Emerging drugs which target the renin-angiotensin-aldosterone system.

Abstract

INTRODUCTION:

The renin-angiotensin-aldosterone system (RAAS) is already the most important target for drugs in the cardiovascular system. However, still new developments are underway to interfere with the system on different levels.

AREAS COVERED:

The novel strategies to interfere with RAAS aim to reduce the synthesis of the two major RAAS effector hormones, angiotensin (Ang) II and aldosterone, or interfere with their receptors, AT1 and mineralocorticoid receptor, respectively. Moreover, novel targets have been identified in RAAS, such as the (pro)renin receptor, and molecules, which counteract the classical actions of Ang II and are therefore beneficial in cardiovascular diseases. These include the AT2 receptor and the ACE2/Ang-(1-7)/Mas axis. The search for drugs activating these tissue-protective arms of RAAS is therefore the most innovative field in RAAS pharmacology.

EXPERT OPINION:

Most of the novel pharmacological strategies to inhibit the classical RAAS need to prove their superiority above the existing treatment in clinical trials and then have to compete against these now quite cheap drugs in a competitive market. The newly discovered targets have functions beyond the cardiovascular system opening up novel therapeutic areas for drugs interfering with RAAS components.

• Authors: Ulrike Muscha Steckelings, Ludovit Paulis, Thomas Unger, Michael Bader
• Journal: Expert opinion on emerging drugs (Expert Opin Emerg Drugs) Vol. 16 Issue 4 Pg. 619-30 (Dec 2011) ISSN: 1744-7623 [Electronic] England
• PMID: 21905943 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Antihypertensive Agents
• Drugs, Investigational
• Angiotensin II
• Aldosterone

Topics

• Aldosterone (biosynthesis)
• Angiotensin II (biosynthesis)
• Antihypertensive Agents (administration & dosage, adverse effects, pharmacology, therapeutic use)
• Clinical Trials as Topic
• Drug Design
• Drugs, Investigational (administration & dosage, adverse effects, pharmacology, therapeutic use)
• Humans
• Hypertension (drug therapy, metabolism)
• Renin-Angiotensin System (drug effects)
• Treatment Outcome