Key result
ACE D allele linked to ~42% greater vasculitis risk than I allele, especially in Caucasians.
Why the study?
The association between the ACE insertion/deletion polymorphism and susceptibility to vasculitis, including HSP, HSPN, and BD, was unclear.
Does the ACE D allele increase susceptibility to vasculitis compared to the I allele?
Meta-Analysis (n=3,483)
Does the ACE D allele increase susceptibility to vasculitis compared to the I allele?
Odds Ratio: 1.42 (95% CI 1.15–1.76)
The ACE D allele is a genetic risk factor for vasculitic disorders, particularly Henoch-Schönlein purpura and Behçet's disease.
May inform vasculitis genetic risk research in Caucasians; leaves open whether ACE genotyping alters clinical management.
Objective: This meta-analysis aimed to evaluate the association between the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and susceptibility to vasculitis, including Henoch-Schönlein purpura (HSP), Henoch-Schönlein purpura nephritis (HSPN), and Behçet's disease (BD).Methods: Relevant studies were systematically retrieved from PubMed, Embase, and Google Scholar until November 2025.Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using different genetic models.Heterogeneity was assessed using the Cochrane Q test and I² statistics, and random-effects models were applied.Statistical analyses were performed using the Review Manager (version 5.4).Results: Fifteen eligible studies, including five on HSP, four on HSPN, and six on BD, were included, with a total of 1,536 cases and 1,947 controls.Pooled analysis demonstrated a significant association between the ACE I/D polymorphism and an increased risk of vasculitis (D vs. I, OR = 1.42, 95% CI 1.15-1.76),with stronger associations observed in Caucasian populations.Subgroup analysis revealed that the D allele was significantly associated with higher susceptibility to HSP and BD, whereas a modest association was detected for HSPN in the allelic comparison model.Conclusion: The findings suggest that the ACE D allele may be a genetic risk factor for vasculitic disorders, especially HSP and BD, supporting the possible involvement of the renin-angiotensin system in the development of autoimmune vascular inflammation.
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Sekar et al. (2026) conducted a meta-analysis in Vasculitis (Henoch-Schönlein purpura, Henoch-Schönlein purpura nephritis, and Behçet's disease) (n=3,483). ACE insertion/deletion (I/D) polymorphism (D allele) vs. I allele was evaluated on Susceptibility to vasculitis (OR 1.42, 95% CI 1.15-1.76). The ACE D allele was significantly associated with an increased risk of vasculitis compared to the I allele (OR 1.42), with stronger associations observed in Caucasian populations.
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