Study Sheds Light on Prevalence of Different Types of Bradykinin-mediated Angioedema

Study Sheds Light on Prevalence of Different Types of Bradykinin-mediated Angioedema

The most common type of angioedema mediated by bradykinin is caused by the use of common blood pressure medications called angiotensin-converting enzyme inhibitors, a review study shows.

This is followed by hereditary angioedema and recurrent angioedema, occurring due to an acquired C1-inhibitor deficiency, researchers say.

The study, “Epidemiology of Bradykinin-mediated angioedema: a systematic investigation of epidemiological studies,” was published in Orphanet Journal of Rare Diseases.

Angioedema is a condition in which the deeper layers of the skin swell due to dilation of blood vessels.

A significant number of angioedema cases are mediated by histamine; however, a substantial proportion can also be mediated by bradykinin — a molecule that plays a prominent role in dilating blood vessels.

Bradykinin-mediated angioedema (Bk-AE) can develop from a variety of circumstances that cause high levels of bradykinin. It can result from a slow-down in bradykinin degradation following the use of an angiotensin-converting enzyme inhibitor (ACEi-AE).

It can also be caused by an acquired deficiency of the C1-inhibitor, which leads to the uncontrolled production of bradykinin, such as that observed in hereditary angioedema (C1-INH-HAE) and recurrent angioedema (C1-INH-AAE).

Treatments for Bk-AE must either target the production or receptor activity of bradykinin. This is essential, particularly in life-threatening situations where inappropriate treatment could lead to risk of suffocation.

Since knowledge of the incidence, prevalence, and distribution of Bk-AE may help improve its management and raise awareness among physicians, researchers conducted a systematic review of the epidemiological literature on Bk-AE.

Through this review, researchers were able to identify four publications that reported the prevalence of ACEI-AE, six that reported C1-INH-HAE, and one that reported C1-INH-AAE.

Overall, researchers discovered that the prevalence of ACEI-AEs is approximately 1.5 per 10,000, C1-INH-HAE is 1.5 per 100,000, and C1-INH-AAE is 1.5 per 1 million, meaning that for every 100 patients with ACEI-AE, there are 10 patients with C1-INH-HAE and one patient with C1-INH-AAE.

Researchers also determined that ACEI-AE patients have approximately one angioedema attack per year, while patients with C1-INH-HAE and C1-INH-AAE experience 10 per year.

Because treatments for histamine-mediated angioedema would not appropriately treat bradykinin-mediated angioedema, these numbers highlight the significant need to determine the underlying cause of angioedema prior to treatment.

“Epidemiological evidence on Bk-AE is largely limited to North America and Europe. ACEI-AE is more common than C1-INH-HAE (10:1), which is more common than C1-INH-AAE (10:1),” the investigators concluded.

“More studies are needed to comprehensively assess the epidemiological burden of Bk-AE,” they said.

Iqra holds a MSc in Cellular and Molecular Medicine from the University of Ottawa in Ottawa, Canada. She also holds a BSc in Life Sciences from Queen’s University in Kingston, Canada. Currently, she is completing a PhD in Laboratory Medicine and Pathobiology from the University of Toronto in Toronto, Canada. Her research has ranged from across various disease areas including Alzheimer’s disease, myelodysplastic syndrome, bleeding disorders and rare pediatric brain tumors.
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Iqra holds a MSc in Cellular and Molecular Medicine from the University of Ottawa in Ottawa, Canada. She also holds a BSc in Life Sciences from Queen’s University in Kingston, Canada. Currently, she is completing a PhD in Laboratory Medicine and Pathobiology from the University of Toronto in Toronto, Canada. Her research has ranged from across various disease areas including Alzheimer’s disease, myelodysplastic syndrome, bleeding disorders and rare pediatric brain tumors.
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One comment

  1. stacy craig says:

    I was prescribed “lisinopril” for my HBP. In 2016 I had digestive problems & black bowel movement. Dr. ordered a Scope & Colonoscopy. My images from those procedures appear to show damage. Also my stool sample(from the Mayo Clinic) tested positive(for blood).Also my blood test(from the Mayo Clinic) showed findings of ANA.
    I know intestinal angioedema is “rare”, yet are there test for its diagnoses. Also research/study, or cases.

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