Kanugula Ashok Kumar, Kaur Jasleen, Batra Jaskaran, Ankireddypalli Anvitha R, Velagapudi Ravikanth
Department of Internal Medicine, Wellstar Health System - Spalding Regional Hospital, Griffin, USA.
Department of Endocrinology, Diabetes, and Metabolism, HealthPartners, Minneapolis, USA.
Cureus. 2023 Jun 21;15(6):e40725. doi: 10.7759/cureus.40725. eCollection 2023 Jun.
The classical view of the renin-angiotensin system (RAS) is that of the circulating hormone pathway involved in salt and water homeostasis and blood pressure regulation. It is also involved in the pathogenesis of cardiac and renal disorders. This led to the creation of drugs blocking the actions of this classical pathway, which improved cardiac and renal outcomes. Our understanding of the RAS has significantly expanded with the discovery of new peptides involved in this complex pathway. Over the last two decades, a counter-regulatory or protective pathway has been discovered that opposes the effects of the classical pathway. Components of RAS are also implicated in the pathogenesis of obesity and its metabolic diseases. The continued discovery of newer molecules also provides novel therapeutic targets to improve disease outcomes. This article aims to provide an overview of an updated understanding of the RAS, its role in physiological and pathological processes, and potential novel therapeutic options from RAS for managing cardiorenal disorders, obesity, and related metabolic disorders.
肾素-血管紧张素系统（RAS）的传统观点认为，它是参与盐和水平衡以及血压调节的循环激素途径。它也参与心脏和肾脏疾病的发病机制。这促使人们研发出阻断这一传统途径作用的药物，这些药物改善了心脏和肾脏疾病的预后。随着参与这一复杂途径的新肽段的发现，我们对RAS的认识有了显著扩展。在过去二十年中，人们发现了一条与传统途径作用相反的反调节或保护途径。RAS的组成部分也与肥胖及其代谢性疾病的发病机制有关。不断发现的新分子也为改善疾病预后提供了新的治疗靶点。本文旨在概述对RAS的最新认识、其在生理和病理过程中的作用，以及RAS用于治疗心肾疾病、肥胖和相关代谢紊乱的潜在新治疗选择。
