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Role of the renin–angiotensin system on abdominal aortic aneurysms
Author(s) -
Malekzadeh Sonaz,
FragaSilva Rodrigo A.,
Trachet Bram,
Montecucco Fabrizio,
Mach François,
Stergiopulos Nikolaos
Publication year - 2013
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12173
Subject(s) - abdominal aortic aneurysm , medicine , pathophysiology , renin–angiotensin system , angiotensin ii , narrative review , aortic aneurysm , disease , angiotensin converting enzyme , angiotensin receptor blockers , bioinformatics , receptor , aneurysm , intensive care medicine , surgery , aorta , blood pressure , biology
Background Abdominal aortic aneurysm ( AAA ) is a complex degenerative disease, which leads to morbidity and mortality in a large portion of the elderly population. Current treatment options for AAA are quite limited as there is no proven indication for pharmacological therapy and surgery is recommended for AAA larger than 5·5 cm in luminal diameter. Thus, there is a great need to elucidate the underlying pathophysiological cellular and molecular mechanisms to develop effective therapies. In this narrative review, we will discuss recent findings concerning some potential molecular and clinical aspects of the renin–angiotensin system ( RAS ) in AAA pathophysiology. Materials and methods This narrative review is based on the material found on MEDLINE and P ub M ed up to A pril 2013. We looked for the terms ‘angiotensin, AT 1 receptor, ACE inhibitors’ in combination with ‘abdominal aortic aneurysm, pathophysiology, pathways’. Results Several basic research and clinical studies have recently investigated the role of the RAS in AAA . In particular, the subcutaneous infusion of Angiotensin II has been shown to induce AAA in A po 56 knockout mice. On the other hand, the pharmacological treatments targeting this system have been shown as beneficial in AAA patients. Conclusions Emerging evidence suggests that RAS may act as a molecular and therapeutic target for treating AAA . However, several issues on the role of RAS and the protective activities of angiotensin‐converting enzyme ( ACE ) inhibitors and Angiotensin 1 receptors blockers against AAA require further clarifications.