The renin-angiotensin-aldosterone system and its therapeutic targets.

Katrina M Mirabito Colafella, Dominique M Bovée, A H Jan Danser

Journal: Experimental eye research 2020;186():107680

PMID: 31129252

Full Text on Elsevier Science View on PubMed

Abstract

The renin-angiotensin-aldosterone system (RAAS) plays a pivotal role in the regulation of blood pressure and body fluid homeostasis and is a mainstay for the treatment of cardiovascular and renal diseases. Angiotensin II and aldosterone are the two most powerful biologically active products of the RAAS, inducing all of the classical actions of the RAAS including vasoconstriction, sodium retention, tissue remodeling and pro-inflammatory and pro-fibrotic effects. In recent years, new components of the RAAS have been discovered beyond the classical pathway that have led to the identification of depressor or so-called protective RAAS pathways and the development of novel therapies targeting this system. Moreover, dual inhibitors which block the RAAS and other systems involved in the regulation of blood pressure or targeting upstream of angiotensin II by selectively deleting liver-derived angiotensinogen, the precursor to all angiotensins, may provide superior treatment for cardiovascular and renal diseases and revolutionize RAAS-targeting therapy.

Address: Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Australia.; Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.; Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. Electronic address: [email protected].

DOI: 10.1016/j.exer.2019.05.020

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MeSH Terms: Angiotensin II Type 1 Receptor Blockers, Angiotensin-Converting Enzyme Inhibitors, Angiotensinogen, Blood Pressure, Body Fluids, Enzyme Inhibitors, Homeostasis, Humans, Neprilysin, Oligopeptides, RNA, Small Interfering, Receptor, Angiotensin, Type 2, Renin-Angiotensin System