Biological target · Enzyme

Angiotensin-converting enzyme (ACE)

Also known as: ACE, kininase II, peptidyl dipeptidase A

The enzyme on the surface of blood-vessel lining cells, above all in the lungs, that converts inactive angiotensin I into angiotensin II and also breaks down bradykinin. ACE inhibitors (lisinopril, ramipril) block it, lowering blood pressure and protecting the heart and kidneys.

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Kind
enzyme
Also called
ACE, kininase II, peptidyl dipeptidase A
Where it is found
The luminal surface of endothelial cells lining blood vessels, particularly the pulmonary capillaries; also kidney tubules, gut, brain and testis.

What it does

Renin from the kidney clips angiotensinogen into angiotensin I, which is inactive until ACE removes two amino acids to make angiotensin II. ACE sits on endothelial cells throughout the circulation, most densely in the pulmonary capillaries, so a single pass through the lungs activates the hormone. The same enzyme inactivates bradykinin, a peptide that widens vessels and, in the airways, irritates cough receptors. Inhibiting ACE therefore lowers angiotensin II (less constriction, less aldosterone, lower glomerular pressure) and raises bradykinin (extra vasodilation, but also the dry cough that affects around one in ten people and the rare but dangerous swelling of angioedema). Because angiotensin II can still be made by other enzymes, ARBs that block the receptor itself are the alternative when the cough is intolerable.

Role in the body

Activation of the renin–angiotensin system (angiotensin II production) and inactivation of bradykinin.

Medicines that act on it

Drug classes

Conditions it is involved in

Educational content. Describes what a receptor, enzyme, channel or pathway does and which medicines act on it. Educational, not prescribing advice.