Enalapril and losartan affect lipid peroxidation in renal transplant recipients with renin-angiotensin system polymorphisms

In this study, the effect of enalapril (E) and/or losartan (L) on lipid peroxidation (LPO) is studied in renal transplantrecipients (RTRs) with regarding to polymorphisms of renin-angiotensin system (RAS). fter determination of genotypes of the angiotensin converting enzyme (ACE I/D), angiotensinogen (AGT M235T) and angiotensin II type 1 receptor (ATR1 A1166C) by polymerase chain reaction, sixty-four RTRs recruited to four groups randomly: first (13 patients) and second (20 patients) groups were treated with enalapril (E+: 10mg/d) and losartan (L+: 50 mg/d) alone, respectively. The third group (13 patients as positive control) received enalapril + losartan (E+L+: 10mg/d + 50 mg/d) and the forth group (18 patients as negative control) received no medication (E-L-). Malondialdehyde (MDA) as LPO marker was measured after 8 weeks. After 2 weeks as washout period, E group changed to L and vice versa as a cross-over design. They were followed for another 8 weeks and MDA was retested. MDA level significantly decreased in all of the groups except the E L. Regardless of the treatment protocol, HDL-c, LDL-c, TG, total cholesterol and reduced MDA levels did not change (P>0.05). Although, patients with DD genotype of ACE had higher MDA (P=0.01) and TG (P=0.03) levels, RAS polymorphisms couldn’t predict the antioxidative response rate to the drugs (P>0.05). Although LPO is higher in DD genotype of ACE polymorphism; E and/or L reduce MDA regardless of the RAS genotypes.