School of Integrated Chinese and Western Medicine, Anhui University of Chinese Medicine, Hefei, China.
Institute of Integrated Chinese and Western Medicine, Anhui Academy of Chinese Medicine, Hefei, China.
J Alzheimers Dis. 2020;78(4):1315-1338. doi: 10.3233/JAD-200770.
It is widely recognized that Alzheimer's disease (AD) has a complicate link to renin-angiotensin system (RAS). It is known that cerebrovascular disease has some connections with AD, but most of the studies are still conducted in parallel or independently. Although previous research came up with large number of hypotheses about the pathogenesis of AD, it does not include the mechanism of RAS-related regulation of AD. It has been found that many components of RAS have been changed in AD. For example, the multifunctional and high-efficiency vasoconstrictor Ang II and Ang III with similar effects are changed under the action of other RAS signal peptides; these signal peptides are believed to help improve nerve injury and cognitive function. These changes may lead to neuropathological changes of AD, and progressive defects of cognitive function, which are association with some hypotheses of AD. The role of RAS in AD gradually attracts our attention, and RAS deserved to be considered carefully in the pathogenesis of AD. This review discusses the mechanisms of RAS participating in the three current hypotheses of AD: neuroinflammation, oxidative stress and amyloid-β protein (Aβ) hypothesis, as well as the drugs that regulate RAS systems already in clinical or in clinical trials. It further demonstrates the importance of RAS in the pathogenesis of AD, not only because of its multiple aspects of participation, which may be accidental, but also because of the availability of RAS drugs, which can be reused as therapies of AD.
人们普遍认为阿尔茨海默病（AD）与肾素-血管紧张素系统（RAS）之间存在复杂的联系。已知脑血管疾病与 AD 有一定的联系，但大多数研究仍在平行或独立进行。尽管之前的研究提出了大量关于 AD 发病机制的假说，但这些假说并不包括 RAS 相关调节 AD 的机制。已经发现，AD 中 RAS 的许多成分发生了改变。例如，多功能、高效的血管收缩素 Ang II 和 Ang III 在其他 RAS 信号肽的作用下发生改变；这些信号肽被认为有助于改善神经损伤和认知功能。这些变化可能导致 AD 的神经病理学变化和认知功能的进行性缺陷，与 AD 的一些假说有关。RAS 在 AD 中的作用逐渐引起了我们的注意，RAS 在 AD 的发病机制中值得仔细考虑。这篇综述讨论了 RAS 参与 AD 目前三个假说的机制：神经炎症、氧化应激和淀粉样蛋白-β 蛋白（Aβ）假说，以及已经在临床或临床试验中调节 RAS 系统的药物。它进一步证明了 RAS 在 AD 发病机制中的重要性，不仅因为它多方面的参与可能是偶然的，还因为 RAS 药物的可用性，可以作为 AD 的治疗方法重新使用。
