Renin-angiotensin-system, a potential pharmacological candidate, in acute respiratory distress syndrome during mechanical ventilation.

Abstract

While effective treatments for acute respiratory distress syndrome (ARDS) are lacking, mechanical lung ventilation can sustain adequate gas exchange in critically ill patients with respiratory failure due to ARDS. However, as a result of the phenomenon of ventilator-induced lung injury (VILI), there is an increasing need to seek beneficial pharmacological therapies for ARDS. Recent studies have suggested the renin-angiotensin system (RAS), which consists of the ACE/Ang-II/AT1R axis and ACE2/Ang-(1-7)/MasR axis, plays a dual role in the pathogenesis of ARDS and VILI. This review highlights the deleterious action of ACE/Ang-II/AT1R axis and the beneficial role of ACE2/Ang-(1-7)/MasR axis, as well as AT2R, in VILI and ARDS, and also discusses the possibility of targeting RAS components with pharmacological interventions to improve outcomes in ARDS.

• Authors: Di Wang, Xiao-Qing Chai, Costan G Magnussen, Graeme R Zosky, Shu-Hua Shu, Xin Wei, Shan-Shan Hu
• Journal: Pulmonary pharmacology & therapeutics (Pulm Pharmacol Ther) Vol. 58 Pg. 101833 (10 2019) ISSN: 1522-9629 [Electronic] England
• PMID: 31376462 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright © 2019 Elsevier Ltd. All rights reserved.

Topics

• Animals
• Humans
• Proto-Oncogene Mas
• Renin-Angiotensin System (drug effects)
• Respiration, Artificial (adverse effects)
• Respiratory Distress Syndrome (pathology, prevention & control, therapy)
• Ventilator-Induced Lung Injury (drug therapy, pathology, prevention & control)