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Enalapril: a powerful in vitro non-thiol acantholytic agent
E de Angelis1, M L Lombardi, M Grassi
1Servizio di Oncologia Sperimentale D Farmaco-Chemioterapia, I Facoltà di Medicina, Università di Napoli Federico II, Italy.
International Journal of Dermatology
|October 1, 1992
Summary
Enalapril, an angiotensin-converting enzyme (ACE) inhibitor, demonstrated potent in vitro acantholytic effects on human skin. This finding suggests a novel mechanism for pemphigus induction by this non-thiol drug.
Area of Science:
- Dermatology
- Pharmacology
- Cell Biology
Background:
- Sulfhydryl-containing drugs (thiol drugs) are known to induce pemphigus and acantholysis.
- Enalapril, an angiotensin-converting enzyme (ACE) inhibitor used for hypertension, has been anecdotally linked to pemphigus induction.
- Unlike thiol drugs, enalapril does not contain sulfhydryl groups, prompting investigation into its mechanism of action.
Purpose of the Study:
- To investigate the in vitro acantholytic effect of enalapril on normal human skin.
- To compare the potency of enalapril's acantholytic effect with that of thiol drugs.
Main Methods:
- Normal human skin samples from multiple donors were cultured.
- Enalapril was applied to the skin samples in vitro.
- Acantholytic changes and suprabasal splitting were assessed microscopically.
Main Results:
- Enalapril induced severe acantholytic changes in keratinocytes.
- Complete suprabasal splitting was observed at concentrations significantly lower than those required for thiol drugs.
- All tested skin samples exhibited high susceptibility to enalapril's acantholytic effect.
- The observed effects occurred after a shorter culture period compared to thiol drugs.
Conclusions:
- Enalapril exhibits a potent in vitro acantholytic effect on human skin.
- Enalapril is a more powerful acantholytic agent in vitro than previously studied thiol drugs.
- These findings suggest a novel mechanism for enalapril-induced pemphigus, independent of thiol group activity.