Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China.
Department of Intensive Care Unit, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China.
Pharmacol Res. 2021 May;167:105409. doi: 10.1016/j.phrs.2020.105409. Epub 2021 Jan 16.
Sepsis, caused by the inappropriate host response to infection, is characterized by excessive inflammatory response and organ dysfunction, thus becomes a critical clinical problem. Commonly, sepsis may progress to septic shock and severe complications, including acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), sepsis-induced myocardial dysfunction (SIMD), liver dysfunction, cerebral dysfunction, and skeletal muscle atrophy, which predominantly contribute to high mortality. Additionally, the global pandemic of coronavirus disease 2019 (COVID-19) raised the concern of development of effectve therapeutic strategies for viral sepsis. Renin-angiotensin system (RAS) may represent as a potent therapeutic target for sepsis therapy. The emerging role of RAS in the pathogenesis of sepsis has been investigated and several preclinical and clinical trials targeting RAS for sepsis treatment revealed promising outcomes. Herein, we attempt to review the effects and mechanisms of RAS manipulation on sepsis and its complications and provide new insights into optimizing RAS interventions for sepsis treatment.
脓毒症是由宿主对感染的不当反应引起的，其特征是过度的炎症反应和器官功能障碍，因此成为一个严重的临床问题。通常，脓毒症可能进展为感染性休克和严重并发症，包括急性肾损伤（AKI）、急性呼吸窘迫综合征（ARDS）、脓毒症引起的心肌功能障碍（SIMD）、肝功能障碍、脑功能障碍和骨骼肌萎缩，这些主要导致高死亡率。此外，2019 年冠状病毒病（COVID-19）的全球大流行引起了人们对开发有效的病毒性脓毒症治疗策略的关注。肾素-血管紧张素系统（RAS）可能是脓毒症治疗的一个有潜力的治疗靶点。RAS 在脓毒症发病机制中的作用已经得到了研究，针对 RAS 的几项临床前和临床试验为脓毒症治疗带来了有希望的结果。在此，我们试图回顾 RAS 对脓毒症及其并发症的作用和机制，并为优化 RAS 干预脓毒症治疗提供新的见解。
