Key result
The ACE DD genotype was significantly more frequent in patients with refractory temporal lobe epilepsy (46%) than in controls (27%), and carbamazepine was shown to directly inhibit ACE activity.
Why the study?
Does carbamazepine inhibit angiotensin I-converting enzyme activity?
Case-Control (n=440)
No
Does carbamazepine inhibit angiotensin I-converting enzyme activity?
Absolute Event Rate: 46% vs 27%
p-value: p=<0.01
Carbamazepine unexpectedly inhibits ACE, providing a direct link between epilepsy treatment and the renin-angiotensin and kallikrein-kinin systems.
Carbamazepine may inhibit ACE in refractory temporal lobe epilepsy; hypothesis-generating for renin-angiotensin effects on seizure control and requires prospective confirmation.
We find that a common mutation that increases angiotensin I-converting enzyme activity occurs with higher frequency in male patients suffering from refractory temporal lobe epilepsy. However, in their brains, the activity of the enzyme is downregulated. As an explanation, we surprisingly find that carbamazepine, commonly used to treat epilepsy, is an inhibitor of the enzyme, thus providing a direct link between epilepsy and the renin-angiotensin and kallikrein-kinin systems.
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Almeida et al. (2012) conducted a case-control in Temporal lobe epilepsy (n=440). ACE DD genotype and Carbamazepine vs. Controls and non-carbamazepine-treated patients was evaluated on Frequency of the ACE DD genotype (p=<0.01). The ACE DD genotype was significantly more frequent in patients with refractory temporal lobe epilepsy (46%) than in controls (27%), and carbamazepine was shown to directly inhibit ACE activity.
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