Targeting the Renin-Angiotensin-Aldosterone System: Preclinical and Clinical Developments

Area of Science:

• Pharmacology
• Cardiovascular Medicine
• Nephrology

Background:

• The renin-angiotensin-aldosterone system (RAAS) is crucial in managing cardiorenovascular diseases like hypertension and heart failure.
• Established RAAS-targeting drugs include mineralocorticoid receptor antagonists, ACE inhibitors, Angiotensin II receptor blockers, and direct renin inhibitors.

Purpose of the Study:

• To review current pharmacological interventions for both classical and protective RAAS pathways.
• To highlight novel therapeutic strategies for cardiovascular and renal disorders.

Main Methods:

• Literature review of established and emerging RAAS-targeting therapies.
• Analysis of pharmacological modulation of the classical RAAS and the alternative RAS.

Main Results:

• Existing RAAS drugs are cornerstones of therapy, with ongoing development for enhanced efficacy and safety.
• Emerging strategies include RNA-based therapeutics and aldosterone synthase inhibitors for RAAS modulation.
• The protective RAS, involving ACE2 and Ang-(1-7), shows promise for counteracting detrimental RAAS effects.

Conclusions:

• Pharmacological targeting of the RAAS remains vital for cardiorenovascular health.
• Innovative approaches to both classical and protective RAAS pathways offer potential for next-generation treatments.
• Further research into the protective RAS may unlock new therapeutic avenues for diverse disorders.