New pathways of the renin-angiotensin system: the role of ACE2 in cardiovascular pathophysiology and therapy.
BACKGROUND
The renin-angiotensin system (RAS) is nowadays an important target in cardiovascular diseases and we are currently on the verge of a new interpretation of its role in cardiovascular homeostasis, mainly due to the identification of the new axis ACE2/angiotensin 1 - 7/Mas receptor.


METHODS
The main aspects related to ACE2 role in cardiovascular physiology and possible pathological and therapeutic implications are reviewed.


RESULTS
A description of the new view of the RAS, along with the key findings that support it. In the cardiovascular system, the ACE2/angiotensin 1 - 7/Mas axis, mainly through the inhibition of fibrosis, inflammation, thrombosis and cell proliferation, modulates RAS activity with significant pathophysiological implications in clinical conditions such as hypertension, myocardial ischemia and heart failure. A more complete understanding of this axis has significant therapeutic relevance and a major effort is being carried out in order to pursue this objective.


CONCLUSIONS
There is increasing evidence that ACE2/angiotensin 1 - 7/Mas receptor axis has a key role in RAS activity regulation with significant pathophysiological implications in several disease states. A therapeutic intervention at this level may open new doors and change the current approach to RAS targeting.
Castro-Chaves
Paulo
P
University of Porto, Department of Physiology, Faculty of Medicine, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
Cerqueira
Rui
R
Pintalhao
Mariana
M
Leite-Moreira
Adelino F
AF
D000085962:Angiotensin-Converting Enzyme 2; D002318:Cardiovascular Diseases / Q000201:enzymology* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007703:Peptidyl-Dipeptidase A / Q000737:chemistry / Q000235:genetics / Q000378:metabolism*; D012084:Renin-Angiotensin System
D007703:Peptidyl-Dipeptidase A; C000705307:ACE2 protein, human; D000085962:Angiotensin-Converting Enzyme 2