Angiotensin-Converting Enzyme in Patients With Early-Stage Psychosis

Do angiotensin-converting enzyme (ACE) levels differ between healthy individuals and patients with psychosis, particularly those with treatment-resistant psychosis? In this cross-sectional study of 200 individuals, ACE protein levels were reduced in both cerebrospinal fluid and serum in patients with early-stage psychosis compared with healthy controls. Patients with treatment-resistant psychosis demonstrated higher ACE genetic burden and lower serum ACE protein levels but no changes in enzymatic activity compared with patients with non–treatment-resistant psychosis. These findings suggest that the reduction of ACE protein is associated with psychosis, particularly treatment-resistant psychosis, potentially through its noncanonical, nonenzymatic functions.

Corresponding Author: Akira Sawa, MD, Department of Psychiatry, Johns Hopkins University School of Medicine, 600 N Wolfe St, Meyer 3-166, Baltimore, MD 21287 (asawa1@jhmi.edu).

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