.2 mg/100 ml) was higher (P < 0.01) than in group I (2.5 .+-. 1.4 mg/100ml) or in group III (4.1 .+-. 1.0 mg/100 ml). The LACE in group II increased with the number of alveolar lymphocytes, in nonsmokers (r = +0.56, df = 34, P < 0.001) and in smokers ( r = +0.88, df = 7, P < 0.01). In the smokers in this group, LACE was higher with respect to the number of lyphocytes than in the nonsmokers. The permeability of the alveolocapillary membrane to albumin and to ACE is increased in active pulmonary sarcoidosis. LACE increases during sarcoidosis and returns to normal when the disease is cured. ACE concentration in alveolar fluid increases with tobacco use.