The Kallikrein-Kinin System and Cardiovascular Diseases: A Narrative Review

Area of Science:

• Physiology
• Biochemistry
• Pharmacology

Background:

• The plasma kallikrein-kinin system (KKS) is integral to cardiovascular physiology, regulating blood pressure, inflammation, and coagulation.
• Kallistatin, an endogenous inhibitor, possesses anti-inflammatory, anti-oxidative, and anti-atherosclerotic effects.
• Plasma kallikrein modulates multiple proteolytic cascades, including coagulation, fibrinolysis, renin-angiotensin system (RAS), and complement pathways.

Purpose of the Study:

• To review the role of the plasma kallikrein-kinin system (KKS) in human physiology, particularly within the cardiovascular system.
• To explore the intricate cross-talk between the KKS and the renin-angiotensin system (RAS).
• To highlight the therapeutic potential of targeting these interacting systems.

Main Methods:

• This study is a narrative review of existing literature.
• It synthesizes information on the KKS, its components, and its interactions with other physiological systems.
• The review analyzes the impact of these interactions on cardiovascular disease pathogenesis.

Main Results:

• Plasma kallikrein plays a dual role, offering cardioprotection at normal levels but exacerbating cardiovascular disease when hyperactive.
• Cross-talk between RAS and KKS is evident, with reciprocal regulation influencing conditions like hypertension and thrombosis.
• Angiotensin II upregulates bradykinin receptors, demonstrating a direct link between the two systems.

Conclusions:

• The interplay between the RAS and KKS is critical in various physiological and pathological conditions.
• Targeting the cross-talk between these systems offers a promising strategy for developing novel therapeutics for cardiovascular diseases.
• Further research into these interactions could lead to more effective treatments for thrombosis, inflammation, and blood pressure dysregulation.