ACE/ACE2 Ratio and MMP-9 Activity as Potential Biomarkers in Tuberculous Pleural Effusions

Hsieh, Wen-Yeh; Kuan, Tang-Ching; Cheng, Kun-Shan; Liao, Yan-Chiou; Chen, Mu-Yuan; Lin, Pei-Heng; Hsu, Yuan-Chang; Huang, Chen-Yi; Hsu, Wei-Hua; Yu, Sheng-Yao; Lin, Chih-Sheng

The present study is the first report about the ACE/ACE2 ratio in tuberculosis diagnosis. Although increased ACE and MMP-9 could be specifically determined in the tuberculous effusion. There are still few concerns should be addressed using ACE and MMP-9 as biomarker for tuberculosis diagnosis, because (1) elevated ACE levels may also be seen in several other cardiovascular disorders, and (2) MMP-9 is an inflammation-induced target in several cases [33] . In the RAS, ACE2/Ang-(1-7) axis has been recently highlighted as the counter balancing arm of the RAS to the ACE/Ang II axis. The regulatory mechanisms focused on the alternating ACE and ACE2 regulation are still lack; therefore, the mechanism of reduced ACE2 found in the pleural effusion of patients with tuberculosis remains to be further explored.