xace-peptidyldipeptidase-a (LH Indholdsside)

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      <HtmlField Name="PageContent"><![CDATA[<h2>Definition</h2>
<ul>
    <li>Enzymkoncentrationsm&aring;ling af peptidyldipeptidase A (angiotensin converting enzyme) (ACE) i serum, m&aring;lt i U/L</li>
    <li>Ved sygdommen&nbsp;<a href="~/link.aspx?_id=03D3C24F4A1C45EEBE4F0C41637D9447&amp;_z=z">sarkoidose</a>&nbsp;produceres ACE af makrofager i alveolerne</li>
</ul>
<h2>Synonymer</h2>
<ul>
    <li>ACE, Angiotensin konverterende enzym; Serum peptidylpeptidase; Angiotensin 1-konverterende enzym; Carboxycathepsin;&nbsp;Dipeptidylcarboxypeptidase;&nbsp;Kininase II;&nbsp;Peptidase P;&nbsp;SACE; s-ACE</li>
</ul>
<h2>Indikationer</h2>
<ul>
    <li>Mistanke om sarkoidose
    <ul>
        <li>Almensymptomer med feber</li>
        <li>Artralgi (arthritis i de store led)</li>
        <li><a href="~/link.aspx?_id=62067D08094A45919ED526BF96D16F04&amp;_z=z">Erythema nodosa</a></li>
        <li>Mediastinale lymfekirtler</li>
    </ul>
    </li>
    <li>ACE kan hos den enkelte patient bruges til sygdoms- og behandlingsmonitorering
    <ul>
        <li>Stigende v&aelig;rdier ved sygdomsprogression</li>
        <li>Faldende v&aelig;rdier ved remission</li>
    </ul>
    </li>
</ul>
<h2>Fortolkninger</h2>
<p>H&oslash;je v&aelig;rdier af P-Peptidyldipeptidase A (ACE)</p>
<ul>
    <li>Sarkoidose i aktiv form
    <ul>
        <li>Niveauet er korreleret til granulom-byrden</li>
        <li>Ved lokaliseret sarcoidose er niveauet typisk lavere end ved udbredt sarcoidose&nbsp;</li>
    </ul>
    </li>
    <li>Lettere forh&oslash;jede v&aelig;rdier kan ogs&aring; ses ved:
    <ul>
        <li><a href="~/link.aspx?_id=F41E9CFC9FCA4C82B4631AE3C76303A2&amp;_z=z">Allergisk alveolitis</a></li>
        <li>Silikose</li>
        <li>Tuberkulose</li>
        <li><a href="~/link.aspx?_id=7350A42D26B44607BAEAAB21D11DB40B&amp;_z=z">Histoplasmose</a></li>
        <li><a href="~/link.aspx?_id=E4952F1176A64A1F91299626791C4A3F&amp;_z=z">Levercirrose</a></li>
        <li>Diabetes mellitus</li>
        <li>Kronisk nyresygdom</li>
        <li><a href="~/link.aspx?_id=01B73EDAEA6749029D805E9C5B9E687E&amp;_z=z">Psoriasis</a></li>
        <li><a href="~/link.aspx?_id=6F8C67265AD4418CBB1BA4514AE6EA53&amp;_z=z">Thyreotoksikose</a></li>
    </ul>
    </li>
</ul>
<h3>Lave v&aelig;rdier af P-Peptidyldipeptidase A (ACE)</h3>
<ul>
    <li>Ingen klinisk betydning</li>
</ul>
<h2>Fejlkilder&nbsp;(og kilder til normal variation)</h2>
<ul>
    <li>Patienter i behandling med ACE-h&aelig;mmer vil f&aring; m&aring;lt falsk for lave v&aelig;rdier</li>
    <li>ACE niveau afh&aelig;nger af genotypen</li>
</ul>
<h2>Fysiologi og biokemi<a href=" " data-type="journal-reference" data-value="Zheng SY, Du X, Dong JZ, Re-evaluating serum angiotensin-converting enzyme in sarcoidosis. Front Immunol 2023;14: 950095" data-value-piped="Zheng SY, Du X, Dong JZ|Re-evaluating serum angiotensin-converting enzyme in sarcoidosis.|Front Immunol|2023|14|950095|37868968" data-url="reference-link" data-pubmedid="37868968" title="Zheng SY, Du X, Dong JZ, Re-evaluating serum angiotensin-converting enzyme in sarcoidosis. Front Immunol 2023;14: 950095"><sup>6</sup></a></h2>
<ul>
    <li>Relaterede analyser: P-Interleukin-2-receptor (Il-2-receptor), P-Immunglobuliner, P-Ca<sup>++</sup> </li>
    <li>ACE er en exopeptidase, som under fysiologiske forhold hovedsagelig dannes i kapill&aelig;rendotelcellerne i lunge- og nyrev&aelig;v. Er prim&aelig;rt et membranbundet enzym, der katalyserer fraspaltningen af et dipeptid fra angiotensin I (decapeptid) til angiotensin II (octapeptid)</li>
    <li>Ved sarcoidose produceres ACE i epitheloidcellegranulomer med flerkernede k&aelig;mpeceller</li>
    <li>Ved affektion af lungerne produceres det i alveol&aelig;re makrofager</li>
    <li>Hovedfunktion
    <ul>
        <li>ACE omdanner angiotensin I til angiotensin II som er en potent arteriel vasokonstriktor</li>
        <li>ACE nedbryder bradykinin som er en potent vasodilatator</li>
    </ul>
    </li>
    <li>&Oslash;get ACE f&oslash;rer ikke til hypertension, og nedsat ACE koncentration har ingen kendt klinisk betydning, men medikamentel h&aelig;mning af ACE benyttes i stor stil i hypertensionsbehandlingen </li>
    <li>Der er p&aring;vist flere polymorfier i ACE genet
    <ul>
        <li>ACE koncentrationen er afh&aelig;ngigt af genotype; s&aring;ledes har personer homozygote for en insertion (I) af et 250-basepar stort DNA fragment i intron 16 en 40 % lavere P-ACE koncentration end homozygote, som mangler (deletion-D) DNA fragmentet<a href=" " data-type="journal-reference" data-value="Zheng SY, Du X, Dong JZ, Re-evaluating serum angiotensin-converting enzyme in sarcoidosis. Front Immunol 2023;14: 950095" data-value-piped="Zheng SY, Du X, Dong JZ|Re-evaluating serum angiotensin-converting enzyme in sarcoidosis.|Front Immunol|2023|14|950095|37868968" data-url="reference-link" data-pubmedid="37868968" title="Zheng SY, Du X, Dong JZ, Re-evaluating serum angiotensin-converting enzyme in sarcoidosis. Front Immunol 2023;14: 950095"><sup>6</sup></a></li>
        <li>Allelfrekvensen af det lange allel er 0,4 og det korte allel 0,6, hvorfor man i fastl&aelig;ggelse af referenceinterval og fortolkningen af resultaterne m&aring; tage hensyn til genotype</li>
    </ul>
    </li>
</ul>
<h2>Pr&oslash;vetagning</h2>
<ul>
    <li>Veneblodpr&oslash;ve
    <ul>
        <li>Serum &ndash; r&oslash;r uden antikoagulans - r&oslash;d prop med eller uden gel</li>
    </ul>
    </li>
</ul>
<h2>Referenceintervaller</h2>
<ul>
    <li>3 - 18 &aring;r: 12 - 75 U/L</li>
    <li>Over 18 &aring;r: 12 - 60 U/L </li>
    <li>D-polymorfisme 60 % h&oslash;jere v&aelig;rdier</li>
    <li>Referenceintervallet er afh&aelig;ngigt af analyseudstyr/analysemetode og populationssammens&aelig;tning mht. allelfrekvens<a href="EditorPage.aspx?da=core&amp;id=%7B4F704EAF-22B5-4F04-82C3-8A1EF60F75FF%7D&amp;ed=FIELD6592436224&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H6592436283&amp;us=sitecore%5Canvi&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value=" Chopra A, Kalkanis A &amp; Judson MA, Biomarkers in sarcoidosis. Expert Review of Clinical Immunology 2016;12: 1191-1208" data-value-piped=" Chopra A, Kalkanis A &amp; Judson MA|Biomarkers in sarcoidosis|Expert Review of Clinical Immunology |2016|12|1191-1208" data-url="reference-link" title=" Chopra A, Kalkanis A &amp; Judson MA, Biomarkers in sarcoidosis. Expert Review of Clinical Immunology 2016;12: 1191-1208"><sup>1</sup></a></li>
    <li>Et resultat mere end 2 gange s&aring; h&oslash;jt som normal-gr&aelig;nsen for den p&aring;g&aelig;ldende analysemetode tyder st&aelig;rkt p&aring; sarkoidose<a href="EditorPage.aspx?da=core&amp;id=%7B4F704EAF-22B5-4F04-82C3-8A1EF60F75FF%7D&amp;ed=FIELD6592436224&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H6592436283&amp;us=sitecore%5Canvi&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value=" Chopra A, Kalkanis A &amp; Judson MA, Biomarkers in sarcoidosis. Expert Review of Clinical Immunology 2016;12: 1191-1208" data-value-piped=" Chopra A, Kalkanis A &amp; Judson MA|Biomarkers in sarcoidosis|Expert Review of Clinical Immunology |2016|12|1191-1208" data-url="reference-link" title=" Chopra A, Kalkanis A &amp; Judson MA, Biomarkers in sarcoidosis. Expert Review of Clinical Immunology 2016;12: 1191-1208"><sup>1</sup></a></li>
</ul>
<h2>NPU-koder og -navne</h2>
<ul>
    <li>NPU01905&nbsp;</li>
</ul>
<h3>Navne</h3>
<ul>
    <li><strong>Kort helterm</strong>
    <ul>
        <li>
        P&mdash;Peptidyldipeptidase A; kat.k.(37 &deg;C; proc.) = ? &micro;kat/L</li>
    </ul>
    </li>
    <li><strong>Brugsnavn</strong>
    <ul>
        <li>P-Peptidyldipeptidase A [ACE]</li>
    </ul>
    </li>
</ul>
<h2>Opf&oslash;lgning p&aring; unormale resultater</h2>
<ul>
    <li>Specialistopgave </li>
    <li>Kliniske symptomer og h&oslash;je v&aelig;rdier af ACE, Il-2-receptor, immunglobuliner og Ca<sup>++</sup> tyder p&aring; sarkoidose og b&oslash;r f&oslash;lges op med biopsi fra et afficeret organ</li>
</ul>]]></HtmlField>
      <HtmlField Name="Resume"><![CDATA[<h2>Resum&eacute;</h2>
<ul>
    <li>M&aring;ling af Angiotensin 1-konverterende enzym kan bruges ved mistanke om og kontrol af sarkoidose,&nbsp;en systemisk granulomat&oslash;s sygdom&nbsp;<a href="/%20" title=" Chopra A, Kalkanis A &amp; Judson MA, Biomarkers in sarcoidosis. Expert Review of Clinical Immunology 2016;12: 1191-1208" data-url="reference-link" data-value-piped=" Chopra A, Kalkanis A &amp; Judson MA|Biomarkers in sarcoidosis|Expert Review of Clinical Immunology |2016|12|1191-1208" data-value=" Chopra A, Kalkanis A &amp; Judson MA, Biomarkers in sarcoidosis. Expert Review of Clinical Immunology 2016;12: 1191-1208" data-type="journal-reference"><sup>1</sup></a><sup>,</sup><a href="/%20" title="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. Lyngbyes laboratoriemedicin. 2. udg. . København: Nyt Nordisk Forlag Arnold Busck A/S; 2010" data-url="reference-link" data-value-piped="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH|Lyngbyes laboratoriemedicin. 2. udg. |København|Nyt Nordisk Forlag Arnold Busck A/S|2010" data-value="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. Lyngbyes laboratoriemedicin. 2. udg. . København: Nyt Nordisk Forlag Arnold Busck A/S; 2010" data-type="book-reference"><sup>2</sup></a><sup>,</sup><a href="/%20" title="Schaffalitzky de Muckadell O, Haunsø S, Vilstrup H. Medicinsk Kompendium. 18. udg. Shaker S, Bendstrup E, Iversen M. Sarcoidose. København: Nyt Nordisk Forlag Arnold Busck A/S; 2013" data-url="reference-link" data-value-piped="Schaffalitzky de Muckadell O, Haunsø S, Vilstrup H|Medicinsk Kompendium. 18. udg. Shaker S, Bendstrup E, Iversen M. Sarcoidose|København| Nyt Nordisk Forlag Arnold Busck A/S|2013" data-value="Schaffalitzky de Muckadell O, Haunsø S, Vilstrup H. Medicinsk Kompendium. 18. udg. Shaker S, Bendstrup E, Iversen M. Sarcoidose. København: Nyt Nordisk Forlag Arnold Busck A/S; 2013" data-type="book-reference"><sup>3</sup></a></li>
    <li>Forh&oslash;jet ACE kan st&oslash;tte diagnosen sarkoidose. Ved akut inds&aelig;ttende sygdom kan ACE dog v&aelig;re normalt p&aring; diagnosetidspunktet og f&oslash;rst blive abnormt h&oslash;jt efter ugers sygdom</li>
    <li>ACE niveauet korrelerer til granulom-byrden og billeddiagnostisk stadieinddeling</li>
    <li>Sensitivitet for ACE som mark&oslash;r for sarkoidose (fra review om ACE<a href="EditorPage.aspx?da=core&amp;id=%7B4F704EAF-22B5-4F04-82C3-8A1EF60F75FF%7D&amp;ed=FIELD731021795&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H731022011&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Hu X, Zou L, Wang S, Zeng T, Li P, Shen Y, Chen L, Performance of Serum Angiotensin-Converting Enzyme in Diagnosing Sarcoidosis and Predicting the Active Status of Sarcoidosis: A Meta-Analysis. Biomolecules 2022;12: " data-value-piped="Hu X, Zou L, Wang S, Zeng T, Li P, Shen Y, Chen L|Performance of Serum Angiotensin-Converting Enzyme in Diagnosing Sarcoidosis and Predicting the Active Status of Sarcoidosis: A Meta-Analysis.|Biomolecules|2022|12||36291609" data-url="reference-link" data-pubmedid="36291609" title="Hu X, Zou L, Wang S, Zeng T, Li P, Shen Y, Chen L, Performance of Serum Angiotensin-Converting Enzyme in Diagnosing Sarcoidosis and Predicting the Active Status of Sarcoidosis: A Meta-Analysis. Biomolecules 2022;12: "><sup>4</sup></a>):</li>
</ul>
<table>
    <tbody>
        <tr>
            <td>&nbsp;</td>
            <td>
            <p>Sensitivitet</p>
            </td>
            <td>Specificitet</td>
        </tr>
        <tr>
            <td>Sarcoidose&nbsp;</td>
            <td>60 %</td>
            <td>93 %</td>
        </tr>
        <tr>
            <td>Ocular sarcoidose</td>
            <td>48 %</td>
            <td>96 %</td>
        </tr>
        <tr>
            <td>Aktiv sarcoidose</td>
            <td>76 %</td>
            <td>80 %</td>
        </tr>
    </tbody>
</table>
<p>Den lave sensitivitet h&aelig;nger sammen med at ACE ogs&aring; er forh&oslash;jet ved en r&aelig;kke&nbsp;inflammatoriske sygdomme, fx tuberkulose<a href="EditorPage.aspx?da=core&amp;id=%7B4F704EAF-22B5-4F04-82C3-8A1EF60F75FF%7D&amp;ed=FIELD1672578340&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H1672578404&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Hu X, Zou L, Wang S, Zeng T, Li P, Shen Y, Chen L, Performance of Serum Angiotensin-Converting Enzyme in Diagnosing Sarcoidosis and Predicting the Active Status of Sarcoidosis: A Meta-Analysis. Biomolecules 2022;12: " data-value-piped="Hu X, Zou L, Wang S, Zeng T, Li P, Shen Y, Chen L|Performance of Serum Angiotensin-Converting Enzyme in Diagnosing Sarcoidosis and Predicting the Active Status of Sarcoidosis: A Meta-Analysis.|Biomolecules|2022|12||36291609" data-url="reference-link" data-pubmedid="36291609" title="Hu X, Zou L, Wang S, Zeng T, Li P, Shen Y, Chen L, Performance of Serum Angiotensin-Converting Enzyme in Diagnosing Sarcoidosis and Predicting the Active Status of Sarcoidosis: A Meta-Analysis. Biomolecules 2022;12: "><sup>4</sup></a><sup>,</sup><a href="EditorPage.aspx?da=core&amp;id=%7B4F704EAF-22B5-4F04-82C3-8A1EF60F75FF%7D&amp;ed=FIELD21714212343&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H21714212402&amp;us=sitecore%5Cneho&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value=" Chopra A, Kalkanis A &amp; Judson MA, Biomarkers in sarcoidosis. Expert Review of Clinical Immunology 2016;12: 1191-1208" data-value-piped=" Chopra A, Kalkanis A &amp; Judson MA|Biomarkers in sarcoidosis|Expert Review of Clinical Immunology |2016|12|1191-1208" data-url="reference-link" title=" Chopra A, Kalkanis A &amp; Judson MA, Biomarkers in sarcoidosis. Expert Review of Clinical Immunology 2016;12: 1191-1208"><sup>1</sup></a><sup>,</sup><a href="EditorPage.aspx?da=core&amp;id=%7B4F704EAF-22B5-4F04-82C3-8A1EF60F75FF%7D&amp;ed=FIELD1672578340&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H1672578404&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Kraaijvanger R, Janssen Bonás M, Vorselaars ADM, Veltkamp M, Biomarkers in the Diagnosis and Prognosis of Sarcoidosis: Current Use and Future Prospects. Front Immunol 2020;11: 1443" data-value-piped="Kraaijvanger R, Janssen Bonás M, Vorselaars ADM, Veltkamp M|Biomarkers in the Diagnosis and Prognosis of Sarcoidosis: Current Use and Future Prospects.|Front Immunol|2020|11|1443|32760396" data-url="reference-link" data-pubmedid="32760396" title="Kraaijvanger R, Janssen Bonás M, Vorselaars ADM, Veltkamp M, Biomarkers in the Diagnosis and Prognosis of Sarcoidosis: Current Use and Future Prospects. Front Immunol 2020;11: 1443"><sup>5</sup></a></p>]]></HtmlField>
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