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Related Concept Videos

Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors01:30

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Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
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Hypertension II: Pathophysiology01:29

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Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
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Antihypertensive Drugs: Direct Renin Inhibitors01:25

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The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
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Antihypertensive Drugs: Angiotensin II Receptor Blockers01:30

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In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Molecules in pathogenesis: angiotensin converting enzyme 2 (ACE2).

Owen Wiese1, Annalise E Zemlin1, Tahir S Pillay2,3

  • 1Division of Chemical Pathology, Faculty of Health Sciences, Stellenbosch University & National Health Laboratory Service (NHLS), Cape Town, South Africa.

Journal of Clinical Pathology
|August 8, 2020
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Summary

Angiotensin-converting enzyme 2 (ACE2) plays a crucial role in blood pressure regulation and opposes the ACE pathway. ACE2 is also the entry point for SARS-CoV-2, impacting COVID-19 progression.

Keywords:
infectionsinflammationkidneylungviruses

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Area of Science:

  • Biochemistry
  • Genetics
  • Physiology

Background:

  • The renin-angiotensin system (RAS) is primarily known for blood pressure regulation.
  • Angiotensin-converting enzyme 2 (ACE2) is a key enzyme in the RAS with diverse physiological roles.
  • ACE2 is the cellular receptor for SARS-CoV-2, the virus causing COVID-19.

Purpose of the Study:

  • To describe the genetics and functions of ACE2.
  • To explore ACE2's physiological functions within the RAS.
  • To discuss ACE2's role in disease pathophysiology.

Main Methods:

  • Literature review of ACE2 genetics, function, and disease association.
  • Analysis of ACE2's role in the renin-angiotensin system.
  • Discussion of ACE2's involvement in SARS-CoV-2 infection and COVID-19.

Main Results:

  • ACE2 opposes the vasopressor ACE pathway by converting Ang I to Ang (1-9) and Ang II to Ang (1-7), initiating vasodilation.
  • ACE2 is expressed in vital organs including lungs, heart, and kidneys.
  • ACE2 knockout mice show increased susceptibility to acute respiratory distress and hypertensive nephropathy.

Conclusions:

  • ACE2 has protective effects in the lung and kidney.
  • SARS-CoV-2 binding and subsequent ACE2 downregulation may explain COVID-19 sequelae.
  • Understanding ACE2's function is critical for managing RAS-related diseases and viral infections.