Association of Angiotensin-Converting Enzyme Genotype, Insertion/Deletion Polymorphism and Saphenous Vein Graft Atherosclerosis in Iranian Patients

ABSTRACT OBJECTIVE: The aim of this study was to evaluate possible interactions among Angiotensin-I converting enzyme genotype, insertion/deletion polymorphism and atherosclerosis of vein grafts in Iranian patients, and characterize their clinical and demographic profile. METHODS: In this cross-sectional study, patients who underwent coronary artery bypass graft surgery more than five years ago, were included for angiographic analysis. Atherosclerosis was determined by quantitative angiography and adjusted Gensini score. The gene angiotensin converting enzyme I/D polymorphism was detected by polymerase chain reaction. RESULTS: A total of 102 patients participated in this study. Eighty-four patients were male. The frequency distribution of DD, ID and II polymorphism were 23.6%, 62.7% and 13.7% respectively. There were no differences among genotypic groups in age, sex, number of risk factors, number of vein grafts and months since bypass surgery. According to adjusted Gensini score [0.18±0.12 (II) vs. 0.11±0.09 (ID) and 0.1±0.09 (DD) P=0.021] the II genotype was associated with severity of vein graft atherosclerosis. CONCLUSION: Although there are conflicting results about gene angiotensin converting enzyme I/D polymorphism and the degree of venous bypass graft degeneration, this study suggests an association between ACE genotype II and atherosclerosis of saphenous vein grafts, however, large samples considering clinical, demographic and ethnic profile are necessary to confirm these results.

Clinical Features of Immunological Dysregulation in Common Variable Immunodeficiency in Iran.

Background: Common Variable Immune Deficiency (CVID) is a primary immunodeficiency with significant clinical manifestations. The aim of this study was to evaluate the clinical and immunological characteristics of CVID patients in Isfahan city, Iran. Methods: Data of 25 CVID Patients were collected from referrals to alzahra hospital and the Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences between 2007 and 2013. The patients were diagnosed according to the Immunodeficiency Disease criteria and all patients re-ceived Intravenous immunoglobulin (IVIG) as a fundamental part of the treatment at a mean dose of 500 mg/kg. Results: The age at onset of disease was between 4 to 37 years and diagnosis was between 2 to 39 years. The median levels of IgG, IgM, and IgA were 36.75, 4.77 and1.05 mg/dL respectively. The per-centage of CD19+ B cells, CD20+, CD3+, CD4+, CD8+, CD16+CD56+ cells was 8.35%, 8%, 80.88%, 28.72%, 38.88%, and 11.08% respectively. Sinusitis (79%), pneumonia (85%) and acute otitis media (40%) were the most common manifestations. In addition, Bronchiectasis was seen in about 25% and Autoimmunity (Thrombocytopenia, RA) was found in 33% of cases. Allergic symptoms were present in 8% of patients. Conclusion: CVID patients can present with a wide range of manifestations such as infections, immu-nological dysfunctions (autoimmunity), allergy and malignancy. A variety of defects in both humoral and cell-mediated immune responses can occur in CVID patients.