Maranduca Minela Aida, Cosovanu Mihai Andrei, Clim Andreea, Pinzariu Alin Constantin, Filip Nina, Drochioi Ilie Cristian, Vlasceanu Vlad Ionut, Timofte Daniel Vasile, Nemteanu Roxana, Plesa Alina, Pertea Mihaela, Serban Ionela Lacramioara
Discipline of Physiology, Department of Morpho-Functional Sciences II, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Internal Medicine Clinic, "St. Spiridon" County Clinical Emergency Hospital, 700115 Iasi, Romania.
Diagnostics (Basel). 2023 Nov 7;13(22):3398. doi: 10.3390/diagnostics13223398.
Autoimmune dermatological diseases (AIDD) encompass a diverse group of disorders characterized by aberrant immune responses targeting the skin and its associated structures. In recent years, emerging evidence suggests a potential involvement of the renin-angiotensin system (RAS) in the pathogenesis and progression of these conditions. RAS is a multicomponent cascade, primarily known for its role in regulating blood pressure and fluid balance. All of the RAS components play an important role in controlling inflammation and other immune responses. Angiotensin II, the main effector, acts on two essential receptors: Angiotensin Receptor 1 and 2 (AT1R and AT2R). A disturbance in the axis can lead to many pathological processes, including autoimmune (AI) diseases. AT1R activation triggers diverse signaling cascades involved in inflammation, fibrosis and tissue remodeling. Experimental studies have demonstrated the presence of AT1R in various cutaneous cells and immune cells, further emphasizing its potential contribution to the AI processes in the skin. Furthermore, recent investigations have highlighted the role of other RAS components, beyond angiotensin-converting enzyme (ACE) and Ang II, that may contribute to the pathophysiology of AIDD. Alternative pathways involving ACE2, Ang receptors and Ang-(1-7) have been implicated in regulating immune responses and tissue homeostasis within the skin microenvironment. Understanding the intricate involvement of the RAS in AIDD may provide novel therapeutic opportunities. Targeting specific components of the RAS, such as angiotensin receptor blockers (ARBs), ACE inhibitors (ACEIs) or alternative RAS pathway modulators, could potentially ameliorate inflammatory responses, reduce tissue damage and lessen disease manifestations. Further research is warranted to outline the exact mechanisms underlying RAS-mediated immune dysregulation in AIDD. This abstract aims to provide a concise overview of the intricate interplay between the RAS and AIDD. Therefore, we elaborate a systematic review of the potential challenge of RAS in the AIDD, including psoriasis, systemic sclerosis, vitiligo, lupus erythematosus and many more.
自身免疫性皮肤病（AIDD）涵盖了一组多样的疾病，其特征是针对皮肤及其相关结构的异常免疫反应。近年来，新出现的证据表明肾素-血管紧张素系统（RAS）可能参与了这些疾病的发病机制和进展。RAS是一个多组分级联反应，主要因其在调节血压和体液平衡中的作用而闻名。RAS的所有组分在控制炎症和其他免疫反应中都起着重要作用。主要效应物血管紧张素II作用于两种重要受体：血管紧张素受体1和2（AT1R和AT2R）。该轴的紊乱可导致许多病理过程，包括自身免疫（AI）疾病。AT1R激活会触发参与炎症、纤维化和组织重塑的多种信号级联反应。实验研究已证明AT1R存在于各种皮肤细胞和免疫细胞中，进一步强调了其对皮肤中AI过程的潜在贡献。此外，最近的研究突出了除血管紧张素转换酶（ACE）和血管紧张素II之外的其他RAS组分在AIDD病理生理学中的作用。涉及ACE2、血管紧张素受体和血管紧张素-（1-7）的替代途径已被证明与调节皮肤微环境中的免疫反应和组织稳态有关。了解RAS在AIDD中的复杂参与情况可能会提供新的治疗机会。靶向RAS的特定组分，如血管紧张素受体阻滞剂（ARB）、ACE抑制剂（ACEI）或替代RAS途径调节剂，可能会改善炎症反应、减少组织损伤并减轻疾病表现。有必要进行进一步研究以阐明RAS介导的AIDD免疫失调的确切机制。本摘要旨在简要概述RAS与AIDD之间的复杂相互作用。因此，我们对RAS在AIDD（包括银屑病、系统性硬化症、白癜风、红斑狼疮等）中的潜在挑战进行了系统综述。
