Kinin-degrading pathways in the human heart.
In experimental animals, kinins protect the myocardium from ischemia-reperfusion injuries and reduce left ventricular hypertrophy and progression of heart failure. This suggests that in humans, also, the presence of an intact kinin system is critical for the prevention of heart failure. In addition to the kinin-generating system, the concentration of kinins, and consequently the extent of their actions, is regulated by their degradation. In the vascular bed of the human heart, bradykinin (BK) is degraded by angiotensin-converting enzyme (ACE). In contrast, in the interstitium of the human heart, BK is degraded by neutral endopeptidase (NEP). For potentiating the beneficial effects of BK, one strategy is elevation of the BK concentration by inhibition of BK-degrading enzymes. An even more effective form of pharmacological control of BK elevation than inhibition of ACE alone might be the combined inhibition of ACE and NEP.
Kokkonen
J O
JO
Wihuri Research Institute, Kalliolinnantie 4, FIN-00140 Helsinki, Finland.
Lindstedt
K A
KA
Kuoppala
A
A
Kovanen
P T
PT
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D000818:Animals; D006801:Humans; D007705:Kinins / Q000187:drug effects / Q000378:metabolism*; D009206:Myocardium / Q000201:enzymology*; D015260:Neprilysin / Q000037:antagonists & inhibitors / Q000187:drug effects / Q000378:metabolism; D007703:Peptidyl-Dipeptidase A / Q000187:drug effects / Q000378:metabolism
D000806:Angiotensin-Converting Enzyme Inhibitors; D007705:Kinins; D007703:Peptidyl-Dipeptidase A; D015260:Neprilysin