The incidence of basal cell carcinoma (BCC) is significantly reduced in
individuals treated with inhibitors of angiotensin I-converting enzyme
(ACE) that produces angiotensin II. The objective of this study was to
investigate the possible association of a functional polymorphism in the
ACE gene, which affects its transcription, with risk for BCC. In DNA
samples of 92 patients with BCC and 103 healthy controls of Greek origin
and comparable age and gender, we studied the ACE gene
insertion/deletion (I/D) polymorphism. Fisher’s exact test was used for
comparison of allele and genotype frequencies between the control and
patients’ groups. The detected low expression I allele frequency in the
group of BCC patients was significantly decreased compared to controls
(15.8 vs. 31.1 %, respectively; P = 0.001). ID heterozygotes exhibited
3.06 times lower BCC risk, compared with DD homozygotes (P = 0.001; OR =
0.327, 95 % CI = 0.174-0.615). The protective role of I allele was
particularly prominent in women (P = 0.007, OR = 0.299, 95 % CI =
0.125-0.716), while for men it exhibited a marginal level (P = 0.041).
These findings indicate that the low expression ACE I allele carriers
have a decreased risk for BCC. The protective effect of the ID genotype
against BCC may be explained by a possible underlying mechanism
involving the effect of produced angiotensin II levels on its receptors
due to putatively different binding affinity