Features of the renin-angiotensin system in ascites and pleural effusion during severe ovarian hyperstimulation syndrome

Delbaere, Anne; Bergmann, Pierre; Englert, Yvon

doi:10.1007/bf02765823

Cited by 8 publications

(4 citation statements)

References 16 publications

(18 reference statements)

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“…In 1994, Rosenberg and coauthors reported elevated renin and prorenin concentrations in the ascites of 3 patients with severe OHSS and speculated that the RAS may contribute to the increased capillary permeability that occurs in OHSS. 97 Markedly elevated AngII and prorenin/renin concentrations have been reported both in plasma and in ascitic fluid of patients with OHSS by Delbaere et al [98][99][100][101] The authors demonstrated that AngII levels in peritoneal fluid are consistently higher than in simultaneously drawn blood, suggesting a local, intraovarian origin of peritoneal AngII. This was shown in patients with severe OHSS (who had the highest levels, 5 times higher in ascites than in the plasma, and 100 times higher than that in control ascites), in women stimulated with gonadotropins and in early pregnancy.…”

Section: Ovarian Hyperstimulation Syndromementioning

confidence: 97%

“…Since the highest AngII levels were found in severe OHSS associated with pregnancy, a synergistic effect of exogenous and endogenous hCG on the ovarian RAS was postulated. In another study of two patients, 99 the same authors simultaneously measured prorenin, renin activity, active renin, and AngII-immunoreactivity (AngII-ir) levels in plasma, ascites, and pleural fluid. All levels were much higher than normal plasmatic laboratory levels; prorenin and AngII-ir levels were highest in the ascites, and no significant differences were found between pleural fluid and plasma, further supporting a role for an ovarian origin of prorenin and AngII.…”

Section: Ovarian Hyperstimulation Syndromementioning

confidence: 99%

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The Ovarian Renin-Angiotensin System (OVRAS): A Major Factor in Ovarian Function and Disease

2016

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This contribution summarizes the pivotal role of the ovarian renin-angiotensin system (OVRAS) in ovarian physiology and disease, with particular emphasis on human clinical implications and established translational applications. The presence of a complete OVRAS in all studied species has been known for decades. The OVRAS has major effects on follicle development/atresia and ovulation and steroid hormone secretion, that is, it is necessary for normal reproduction. It is well established that OVRAS activity is regulated by gonadotropins and depends on activation of proteases in the area of growing follicles. Angiotensin and angiotensin receptors are widely distributed in the ovarian follicle, preovulatory theca and granulosa cells, and postovulatory mural granulosa-lutein cells and regulate steroidogenesis. Molecular blockade of the OVRAS inhibits oocyte maturation and ovulation. Pathologically abnormal OVRAS function has been associated with infertility, polycystic ovarian syndrome (PCOS), ovarian hyperstimulation syndrome (OHSS), and ovarian cancer. Both hyperandrogenism in PCOS and third space fluid accumulation in OHSS have been convincingly linked to overexpression of renin and angiotensin. Blockade of angiotensin receptors is under study for the treatment of gynecologic cancer, OHSS, and PCOS. However, a full understanding of the OVRAS and translational applications is lacking. In part, this is due to the discovery in recent years of previously unknown renin-angiotensin system (RAS) components and novel functions of "classical" RAS components that remain to be integrated into translational studies; newer, more specific agents to block RAS components are available only now for such research and treatment. The need for further studies is evident.

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Section: Ovarian Hyperstimulation Syndromementioning

confidence: 97%

Section: Ovarian Hyperstimulation Syndromementioning

confidence: 99%

The Ovarian Renin-Angiotensin System (OVRAS): A Major Factor in Ovarian Function and Disease

2016

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“…A direct correlation has been demonstrated between plasma renin activity, aldosterone level and the severity of OHSS. The levels of prorenin and Ang II were much higher in the ascites of severe OHSS than in the pleural fluid and the plasma [ 79 , 80 , 81 ]. Morris et al [ 82 ] reported that enalapril, an ACE1 inhibitor, decreased the incidence of OHSS in a rabbit model; however, Gul et al [ 83 ] did not notice any significant benefits of enalapril administration in reducing the severity of OHSS symptoms such as ascites formation.…”

Section: Ovarian Diseases Related To the Ace2/ang-(1-7)/mas1 Axismentioning

confidence: 99%

Involvement of ACE2/Ang-(1-7)/MAS1 Axis in the Regulation of Ovarian Function in Mammals

Domińska

2020

IJMS

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In addition to the classic, endocrine renin-angiotensin system, local renin-angiotensin system (RAS) has been documented in many tissues and organs, including the ovaries. The localization and functional activity of the two opposing axes of the system, viz. ACE1/Ang II/AT1 and ACE2/Ang-(1-7)/MAS1, differs between animal species and varied according to the stage of follicle development. It appears that the angiotensin peptides and their receptors participate in reproductive processes such as folliculogenesis, steroidogenesis, oocyte maturation, and ovulation. In addition, changes in the constituent compounds of local RAS may contribute to pathological conditions, such as polycystic ovary syndrome, ovarian hyperstimulation syndrome, and ovarian cancer. This review article examines the expression, localization, metabolism, and activity of individual elements of the ACE2/Ang-(1-7)/MAS1 axis in the ovaries of various animal species. The manuscript also presents the relationship between the secretion of gonadotropins and sex hormones and expression of Ang-(1-7) and MAS1 receptors. It also summarizes current knowledge regarding the positive and negative impact of ACE2/Ang-(1-7)/MAS1 axis on ovarian function.

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“…Dieses wird im Rahmen der IVF in hohen Dosen zur Follikelstimulation eingesetzt [8,13]. Neben hCG als wichtigem Mediator in der Entstehung des OHSS wird aber auch eine Rolle des Renin-Angiotensin-Systems [6] sowie von TNF-á und einigen Interleukinen (v. a. IL-1, IL-6) diskutiert. Letztere sind, ebenso wie die erhöhten VEGF-Spiegel, mit klinischer Besserung rückläufig [1,5].…”

Section: Ergussanalytikunclassified

Das ovarielle Hyperstimulationssyndrom - eine seltene Differenzialdiagnose des einseitigen Pleuraergusses

Markus¹,

Weber²,

Morresi‐Hauf³

et al. 2005

Pneumologie

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This case presentation describes a 29 year-old female who developed a severe ovarian hyperstimulation syndrome (OHSS) with ascites and a right-sided pleural effusion following in-vitro-fertilisation. A total of 4,2 l of pleural fluid was removed during 3 thoracocenteses. The symptoms as well as the fluid production ceased after 2 weeks. The OHSS is altogether a rare, but potentially life-threatening complication of in-vitro-fertilisation. Due to the well-characterized clinical setting in which the syndrome appears, there are only few differential diagnoses to consider. OHSS is likely to originate from altered capillary permeability, but its pathogenesis is not yet fully understood. Clinical symptoms usually resolve within 2 weeks of supportive therapy. In case of persistency, however, especially pulmonary embolism and infectious causes of pleural fluid production have to be excluded.

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Features of the renin-angiotensin system in ascites and pleural effusion during severe ovarian hyperstimulation syndrome

Abstract: Purpose: The purpose of this work was to investigate the ovarian renin-angiotensin system (RAS) during

Cited by 8 publications

References 16 publications

The Ovarian Renin-Angiotensin System (OVRAS): A Major Factor in Ovarian Function and Disease

The Ovarian Renin-Angiotensin System (OVRAS): A Major Factor in Ovarian Function and Disease

Involvement of ACE2/Ang-(1-7)/MAS1 Axis in the Regulation of Ovarian Function in Mammals

Das ovarielle Hyperstimulationssyndrom - eine seltene Differenzialdiagnose des einseitigen Pleuraergusses

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