Comment on “angiotensin-converting-enzyme 2 inhibits liver fibrosis in mice”


  • Potential conflict of interest: Nothing to report.

To the Editor:

In their article in the September 2009 issue of HEPATOLOGY, Österreicher et al. conclude with a protective role for angiotensin-converting enzyme 2 (ACE2) on liver injury.1 ACE2 acts to counterbalance up-regulation of the renin-angiotensin system (RAS) through degradation of angiotensin II to angiotensin 1-7. Based on previous reports on other disease models of RAS overactivity, we would like to highlight another potential anti-RAS mechanism. In these models, immunoassay studies have identified the presence of circulating antibodies against ACE and angiotensin II considered to exert a neutralizing effect.2, 3 Currently, no studies evaluating the levels of serum/tissue anti-RAS antibodies in chronic liver disease models are reported in the literature. It is possible that standardization of their titers could prove to be of prognostic significance.

Michael G. Lenos M.D.*, Sofia-Maria Tsaniklidou M.D.†, * Department of Pathology, General Hospital of Athens ‘HIPPOCRATION’, Athens, Greece, † Department of Microbiology, General Hospital of Athens ‘GENNIMATAS’, Athens, Greece.