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Direct Effect of Lisinopril, Ramipril, and Captopril on Endothelial Progenitor Cell (EPC) Proliferation from Peripheral Blood of Stable Coronary Artery Disease Patient

Author : R. N. Rosyadi*, Y. H. Oktaviono*, D. Soemantri*
Upload Date : 19-04-2018

Background: EPC has showed beneficial effect as biomarker and therapeutic material in coronary artery disease (CAD). Efforts have tried to increase EPC level and function. Recent studies found that angiotensin converting enzyme inhibitor (ACEI) improved circulating EPC in CAD patient. In contrast, angiotensin receptor blocker (ARB) reduced circulating EPC in kidney transplanted patient. This controversial effect suggests that there is direct effect of ACEI on EPC level beyond classical renin angiotensin aldosterone system (RAAS) pathway.

Objective: To analyze the direct effect of lisinopril on EPC proliferation from peripheral blood of stable coronary artery disease patient.

Methods: This is an in vitro quasy experimental post-test control group study. The MNCs were isolated from peripheral blood of stable coronary artery disease patient and were cultured in CFU-Hill medium for 3 days. Samples put into four groups i.e. lisinopril, ramipril, captopril and control group. Every group was divided into 3 subgroups with different doses, 2 µmol/L, 10 µmol/L, and 50 µmol/L. EPC proliferation was evaluated afterwards with MTT cell proliferation assay. Colony forming were observed to confirm functional characteristics of EPC. Data were analyzed using ANOVA test.

Results: MTT cell proliferation assay showed a significant increase of EPC proliferation in captopril, ramipril, and lisinopril groups compared with control group (0.231 ± 0.013, 0.236 ± 0.002, 0.246 ± 0.018 vs 0.168 ± 0.016, p<0.05). It also revealed significant difference in EPC proliferation between each experiment groups, which lisinopril showed the highest number. There was significant difference in subgroup of doses where the higher dose gave better effect on EPC proliferation. Highest number of colony count found in ramipril group, followed by lisinorpil, and captopril.

Conclusion: ACEI increase EPC proliferation from peripheral blood of stable coronary artery disease patient. Lisinopril showed the best effect on EPC proliferation. Each ACEI increased EPC proliferation dose-dependently.

KEYWORDS : ACEI, EPC proliferation, RAAS

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