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Nancy J Brown - One of the best experts on this subject based on the ideXlab platform.
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dipeptidyl peptidase iv in angiotensin converting Enzyme Inhibitor associated angioedema
Hypertension, 2008Co-Authors: James Brian Byrd, Karine Touzin, Saba Sile, James V Gainer, Chang Yu, John H Nadeau, Albert Adam, Nancy J BrownAbstract:Angioedema is a potentially life-threatening adverse effect of angiotensin-converting Enzyme Inhibitors. Bradykinin and substance P, substrates of angiotensin-converting Enzyme, increase vascular permeability and cause tissue edema in animals. Studies indicate that amino-terminal degradation of these peptides, by aminopeptidase P and dipeptidyl peptidase IV, may be impaired in individuals with angiotensin-converting Enzyme Inhibitor–associated angioedema. This case-control study tested the hypothesis that dipeptidyl peptidase IV activity and antigen are decreased in sera of patients with a history of angiotensin-converting Enzyme Inhibitor–associated angioedema. Fifty subjects with a history of angiotensin-converting Enzyme Inhibitor–associated angioedema and 176 angiotensin-converting Enzyme Inhibitor–exposed control subjects were ascertained. Sera were assayed for angiotensin-converting Enzyme activity, aminopeptidase P activity, aminopeptidase N activity, dipeptidyl peptidase IV activity, and antigen and the ex vivo degradation half-lives of bradykinin, des-Arg 9 -bradykinin, and substance P in a subset. The prevalence of smoking was increased and of diabetes decreased in case versus control subjects. Overall, dipeptidyl peptidase IV activity (26.6±7.8 versus 29.6±7.3 nmol/mL per minute; P =0.026) and antigen (465.8±260.8 versus 563.1±208.6 ng/mL; P =0.017) were decreased in sera from individuals with angiotensin-converting Enzyme Inhibitor–associated angioedema compared with angiotensin-converting Enzyme Inhibitor–exposed control subjects without angioedema. Dipeptidyl peptidase IV activity (21.5±4.9 versus 29.8±6.7 nmol/mL per minute; P =0.001) and antigen (354.4±124.7 versus 559.8±163.2 ng/mL; P =0.003) were decreased in sera from cases collected during angiotensin-converting Enzyme inhibition but not in the absence of angiotensin-converting Enzyme inhibition. The degradation half-life of substance P correlated inversely with dipeptidyl peptidase IV antigen during angiotensin-converting Enzyme inhibition. Environmental or genetic factors that reduce dipeptidyl peptidase IV activity may predispose individuals to angioedema.
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Dipeptidyl Peptidase IV in Angiotensin-Converting Enzyme Inhibitor–Associated Angioedema
Hypertension, 2007Co-Authors: James Brian Byrd, Karine Touzin, Saba Sile, James V Gainer, Chang Yu, John H Nadeau, Albert Adam, Nancy J BrownAbstract:Angioedema is a potentially life-threatening adverse effect of angiotensin-converting Enzyme Inhibitors. Bradykinin and substance P, substrates of angiotensin-converting Enzyme, increase vascular permeability and cause tissue edema in animals. Studies indicate that amino-terminal degradation of these peptides, by aminopeptidase P and dipeptidyl peptidase IV, may be impaired in individuals with angiotensin-converting Enzyme Inhibitor–associated angioedema. This case-control study tested the hypothesis that dipeptidyl peptidase IV activity and antigen are decreased in sera of patients with a history of angiotensin-converting Enzyme Inhibitor–associated angioedema. Fifty subjects with a history of angiotensin-converting Enzyme Inhibitor–associated angioedema and 176 angiotensin-converting Enzyme Inhibitor–exposed control subjects were ascertained. Sera were assayed for angiotensin-converting Enzyme activity, aminopeptidase P activity, aminopeptidase N activity, dipeptidyl peptidase IV activity, and antigen and the ex vivo degradation half-lives of bradykinin, des-Arg 9 -bradykinin, and substance P in a subset. The prevalence of smoking was increased and of diabetes decreased in case versus control subjects. Overall, dipeptidyl peptidase IV activity (26.6±7.8 versus 29.6±7.3 nmol/mL per minute; P =0.026) and antigen (465.8±260.8 versus 563.1±208.6 ng/mL; P =0.017) were decreased in sera from individuals with angiotensin-converting Enzyme Inhibitor–associated angioedema compared with angiotensin-converting Enzyme Inhibitor–exposed control subjects without angioedema. Dipeptidyl peptidase IV activity (21.5±4.9 versus 29.8±6.7 nmol/mL per minute; P =0.001) and antigen (354.4±124.7 versus 559.8±163.2 ng/mL; P =0.003) were decreased in sera from cases collected during angiotensin-converting Enzyme inhibition but not in the absence of angiotensin-converting Enzyme inhibition. The degradation half-life of substance P correlated inversely with dipeptidyl peptidase IV antigen during angiotensin-converting Enzyme inhibition. Environmental or genetic factors that reduce dipeptidyl peptidase IV activity may predispose individuals to angioedema.
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angiotensin converting Enzyme Inhibitor associated angioedema
Immunology and Allergy Clinics of North America, 2006Co-Authors: James Brian Byrd, Albert Adam, Nancy J BrownAbstract:Angioedema, characterized by swelling of the lips, face, and tongue, occurs in anywhere from 0.1% to 6% of angiotensin-converting Enzyme (ACE) Inhibitor users. The incidence is more common in black Americans than in white Americans, in women than in men, and in smokers than in nonsmokers. The remitting and relapsing nature of ACE Inhibitor-associated angioedema can confound clinical recognition of the adverse event but also provides clues to its causes. Defective degradation of vasoactive peptide substrates of ACE, such as bradykinin or substance P, may contribute via non-ACE pathways to the pathogenesis of ACE Inhibitor-associated angioedema.
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black americans have an increased rate of angiotensin converting Enzyme Inhibitor associated angioedema
Clinical Pharmacology & Therapeutics, 1996Co-Authors: Nancy J Brown, Mary Snowden, Marie R GriffinAbstract:Objective To study the association of race and other patient characteristics associated with angiotensin converting Enzyme (ACE) Inhibitor-associated angioedema. Methods This was a retrospective cohort study of participants in the Tennessee Medicaid Program (≥15 years of age) to whom ACE Inhibitors had been prescribed from 1986 through 1992. Results We identified 82 patients with confirmed angioedema during 51,752 person-years of ACE Inhibitor use, giving an overall rate of angioedema of 1.6 per 1000 person-years of ACE Inhibitor use. After potential confounding factors were controlled for, the adjusted relative risk (RR) of angioedema among black American users of ACE Inhibitors was 4.5 (95% confidence interval [CI] 2.9 to 6.8) compared with white subjects. In addition to race, other factors associated with a significantly increased relative risk in the entire population were the first 30 days of ACE Inhibitor use (RR, 4.6; 95% CI, 2.5 to 8.5) compared to >1 year of use, use of either lisinopril (RR, 2.2; 95% CI, 1.2 to 3.9) or enalapril (RR, 2.2; 95% CI, 1.4 to 3.5) compared to captopril, and previous hospitalization for any diagnosis within 30 days (RR, 2.0; 95% CI, 1.1 to 3.6). Neither ACE Inhibitor dose nor concurrent diuretic use was associated with the risk of angioedema. Conclusions These data suggest that black Americans have a substantially increased risk of ACE Inhibitor-associated angioedema compared with white subjects and that this increased risk cannot be attributed to an effect of dose, specific ACE Inhibitor, or concurrent medications. Clinical Pharmacology & Therapeutics (1996) 60, 8–13; doi:
Marco Cicardi - One of the best experts on this subject based on the ideXlab platform.
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long term follow up of 111 patients with angiotensin converting Enzyme Inhibitor related angioedema
Journal of Hypertension, 2011Co-Authors: L Beltrami, Andrea Zanichelli, Lorenza C Zingale, Romualdo Vacchini, Stefano Carugo, Marco CicardiAbstract:ObjectiveTo investigate, for the first time, the frequency of recurrences of angiotensin-converting Enzyme Inhibitor (ACE-I)-related angioedema after the discontinuation of ACE-I.MethodsThis retrospective study was conducted in an outpatient tertiary-level centre for a total period of 173 months (ab
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angioedema associated with angiotensin converting Enzyme Inhibitor use outcome after switching to a different treatment
JAMA Internal Medicine, 2004Co-Authors: Marco Cicardi, Lorenza C Zingale, Luigi Bergamaschini, A AgostoniAbstract:Background:Angiotensin-convertingEnzyme(ACE)Inhibitorsareassociatedwithangioedemaepisodesthatare potentiallylife-threatening.Fewdataareavailableonthe outcome of patients reporting this adverse effect when they are switched to another drug. Scattered reports of angioedema associated with angiotensin II receptor blocker(ARB)usequestionthesafetyofusingthesedrugs in patients with ACE Inhibitor–related angioedema. We describe 64 consecutive patients with ACE Inhibitor– relatedangioedema,theoutcomeafterdiscontinuingthis treatment, and the safety of using ARBs. Methods: Retrospective analysis of 64 consecutive patients (January 1993 to June 2002) presenting with angioedema onset while receiving treatment with an ACE Inhibitor.
Lippincott Williams Wilkins - One of the best experts on this subject based on the ideXlab platform.
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does the new angiotensin converting Enzyme Inhibitor cilazapril prevent restenosis after percutaneous transluminal coronary angioplasty results of the mercator study a multicenter randomized double blind placebo controlled trial multicenter european
Circulation, 1992Co-Authors: Lippincott Williams WilkinsAbstract:BACKGROUND Cilazapril is a novel angiotensin converting Enzyme Inhibitor with antiproliferative effects in the rat model after balloon injury. METHODS AND RESULTS We conducted a randomized, double-blind placebo-controlled trial to assess the effect of cilazapril in angiographic restenosis prevention after percutaneous transluminal coronary angioplasty (PTCA). Patients received cilazapril 2.5 mg in the evening after successful PTCA and 5 mg b.i.d. for 6 months or matched placebo. In addition, all patients received aspirin for 6 months. Coronary angiograms before PTCA, after PTCA, and at 6-month follow-up were quantitatively analyzed. In 94% of 735 recruited patients, PTCA was successful and all inclusion and exclusion criteria were met. For the per-protocol analysis, quantitative angiography after PTCA and at follow-up was available in 595 patients who complied with the treatment regimen (309 control, 286 cilazapril). The mean difference in minimal coronary lumen diameter between post-PTCA and follow-up angiogram (primary end point) was -0.29 +/- 0.49 mm in the control group and -0.27 +/- 0.51 mm in the cilazapril group. Clinical events during 6-month follow-up, analyzed on an intention-to-treat basis, were ranked according to the most serious clinical event ranging from death (control, two; cilazapril, three), nonfatal myocardial infarction (control, eight; cilazapril, 5), coronary revascularization (control, 51; cilazapril, 53), or recurrent angina requiring medical therapy (control, 67; cilazapril, 68) to none of the above (control, 224; cilazapril, 212). There were no significant differences in ranking. CONCLUSIONS Long-term angiotensin converting Enzyme inhibition with cilazapril in a dose of 5 mg b.i.d. does not prevent restenosis and does not favorably influence the overall clinical outcome after PTCA.
James Brian Byrd - One of the best experts on this subject based on the ideXlab platform.
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genetic variants associated with angiotensin converting Enzyme Inhibitor associated angioedema
Pharmacogenetics and Genomics, 2013Co-Authors: James Brian Byrd, Guillaume Pare, Michiaki Kubo, Catherine A Mccarty, Alencia Woodardgrice, Sonia S Anand, Rebecca L Zuvich, Yuki Bradford, Stephanie RossAbstract:ObjectiveThe objective of this study was to identify genetic variants associated with angiotensin-converting Enzyme (ACE) Inhibitor-associated angioedema.Participants and methodsWe carried out a genome-wide association study in 175 individuals with ACE Inhibitor-associated angioedema and 489 ACE inh
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dipeptidyl peptidase iv in angiotensin converting Enzyme Inhibitor associated angioedema
Hypertension, 2008Co-Authors: James Brian Byrd, Karine Touzin, Saba Sile, James V Gainer, Chang Yu, John H Nadeau, Albert Adam, Nancy J BrownAbstract:Angioedema is a potentially life-threatening adverse effect of angiotensin-converting Enzyme Inhibitors. Bradykinin and substance P, substrates of angiotensin-converting Enzyme, increase vascular permeability and cause tissue edema in animals. Studies indicate that amino-terminal degradation of these peptides, by aminopeptidase P and dipeptidyl peptidase IV, may be impaired in individuals with angiotensin-converting Enzyme Inhibitor–associated angioedema. This case-control study tested the hypothesis that dipeptidyl peptidase IV activity and antigen are decreased in sera of patients with a history of angiotensin-converting Enzyme Inhibitor–associated angioedema. Fifty subjects with a history of angiotensin-converting Enzyme Inhibitor–associated angioedema and 176 angiotensin-converting Enzyme Inhibitor–exposed control subjects were ascertained. Sera were assayed for angiotensin-converting Enzyme activity, aminopeptidase P activity, aminopeptidase N activity, dipeptidyl peptidase IV activity, and antigen and the ex vivo degradation half-lives of bradykinin, des-Arg 9 -bradykinin, and substance P in a subset. The prevalence of smoking was increased and of diabetes decreased in case versus control subjects. Overall, dipeptidyl peptidase IV activity (26.6±7.8 versus 29.6±7.3 nmol/mL per minute; P =0.026) and antigen (465.8±260.8 versus 563.1±208.6 ng/mL; P =0.017) were decreased in sera from individuals with angiotensin-converting Enzyme Inhibitor–associated angioedema compared with angiotensin-converting Enzyme Inhibitor–exposed control subjects without angioedema. Dipeptidyl peptidase IV activity (21.5±4.9 versus 29.8±6.7 nmol/mL per minute; P =0.001) and antigen (354.4±124.7 versus 559.8±163.2 ng/mL; P =0.003) were decreased in sera from cases collected during angiotensin-converting Enzyme inhibition but not in the absence of angiotensin-converting Enzyme inhibition. The degradation half-life of substance P correlated inversely with dipeptidyl peptidase IV antigen during angiotensin-converting Enzyme inhibition. Environmental or genetic factors that reduce dipeptidyl peptidase IV activity may predispose individuals to angioedema.
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Dipeptidyl Peptidase IV in Angiotensin-Converting Enzyme Inhibitor–Associated Angioedema
Hypertension, 2007Co-Authors: James Brian Byrd, Karine Touzin, Saba Sile, James V Gainer, Chang Yu, John H Nadeau, Albert Adam, Nancy J BrownAbstract:Angioedema is a potentially life-threatening adverse effect of angiotensin-converting Enzyme Inhibitors. Bradykinin and substance P, substrates of angiotensin-converting Enzyme, increase vascular permeability and cause tissue edema in animals. Studies indicate that amino-terminal degradation of these peptides, by aminopeptidase P and dipeptidyl peptidase IV, may be impaired in individuals with angiotensin-converting Enzyme Inhibitor–associated angioedema. This case-control study tested the hypothesis that dipeptidyl peptidase IV activity and antigen are decreased in sera of patients with a history of angiotensin-converting Enzyme Inhibitor–associated angioedema. Fifty subjects with a history of angiotensin-converting Enzyme Inhibitor–associated angioedema and 176 angiotensin-converting Enzyme Inhibitor–exposed control subjects were ascertained. Sera were assayed for angiotensin-converting Enzyme activity, aminopeptidase P activity, aminopeptidase N activity, dipeptidyl peptidase IV activity, and antigen and the ex vivo degradation half-lives of bradykinin, des-Arg 9 -bradykinin, and substance P in a subset. The prevalence of smoking was increased and of diabetes decreased in case versus control subjects. Overall, dipeptidyl peptidase IV activity (26.6±7.8 versus 29.6±7.3 nmol/mL per minute; P =0.026) and antigen (465.8±260.8 versus 563.1±208.6 ng/mL; P =0.017) were decreased in sera from individuals with angiotensin-converting Enzyme Inhibitor–associated angioedema compared with angiotensin-converting Enzyme Inhibitor–exposed control subjects without angioedema. Dipeptidyl peptidase IV activity (21.5±4.9 versus 29.8±6.7 nmol/mL per minute; P =0.001) and antigen (354.4±124.7 versus 559.8±163.2 ng/mL; P =0.003) were decreased in sera from cases collected during angiotensin-converting Enzyme inhibition but not in the absence of angiotensin-converting Enzyme inhibition. The degradation half-life of substance P correlated inversely with dipeptidyl peptidase IV antigen during angiotensin-converting Enzyme inhibition. Environmental or genetic factors that reduce dipeptidyl peptidase IV activity may predispose individuals to angioedema.
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angiotensin converting Enzyme Inhibitor associated angioedema
Immunology and Allergy Clinics of North America, 2006Co-Authors: James Brian Byrd, Albert Adam, Nancy J BrownAbstract:Angioedema, characterized by swelling of the lips, face, and tongue, occurs in anywhere from 0.1% to 6% of angiotensin-converting Enzyme (ACE) Inhibitor users. The incidence is more common in black Americans than in white Americans, in women than in men, and in smokers than in nonsmokers. The remitting and relapsing nature of ACE Inhibitor-associated angioedema can confound clinical recognition of the adverse event but also provides clues to its causes. Defective degradation of vasoactive peptide substrates of ACE, such as bradykinin or substance P, may contribute via non-ACE pathways to the pathogenesis of ACE Inhibitor-associated angioedema.
Albert Adam - One of the best experts on this subject based on the ideXlab platform.
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acute hypotensive transfusion reaction during liver transplantation in a patient on angiotensin converting Enzyme Inhibitors from low aminopeptidase p activity
Liver Transplantation, 2008Co-Authors: Cataldo Doria, Albert Adam, Elia Elia, Yoogoo Kang, Anik Desormeaux, Carlo B Ramirez, Adam M Frank, Fabrizio Di Francesco, Jay H HermanAbstract:Acute hypotensive transfusion reactions are newly characterized transfusion reactions in which hypotension is the prominent feature. The pathophysiology of acute hypotensive transfusion reactions is related to the bradykinin function and its metabolism. A liver transplant recipient on treatment with an angiotensin converting Enzyme Inhibitor developed sudden hypotension, that is, systolic pressure of 60 mm Hg, after receiving 200 mL of a blood product mixture without significant surgical blood loss. He responded to the resuscitation measure, although hypotension developed again after a challenge transfusion of 200 mL of the blood mixture. A severe hypotensive reaction to the blood transfusion and diffuse bleeding from the dissection surfaces forced the transplantation to be aborted after the common bile duct had been divided. We hypothesized that the patient had an acute hypotensive transfusion reaction due to disordered bradykinin metabolism. Analysis of his blood showed low levels of both angiotensin converting Enzyme and aminopeptidase P Enzyme activity, confirming that the patient experienced an acute hypotensive transfusion reaction that was due to the use of the angiotensin converting Enzyme Inhibitor and was precipitated by an abnormality in the metabolic Enzyme pathway. It is recommended to discontinue angiotensin converting Enzyme Inhibitors and switch to a different class of antihypertensive medications for patients with a high Model for End-Stage Liver Disease score on the waiting list for liver transplantation. Liver Transpl 14:684–687, 2008. © 2008 AASLD.
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dipeptidyl peptidase iv in angiotensin converting Enzyme Inhibitor associated angioedema
Hypertension, 2008Co-Authors: James Brian Byrd, Karine Touzin, Saba Sile, James V Gainer, Chang Yu, John H Nadeau, Albert Adam, Nancy J BrownAbstract:Angioedema is a potentially life-threatening adverse effect of angiotensin-converting Enzyme Inhibitors. Bradykinin and substance P, substrates of angiotensin-converting Enzyme, increase vascular permeability and cause tissue edema in animals. Studies indicate that amino-terminal degradation of these peptides, by aminopeptidase P and dipeptidyl peptidase IV, may be impaired in individuals with angiotensin-converting Enzyme Inhibitor–associated angioedema. This case-control study tested the hypothesis that dipeptidyl peptidase IV activity and antigen are decreased in sera of patients with a history of angiotensin-converting Enzyme Inhibitor–associated angioedema. Fifty subjects with a history of angiotensin-converting Enzyme Inhibitor–associated angioedema and 176 angiotensin-converting Enzyme Inhibitor–exposed control subjects were ascertained. Sera were assayed for angiotensin-converting Enzyme activity, aminopeptidase P activity, aminopeptidase N activity, dipeptidyl peptidase IV activity, and antigen and the ex vivo degradation half-lives of bradykinin, des-Arg 9 -bradykinin, and substance P in a subset. The prevalence of smoking was increased and of diabetes decreased in case versus control subjects. Overall, dipeptidyl peptidase IV activity (26.6±7.8 versus 29.6±7.3 nmol/mL per minute; P =0.026) and antigen (465.8±260.8 versus 563.1±208.6 ng/mL; P =0.017) were decreased in sera from individuals with angiotensin-converting Enzyme Inhibitor–associated angioedema compared with angiotensin-converting Enzyme Inhibitor–exposed control subjects without angioedema. Dipeptidyl peptidase IV activity (21.5±4.9 versus 29.8±6.7 nmol/mL per minute; P =0.001) and antigen (354.4±124.7 versus 559.8±163.2 ng/mL; P =0.003) were decreased in sera from cases collected during angiotensin-converting Enzyme inhibition but not in the absence of angiotensin-converting Enzyme inhibition. The degradation half-life of substance P correlated inversely with dipeptidyl peptidase IV antigen during angiotensin-converting Enzyme inhibition. Environmental or genetic factors that reduce dipeptidyl peptidase IV activity may predispose individuals to angioedema.
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Dipeptidyl Peptidase IV in Angiotensin-Converting Enzyme Inhibitor–Associated Angioedema
Hypertension, 2007Co-Authors: James Brian Byrd, Karine Touzin, Saba Sile, James V Gainer, Chang Yu, John H Nadeau, Albert Adam, Nancy J BrownAbstract:Angioedema is a potentially life-threatening adverse effect of angiotensin-converting Enzyme Inhibitors. Bradykinin and substance P, substrates of angiotensin-converting Enzyme, increase vascular permeability and cause tissue edema in animals. Studies indicate that amino-terminal degradation of these peptides, by aminopeptidase P and dipeptidyl peptidase IV, may be impaired in individuals with angiotensin-converting Enzyme Inhibitor–associated angioedema. This case-control study tested the hypothesis that dipeptidyl peptidase IV activity and antigen are decreased in sera of patients with a history of angiotensin-converting Enzyme Inhibitor–associated angioedema. Fifty subjects with a history of angiotensin-converting Enzyme Inhibitor–associated angioedema and 176 angiotensin-converting Enzyme Inhibitor–exposed control subjects were ascertained. Sera were assayed for angiotensin-converting Enzyme activity, aminopeptidase P activity, aminopeptidase N activity, dipeptidyl peptidase IV activity, and antigen and the ex vivo degradation half-lives of bradykinin, des-Arg 9 -bradykinin, and substance P in a subset. The prevalence of smoking was increased and of diabetes decreased in case versus control subjects. Overall, dipeptidyl peptidase IV activity (26.6±7.8 versus 29.6±7.3 nmol/mL per minute; P =0.026) and antigen (465.8±260.8 versus 563.1±208.6 ng/mL; P =0.017) were decreased in sera from individuals with angiotensin-converting Enzyme Inhibitor–associated angioedema compared with angiotensin-converting Enzyme Inhibitor–exposed control subjects without angioedema. Dipeptidyl peptidase IV activity (21.5±4.9 versus 29.8±6.7 nmol/mL per minute; P =0.001) and antigen (354.4±124.7 versus 559.8±163.2 ng/mL; P =0.003) were decreased in sera from cases collected during angiotensin-converting Enzyme inhibition but not in the absence of angiotensin-converting Enzyme inhibition. The degradation half-life of substance P correlated inversely with dipeptidyl peptidase IV antigen during angiotensin-converting Enzyme inhibition. Environmental or genetic factors that reduce dipeptidyl peptidase IV activity may predispose individuals to angioedema.
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angiotensin converting Enzyme Inhibitor associated angioedema
Immunology and Allergy Clinics of North America, 2006Co-Authors: James Brian Byrd, Albert Adam, Nancy J BrownAbstract:Angioedema, characterized by swelling of the lips, face, and tongue, occurs in anywhere from 0.1% to 6% of angiotensin-converting Enzyme (ACE) Inhibitor users. The incidence is more common in black Americans than in white Americans, in women than in men, and in smokers than in nonsmokers. The remitting and relapsing nature of ACE Inhibitor-associated angioedema can confound clinical recognition of the adverse event but also provides clues to its causes. Defective degradation of vasoactive peptide substrates of ACE, such as bradykinin or substance P, may contribute via non-ACE pathways to the pathogenesis of ACE Inhibitor-associated angioedema.