Angiotensin converting enzyme expression in primary pulmonary hypertension.

We compared immunoreactivity for angiotensin converting enzyme (ACE) in pulmonary artery and lung parenchymal tissues (obtained at the time of resection for lung transplantation) from eight patients with Stage IV primary pulmonary hypertension (PPH) with the reactivity in similar tissues from eight normal donors. ACE immunoreactivity was markedly and consistently increased in the endothelium and subendothelial neointimal regions of elastic pulmonary arteries from patients with PPH as compared with normal pulmonary arteries. Immunoreactivity in normal muscular pulmonary arteries was usually less than in surrounding capillary endothelial cells, whereas it was usually of comparable intensity with that in surrounding alveolar capillaries in muscular pulmonary arteries of patients with PPH. These observations suggest that ACE may be involved in the pathogenesis of vascular remodeling associated with neointimal formation in pulmonary arteries.