Document Detail

Modulation of the renin-angiotensin-aldosterone system in sepsis: a new therapeutic approach?
MedLine Citation:
PMID:  20001206     Owner:  NLM     Status:  MEDLINE    
IMPORTANCE OF THE FIELD: Severe sepsis is characterized by relative hypotension associated with a high cardiac output, peripheral vasodilation, and organ dysfunction. The renin-angiotensin-aldosterone system (RAAS) is primarily activated to increase blood pressure, but recently potential pro-inflammatory effects of angiotensin II have attracted interest because of the reported association between angiotensin II levels and organ failure and mortality in sepsis. RAAS antagonists could represent a new therapeutic option in this setting. AREAS COVERED IN THIS REVIEW: The role of RAAS activation in severe sepsis and septic shock, and the potential benefits (and risks) of using RAAS antagonists. WHAT THE READER WILL GAIN: Insight into RAAS function in severe sepsis and the potential for RAAS inhibitors to be used as an adjunctive therapy in patients with severe sepsis, with discussion of promising results from animal models of sepsis. TAKE HOME MESSAGE: Use of RAAS antagonists is an emerging therapeutic option in severe sepsis because these agents may reduce endothelial damage, organ failure, and mortality. However, timing of administration of RAAS antagonists is important because reduced RAAS function may contribute to refractive hypotension later on in septic shock and benefits of RAAS antagonists seem to be restricted to the early phases of sepsis.
Diamantino Ribeiro Salgado; Jos? Rodolfo Rocco; Eli?zer Silva; Jean-Louis Vincent
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Expert opinion on therapeutic targets     Volume:  14     ISSN:  1744-7631     ISO Abbreviation:  Expert Opin. Ther. Targets     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-16     Completed Date:  2010-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101127833     Medline TA:  Expert Opin Ther Targets     Country:  England    
Other Details:
Languages:  eng     Pagination:  11-20     Citation Subset:  IM    
Federal University of Rio de Janeiro, Clementino Fraga Filho University Hospital, Department of Internal Medicine, Cidade Universit?ria - Ilha do Fund?o - Rio de Janeiro, Brazil.
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MeSH Terms
Angiotensin II / physiology
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Hemodynamics / drug effects,  physiology
Microcirculation / drug effects,  physiology
Receptor, Angiotensin, Type 2 / metabolism,  physiology
Renin-Angiotensin System / drug effects*,  physiology
Sepsis / drug therapy*,  physiopathology
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Receptor, Angiotensin, Type 2; 11128-99-7/Angiotensin II

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