The renin-angiotensin system: an old, newly discovered player in immunoregulation.
Clinical and experimental studies that discuss the different immune functions of the renin-angiotensin system (RAS) in kidney diseases were reviewed, with emphasis on studies of kidney transplantation. The RAS has been shown to affect both the innate and adaptive immune responses and has a well-established role in fibrinogenesis. Of special clinical interest is the ability of the RAS to activate the transforming growth factor beta(1) and the Smad pathways leading to fibrinogenesis. In addition to the RAS enhancing effect on the activity of T cells, several components of the RAS have also been shown to be chemotactic to macrophages, T cells, and natural killer cells. Experimental studies have found that RAS blockade decreases the histologic lesions of chronic allograft nephropathy but can enhance acute graft vasculopathy. Although the blockade of RAS has been commonly practiced to reduce posttransplantation hypertension, proteinuria, and erythrocytosis, however, its role in prolonging graft survival is not well established.
Geara
Abdallah S
AS
Internal Medicine Department, Staten Island University Hospital, Staten Island, NY 10305, USA.
Azzi
Jamil
J
Jurewicz
Mollie
M
Abdi
Reza
R
D000804:Angiotensin II / Q000276:immunology / Q000502:physiology; D000818:Animals; D002634:Chemotaxis, Leukocyte; D003713:Dendritic Cells / Q000276:immunology; D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival / Q000276:immunology; D006801:Humans; D007674:Kidney Diseases / Q000276:immunology; D016030:Kidney Transplantation / Q000009:adverse effects; D007694:Killer Cells, Natural / Q000276:immunology; D007703:Peptidyl-Dipeptidase A / Q000235:genetics; D011110:Polymorphism, Genetic; D055031:Primary Graft Dysfunction / Q000276:immunology; D012084:Renin-Angiotensin System / Q000235:genetics / Q000276:immunology* / Q000502:physiology; D013601:T-Lymphocytes / Q000276:immunology; D053773:Transforming Growth Factor beta1 / Q000276:immunology
D053773:Transforming Growth Factor beta1; D000804:Angiotensin II; D007703:Peptidyl-Dipeptidase A