[The evaluation of serum angiotensin-converting enzyme in silicosis and silicotuberculosis]. / Valutazione dell'angiotensin converting enzyme sierico nella silicosi e silicotubercolosi polmonare.

In order to verify the value of the determination of serum angiotensin converting enzyme (ACEs) in the assessment of silicosis and silicotuberculosis, we studied 105 subjects: 61 suffering from silicosis, 12 from silicotuberculosis, 19 from tuberculosis and 13 from chronic obstructive pulmonary disease (COPD). The patients with silicosis and silicotuberculosis were classified into two categories on the basis of the radiological pattern of pneumoconiosis according to the ILO 1980 CLASSIFICATION: mild silicosis (from 1/1 to 2/1) and severe silicosis (from 2/2 to 3+ and/or conglomerate masses). ACEs values were higher in the subjects suffering from silicotuberculosis and silicosis; in the latter, however, we did not find any significant relation between ACEs values and the radiological pattern. The lowest values of ACEs were found in the COPD group. Our data showed a statistically significant difference between silicotic or silicotuberculotic patients and the COPD group (p less than 0.05). It can be supposed that COPD, which was also found in all subjects suffering from silicosis or silicotuberculosis, might have caused an underestimation of the observed ACEs values which, however, were higher than normal. This increase might have been caused by a numerical or functional enhancement of the macrophages, which produce ACE and play an important role in the pathogenesis of such diseases.

Determination of antibodies to Borrelia burgdorferi in sarcoidosis.

Borrelia burgdorferi, i.e. the etiologic agent of Lyme disease, has been causatively linked to sarcoidosis. To evaluate the possible role of this spirochete in the pathogenesis of sarcoidosis we tested for the presence of antibodies to B. burgdorferi on serum samples obtained from 21 sarcoid patients living in an Italian mountain area where Lyme borreliosis is endemic. No patient showed antibodies to B. burgdorferi. Our data does not substantiate the hypothesis that sarcoidosis may be a borreliosis.