Angiotensin converting enzyme 2 and the kidney.

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Biochemistry

Background:

• Angiotensin-converting enzyme 2 (ACE2) metabolizes angiotensin II (AngII), influencing the kidney's renin-angiotensin system (RAS).
• ACE2 activity is crucial in modulating blood pressure and preventing renal injury, especially when the RAS is upregulated in disease states.

Purpose of the Study:

• To review recent studies on the interplay between ACE2 and the kidney under normal and pathological conditions.
• To highlight the significance of ACE2 function in disease states with upregulated RAS.

Main Methods:

• Review of recent experimental and human studies.
• Analysis of ACE2's role in renal and cardiovascular function.
• Investigation of ACE2 ectodomain shedding as a regulatory mechanism.

Main Results:

• ACE2 plays a key role in renal and cardiovascular function.
• Shedding of ACE2 ectodomain alters enzymatic activity and regulates the RAS.
• Decreased ACE2 activity correlates with increased blood pressure, diabetes, and oxidative stress.
• Increased ACE2 levels appear renoprotective.

Conclusions:

• ACE2 critically modulates renal injury, supported by experimental and human studies.
• Therapeutic strategies targeting increased ACE2 activity and the ACE2-Ang(1-7)-MasR axis show clinical potential.
• These strategies are particularly relevant for diseases involving upregulated renal RAS.