Simões E Silva Ana Cristina, Lanza Katharina, Palmeira Vitória Andrade, Costa Larissa Braga, Flynn Joseph T
Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Avenida Alfredo Balena, 190, 2nd floor, Room # 281, Belo Horizonte, MG, 30130-100, Brazil.
Pediatric Nephrology Unit, Department of Pediatrics, Faculty of Medicine, UFMG, Belo Horizonte, Brazil.
Pediatr Nephrol. 2021 Jun;36(6):1407-1426. doi: 10.1007/s00467-020-04759-1. Epub 2020 Sep 29.
The last decade was crucial for our understanding of the renin-angiotensin-aldosterone system (RAAS) as a two-axis, counter-regulatory system, divided into the classical axis, formed by angiotensin-converting enzyme (ACE), angiotensin II (Ang II), and the angiotensin type 1 receptor (AT1R), and the alternative axis comprising angiotensin-converting enzyme 2 (ACE2), angiotensin-(1-7) (Ang-(1-7)), and the Mas receptor. Breakthrough discoveries also took place, with other RAAS endopeptides being described, including alamandine and angiotensin A. In this review, we characterize the two RAAS axes and the role of their components in pediatric kidney diseases, including childhood hypertension (HTN), pediatric glomerular diseases, congenital abnormalities of the kidney and urinary tract (CAKUT), and chronic kidney disease (CKD). We also present recent findings on potential interactions between the novel coronavirus, SARS-CoV-2, and components of the RAAS, as well as potential implications of coronavirus disease 2019 (COVID-19) for pediatric kidney diseases.
过去十年对于我们理解肾素-血管紧张素-醛固酮系统（RAAS）作为一个双轴、反调节系统至关重要，该系统分为经典轴和替代轴，经典轴由血管紧张素转换酶（ACE）、血管紧张素II（Ang II）和血管紧张素1型受体（AT1R）组成，替代轴由血管紧张素转换酶2（ACE2）、血管紧张素-（1-7）（Ang-（1-7））和Mas受体组成。还出现了突破性发现，描述了其他RAAS内肽，包括alamandine和血管紧张素A。在本综述中，我们描述了RAAS的两个轴及其成分在儿童肾脏疾病中的作用，包括儿童高血压（HTN）、儿童肾小球疾病、先天性肾脏和尿路异常（CAKUT）以及慢性肾脏病（CKD）。我们还介绍了关于新型冠状病毒SARS-CoV-2与RAAS成分之间潜在相互作用的最新发现，以及2019冠状病毒病（COVID-19）对儿童肾脏疾病的潜在影响。
