Role of Angiotensin-Converting Enzyme Polymorphisms in the Pathogenesis and Outcomes of Neonatal Sepsis

Abstract

Neonatal sepsis remains a critical concern in neonatology, with significant morbidity and mortality worldwide. Recent advances in genetic research have highlighted the potential role of angiotensin-converting enzyme (ACE) polymorphisms in influencing susceptibility, disease progression, and outcomes in neonatal sepsis. This review aims to consolidate current evidence on the association between ACE gene polymorphisms, particularly the insertion/deletion (I/D) polymorphism, and neonatal sepsis. We explore the underlying molecular mechanisms, including ACE's role in the renin-angiotensin system, inflammation, and immune response modulation. Furthermore, we discuss findings from epidemiological studies examining the prevalence of ACE polymorphisms in septic neonates, as well as their potential use as biomarkers for risk stratification and therapeutic targeting. Challenges such as genetic variability across populations, small sample sizes, and heterogeneity in study designs are also addressed. By integrating genetic insights with clinical implications, this review provides a comprehensive understanding of ACE polymorphisms in neonatal sepsis and identifies gaps for future research to improve prevention and management strategies.