Renin-angiotensin system and cancer: epidemiology, cell signaling, genetics and epigenetics

B Afsar1, R E Afsar2, L A Ertuglu3

  • 1Department of Internal Medicine, Division of Nephrology, Suleyman Demirel University, School of Medicine, 71100, Isparta, Turkey. afsarbrs@yahoo.com.

Insights

Blocking the renin-angiotensin system (RAS) with ACE inhibitors or ARBs may impact cancer development. This review explores RAS receptors, epidemiology, and pathogenesis in various cancers.

Area of Science:

  • Oncology
  • Cardiovascular Pharmacology

Background:

  • Cancer presents a growing global health and economic burden.
  • The renin-angiotensin system (RAS) is crucial for cardiovascular regulation, with inhibitors widely used for hypertension and heart failure.
  • Emerging evidence links RAS activation and blockade to diverse cancer types, though findings are conflicting.

Purpose of the Study:

  • To review the multifaceted roles of RAS receptors in cancer development.
  • To synthesize epidemiological and pathogenetic data concerning RAS blockade and cancer.
  • To elucidate the influence of RAS on cancer through cell signaling, apoptosis, and genetic/epigenetic factors.

Main Methods:

  • Literature review of epidemiological and experimental studies.
  • Analysis of data on RAS receptor subtypes and their association with cancer.
  • Examination of molecular mechanisms including cell signaling, apoptosis, and genetic/epigenetic alterations.

Main Results:

  • Studies indicate RAS blockade can be protective in some cancers.
  • Contradictory findings suggest RAS blockade may be unrelated or detrimental in other cancer types.
  • Discrepancies may arise from the diverse roles of different RAS receptors and effectors.

Conclusions:

  • The relationship between RAS blockade and cancer is complex and context-dependent.
  • Understanding specific RAS receptor roles is critical for predicting outcomes.
  • Further research into RAS signaling pathways in cancer pathogenesis is warranted.

Related Concept Videos

Hormonal Regulation01:33

Hormonal Regulation

The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
35.2K
mTOR Signaling and Cancer Progression03:03

mTOR Signaling and Cancer Progression

The mammalian target of rapamycin or mTOR protein was discovered in 1994 due to its direct interaction with rapamycin. The protein gets its name from a yeast homolog called TOR. The mTOR protein complex in mammalian cells plays a major role in balancing anabolic processes such as the synthesis of proteins, lipids, and nucleotides and catabolic processes, such as autophagy in response to environmental cues, such as availability of nutrients and growth factors.
The mTOR pathway or the...
4.5K
Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

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,...
538
Mitogens and the Cell Cycle02:38

Mitogens and the Cell Cycle

Mitogens and their receptors play a crucial role in controlling the progression of the cell cycle. However, the loss of mitogenic control over cell division leads to tumor formation. Therefore, mitogens and mitogen receptors play an important role in cancer research. For instance, the epidermal growth factor (EGF) - a type of mitogen and its transmembrane receptor (EGFR), decides the fate of the cell's proliferation. When EGF binds to EGFR, a member of the ErbB family of tyrosine kinase...
7.5K
Adaptive Mechanisms in Cancer Cells02:53

Adaptive Mechanisms in Cancer Cells

Cancer cells accumulate genetic changes at an abnormally rapid rate due to the defects in the DNA repair mechanisms. From an evolutionary perspective, such genetic instability is advantageous for cancer development. Mutant cell lines accumulate a series of beneficial mutations that contribute to their progression into cancer.
Some of the advantages that cancer cells have on normal cells include - enhanced ability to divide without terminally differentiating, induce new blood vessel formation,...
6.7K
Hormonal Regulation of Blood Pressure01:17

Hormonal Regulation of Blood Pressure

Endocrinal or hormonal intervention in the cardiovascular system is predominantly exerted by the catecholamines - epinephrine and norepinephrine, as well as a slew of hormones that interact with renal function to modulate blood volume.
Epinephrine and Norepinephrine
The adrenal medulla releases epinephrine and norepinephrine, catecholamines that enhance and extend the sympathetic or "fight or flight" physiological response. These hormones escalate heart rate and the force of contraction...
5.5K