Farag Ehab, Sessler Daniel I, Ebrahim Zeyd, Kurz Andrea, Morgan Joseph, Ahuja Sanchit, Maheshwari Kamal, John Doyle D
Department of Outcomes Research, Anaesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA; Department of General Anaesthesiology, Anaesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: http://www.OR.org/.
Department of Outcomes Research, Anaesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA.
J Clin Neurosci. 2017 Dec;46:1-8. doi: 10.1016/j.jocn.2017.08.055. Epub 2017 Sep 8.
The traditional renin-angiotensin system (RAS) is indispensable system in adjusting sodium homeostasis, body fluid volume, and controlling arterial blood pressure. The key elements are renin splitting inactive angiotensinogen to yield angiotensin (Ang-I). Ang-1 is then changed by angiotensin-1 converting enzyme (ACE) into angiotensin II (Ang-II). Using PubMed, Google Scholar, and other means, we searched the peer-reviewed literature from 1990 to 2013 for articles on newly discovered findings related to the RAS, especially focusing on how the system influences the central nervous system (CNS). The classical RAS is now considered to be only part of the picture; the discovery of additional RAS pathways in the brain and elsewhere has yielded a vastly improved understanding of how the RAS influences the CNS. Newly discovered effects of the RAS on brain tissue include neuroprotection, cognition, and cerebral vasodilation. A number of brain biochemical pathways are influenced by the brain RAS. Within various pathways, there are potential opportunities for classical pharmacologic interventions as well as the possibility of controlling gene expression.
传统的肾素-血管紧张素系统(RAS)是调节钠稳态、体液容量和控制动脉血压不可或缺的系统。其关键要素是肾素将无活性的血管紧张素原裂解产生血管紧张素(Ang-I)。然后,Ang-1在血管紧张素转换酶(ACE)的作用下转变为血管紧张素II(Ang-II)。我们利用PubMed、谷歌学术搜索等手段,检索了1990年至2013年同行评议的文献,查找与RAS相关的新发现的文章,尤其关注该系统如何影响中枢神经系统(CNS)。现在认为经典的RAS只是其中一部分情况;在大脑及其他部位发现的额外RAS途径,极大地增进了我们对RAS如何影响CNS的理解。RAS对脑组织的新发现作用包括神经保护、认知和脑血管舒张。脑RAS影响多种脑生化途径。在各种途径中,存在经典药物干预的潜在机会以及控制基因表达的可能性。