Impact of renin-angiotensin system blockade on structure and function of glomerular membrane components in animal models of kidney disease.
The most promising therapeutic intervention to slow the progression of renal diseases is the inhibition of the renin-angiotensin system, either using angiotensin-converting enzyme inhibitors or angiotensin II (Ang II) receptor antagonists. In this article, we review the experimental evidences that are available on the effects of these treatments on glomerular capillary wall (GCW) function. Besides the well-known hemodynamic effects, Ang II antagonism exert specific actions on glomerular permeability to water and macromolecules, consisting in the elevation of hydraulic permeability and amelioration of membrane-sieving function. Experimental investigations of functional and structural properties of the glomerular membrane have been performed to discover the mechanisms responsible for the protective effects of these treatments. On the basis of these observations, we illustrate how Ang II antagonism interfere with the complex nature of the glomerular capillary affecting its hemodynamics, modulate its cellular components and result in the preservation of GCW function.
Remuzzi
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Biomedical Engineering Laboratory, Mario Negri Institute for Pharmacological Research, Bergamo, Italy.
Mohamed
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EI
D000804:Angiotensin II / Q000494:pharmacology; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D000818:Animals; D001485:Basement Membrane / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D002196:Capillaries / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D004195:Disease Models, Animal; D007674:Kidney Diseases / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D007678:Kidney Glomerulus / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D012084:Renin-Angiotensin System / Q000187:drug effects* / Q000502:physiology*
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000804:Angiotensin II