Stoiljkovic Marko, Jakovljevic Vladimir, Milosavljevic Jovan, Bolevich Sergey, Jeremic Nevena, Canovic Petar, Fisenko Vladimir Petrovich, Tikhonov Dmitriy Alexandrovich, Krylova Irina Nikolaevna, Bolevich Stefani, Chichkova Natalia Vasilievna, Zivkovic Vladimir
General Hospital "Sveti Luka", 11300 Smederevo, Serbia.
Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.
Int J Mol Sci. 2025 Jul 25;26(15):7215. doi: 10.3390/ijms26157215.
Captopril, a well-established angiotensin-converting enzyme (ACE) inhibitor, has garnered attention for its cardioprotective effects in preventing heart remodeling and maintaining cardiac function, significantly improving life quality. However, recent studies have revealed that in addition to known hemodynamic alterations, captopril exhibits significant antioxidant, anti-inflammatory, and immunomodulatory effects that may underlie its protective mechanisms. Although it appeared to be overlooked in clinical practice, in recent years, additional efforts have been made to uncover the mechanisms of all drug effects, as recent research studies predict a wide spectrum of diseases beyond the recommended indications. This review thoroughly examines the mechanisms by which captopril mediates its protective effects, bridging basic biochemical observations with applied clinical investigation, especially during ischemic reperfusion (I/R) injury, hypertension, and heart failure (HF). Evidence points to captopril as a promising agent for modulating oxidative and inflammatory pathways that are crucial for cardiovascular medicine. Directions for future research are defined to determine the molecular targets of captopril further and to optimize its clinical utility in the management of cardiovascular and possibly other diseases.
卡托普利是一种成熟的血管紧张素转换酶（ACE）抑制剂，因其在预防心脏重塑和维持心脏功能方面的心脏保护作用而受到关注，显著提高了生活质量。然而，最近的研究表明，除了已知的血流动力学改变外，卡托普利还具有显著的抗氧化、抗炎和免疫调节作用，这些作用可能是其保护机制的基础。尽管它在临床实践中似乎被忽视了，但近年来，人们做出了更多努力来揭示所有药物作用的机制，因为最近的研究预测了超出推荐适应症范围的广泛疾病。本综述全面探讨了卡托普利介导其保护作用的机制，将基础生化观察与应用临床研究联系起来，特别是在缺血再灌注（I/R）损伤、高血压和心力衰竭（HF）期间。有证据表明，卡托普利是一种有前途的药物，可调节对心血管医学至关重要的氧化和炎症途径。确定了未来研究的方向，以进一步确定卡托普利的分子靶点，并优化其在心血管疾病及可能的其他疾病管理中的临床应用。
