Tuberc Respir Dis.  2003 Nov;55(5):478-487.

The Therapeutic Effect of Angiotensin II Receptor Antagonist in Idiopathic Pulmonary Fibrosis

• Woo DS
• Seol WJ
• Kyung SY
• Lim YH
• An CH
• Park JW
• Jeong SH
• Lee JW

Abstract

BACKGROUND: There have been several studies showing that the angiotensin II and angiotensin converting enzyme(ACE) contributes to the apoptosis of alveolar epithelial cells in idiopathic interstitial pneumonia and the activation of fibroblasts during the process of pulmonary fibrosis. These results suggest that the pulmonary fibrosis can be inhibited by the angiotensin II receptor antagonist(AGIIRA). This study was performed to identify the therapeutic effect of AGIIRA in idiopathic pulmonary fibrosis(IPF). METHOD: Thirteen patients with IPF, who were diagnosed with an open lung biopsy(6 patients) and furfilling the ATS criteria(7 patients) between March 1999 and October 2001 at the Gachon medical center, were enrolled in this study. Of these patients, eight patients were treated with a regimen including AGIIRA(AT group), and five were treated without AGIIRA(NT group). The pulmonary function tests and dyspnea(ATS scale) were measured at diagnosis and 1 year after treatment. All the data was collected to analyze the therapeutic effect of AGIIRA on the patients with IPF.
RESULTS
The AT group contained 8 patients(M:F=4:4) and the NT group contained 5 patients (M:F=3:2). There was no significant difference in the serum angiotensin II level between the two groups(202.5+/-58.5 vs 163.7+/-47.3pg/ml, p>0.05). The AT group showed an upward trend in TLC(+3%), FVC(+4%), FEV1(+3%) and DLco(+2%) compared to the NT group(TLC(-14%), FVC(-3%), FEV1(-4%) except for DLco(+5%)). The dyspnea score in the AT group improved significantly but not in the NT group.
CONCLUSION
These results suggest that the angiotensin II receptor antagonist may have an effect on stabilizing IPF.

Keyword

Idiopathic pulmonary fibrosis; Angiotensin II; Angiotensin II receptor antagonist

MeSH Terms

Angiotensin II*
Angiotensins*
Apoptosis
Diagnosis
Dyspnea
Epithelial Cells
Fibroblasts
Humans
Idiopathic Interstitial Pneumonias
Idiopathic Pulmonary Fibrosis*
Lung
Pulmonary Fibrosis
Receptors, Angiotensin*
Respiratory Function Tests
Angiotensin II
Angiotensins
Receptors, Angiotensin