Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
Curr Med Chem. 2021;28(28):5733-5787. doi: 10.2174/0929867328666210212101854.
The Renin-Angiotensin System (RAS) comprises a complex molecular cascade with two counter-regulatory axes, the classical and the alternative. Angiotensin II and Angiotensin-(1-7), the main peptides of the RAS, exert opposite effects in multiple organs and systems, including the cardiovascular, renal, pulmonary, and immune systems. Strong evidence supports the hypothesis of a local RAS in the Central Nervous System (CNS) and its modulatory roles in neuroendocrinology and neurotransmission.
In this narrative review, we provide a comprehensive approach to experimental and clinical data regarding RAS molecule expression and their possible roles in the physiology and physiopathology of CNS diseases.
This non-systematic review summarizes evidence on RAS implications in CNS diseases and their possible relationships with COVID-19.
We divided the possible RAS mechanisms in distinct conditions during the lifespan, approaching from congenital infections to neurodegenerative alterations, passing through mood disorders and cerebrovascular diseases. We also gathered current evidence about the possible effects of RAS in Covid-19, particularly in cases with neurological manifestations.
Although there are limitations and controversies, the analysis of RAS mechanisms in the CNS certainly represents an interesting field of research. However, further investigation is necessary to support the noteworthy interactions and provide a better comprehension of the cross-talk between RAS and the CNS. Investigations in this research field may shed light on the novel therapeutic targets.
肾素-血管紧张素系统（RAS）由一个复杂的分子级联反应组成，具有两个相互拮抗的轴，即经典轴和替代轴。血管紧张素 II 和血管紧张素-(1-7)是 RAS 的主要肽类物质，在多个器官和系统中发挥相反的作用，包括心血管、肾脏、肺和免疫系统。强有力的证据支持中枢神经系统（CNS）中存在局部 RAS 的假说，以及其在神经内分泌学和神经传递中的调节作用。
在本叙述性综述中，我们提供了对 RAS 分子表达及其在 CNS 疾病生理和病理生理学中可能作用的实验和临床数据的综合方法。
本非系统性综述总结了 RAS 对 CNS 疾病的影响及其与 COVID-19 可能存在的关系的证据。
我们根据生命过程中的不同情况，将 RAS 可能的机制分为先天性感染到神经退行性改变、情绪障碍和脑血管疾病等不同情况。我们还收集了目前关于 RAS 在 COVID-19 中可能作用的证据，特别是在有神经系统表现的病例中。
尽管存在局限性和争议，但对 CNS 中 RAS 机制的分析无疑是一个有趣的研究领域。然而，为了支持 RAS 与 CNS 之间的相互作用，并提供对 RAS 与 CNS 之间相互作用的更好理解，还需要进一步的研究。对这一研究领域的研究可能会揭示新的治疗靶点。
