Effect of Losartan and Enalapril on Acute Phase Reeactant (CPR) and Total Anti-oxidant in Renal Transplant Recipients with Renin-Angiotensin system polymorphisms

As renin-angiotensin system (RAS) activity could affect the severity of oxidative stress and inflammatory markers; the effect of enalapril and losartan on these markers in renal transplant recipients (RTRs) with RAS polymorphisms was assessed. After determination of RAS genotypes including angiotensin converting enzyme (ACE I/D), Angiotensinogen (AGT M235T) and angiotensin II type 1 receptor (ATR1 A1166C) by PCR, seventy-six RTRs recruited to four groups randomly: first group (17 patients) and second group (24 patients) were treated with E (E+: 10mg/daily) and L (L+: 50 mg/daily) alone, respectively. The third group (17 patients as positive control) received E+L (E+L+: 10mg/daily + 50 mg/daily) and the 4th group (18 patients as negative control) received no medication (E-L-). Hs-CRP and total anti-oxidant (TA) as inflammatory and anti-oxidative markers were measured after 2 months. 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 hs-CRP and TA were retested. Following up the patients (after 2, 4 months of treatment) in treated groups revealed that hs-CRP and TA levels were significantly decreased and increased (consequently) in E+L+, L+, E+ groups (P< 0.05). On analyzing the relationship between RAS polymorphisms with baseline hs-CRP and TA levels, CC genotype of ATR1 had lower hs-CRP levels (P=0.04). But none of the RAS polymorphisms could predict the anti-oxidative and anti-inflammatory response rate to the drugs (P> 0.05). E and/or L reduce hs-CRP and increase TA regardless of the RAS genotypes.