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Association of polymorphisms in the angiotensin-converting enzyme gene with syndromal panic attacks

Molecular Psychiatry volume 13, pages 242–243 (2008)Cite this article

The angiotensin-converting enzyme (ACE) catalyses the conversion of angiotensin I to physiologically active angiotensin II. The angiotensin system is implicated in the control of blood pressure as well as cardiovascular and respiratory functions, and exerts central effects within the brain.1 Recently, a functional role of polymorphisms in the ACE gene was reported in unipolar depression.2 The implication of ACE in anxiety disorders is unclear so far, but its close relation to cardiovascular and respiratory control may suggest a role in the etiology of panic attacks. Three previous genetic association studies focused on the insertion/deletion polymorphism in the ACE gene in patients with panic disorder. A Japanese study failed to detect an effect, whereas two European studies reported a significant association of the less active I allele with panic disorder mainly in the male subgroup of panic patients.3, 4, 5

To further elucidate the role of the ACE in the genetic vulnerability for panic attacks, we first genotyped the 24 single nucleotide polymorphisms (SNPs) covering the ACE gene region (±10 kb) reported in Baghai et al. (2006), in 175 patients with syndromal panic attacks (including panic disorder with and without agoraphobia 87.7%, social and special phobia 13.3%), who were recruited from our Anxiety Disorders Outpatient Clinic, versus 445 healthy controls matched for ethnicity, age and sex (sample 1, Max Planck Institute for Psychiatry (MPI)). Patients and controls underwent a thorough clinical and laboratory examination. The controls were screened for the presence of anxiety and affective disorders using the Composite International Diagnostic Screener6 and excluded in the case of any indication for one of these disorders. The diagnosis in patients was ascertained by trained psychiatrists applying Diagnostic and Statistical Manual of Mental Disorders Version IV (DSM-IV) criteria and the Structured Clinical Interview for DSM-IV (severe combined immuno-deficiency I and II).6 The replication of significant SNPs was performed in a second German sample from the University of Münster, consisting of patients with panic disorder with and without agoraphobia (n=169) and blood donors as controls (n=334) matched for gender and age (sample 2, Münster). Genotyping was performed as described in Baghai et al.2

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Authors and Affiliations

  1. Departrment of Neuroendocrinology, Max Planck Institute of Psychiatry, München, Germany

    A Erhardt, S Lucae, N Kern, P G Unschuld, M Ising, R Lieb, M Uhr, E B Binder, B Müller-Myhsok, M E Keck & F Holsboer

  2. Department of Psychiatry, University of Münster, Münster, Germany

    C Hohoff & J Deckert

  3. Department of Psychiatry, University of Würzburg, Würzburg, Germany

    J Deckert

  4. Department of Psychiatry, University of Göttingen, Göttingen, Germany

    B Bandelow

  5. Department of Psychiatry, University of Bonn, Bonn, Germany

    W Maier

Authors
  1. A Erhardt
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  2. S Lucae
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  3. N Kern
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  4. P G Unschuld
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  5. M Ising
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  6. R Lieb
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  7. M Uhr
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  8. C Hohoff
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  9. J Deckert
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  10. B Bandelow
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  11. W Maier
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  12. E B Binder
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  13. B Müller-Myhsok
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  14. M E Keck
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  15. F Holsboer
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Corresponding author

Correspondence to W Maier.

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Erhardt, A., Lucae, S., Kern, N. et al. Association of polymorphisms in the angiotensin-converting enzyme gene with syndromal panic attacks. Mol Psychiatry 13, 242–243 (2008). https://doi.org/10.1038/sj.mp.4002094

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