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We read the recent paper by Garg et al 1 with interest. The renin-angiotensin system (RAS) has an established role in the pathogenesis of fibrosis and inflammation in renal and cardiovascular disease. However, high concentrations of ACE and renin are also found in the small and large intestines. These, along with angiotensin II, are elevated further within the inflamed colonic tissue of patients with IBD, compared with healthy controls.1 2 ACE inhibitor (ACE-I) or angiotensin II receptor blocker (ARB) therapy may inhibit the effects of RAS in IBD. In their study Garg et al 1 demonstrated lower rates of hospitalisation and surgery among patients with IBD receiving these drugs. We aimed to examine the relationship between ACE-I …
Contributors DJG and ACF conceived and drafted the study. DJG, KMF and DH collected all data. DJG and ACF analysed and interpreted the data. KMF drafted the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; internally peer reviewed.