Role and Mechanism of the Renin-Angiotensin-Aldosterone System in the Onset and Development of Cardiorenal Syndrome

Ma, Kexin; Gao, Weifang; Liang, Wenjie; Ma, Guilin

doi:10.1155/2022/3239057

Cited by 24 publications

(19 citation statements)

References 84 publications

(113 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Aldosterone is the final effector of the RAAS, and the increased aldosterone contributes to cardiorenal damage, thus RAAS blockade has been considered to improve cardiovascular disease, hypertension, and diabetic CKD by controlling blood pressure and reducing vascular injury [ 29 ]. However, RAAS blockade in patients with perioperative AKI is controversial due to impaired autoregulation of glomerular and arteriolar pressure [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Mineralocorticoid Receptor Antagonism Attenuates Multiple Organ Failure after Renal Ischemia and Reperfusion in Mice

Park

Dusabimana

et al. 2023

IJMS

View full text Add to dashboard Cite

Renal ischemia reperfusion (IR) injury is a major cause of acute kidney injury (AKI) that is often complicated by multiple organ failure of the liver and intestine. The mineralocorticoid receptor (MR) is activated in patients with renal failure associated with glomerular and tubular damage. We thus investigated whether canrenoic acid (CA), a mineralocorticoid receptor (MR) antagonist, protects against AKI-induced hepatic and intestinal injury, suggesting the underlying mechanisms. Mice were divided into five groups: sham mice, mice subjected to renal IR, and mice pretreated with canrenoic acid (CA; 1 or 10 mg/kg) 30 min prior to renal IR. At 24 h after renal IR, the levels of plasma creatinine, alanine aminotransferase and aldosterone were measured, and structural changes and inflammatory responses of the kidney, liver, and intestine were analyzed. We found that CA treatment reduced plasma creatinine levels, tubular cell death and oxidative stress induced by renal IR. CA treatment also decreased renal neutrophil infiltration and inflammatory cytokine expression and inhibited the release of high-mobility group box 1 induced by renal IR. Consistently, CA treatment reduced renal IR-induced plasma alanine transaminase, hepatocellular injury and neutrophil infiltration, and inflammatory cytokine expression. CA treatment also decreased small intestinal cell death, neutrophil infiltration and inflammatory cytokine expression induced by renal IR. Taken together, we conclude that MR antagonism by CA treatment protects against multiple organ failure in the liver and intestine after renal IR.

show abstract

Section: Discussionmentioning

confidence: 99%

Mineralocorticoid Receptor Antagonism Attenuates Multiple Organ Failure after Renal Ischemia and Reperfusion in Mice

Park

Dusabimana

et al. 2023

IJMS

View full text Add to dashboard Cite

show abstract

“…After 1 week of infusion of Ang II increase product extra culler matrix protein collagen and fibronectin with the continued rise CTGF and formation of fibrosis. After 2 weeks of infusion with Ang II increase level of TGF-β1 and CTGF by epithelial cells, mesangial cells and endothelial cells 49 . TGF-causes mesangial enlargement due to mesangial cell hypertrophy, proliferation (and eventually apoptosis), and the production of extracellular matrix (ECM).…”

Section: Groupsmentioning

confidence: 95%

Determining ACE-2 Level and Some Relevant Biochemical Parameters and studying the effect of Gender in Iraqi Diabetic Patients with Glomeruli and Renal Tubules Fibrosis as Early Prediction Marker

2023

View full text Add to dashboard Cite

Diabetic kidney disease is an illness of the glomerulus that interferes with the glomerular filtration barrier (GFB), which is worked to enable kidney to selective purification of water and solutes in addition to limiting the movement of large macromolecules such as albumin. In the glomerular endothelium, mesangial cells, foot cells, and the brush border of the proximal tubules, ACE-2 is expressed and that the kidneys represent the highest-expressing region of this enzyme. Thus, the current study aimed to evaluate ACE-2 level in this case compared to healthy condition. The study Conducted with 120 male and female ranging in age (30-65) years old. Ninety patients with type 2 diabetes subdivided into three groups on the basis of ACR criteria including normoalbuminuria, microalbuminuria, macroalbuminuria (30 patients for each group) and 30 healthy people served as the control group, all visited Baghdad Teaching Hospital / Medical City and Al-Yarmouk Teaching Hospital, at the period between December 2021 and May 2022. ACE-2 levels were determined using the ELISA technique. Urea results showed significant differences between diabetic nephropathy in patient and control group in female cases but no significant differences in male patients with diabetic nephropathy and control group. Similar results were obtained in K ion. Also the results revealed significant differences in Na ion, ACR, eGFR, Urea, FBS, creatinine between diabetic nephropathy groups and healthy group.ACE-2 represents a good marker for early prediction in diabetic nephropathy case. ROC data analysis support the importance of ACE-2 in diagnosis of the studied disease case.

show abstract

“…This is likely an appropriate response as a meta-analysis synthesizing results from early COVID-19 studies showed hypertensive patients had 2.27- and 3.48-fold higher risk of severity and fatality due to COVID-19 infection, respectively [ 56 ]. ACE2 downregulation or inactivity poses a serious threat to human health as overactivation of the RAAS system is often a contributor to multi-organ failure [ 57 ].…”

Section: Disease Statesmentioning

confidence: 99%

Angiotensin-Converting Enzyme 2 Expression and Severity of SARS-CoV-2 Infection

et al. 2023

View full text Add to dashboard Cite

Angiotensin-converting enzyme 2 (ACE2), first discovered in 2000, serves as an important counterregulatory enzyme to the angiotensin II-mediated vasoconstrictive, pro-inflammatory, and pro-fibrotic actions of the renin–angiotensin system (RAS). Conversion of angiotensin II to the peptide angiotensin 1–7 (ANG 1–7) exerts protective vasodilatory, anti-inflammatory, and anti-fibrotic actions through interaction with the MasR receptor. There are many important considerations when noting the role of ACE2 in the pathogenesis and sequelae of COVID-19 infection. ACE2, in the role of COVID-19 infection, was recognized early in 2020 at the beginning of the pandemic as a cell membrane-bound and soluble binding site for the viral spike protein facilitating entering into tissue cells expressing ACE2, such as the lungs, heart, gut, and kidneys. Mechanisms exist that alter the magnitude of circulating and membrane-bound ACE2 (e.g., SARS-CoV-2 infection, viral variants, patient characteristics, chronic disease states, and the degree of cell surface expression of ACE2) and the influence these mechanisms have on the severity of disease and associated complications (e.g., respiratory failure, systemic inflammatory response syndrome, acute myocarditis, acute kidney injury). Several medications alter the ACE2 receptor expression, but whether these medications can influence the course of the disease and improve outcomes is unclear. In this review, we will discuss what is known about the interrelation of SARS-CoV-2, ACE2 and the factors that may contribute to the variability of its expression and potential contributors to the severity of COVID-19 infection.

show abstract

Role and Mechanism of the Renin-Angiotensin-Aldosterone System in the Onset and Development of Cardiorenal Syndrome

Cited by 24 publications

References 84 publications

Mineralocorticoid Receptor Antagonism Attenuates Multiple Organ Failure after Renal Ischemia and Reperfusion in Mice

Mineralocorticoid Receptor Antagonism Attenuates Multiple Organ Failure after Renal Ischemia and Reperfusion in Mice

Determining ACE-2 Level and Some Relevant Biochemical Parameters and studying the effect of Gender in Iraqi Diabetic Patients with Glomeruli and Renal Tubules Fibrosis as Early Prediction Marker

Angiotensin-Converting Enzyme 2 Expression and Severity of SARS-CoV-2 Infection

Contact Info

Product

Resources

About