Division of Pediatric Nephrology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Int J Mol Sci. 2024 Mar 14;25(6):3298. doi: 10.3390/ijms25063298.
The identification of pathological links among metabolic disorders, kidney ailments, and cardiovascular conditions has given rise to the concept of cardiovascular-kidney-metabolic (CKM) syndrome. Emerging prenatal risk factors seem to increase the likelihood of CKM syndrome across an individual's lifespan. The renin-angiotensin system (RAS) plays a crucial role in maternal-fetal health and maintaining homeostasis in cardiovascular, metabolic, and kidney functions. This review consolidates current preclinical evidence detailing how dysregulation of the RAS during pregnancy and lactation leads to CKM characteristics in offspring, elucidating the underlying mechanisms. The multi-organ effects of RAS, influencing fetal programming and triggering CKM traits in offspring, suggest it as a promising reprogramming strategy. Additionally, we present an overview of interventions targeting the RAS to prevent CKM traits. This comprehensive review of the potential role of the RAS in the early-life programming of CKM syndrome aims to expedite the clinical translation process, ultimately enhancing outcomes in cardiovascular-kidney-metabolic health.
代谢紊乱、肾脏疾病和心血管疾病之间的病理联系的确定催生了心血管-肾脏-代谢（CKM）综合征的概念。新兴的产前危险因素似乎增加了个体在整个生命周期中出现 CKM 综合征的可能性。肾素-血管紧张素系统（RAS）在母婴健康和维持心血管、代谢和肾脏功能的体内平衡方面发挥着关键作用。这篇综述综合了目前的临床前证据，详细说明了妊娠和哺乳期 RAS 失调如何导致后代出现 CKM 特征，阐明了潜在的机制。RAS 的多器官效应影响胎儿编程，并在后代中引发 CKM 特征，表明它是一种有前途的重编程策略。此外，我们还概述了针对 RAS 的干预措施，以预防 CKM 特征。本综述全面探讨了 RAS 在 CKM 综合征早期生命编程中的潜在作用，旨在加速临床转化过程，最终改善心血管-肾脏-代谢健康的结果。
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