ACE

Chr 17AR

angiotensin I converting enzyme

Also known as: ACE1, CD143, DCP, DCP1

This gene encodes an enzyme involved in blood pressure regulation and electrolyte balance. It catalyzes the conversion of angiotensin I into a physiologically active peptide angiotensin II. Angiotensin II is a potent vasopressor and aldosterone-stimulating peptide that controls blood pressure and fluid-electrolyte balance. This angiotensin converting enzyme (ACE) also inactivates the vasodilator protein, bradykinin. Accordingly, the encoded enzyme increases blood pressure and is a drug target of ACE inhibitors, which are often prescribed to reduce blood pressure. This enzyme additionally plays a role in fertility through its ability to cleave and release GPI-anchored membrane proteins in spermatozoa. Many studies have associated the presence or absence of a 287 bp Alu repeat element in this gene with the levels of circulating enzyme. This polymorphism, as well as mutations in this gene, have been implicated in a wide variety of diseases including cardiovascular pathophysiologies, psoriasis, renal disease, stroke, and Alzheimer's disease. Regulation of the homologous ACE2 gene may be involved in progression of disease caused by several human coronaviruses, including SARS-CoV and SARS-CoV-2. Alternative splicing results in multiple transcript variants encoding both somatic (sACE) and male-specific testicular (tACE) isoforms. [provided by RefSeq, Sep 2020]

Primary Disease Associations & Inheritance

[Angiotensin I-converting enzyme, benign serum increase]MIM #621420
{Microvascular complications of diabetes 3}MIM #612624
Renal tubular dysgenesisMIM #267430
AR
UniProtIschemic stroke
UniProtIntracerebral hemorrhage
12
Active trials
487
ClinVar variants
30
Pathogenic / LP
-0.7
Missense Z
1.08
LOEUF
11
Pubs (2 yr)
Clinical SummaryACE
🧬
Gene-Disease Validity (ClinGen)
renal tubular dysgenesis - ACE · ARDefinitive

Definitive — sufficient evidence for diagnostic panels

Population Constraint (gnomAD)
Low constraint (pLI 0.00) — loss-of-function variants are relatively tolerated in the population.
📋
ClinVar Variants
30 Pathogenic / Likely Pathogenic· 300 VUS of 487 total submissions
💊
Clinical Trials
12 active or recruiting trials — potential therapeutic options may be available
📖
GeneReview available — ACE
Authoritative clinical overview · Recommended first read
Open GeneReview ↗
Some data sources returned errors (1)

ensembl: TimeoutError: The operation was aborted due to timeout

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Tolerant — LoF & missense variants common in population
LoF Constraint?LOEUF (Loss-of-function Observed/Expected Upper bound Fraction) is the upper bound of the 90% CI for LoF OE — the preferred gnomAD v4 metric. Lower = more intolerant to LoF. LOEUF < 0.35 = highly constrained.
1.08LOEUF
pLI 0.000
Z-score 0.98
OE 0.87 (0.711.08)
Tolerant

Highly tolerant — LoF variants common in population

Missense Constraint?Missense Z-score: standard deviations fewer missense variants observed vs. expected. Z > 3.09 (p < 0.001) = gene does not tolerate missense variation. OE missense < 0.6 is also considered constrained.
-0.69Z-score
OE missense 1.07 (1.011.14)
797 obs / 743.8 exp
Tolerant

Tolerant to missense variation

Observed / Expected Ratios?Shaded band = 90% confidence interval. Vertical tick = point estimate. Grey threshold line = gnomAD constraint cutoff for that variant class.
LoF OE?Ratio of observed to expected LoF variants. Upper CI bound (LOEUF) ≤ 0.35 = strong LoF constraint signal.0.87 (0.711.08)
00.351.4
Missense OE?Ratio of observed to expected missense variants. OE ≤ 0.6 = fewer missense variants than expected by chance.1.07 (1.011.14)
00.61.4
Synonymous OE?Control metric — synonymous variants are largely neutral and expected near OE = 1.0. Significant deviation may indicate annotation issues.1.24
01.21.6
LoF obs/exp: 62 / 70.9Missense obs/exp: 797 / 743.8Syn Z: -3.33

ClinVar Variant Classifications

487 submitted variants in ClinVar

Classification Summary

Pathogenic10
Likely Pathogenic20
VUS300
Likely Benign136
Benign11
Conflicting10
10
Pathogenic
20
Likely Pathogenic
300
VUS
136
Likely Benign
11
Benign
10
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
7
0
3
0
10
Likely Pathogenic
13
2
4
1
20
VUS
3
262
22
13
300
Likely Benign
0
12
41
83
136
Benign
0
1
9
1
11
Conflicting
10
Total232777998487

LoF = frameshift, stop gained/lost, canonical splice · Counts from ClinVar esearch · Updated hourly

View in ClinVar →

Protein Context — Lollipop Plot

ACE · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

OMIM — Genotype-Phenotype Relationships

1 OMIM entry

[Angiotensin I-converting enzyme, benign serum increase]

MIM #621420

Molecular basis of disorder known

{Microvascular complications of diabetes 3}

MIM #612624

Molecular basis of disorder known

Renal tubular dysgenesis

MIM #267430

Molecular basis of disorder known

Autosomal recessive
Clinical Literature
Landmark / reviewRecent case evidence
Full-Text Mentions
NLP-detected gene mentions in article bodies · via PubTator3
PubTator3
ACE Inhibitors
Goyal A et al.
2022
Update on ACER.
Miles MF·Alcohol Clin Exp Res (Hoboken)
2024
A Pair of "ACEs".
Hersh EV et al.·J Dent Res
2022
Launching the ACE.
Calvert K et al.·Aust N Z J Obstet Gynaecol
2024
[The shockwave: an ace in the hole?]
Compagnone M et al.·G Ital Cardiol (Rome)
2021
The ACE of spades - Poem.
Schreyer L·Br J Psychiatry
2023
Ace-ylation in the hole.
J Niphakis M et al.·Nat Chem Biol
2022
Top 10 full-text resultsSearch PubTator3 ↗

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

COVID-19Antibody COVID-19

The Role of Obesity in Severe COVID-19 Pathophysiology

RECRUITING
NCT06968442Phase NAFranciscus GasthuisStarted 2025-04-22
Venipuncture
Sarcoidosis

Immunological Mechanisms in Sarcoidosis

RECRUITING
NCT06576505Region StockholmStarted 2024-07-07
peripheral blood sampling, bronchoscopy, upper airway and faeces sampling
Lymphoma, Large B-Cell, Diffuse

Biomarker Driven Intensified ChemoImmunotherapy With Early CNS Prophylaxis

ACTIVE NOT RECRUITING
NCT03293173Phase PHASE2Nordic Lymphoma GroupStarted 2017-08-04
R-CHOEPDA-EPOCH-R
Alport Syndrome

Safety and Efficacy of ACEI in Alport Syndrome Patients With COL4A3/COL4A4/COL4A5 Variants

NOT YET RECRUITING
NCT05133050Phase NAXinhua Hospital, Shanghai Jiao Tong University School of MedicineStarted 2022-01-01
Ramipril
Angio-Oedema Caused by Angiotensin-Converting-Enzyme Inhibitor

Bradykinin-degradating Enzymes Activities in Angiotensin-Converting Enzyme Inhibitors-associated Angioedema

RECRUITING
NCT04763577University Hospital, GrenobleStarted 2021-10-27
Assay of Bradykinin-degradating enzymes.
Food AllergyEosinophilic Esophagitis

Molecular Basis of Food Allergy

ENROLLING BY INVITATION
NCT01832324Children's Hospital of PhiladelphiaStarted 2011-01
Epigenetic Effects of Intranasal SteroidsEnvironmental Exposure

Epigenetic Health Benefits of Budesonide

ACTIVE NOT RECRUITING
NCT04342039Phase PHASE4University of British ColumbiaStarted 2021-01-07
Budesonide NasalPlacebo
Intestinal MicrobiomeProbioticRunners

The Effect of Probiotic Supplementation on the Exercise Performance of Long-distance Runners.

ACTIVE NOT RECRUITING
NCT07411482Phase NAMedical University of GdanskStarted 2023-12-01
probiotics or placeboBox diet
Diabete Type 1Diabete Type 2Prediabetes

Effects of LP-LDL® on Lipid Metabolism, Glycemic Control, Inflammatory Markers, and Cognitive Function in Individuals With Prediabetes and Diabetes Mellitus

NOT YET RECRUITING
NCT07373392Phase NAAalborg UniversityStarted 2026-01-25
Lactobacillus plantarum ECGC 13110402Placebo
Chronic Kidney DiseasesHemodialysis Complication

Clinical Outcomes of Hemodialysis in Brazil (COHEBRA): a Prospective Cohort Study

ENROLLING BY INVITATION
NCT05273424Catholic University of PelotasStarted 2017-06-01
Asthma

Genetic Association With Various Severities, Phenotypes and Endotypes of Asthma.

RECRUITING
NCT06196034Chinese University of Hong KongStarted 2024-03-01
No intervention
Decompensated Cirrhosis

Fecal Microbiome Transplantation in Cirrhosis: Trial in Patients With Decompensated Cirrhosis

NOT YET RECRUITING
NCT06533852Phase PHASE3Consorcio Centro de Investigación Biomédica en Red (CIBER)Started 2024-12
Fecal Microbiome Transplantation (FMT)FMT Placebo