Title:The Renin-Angiotensin System: New Insight into Old Therapies
Volume: 20
Issue: 10
Author(s): M. Ramirez-Sanchez, I. Prieto, R. Wangensteen, I. Banegas, A. B. Segarra, A. B. Villarejo, F. Vives, J. Cobo and M. de Gasparo
Affiliation:
Keywords:
Renin-angiotensin system, angiotensinases, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers,
beta-blockers, brain asymmetry
Abstract: Although the renin-angiotensin system (RAS) is already an old acquaintance, there are often exciting
discoveries that improve our knowledge of it and open new therapeutic possibilities. Moreover, well-established drugs,
such as angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), or beta-blockers, show
that their mechanism of action may be the result of parallel pathways other than the ones initially established. A detailed
analysis of the RAS can be carried out in part through the study of the enzymes, named angiotensinases, involved in its
cascade, whose activity is a reflection of the functionality of their peptide substrates. The study of these enzymes offers
the possibility of controlling the effects of angiotensins through various pharmacological manipulations. For example,
angiotensinase inhibitors or activators are being used or have been proposed as antihypertensive agents. They have also
been suggested as analgesic and antidepressant drugs or targets for drug development against different pathologies such as
Alzheimer's disease, epilepsy or ischemia. On the other hand, the analysis of brain asymmetry has revealed surprising
results about the laterality of central and peripheral components of the RAS. Such studies indicate that the neurovisceral
integration, already proposed by Claude Bernard (1867) should also be analyzed from a bilateral perspective. In this review,
the RAS and the role of various angiotensinases implicated in the cascade are revisited. Therapeutic strategies involving
some components of the RAS with an unusual vision resulting from a bilateral perspective added to their study
are discussed.
