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Therapeutic targets of renin-angiotensin system in ocular disorders
Rajesh Choudhary1, Mandeep Singh Kapoor1, Amrita Singh1
1Department of Pharmacology, Institute of Pharmaceutical Sciences, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur Chhattisgarh, India.
Purpose:
To review current literature on the renin-angiotensin system (RAS)-mediated pathogenic mechanisms and therapeutic targets in ocular diseases.
Methods:
A comprehensive literature survey was performed on PubMed, Scopus, and Google Scholar databases published from 1977 to 2016. The search terms were a RAS, angiotensin, angiotensin receptor, prorenin, pro (renin) receptor, angiotensin converting enzyme inhibitor, angiotensin receptor blocker associated with ocular disorders like cataract, glaucoma, diabetic retinopathy (DR), macular degeneration, and uveitis. Articles were reviewed on the basis of the association between ocular disorders and RAS and relevant articles were discussed.
Results:
The literature revealed that the individual RAS components including renin, angiotensins, angiotensin converting enzymes, and RAS receptors have been expressed in the specific ocular tissues like retina, choroid, and ciliary body. The activation of both circulatory and local RAS potentiate the various inflammatory and angiogenic signaling molecules, including vascular endothelial growth factor (VEGF), extracellular signal-regulated kinase, and advanced glycation end products (AGE) in the ocular tissues and leads to several blinding disorders like DR, glaucoma, and macular degeneration. The classical and newer RAS inhibitors have illustrated protective effects on blinding disorders, including DR, glaucoma, macular degeneration, uveitis, and cataract.
Conclusions:
The RAS components are present in the extrarenal tissues including ocular tissue and have an imperative role in the ocular pathophysiology. The clinical studies are needed to show the role of therapeutic modalities targeting RAS in the treatment of different ocular disorders.
Insights
The renin-angiotensin system (RAS) plays a key role in eye diseases like diabetic retinopathy and glaucoma. Targeting RAS with inhibitors shows promise for treating these blinding conditions.
Area of Science:
- Ophthalmology
- Cardiovascular Research
- Molecular Biology
Background:
- The renin-angiotensin system (RAS) is crucial in regulating blood pressure.
- Emerging evidence suggests RAS involvement in ocular pathophysiology.
Purpose of the Study:
- To review literature on RAS-mediated mechanisms in eye diseases.
- To identify therapeutic targets within the RAS for ocular disorders.
Main Methods:
- Comprehensive literature search of PubMed, Scopus, and Google Scholar (1977-2016).
- Keywords included RAS components and ocular conditions like diabetic retinopathy, glaucoma, and uveitis.
- Articles reviewed for RAS association with ocular disorders.
Main Results:
- RAS components are expressed in ocular tissues (retina, choroid, ciliary body).
- RAS activation promotes inflammation and angiogenesis, contributing to blinding diseases.
- RAS inhibitors demonstrate protective effects against diabetic retinopathy, glaucoma, and macular degeneration.
Conclusions:
- RAS is integral to ocular pathophysiology beyond its systemic roles.
- Further clinical studies are required to validate RAS-targeting therapies for ocular diseases.
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