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Renin angiotensin aldosterone system in pulmonary fibrosis: Pathogenesis to therapeutic possibilities.

Pharmacological research Peer reviewed publication
volume 174 pages 105924
December 2021
DOI: 10.1016/j.phrs.2021.105924 PMID: 34607005
EISSN: 1096-1186 ISSN: 1043-6618 KBID: 845 LN: Shenoy Vinayak CHSU: Faculty LN: Shenoy LN: Shenoy V
  1. https://pubmed.ncbi.nlm.nih.gov/34607005
  2. https://www.ncbi.nlm.nih.gov/pubmed/34607005
  3. https://doi.org/10.1016/j.phrs.2021.105924

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Description

Pulmonary fibrosis is a devastating lung disease with multifactorial etiology characterized by alveolar injury, fibroblast proliferation and excessive deposition of extracellular matrix proteins, which progressively results in respiratory failure and death. Accumulating evidence from experimental and clinical studies supports a central role of the renin angiotensin aldosterone system (RAAS) in the pathogenesis and progression of idiopathic pulmonary fibrosis. Angiotensin II (Ang II), a key vasoactive peptide of the RAAS mediates pro-inflammatory and pro-fibrotic effects on the lungs, adversely affecting organ function. Recent years have witnessed seminal discoveries in the field of RAAS. Identification of new enzymes, peptides and receptors has led to the development of several novel concepts. Of particular interest is the establishment of a protective axis of the RAAS comprising of Angiotensin converting enzyme 2 (ACE2), Angiotensin-(1-7) [Ang-(1-7)], and the Mas receptor (the ACE2/Ang-(1-7)/Mas axis), and the discovery of a functional role for the Angiotensin type 2 (AT2) receptor. Herein, we will review our current understanding of the role of RAAS in lung fibrogenesis, provide evidence on the anti-fibrotic actions of the newly recognized RAAS components (the ACE2/Ang-(1-7)/Mas axis and AT2 receptor), discuss potential strategies and translational efforts to convert this new knowledge into effective therapeutics for PF.

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Affiliations

  1. College of Pharmacy, California Health Sciences University, Clovis, CA, USA. Electronic address: vshenoy@chsu.edu.
  2. College of Pharmacy, VNS Group of Institutions, Bhopal, India.
  3. Congenital Heart Center, Department of Pediatrics, University of Florida, College of Medicine, Gainesville, FL, USA.
  4. Department of Internal Medicine, Kansas University Medical Center, Kansas City, KS, USA.

Publisher

Elsevier (Netherlands)

Languages

English

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