title: The renin-angiotensin system and its involvement in vascular disease.
abstract: The renin-angiotensin system (RAS) plays a critical role in the pathogenesis of many types of cardiovascular diseases including cardiomyopathy, valvular heart disease, aneurysms, stroke, coronary artery disease and vascular injury. Besides the classical regulatory effects on blood pressure and sodium homoeostasis, the RAS is involved in the regulation of contractility and remodelling of the vessel wall. Numerous studies have shown beneficial effect of inhibition of this system in the pathogenesis of cardiovascular diseases. However, dysregulation and overexpression of the RAS, through different molecular mechanisms, also induces, the initiation of vascular damage. The key effector peptide of the RAS, angiotensin II (Ang II) promotes cell proliferation, apoptosis, fibrosis, oxidative stress and inflammation, processes known to contribute to remodelling of the vasculature. In this review, we focus on the components that are under the influence of the RAS and contribute to the development and progression of vascular disease; extracellular matrix defects, atherosclerosis and ageing. Furthermore, the beneficial therapeutic effects of inhibition of the RAS on the vasculature are discussed, as well as the need for additive effects on top of RAS inhibition.
authors.affiliation: Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Genetics, Erasmus MC, Rotterdam, The Netherlands; Department of Vascular Surgery, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Bibi S
authors.initials: BS
authors.lastname: van Thiel
authors.affiliation: Department of Genetics, Erasmus MC, Rotterdam, The Netherlands; Department of Vascular Surgery, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Ingrid
authors.initials: I
authors.lastname: van der Pluijm
authors.affiliation: Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Vascular Surgery, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Luuk
authors.initials: L
authors.lastname: te Riet
authors.affiliation: Department of Genetics, Erasmus MC, Rotterdam, The Netherlands; Department of Vascular Surgery, Erasmus MC, Rotterdam, The Netherlands; Department of Radiation Oncology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Essers
authors.affiliation: Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus MC, Rotterdam, The Netherlands. Electronic address: a.danser@erasmusmc.nl.
authors.forename: A H Jan
authors.initials: AH
authors.lastname: Danser
mesh_terms: D000818:Animals; D018450:Disease Progression; D006801:Humans; D058990:Molecular Targeted Therapy; D012084:Renin-Angiotensin System / Q000187:drug effects; D014652:Vascular Diseases / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology
keywords: Ageing; Angiotensin II; Atherosclerosis; Extracellular matrix; Reactive oxygen species; Renin–angiotensin system; Therapeutic intervention; Vascular disease