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Renin-angiotensin system: Basic and clinical aspects-A general perspective.

Endocrinologia, diabetes y nutricion·2022

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Renin-angiotensin system: Basic and clinical aspects-A general perspective.

Rafael Antonio Vargas Vargas^1,2, Jesús María Varela Millán^1,2, Esperanza Fajardo Bonilla¹

¹Universidad Militar Nueva Granada, Facultad de medicina, Bogotá, Colombia.

Endocrinologia, Diabetes Y Nutricion

|November 1, 2021

Summary

The complex renin-angiotensin system (RAS) has two subsystems, classic and alternative, impacting cardiovascular and chronic diseases. Further research is needed to clarify its full role in health and conditions like COVID-19.

Keywords:

ACE2 ACEI Angiotensin 1-7 Angiotensin II Renin

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Area of Science:

Endocrinology and Physiology
Cardiovascular Research
Infectious Diseases

Background:

The renin-angiotensin system (RAS) is a complex hormonal network crucial for regulating cardiovascular function and related diseases.
Recent discoveries reveal two antagonistic RAS subsystems: the classic and alternative, influencing inflammation, hypertrophy, and fibrosis.
Local RAS in tissues and its role in COVID-19 pathogenesis, particularly ACE2 interaction, highlight its systemic importance.

Purpose of the Study:

To provide a narrative review of the preclinical and clinical aspects of the renin-angiotensin system.
To discuss the complexity of the RAS, including its classic and alternative subsystems.
To identify areas for future research and clarify unresolved aspects of RAS function.

Main Methods:

Narrative review of existing preclinical and clinical literature on the RAS.
Synthesis of current understanding regarding RAS subsystems and their roles in disease.
Identification of knowledge gaps and future research directions.

Main Results:

The RAS is more complex than previously thought, featuring antagonistic classic and alternative pathways.
The classic RAS is implicated in inflammatory and fibrotic pathologies contributing to chronic diseases.
RAS plays a role in COVID-19 severity via angiotensin-converting enzyme 2 (ACE2) interactions in the respiratory system.

Conclusions:

The dual nature of the RAS necessitates a deeper understanding of its regulatory balance.
Further investigation into tissue-specific RAS and its interaction with viral infections like COVID-19 is crucial.
Clarifying the multifaceted roles of the RAS is essential for developing novel therapeutic strategies.