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

Endocrinologia, diabetes y nutricion·2021
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Renin-angiotensin system: Basic and clinical aspects-A general perspective.

Rafael Antonio Vargas Vargas1, Jesús María Varela Millán1, Esperanza Fajardo Bonilla2

  • 1Universidad Militar Nueva Granada, Facultad de medicina, Bogotá, Colombia; Universidad Santo Tomás, Maestría en actividad física para la salud, Bogotá, Colombia.

Endocrinologia, Diabetes Y Nutricion
|March 2, 2022
PubMed
Summary

The complex renin-angiotensin system (RAS) has classic and alternative pathways impacting cardiovascular and chronic diseases. Further research is needed to fully understand its multifaceted roles and therapeutic potential.

Keywords:
ACE2ACEIAngiotensin 1-7Angiotensin IIAngiotensina 1-7ECA2IECAReninRenina angiotensina ii

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Area of Science:

  • Endocrinology
  • Cardiovascular Physiology
  • Molecular Biology

Background:

  • The renin-angiotensin system (RAS) is a complex hormonal network crucial for regulating cardiovascular function.
  • Historically, RAS research focused on its role in cardiovascular diseases, leading to targeted pharmacological treatments.
  • Recent discoveries reveal a more intricate RAS with two antagonistic subsystems and tissue-specific roles.

Purpose of the Study:

  • To present a comprehensive narrative review of the preclinical and clinical aspects of the RAS.
  • To highlight the expanded understanding of the RAS beyond cardiovascular regulation.
  • To identify areas requiring further investigation within the RAS.

Main Methods:

  • Narrative review of existing preclinical and clinical literature on the RAS.
  • Synthesis of evidence regarding the dual subsystem model of the RAS.
  • Exploration of the RAS's involvement in inflammation, hypertrophy, fibrosis, and chronic diseases.

Main Results:

  • The RAS comprises classic and alternative subsystems with generally opposing effects, maintaining physiological balance.
  • The classic RAS is implicated in pathologies characterized by inflammation, hypertrophy, and fibrosis, contributing to chronic diseases.
  • Local RAS exist in various tissues, and the system plays a role in COVID-19 severity via angiotensin-converting enzyme 2 interactions.

Conclusions:

  • The RAS is a highly complex system with significant implications for multiple body systems and chronic disease development.
  • Understanding the interplay between RAS subsystems and local tissue RAS is critical for comprehending disease pathogenesis.
  • Further research is essential to elucidate the full spectrum of RAS functions and develop novel therapeutic strategies.