Document Detail

Angiotensin-converting enzyme 2 is a key modulator of the renin-angiotensin system in cardiovascular and renal disease.
MedLine Citation:
PMID:  21099686     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: Angiotensin-converting enzyme 2 (ACE2) has recently emerged as a key regulator of the renin-angiotensin system in both health and disease.
RECENT FINDINGS: ACE2 deficiency is associated with elevated tissue and circulating levels of angiotensin II and reduced levels of angiotensin 1-7. Phenotypically, this results in a modest elevation in systolic blood pressure and left ventricular hypertrophy. In atherosclerosis-prone apolipoprotein E knockout mice, ACE2 deficiency results in augmented vascular inflammation and an inflammatory response that contributes to increased atherosclerotic plaque formation. In the kidney, ACE2 deficiency is associated with progressive glomerulosclerosis. Interventions such as ACE2 replenishment or augmentation of its actions have proven successful in reducing hypertension, plaque accumulation, and renal and cardiac damage in a range of different models. Although promising, the balance of the renin-angiotensin system remains complicated, with some evidence that overexpression of ACE2 may have adverse cardiac effects, and ACE2 and its metabolic products may promote epithelial-to-mesenchymal transition.
SUMMARY: Repletion of ACE2's activities offers a new strategy to complement current clinical interventions in treating hypertension, renal and cardiovascular disease. In particular conditions where ACE inhibition and angiotensin receptor blockade are partially effective, the adjunctive actions of ACE2 may not only reduce clinical escape but also augment the efficacy of interventions.
Chris Tikellis; Stella Bernardi; Wendy C Burns
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in nephrology and hypertension     Volume:  20     ISSN:  1473-6543     ISO Abbreviation:  Curr. Opin. Nephrol. Hypertens.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-02-17     Completed Date:  2011-06-08     Revised Date:  2013-05-02    
Medline Journal Info:
Nlm Unique ID:  9303753     Medline TA:  Curr Opin Nephrol Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  62-8     Citation Subset:  IM    
Division of Diabetic Complications, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
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MeSH Terms
Atherosclerosis / etiology
Cardiovascular Diseases / etiology*
Chronic Disease
Hypertension / etiology
Kidney Diseases / etiology*
Myocardium / enzymology
Peptidyl-Dipeptidase A / deficiency,  physiology*
Renin-Angiotensin System / physiology*
Reg. No./Substance:
EC A; EC 3.4.17.-/angiotensin converting enzyme 2

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