Counter-regulatory renin-angiotensin system in cardiovascular disease

Nat Rev Cardiol. 2020 Feb;17(2):116-129. doi: 10.1038/s41569-019-0244-8. Epub 2019 Aug 19.

Abstract

The renin-angiotensin system is an important component of the cardiovascular system. Mounting evidence suggests that the metabolic products of angiotensin I and II - initially thought to be biologically inactive - have key roles in cardiovascular physiology and pathophysiology. This non-canonical axis of the renin-angiotensin system consists of angiotensin 1-7, angiotensin 1-9, angiotensin-converting enzyme 2, the type 2 angiotensin II receptor (AT2R), the proto-oncogene Mas receptor and the Mas-related G protein-coupled receptor member D. Each of these components has been shown to counteract the effects of the classical renin-angiotensin system. This counter-regulatory renin-angiotensin system has a central role in the pathogenesis and development of various cardiovascular diseases and, therefore, represents a potential therapeutic target. In this Review, we provide the latest insights into the complexity and interplay of the components of the non-canonical renin-angiotensin system, and discuss the function and therapeutic potential of targeting this system to treat cardiovascular disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Cardiovascular Agents / therapeutic use
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / physiopathology*
  • Cardiovascular System / drug effects
  • Cardiovascular System / metabolism
  • Cardiovascular System / physiopathology*
  • Humans
  • Molecular Targeted Therapy
  • Proto-Oncogene Mas
  • Renin-Angiotensin System* / drug effects

Substances

  • Cardiovascular Agents
  • MAS1 protein, human
  • Proto-Oncogene Mas