Department of Pharmacology, SB College of Pharmacy, Sivakasi, India.
J Cardiovasc Pharmacol. 2010 Nov;56(5):570-9. doi: 10.1097/fjc.0b013e3181f21576.
The overactivation of the renin–angiotensin–aldosterone system accounts for many cardiovascular and renal abnormalities. At several levels of its cascade, the renin–angiotensin–aldosterone system can be efficiently inhibited, of which interruption of the generation of angiotensin I by renin inhibition is considered most efficacious. All of these interruptions (renin inhibition, angiotensin-converting enzyme inhibition, and AT1 receptor blockade) increase plasma renin levels by inhibiting the negative feedback loop exerted by angiotensin II on renin production. Recent studies show that both prorenin and renin activate angiotensin II-independent signaling cascade through (pro)renin receptor, a new-fangled player of the old renin-angiotensin-aldosterone system. The probable mechanisms by which prorenin, renin, and (pro)renin receptors are functionally interrelated in pathophysiological conditions have been debated over the past decade without satisfactory conclusion. We revisited these areas and critically examined the relationship between elevated levels of circulating prorenin and renin-induced activation of the (pro)renin receptor and incidences of hypertension and end-organ damage. The complexity of the (pro)renin receptor has grown up with recent reports that this multifunctional receptor is a component of the Wnt receptor complex. This complexity and the receptor's function as an adaptor between the Wnt receptor and the vacuolar H+-ATPase complex has also been addressed in this review.
肾素-血管紧张素-醛固酮系统的过度激活导致许多心血管和肾脏异常。在其级联的几个水平上,可以有效地抑制肾素-血管紧张素-醛固酮系统,其中通过抑制肾素抑制血管紧张素 I 的产生来抑制血管紧张素 II 的负反馈环被认为是最有效的。所有这些中断(肾素抑制、血管紧张素转换酶抑制和 AT1 受体阻断)通过抑制血管紧张素 II 对肾素产生的负反馈环,增加血浆肾素水平。最近的研究表明,原肾素和肾素都通过(前)肾素受体激活血管紧张素 II 非依赖性信号级联,(前)肾素受体是肾素-血管紧张素-醛固酮系统的一个新的角色。在过去的十年中,人们一直在争论原肾素、肾素和(前)肾素受体在病理生理条件下功能相关的可能机制,但没有得出令人满意的结论。我们重新审视了这些领域,并批判性地检查了循环原肾素水平升高与肾素诱导的(前)肾素受体激活以及高血压和终末器官损伤发生率之间的关系。(前)肾素受体的复杂性随着最近的报道而增加,这些报道表明该多功能受体是 Wnt 受体复合物的一部分。本文还讨论了这种复杂性以及该受体作为 Wnt 受体和液泡 H+-ATP 酶复合物之间衔接子的功能。