Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA.
Am J Ther. 2011 Nov;18(6):e202-8. doi: 10.1097/MJT.0b013e3181df8df5.
The renin-angiotensin system (RAS) is involved in hepatic fibrosis. To date there is no known effective treatment for hepatic fibrosis. Modulation of the RAS with angiotensin converting enzyme inhibitors and angiotensin receptor blockers may be a promising therapeutic option for the treatment of hepatic fibrosis. This review provides an update about the role of RAS in hepatic fibrosis, and treatment of hepatic fibrosis in the light of different studies in animals and humans is also updated. RAS induces key steps involved in hepatic fibrosis, such as activation of hepatic stellate cells and expression of transforming growth factor β1. Treatment with angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers attenuate fibrosis progression in both animal and human studies. Further, controlled studies are required to evaluate the role of RAS inhibitors and angiotensin-converting enzyme 2 in patients with chronic liver diseases in whom the causative agent cannot be removed.
肾素-血管紧张素系统（RAS）参与肝纤维化的形成。迄今为止，尚无已知的有效治疗肝纤维化的方法。用血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂来调节 RAS 可能是治疗肝纤维化的一种很有前途的治疗选择。本综述提供了关于 RAS 在肝纤维化中的作用的最新信息，并根据动物和人类的不同研究更新了肝纤维化的治疗方法。RAS 诱导肝纤维化形成的关键步骤，如肝星状细胞的激活和转化生长因子 β1 的表达。血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂的治疗可减轻动物和人类研究中的纤维化进展。此外，需要进行对照研究来评估 RAS 抑制剂和血管紧张素转换酶 2 在慢性肝病患者中的作用，在这些患者中，不能去除病因。
