title: Angiotensin AT(1) receptor signalling modulates reparative angiogenesis induced by limb ischaemia.
abstract: 1. The concept that angiotensin II exerts pro-angiogenic activity is not universally accepted. We evaluated whether inhibition of the renin-angiotensin system (RAS) would influence reparative angiogenesis in a murine model of limb ischaemia. 2. Perfusion recovery following surgical removal of the left femoral artery was analysed by laser Doppler flowmetry in mice given the ACE inhibitor ramipril (1 mg kg(-1) per day), the AT(1) antagonist losartan (15 mg kg(-1) per day), or vehicle. Muscular capillarity was examined at necroscopy. Ramipril-induced effects were also studied under combined blockade of kinin B(1) and B(2) receptors. Furthermore, the effects of ischaemia on AT(1) gene expression and ACE activity were determined. 3. In untreated mice, muscular AT(1a) gene expression was transiently decreased early after induction of limb ischaemia, whereas AT(1b) mRNA was up-regulated. ACE activity was reduced in ischaemic muscles at 1 and 3 days. Gene expression of AT(1) isoforms as well as ACE activity returned to basal values by day 14. Spontaneous neovascularization allowed for complete perfusion recovery of the ischaemic limb after 21 days. 4. Reparative angiogenesis was negatively influenced by either ramipril (P<0.02) or losartan (P<0.01), leading to delayed and impaired post-ischaemic recovery (50 - 70% less compared with controls). Ramipril-induced effects remained unaltered under kinin receptor blockade. 5. The present study indicates that (a) expression of angiotensin II AT(1) receptors and ACE activity are modulated by ischaemia, (b) ACE-inhibition or AT(1) antagonism impairs reparative angiogenesis, and (c) intact AT(1) receptor signalling is essential for post-ischaemic recovery. These results provide new insights into the role of the RAS in vascular biology and suggest cautionary use of ACE inhibitors and AT(1) antagonists in patients at risk for developing peripheral ischaemia.
authors.affiliation: Cardiovascular Medicine and Gene Therapy Section of the National Laboratory, Italian National Institute of Biostructures and Biosystems, Osilo, Sassari, Italy. emanueli@yahoo.com
authors.forename: Costanza
authors.initials: C
authors.lastname: Emanueli
authors.forename: Maria Bonaria
authors.initials: MB
authors.lastname: Salis
authors.forename: Tiziana
authors.initials: T
authors.lastname: Stacca
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pinna
authors.forename: Leonardo
authors.initials: L
authors.lastname: Gaspa
authors.forename: Paolo
authors.initials: P
authors.lastname: Madeddu
authors.forename: Paolo
authors.initials: P
authors.lastname: Maddeddu
mesh_terms: D000804:Angiotensin II / Q000378:metabolism; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D000818:Animals; D000959:Antihypertensive Agents / Q000494:pharmacology; D005121:Extremities / Q000098:blood supply / Q000601:surgery; D005263:Femoral Artery / Q000601:surgery; D015870:Gene Expression; D007511:Ischemia / Q000503:physiopathology*; D019808:Losartan / Q000494:pharmacology; D008297:Male; D051379:Mice; D018919:Neovascularization, Physiologic / Q000502:physiology*; D007703:Peptidyl-Dipeptidase A / Q000378:metabolism*; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D017257:Ramipril / Q000494:pharmacology; D044140:Receptor, Angiotensin, Type 1; D044139:Receptor, Angiotensin, Type 2; D043783:Receptor, Bradykinin B1; D043782:Receptor, Bradykinin B2; D011945:Receptors, Angiotensin / Q000235:genetics* / Q000378:metabolism; D018002:Receptors, Bradykinin / Q000187:drug effects; D012084:Renin-Angiotensin System / Q000502:physiology; D015398:Signal Transduction
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D012333:RNA, Messenger; D044140:Receptor, Angiotensin, Type 1; D044139:Receptor, Angiotensin, Type 2; D043783:Receptor, Bradykinin B1; D043782:Receptor, Bradykinin B2; D011945:Receptors, Angiotensin; D018002:Receptors, Bradykinin; D000804:Angiotensin II; D007703:Peptidyl-Dipeptidase A; D019808:Losartan; D017257:Ramipril