Department of Anesthesiology and Pain Medicine, Anhui Provincial Hospital, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, 230001, Anhui, China.
Department of Anesthesiology and Pain Medicine, Anhui Provincial Hospital, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, 230001, Anhui, China.
Pulm Pharmacol Ther. 2019 Oct;58:101833. doi: 10.1016/j.pupt.2019.101833. Epub 2019 Aug 1.
While effective treatments for acute respiratory distress syndrome (ARDS) are lacking, mechanical lung ventilation can sustain adequate gas exchange in critically ill patients with respiratory failure due to ARDS. However, as a result of the phenomenon of ventilator-induced lung injury (VILI), there is an increasing need to seek beneficial pharmacological therapies for ARDS. Recent studies have suggested the renin-angiotensin system (RAS), which consists of the ACE/Ang-II/AT1R axis and ACE2/Ang-(1-7)/MasR axis, plays a dual role in the pathogenesis of ARDS and VILI. This review highlights the deleterious action of ACE/Ang-II/AT1R axis and the beneficial role of ACE2/Ang-(1-7)/MasR axis, as well as AT2R, in VILI and ARDS, and also discusses the possibility of targeting RAS components with pharmacological interventions to improve outcomes in ARDS.
虽然急性呼吸窘迫综合征 (ARDS) 的有效治疗方法仍缺乏，但机械性肺通气可以在因 ARDS 而发生呼吸衰竭的重症患者中维持充分的气体交换。然而，由于呼吸机所致肺损伤 (VILI) 的现象，人们越来越需要寻找对 ARDS 有益的药理学治疗方法。最近的研究表明，肾素-血管紧张素系统 (RAS) 由 ACE/Ang-II/AT1R 轴和 ACE2/Ang-(1-7)/MasR 轴组成，在 ARDS 和 VILI 的发病机制中发挥双重作用。这篇综述强调了 ACE/Ang-II/AT1R 轴的有害作用以及 ACE2/Ang-(1-7)/MasR 轴和 AT2R 在 VILI 和 ARDS 中的有益作用，并讨论了用药理学干预靶向 RAS 成分以改善 ARDS 结局的可能性。
