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Nova spoznanja o reninsko-angiotenzinskemu sistemu s poudarkom na (pro)reninu in (pro)reninskem receptorju ter možnostih njune zavore = New knowledge of renin-anginotensin-aldosterone system with emphasis on (pro)renin, (pro)renin receptor and possibilities of their blockade
Šušteršič, Miha, dr. med. ; Bunc, Matjaž
With discovery of renin in the year 1898 began the research period of renin-angiotensin-aldosterone system (RAAS). Classical RAAS pathway that begins with re lease of renin from the jugstaglomerular ...cells in kidneys into the circulation, transformation of angiotensin-I (A-I) to angiotensin-II (A-II) and release of aldosterone is now widely known concept of regulating arterial blood pressure, tissue perfusion, electrolyte balance and extracellular volume, which could be, bas ed to our current knowledge, accounted for as incomplete. In this review we: (1) Critically addressed the current view on the role of prorenin on (pro)renin receptor in tissue RAAS andits role in evolveme nt of disease; (2) Show new knowledge about derivates of angiotensin and their effects in tissue RAAS and (3) evaluate new ways of blocking the RAAS. Our conclusions are: (1) Prorenin is not just the inactive product of the renin family but, with binding to the (pro)renin receptor, accelerates the A-I generation and activation of intracellular signaling cascade (independently of A-I and A-II production), that leads to tissue damage; (2) The research led to various derivates of angiotensin and the ir receptors among which angiotensin-(1-7) is the most interesting, since it displays opposite effects to A-II and (3) Treatment with direct renin inhibitors promises a lot, not only for treating of arterial hypertension, butalso in treating congestive heart failure, after myocardial infarction, diabetes mellitus and kidney disease, but for their role in treating those conditions we will have to wait for the conclusions of currently set trials.
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