{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T08:02:43Z","timestamp":1793088163612,"version":"4.5.0"},"reference-count":64,"publisher":"Walter de Gruyter GmbH","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6,27]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"j_cclm-2017-0837_s_999\"><jats:title id=\"d6352801e26857\">Background:<\/jats:title><jats:p>Serum angiotensin-converting enzyme (ACE) activity determination can aid the early diagnosis of sarcoidosis. We aimed to optimize a fluorescent kinetic assay for ACE activity by screening the confounding effects of endogenous ACE inhibitors and interfering factors. Genotype-dependent and genotype-independent reference values of ACE activity were established, and their diagnostic accuracies were validated in a clinical study.<\/jats:p><\/jats:sec><jats:sec id=\"j_cclm-2017-0837_s_998\"><jats:title id=\"d6352801e26865\">Methods:<\/jats:title><jats:p>Internally quenched fluorescent substrate, Abz-FRK(Dnp)P-OH was used for ACE-activity measurements. A total of 201 healthy individuals and 59 presumably sarcoidotic patients were enrolled into this study. ACE activity and insertion\/deletion (<jats:italic>I\/D<\/jats:italic>) genotype of the<jats:italic>ACE<\/jats:italic>gene were determined.<\/jats:p><\/jats:sec><jats:sec id=\"j_cclm-2017-0837_s_997\"><jats:title id=\"d6352801e26879\">Results:<\/jats:title><jats:p>Here we report that serum samples should be diluted at least 35-fold to eliminate the endogenous inhibitor effect of albumin. No significant interferences were detected: up to a triglyceride concentration of 16 mM, a hemoglobin concentration of 0.71 g\/L and a bilirubin concentration of 150 \u03bcM. Genotype-dependent reference intervals were considered as 3.76\u201311.25 U\/L, 5.22\u201311.59 U\/L, 7.19\u201314.84 U\/L for<jats:italic>II<\/jats:italic>,<jats:italic>ID<\/jats:italic>and<jats:italic>DD<\/jats:italic>genotypes, respectively.<jats:italic>I\/D<\/jats:italic>genotype-independent reference interval was established as 4.85\u201313.79 U\/L. An ACE activity value was considered positive for sarcoidosis when it exceeded the upper limit of the reference interval. The optimized assay with genotype-dependent reference ranges resulted in 42.5% sensitivity, 100% specificity, 100% positive predictive value and 32.4% negative predictive value in the clinical study, whereas the genotype-independent reference range proved to have inferior diagnostic efficiency.<\/jats:p><\/jats:sec><jats:sec id=\"j_cclm-2017-0837_s_996\"><jats:title id=\"d6352801e26899\">Conclusions:<\/jats:title><jats:p>An optimized fluorescent kinetic assay of serum ACE activity combined with<jats:italic>ACE I\/D<\/jats:italic>genotype determination is an alternative to invasive biopsy for confirming the diagnosis of sarcoidosis in a significant percentage of patients.<\/jats:p><\/jats:sec>","DOI":"10.1515\/cclm-2017-0837","type":"journal-article","created":{"date-parts":[[2018,2,9]],"date-time":"2018-02-09T10:01:31Z","timestamp":1518170491000},"page":"1117-1125","source":"Crossref","is-referenced-by-count":19,"title":["Optimized angiotensin-converting enzyme activity assay for the accurate diagnosis of sarcoidosis"],"prefix":"10.1515","volume":"56","author":[{"given":"Alexandra","family":"Csongr\u00e1di","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attila","family":"Enyedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Istv\u00e1n","family":"Tak\u00e1cs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tam\u00e1s","family":"V\u00e9gh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivetta S.","family":"M\u00e1nyin\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zs\u00f3fia","family":"P\u00f3lik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Istv\u00e1n Tibor","family":"Altorjay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f3zsef","family":"Balla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gy\u00f6rgy","family":"Balla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Istv\u00e1n","family":"\u00c9des","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e1nos","family":"Kappelmayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attila","family":"T\u00f3th","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zolt\u00e1n","family":"Papp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3262-884X","authenticated-orcid":false,"given":"Mikl\u00f3s","family":"Fagyas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","reference":[{"key":"ref341","first-page":"735","article-title":"ATS\/ERS\/WASOG statement on sarcoidosis. 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