Molina-Van den Bosch M, Jacobs-Cachá C, Vergara A, Serón D, Soler M J
Grup de Nefrología, Vall d'Hebron Institut de Recerca (VHIR), Servei de Nefrología, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital, Barcelona, España.
Grup de Nefrología, Vall d'Hebron Institut de Recerca (VHIR), Servei de Nefrología, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital, Barcelona, España.
Hipertens Riesgo Vasc. 2021 Jul-Sep;38(3):125-132. doi: 10.1016/j.hipert.2020.12.001. Epub 2021 Jan 30.
The renin-angiotensin-aldosterone (RAAS) system and its effects on blood pressure and the regulation of water and electrolyte balance have been studied focusing on the cardiovascular and renal system. The activation of RAAS in other organs has local and systemic repercussions by modeling the macro- and microvasculture of peripheral organs. The brain RAAS influence on systemic blood pressure through the sympathetic nervous system. The angiotensin converting enzyme/angiotensin II/angiotensin 1 receptor axis (ACE/AngII/AT1), classical pathway, and angiotensin converting enzyme type 2/angiotensin (1-7)/Mas receptor (ACE2/Ang (1-7)/MasR), non-classical pathway, are involved in the modulation of the sympathetic response. The imbalance of these two axes with subsequently Ang II accumulation promote neurogenic hypertension and other vascular pathologies. The aminopeptidase/angiotensin IV/angiotensin 4 receptor (AMN/Ang IV/AT4) axis, which is exclusive of the brain, acts on cerebral microvasculature and participates in cognition, memory, and learning. The aim of this review is to decipher the major central RAAS mechanisms involved in blood pressure regulation. In addition, paracrine functions of brain RAAS and its role in neuroprotection and cognition are also described in this review.
肾素-血管紧张素-醛固酮(RAAS)系统及其对血压以及水和电解质平衡调节的影响已围绕心血管和肾脏系统展开研究。通过对外周器官的宏观和微血管进行建模,RAAS在其他器官中的激活具有局部和全身影响。脑RAAS通过交感神经系统影响全身血压。血管紧张素转换酶/血管紧张素II/血管紧张素1受体轴(ACE/AngII/AT1)(经典途径)和血管紧张素转换酶2/血管紧张素(1-7)/Mas受体(ACE2/Ang(1-7)/MasR)(非经典途径)参与交感反应的调节。这两个轴失衡并随后导致Ang II积累会促进神经源性高血压和其他血管病变。氨基肽酶/血管紧张素IV/血管紧张素4受体(AMN/Ang IV/AT4)轴(仅存在于脑内)作用于脑微血管并参与认知、记忆和学习。本综述的目的是解读参与血压调节的主要中枢RAAS机制。此外,本综述还描述了脑RAAS的旁分泌功能及其在神经保护和认知中的作用。