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Published on: September 28, 2015
Association of the Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism with Increased Susceptibility to
Praveen Kumar Chandra Sekar1, Ramakrishnan Veerabathiran1
1Human Cytogenetics and Genomics Laboratory, Faculty of Allied Health Sciences, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India.
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.