Angiotensin-converting enzyme

血管紧张素转换酶
  • 文章类型: Journal Article
    本研究研究了厌氧处理对紫色叶茶非挥发性成分和血管紧张素转换酶(ACE)抑制活性的影响。结果表明,经过8小时的厌氧处理,γ-氨基丁酸(GABA)含量从0.02mg/g显著增加到1.72mg/g(p<0.05),而乳酸含量从检测不到的水平逐渐上升到3.56mg/g。值得注意的是,某些黄酮醇如槲皮素和杨梅素表现出显著的增量,而花色苷(1.01mg/g)和表没食子儿茶素-3-(3\'\'-O-甲基)没食子酸酯(13.47mg/g)的总含量几乎没有变化。此外,在浓度为2mg/mL时,紫色叶茶的ACE抑制率从42.16%显著提高到49.20%(p<0.05)。此外,在体外ACE抑制活性和分子对接分析中,galloted儿茶素比非galloted儿茶素均显示出较强的ACE抑制活性。这些发现可能有助于开发具有潜在治疗高血压的特殊紫色叶茶产品。
    This study investigated the effect of anaerobic treatment on the non-volatile components and angiotensin-converting enzyme (ACE) inhibitory activity in purple-colored leaf tea. Results showed that after 8 h of anaerobic treatment, the γ-aminobutyric acid (GABA) content significantly increased from 0.02 mg/g to 1.72 mg/g (p < 0.05), while lactic acid content gradually rose from non-detectable levels to 3.56 mg/g. Notably, certain flavonols like quercetin and myricetin exhibited significant increments, whereas the total anthocyanins (1.01 mg/g) and epigallocatechin-3-(3\'\'-O-methyl) gallate (13.47 mg/g) contents remained almost unchanged. Furthermore, the ACE inhibition rate of purple-colored leaf tea increased significantly from 42.16% to 49.20% (p < 0.05) at a concentration of 2 mg/mL. Moreover, galloylated catechins showed stronger ACE inhibitory activity than non-galloylated catechins in both in vitro ACE inhibitory activity and molecular docking analysis. These findings might contribute to the development of special purple-colored leaf tea products with potential therapy for hypertension.
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  • 文章类型: Journal Article
    肾素-血管紧张素-醛固酮系统(RAAS)的激活在高血压中起重要的病理生理作用。血管紧张素原血管紧张素转换酶的mRNA水平增加,血管紧张素1型受体基因,Agtr1a,醛固酮合成酶基因,CYP11B2,已在心脏报告,血管,盐敏感性高血压的肾脏。然而,心血管和肾组织中RAAS各组分的基因调控机制尚不清楚。表观遗传机制,这对调节基因表达很重要,包括DNA甲基化,组蛋白翻译后修饰,和microRNA(miRNA)调控。CEBP结合位点的低DNA甲基化与内脏脂肪组织和盐敏感性高血压大鼠心脏中AGT表达增加之间存在密切联系。一些miRNA影响AGT表达并与心血管疾病相关。ACE和ACE2基因的表达均受DNA甲基化调控,组蛋白修饰,和miRNA。血管紧张素原和CYP11B2的表达受表观遗传修饰可逆调节,并与盐敏感性高血压有关。盐皮质激素受体(MR)存在于心血管和肾脏组织中,其中许多miRNA影响表达并有助于高血压的发病机制。11β-羟基类固醇脱氢酶2型(HSD11B2)基因的表达也受甲基化和miRNA的调控。肾脏和血管HSD11B2的表观遗传调节是盐敏感性高血压的重要致病机制。
    Activation of the renin-angiotensin-aldosterone system (RAAS) plays an important pathophysiological role in hypertension. Increased mRNA levels of the angiotensinogen angiotensin-converting enzyme, angiotensin type 1 receptor gene, Agtr1a, and the aldosterone synthase gene, CYP11B2, have been reported in the heart, blood vessels, and kidneys in salt-sensitive hypertension. However, the mechanism of gene regulation in each component of the RAAS in cardiovascular and renal tissues is unclear. Epigenetic mechanisms, which are important for regulating gene expression, include DNA methylation, histone post-translational modifications, and microRNA (miRNA) regulation. A close association exists between low DNA methylation at CEBP-binding sites and increased AGT expression in visceral adipose tissue and the heart of salt-sensitive hypertensive rats. Several miRNAs influence AGT expression and are associated with cardiovascular diseases. Expression of both ACE and ACE2 genes is regulated by DNA methylation, histone modifications, and miRNAs. Expression of both angiotensinogen and CYP11B2 is reversibly regulated by epigenetic modifications and is related to salt-sensitive hypertension. The mineralocorticoid receptor (MR) exists in cardiovascular and renal tissues, in which many miRNAs influence expression and contribute to the pathogenesis of hypertension. Expression of the 11beta-hydroxysteroid dehydrogenase type 2 (HSD11B2) gene is also regulated by methylation and miRNAs. Epigenetic regulation of renal and vascular HSD11B2 is an important pathogenetic mechanism for salt-sensitive hypertension.
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  • 文章类型: Journal Article
    背景:高血压是印度尼西亚普遍存在的健康问题,高比例的患者对ACE抑制剂治疗无反应。方法:这项多中心病例对照研究调查了印度尼西亚高血压患者ACEI/D与卡托普利疗效之间的相关性。高血压患者分为对照组(n=69)和病例组(n=73)。使用PCR和电泳鉴定ACEI/D。结果:基因型频率或等位基因分布均无明显差异。三种基因型之间的血压降低差异也缺乏统计学意义。结论:在印度尼西亚高血压患者中,卡托普利治疗后,ACEI/D与血压降低没有显着相关。这些结果强调了ACEI/D在卡托普利治疗高血压中的有限预测效用。
    [方框:见正文]。
    Background: Hypertension is a prevalent health concern in Indonesia, with a high percentage of patients unresponsive to ACE inhibitor treatment. Methods: This multicenter case-control study investigated the correlation between ACE I/D and captopril effectiveness in Indonesian hypertensive patients. Hypertensive patients were divided into control (n = 69) and case (n = 73) groups. ACE I/D was identified using PCR and electrophoresis. Results: No significant differences in genotype frequencies or allele distribution were observed. The difference of blood pressure reduction among the three genotypes also lacked statistical significance. Conclusion: ACE I/D is not significantly associated with blood pressure reduction following captopril therapy in Indonesian hypertensive patients. These results underscore the limited predictive utility of ACE I/D in managing hypertension with captopril.
    [Box: see text].
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  • 文章类型: Journal Article
    异亮氨酸-脯氨酸-脯氨酸(Ile-Pro-Pro,IPP)是抑制血管紧张素转换酶(ACE)活性的天然食物源三肽。这项研究的目的是确定IPP在减弱交感神经活动中的中枢和外周作用。氧化应激和高血压。雄性Sprague-Dawley大鼠接受假手术(Sham)或两肾一夹(2K1C)手术,以诱发肾血管性高血压。记录肾交感神经活动和血压。向下丘脑室旁核(PVN)双侧微量注射IPP减弱了交感神经活动(-16.1±2.5%,P<0.001)和高血压(-8.7±1.5mmHg,P<0.01)在2K1C大鼠中通过抑制ACE活性以及随后的血管紧张素II和PVN中的超氧化物产生。静脉内注射IPP也减弱了交感神经活动(-15.1±2.1%,P<0.001)和高血压(-16.8±2.3mmHg,P<0.001)通过抑制2K1C大鼠PVN和动脉的ACE活性和氧化应激。静脉内IPP的作用持续时间比PVN微量注射的作用持续时间长,但是静脉注射的交感神经抑制作用比PVN微量注射晚。腹膜内注射IPP(400pmol/天,持续20天)可通过抑制2K1C大鼠PVN和动脉的ACE活性和氧化应激来减轻高血压和血管重塑。这些结果表明IPP通过抑制ACE活性和氧化应激来减弱高血压和交感神经活性。外周IPP的交感神经抑制作用主要是由ACE抑制PVN引起的,降压作用与交感神经抑制和动脉ACE抑制有关。长期腹膜内IPP治疗减轻高血压,氧化应激和血管重塑。
    Isoleucine-proline-proline (Ile-Pro-Pro, IPP) is a natural food source tripeptide that inhibits angiotensin-converting enzyme (ACE) activity. The aim of this study was to determine the central and peripheral roles of IPP in attenuating sympathetic activity, oxidative stress and hypertension. Male Sprague-Dawley rats were subjected to sham-operated surgery (Sham) or two-kidney one-clip (2K1C) surgery to induce renovascular hypertension. Renal sympathetic nerve activity and blood pressure were recorded. Bilateral microinjections of IPP to hypothalamic paraventricular nucleus (PVN) attenuated sympathetic activity (-16.1 ± 2.5%, P < 0.001) and hypertension (-8.7 ± 1.5 mmHg, P < 0.01) in 2K1C rats by inhibiting ACE activity and subsequent angiotensin II and superoxide production in the PVN. Intravenous injections of IPP also attenuated sympathetic activity (-15.1 ± 2.1%, P < 0.001) and hypertension (-16.8 ± 2.3 mmHg, P < 0.001) via inhibiting ACE activity and oxidative stress in both PVN and arteries of 2K1C rats. The duration of the effects of the intravenous IPP was longer than those of the PVN microinjection, but the sympatho-inhibitory effect of intravenous injections occurred later than that of the PVN microinjection. Intraperitoneal injection of IPP (400 pmol/day for 20 days) attenuated hypertension and vascular remodeling via inhibiting ACE activity and oxidative stress in both PVN and arteries of 2K1C rats. These results indicate that IPP attenuates hypertension and sympathetic activity by inhibiting ACE activity and oxidative stress. The sympathoinhibitory effect of peripheral IPP is mainly caused by the ACE inhibition in PVN, and the antihypertensive effect is related to the sympathoinhibition and the arterial ACE inhibition. Long-term intraperitoneal IPP therapy attenuates hypertension, oxidative stress and vascular remodeling.
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  • 文章类型: Journal Article
    肾素-血管紧张素-醛固酮系统(RAAS)与全身性和神经性高血压有关。RAAS抑制剂的输注降低了交感神经节的动脉压和使用依赖性突触传递的功效。当前的研究旨在阐明RAAS介导的受体对左心室心肌细胞的影响以及高血压转基因模型心脏中肌膜结合载体系统的作用。与正常血压的啮齿动物相比,在(mREN2)27转基因动物中观察到血管紧张素II(AngII)受体亚型1(AT1R)的mRNA和蛋白质表达显着增加。同时,在高血压啮齿类动物中,AT1R上调,MAS1原癌基因蛋白受体和AngII亚型2受体下调.肌膜Na+-K+-ATP酶的表达有修饰,Na+-Ca2+交换剂,和转基因高血压模型中的肌内质网钙ATP酶。这些观察结果表明,慢性RAAS激活导致受体平衡发生变化,有利于通过修饰膜结合的载体蛋白和血压来增强心脏收缩力和破坏钙处理。该研究提供了对RAAS介导的心脏功能障碍的潜在机制的见解,并强调了在高血压中靶向AngII保护臂的潜在价值。
    The Renin-Angiotensin-Aldosterone System (RAAS) has been implicated in systemic and neurogenic hypertension. The infusion of RAAS inhibitors blunted arterial pressure and efficacy of use-dependent synaptic transmission in sympathetic ganglia. The current investigation aims to elucidate the impact of RAAS-mediated receptors on left ventricular cardiomyocytes and the role of the sarcolemma-bound carrier system in the heart of the hypertensive transgene model. A significant increase in mRNA and the protein expression for angiotensin II (AngII) receptor subtype-1 (AT1R) was observed in (mREN2)27 transgenic compared to the normotensive rodents. Concurrently, there was an upregulation in AT1R and a downregulation in the MAS1 proto-oncogene protein receptor as well as the AngII subtype-2 receptor in hypertensive rodents. There were modifications in the expressions of sarcolemma Na+-K+-ATPase, Na+-Ca2+ exchanger, and Sarcoendoplasmic Reticulum Calcium ATPase in the transgenic hypertensive model. These observations suggest chronic RAAS activation led to a shift in receptor balance favoring augmented cardiac contractility and disruption in calcium handling through modifications of membrane-bound carrier proteins and blood pressure. The study provides insight into mechanisms underlying RAAS-mediated cardiac dysfunction and highlights the potential value of targeting the protective arm of AngII in hypertension.
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  • 文章类型: Journal Article
    血管紧张素转换酶(ACE,EC3.4.15.1)是调节血压的非常重要的因素。此外,天然化合物对ACE的抑制作用已成为治疗高血压的重要研究领域。从绵羊血浆中纯化并表征ACE。分子对接研究与硫胺素的抑制作用,核黄素,和卡托普利对ACE的影响进行了研究。
    这里,通过亲和层析从绵羊血浆中纯化ACE。研究了硫胺素和核黄素对ACE的影响。进行了分子对接研究,以了解硫胺素之间的分子相互作用,核黄素,和卡托普利与ACE。
    发现纯化系数为8636倍。硫胺素的结合能,核黄素,卡托普利的浓度为-6.7千卡/摩尔,-8.1千卡/摩尔,和-5.5千卡/摩尔,分别。硫胺素与ASP:415,HIS:513和LYS:454符合三个常规氢键。核黄素与GLN:281,GLU:376,THR:282和TYR:520形成四个常规氢键。卡托普利与ARG:124形成两个常规氢键,一个与TYR:62和ASN:85形成常规氢键,一个与ASN:66形成碳氢键。分子对接结果表明,硫胺素,核黄素,卡托普利通过氢键和疏水相互作用与ACE相互作用。硫胺素和核黄素对ACE有明显的抑制作用。硫胺素的IC50值,核黄素,卡托普利被发现为960.56µM,11.02µM,和1.60nM,分别。硫胺素的Ki值,核黄素,和卡托普利被确定为1352.04µM,12.30µM,和1.06nM,分别。
    在这项工作中,结论是硫胺素和核黄素可能具有ACE抑制剂作用对高血压具有预防和治疗作用。硫胺素和核黄素显示出比卡托普利更低的抑制作用和更高的IC50。然而,当硫胺素和核黄素维生素的抑制作用与卡托普利相比时,结论是它们可能是副作用较小的天然抑制剂。
    UNASSIGNED: Angiotensin-converting enzyme (ACE, EC 3.4.15.1) is a very important factor in the regulation of blood pressure. Also, the inhibition of ACE with natural compounds has been a very important research area in the treatment of high blood pressure. ACE was purified and characterized from sheep plasma. Molecular docking studies and the inhibition effect of thiamine, riboflavin, and captopril on ACE were investigated.
    UNASSIGNED: Herein, ACE was purified from sheep plasma by affinity chromatography. The effect of thiamine and riboflavin on ACE was researched. Molecular docking studies were performed to understand the molecular interactions between thiamine, riboflavin, and captopril with ACE.
    UNASSIGNED: The purification coefficient was found to be 8636 fold. The binding energy of thiamine, riboflavin, and captopril was found to be -6.7 kcal/mol, -8.1 kcal/mol, and -5.5 kcal/mol, respectively. Thiamine conformed to three conventional hydrogen bonds with ASP:415, HIS:513, and LYS:454. Riboflavin formed four conventional hydrogen bonds with GLN:281, GLU:376, THR:282, and TYR:520. Captopril formed two conventional hydrogen bonds with ARG:124, one conventional hydrogen bond with TYR:62 and ASN:85, and one carbon-hydrogen bond with ASN:66. Molecular docking results showed that thiamine, riboflavin, and captopril interacted with ACE through hydrogen bonding and hydrophobic interactions. Thiamine and riboflavin indicated significant inhibition effects on ACE. The IC50 values of thiamine, riboflavin, and captopril were found as 960.56 µM, 11.02 µM, and 1.60 nM, respectively. Ki values for thiamine, riboflavin, and captopril were determined as 1352.04 µM, 12.30 µM, and 1.06 nM, respectively.
    UNASSIGNED: In this work, it was concluded that thiamine and riboflavin may have preventive and therapeutical impacts against high blood pressure with their ACE inhibitor effect. Thiamine and riboflavin showed a lower inhibitory effect with a higher IC50 than captopril. However, when the inhibitory effect of thiamine and riboflavin vitamins is compared to captopril, it is concluded that they may be natural inhibitors with fewer side effects.
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  • 文章类型: Journal Article
    冠状病毒(CoV)属于RNA病毒家族。已知该家族中的病毒在人类中引起轻度呼吸道疾病。导致冠状病毒-19疾病(COVID-19)的新型SARS-COV2病毒的起源是中国武汉市,它从那里传播以引起全球大流行。尽管肺部是19型冠状病毒病(COVID-19)的主要靶器官,自从它爆发以来,已知这种疾病会影响心脏,血管,肾,肠,肝脏和大脑。本文旨在总结冠状病毒病-19对心脏和肝脏的灾难性影响及其发病机制。
    本评论中使用的信息来自PubMed上发表的相关文章,谷歌学者,Google,世卫组织网站,CDC和其他来源。使用与COVID-19相关的关键搜索语句和短语来检索信息。原创研究文章,审查文件,研究信函和病例报告被用作信息来源。
    除了造成严重的肺损伤,据报道,COVID-19还影响并导致许多其他器官的功能障碍。COVID-19感染可通过下调膜结合活性血管紧张素转换酶(ACE)来影响人。ACE2表达不足的人更容易感染COVID-19。患者预先存在的合并症是使个体易患严重COVID-19的主要危险因素。
    疾病的严重程度及其广谱表型是直接和间接致病因素综合作用的结果。因此,协调许多治疗偏好的方案应该是使疾病降级并避免由于疾病引起的多器官损伤和功能障碍而导致的死亡的最佳替代方案。
    UNASSIGNED: Coronaviruses (CoVs) belong to the RNA viruses family. The viruses in this family are known to cause mild respiratory disease in humans. The origin of the novel SARS-COV2 virus that caused the coronavirus-19 disease (COVID-19) is the Wuhan city in China from where it disseminated to cause a global pandemic. Although lungs are the predominant target organ for Coronavirus Disease-19 (COVID-19), since its outbreak, the disease is known to affect heart, blood vessels, kidney, intestine, liver and brain. This review aimed to summarize the catastrophic impacts of Coronavirus disease-19 on heart and liver along with its mechanisms of pathogenesis.
    UNASSIGNED: The information used in this review was obtained from relevant articles published on PubMed, Google Scholar, Google, WHO website, CDC and other sources. Key searching statements and phrases related to COVID-19 were used to retrieve information. Original research articles, review papers, research letters and case reports were used as a source of information.
    UNASSIGNED: Besides causing severe lung injury, COVID-19 has also been reported to affect and cause dysfunction of many other organs. COVID-19 infection can affect people by downregulating membrane-bound active angiotensin-converting enzyme (ACE). People who have deficient ACE2 expression are more vulnerable to COVID-19 infection. The patients\' pre-existing co-morbidities are major risk factors that predispose individuals to severe COVID-19.
    UNASSIGNED: The disease severity and its broad spectrum phenotype is a result of combined direct and indirect pathogenic factors. Therefore, protocols that harmonize many therapeutic preferences should be the best alternatives to de-escalate the disease and obviate deaths caused as a result of multiple organ damage and dysfunction induced by the disease.
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  • 文章类型: Journal Article
    炎症性肠病(IBD)是一种由肠中的免疫疾病引起的非特异性慢性炎症性疾病,易于复发和无法治愈。对IBD发病机制的认识尚不清楚。在这项研究中,我们发现ACE(血管紧张素转换酶),在肠道中大量表达,在IBD中发挥着重要作用。斑马鱼中ACE的缺失引起肠道炎症,炎症标记基因白细胞介素1β(il1b)表达增加,基质金属肽酶9(mmp9),骨髓特异性过氧化物酶(mpx),白细胞衍生的趋化因子-2-样(凝集素2l),和趋化因子(C-X-C基序)配体8b(cxcl8b)。此外,e-/-突变体的粘液分泌明显高于野生型斑马鱼,验证肠道炎症的表型。使用葡聚糖硫酸钠(DSS)构建的IBD模型进一步证实了这一点,其中突变斑马鱼对肠炎的易感性更高。我们的研究揭示了ACE在肠道稳态中的作用,为潜在的治疗干预提供了新的目标。
    Inflammatory bowel disease (IBD) is a nonspecific chronic inflammatory disease resulting from an immune disorder in the intestine that is prone to relapse and incurable. The understanding of the pathogenesis of IBD remains unclear. In this study, we found that ace (angiotensin-converting enzyme), expressed abundantly in the intestine, plays an important role in IBD. The deletion of ace in zebrafish caused intestinal inflammation with increased expression of the inflammatory marker genes interleukin 1 beta (il1b), matrix metallopeptidase 9 (mmp9), myeloid-specific peroxidase (mpx), leukocyte cell-derived chemotaxin-2-like (lect2l), and chemokine (C-X-C motif) ligand 8b (cxcl8b). Moreover, the secretion of mucus in the ace-/- mutants was significantly higher than that in the wild-type zebrafish, validating the phenotype of intestinal inflammation. This was further confirmed by the IBD model constructed using dextran sodium sulfate (DSS), in which the mutant zebrafish had a higher susceptibility to enteritis. Our study reveals the role of ace in intestinal homeostasis, providing a new target for potential therapeutic interventions.
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  • 文章类型: Journal Article
    背景:这项研究的目的是确定伊朗人群(伊朗西阿塞拜疆省)中CAD患者和健康对照者的血管紧张素转换酶(ACE)基因(I/D)变异。
    方法:这项横断面研究包括95名CAD患者和203名健康对照。使用PCR评估ACEI/D多态性,并确定了它们的频率。
    结果:有298人,95名CAD患者,和203个控件,平均年龄50.96±3.45和51.14±10.20。我们发现CAD患者的D等位基因频率明显高于对照组(P=0.0009)。相比之下,对照组中I等位基因的频率显著高于CAD患者(P=0.0009).CAD患者中D等位基因携带者基因型(DDID)的频率高于对照组(P=0.008)。ACEII基因型状态携带者在对照组中比在CAD患者中更常见(P=0.008)。然而,在ACEID基因型的情况下,试验组中无显著差异(P=0.47).
    结论:这些发现表明ACEDD基因型的个体易患CAD,而具有ACEII基因型状态的个体受到保护。
    BACKGROUND: The purpose of this study was to identify the angiotensin-converting enzyme (ACE) gene (I/D) variations in CAD patients and healthy controls in an Iranian population (West Azerbaijan province of Iran).
    METHODS: This cross-sectional study included 95 CAD patients and 203 healthy controls. ACE I/D polymorphisms were assessed using PCR, and their frequency was determined.
    RESULTS: There were 298 people, 95 CAD patients, and 203 controls, with an average age of 50.96±3.45 and 51.14±10.20. We discovered that the frequency of the D allele was significantly higher in CAD patients than in controls (P = 0.0009). In contrast, the frequency of the I allele was significantly higher in controls than in CAD patients (P = 0.0009). The D allele carriers genotypes (DD + ID) were more frequent in the CAD patients than in the control group (P = 0.008). The ACE II genotype-state carriers were more common in the control group than in CAD patients (P = 0.008). However, in the case of the ACE ID genotype, no significant differences were not found in the tested groups (P = 0.47).
    CONCLUSIONS: These findings suggest that individuals with the ACE DD genotype are predisposed to CAD, whereas individuals with the ACE II genotype state are protected.
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  • 文章类型: Journal Article
    近年来,危重病人对肾素-血管紧张素-醛固酮系统的兴趣重新兴起。新出现的数据表明,这个至关重要的稳态系统,在压力条件下对维持全身和肾脏血流动力学起着至关重要的作用,在感染性休克时发生了改变,最终导致血管紧张素II-血管紧张素II1型受体信号传导受损。的确,来自实验模型和人体研究的现有证据表明,感染性休克期间肾素-血管紧张素-醛固酮系统的改变可发生在三个不同的水平:1.血管紧张素II的生成受损,可能归因于血管紧张素转换酶活性的缺陷;2.肽酶对血管紧张素II的降解增强;和/或3.由于内在化或合成减少导致血管紧张素II1型受体的不可用性。这些改变可以独立发生或组合发生,最终导致肾素-血管紧张素-醛固酮系统输入和下游血管紧张素II1型受体信号之间的解偶联。目前尚不清楚外源性血管紧张素II输注是否可以充分解决所有这些机制。可能需要额外的干预措施。这些观察为研究开辟了新的途径,并为改善患者预后的新治疗策略提供了潜力。在不久的将来,对感染性休克中肾素-血管紧张素-醛固酮系统改变的更深入了解应有助于破译患者的表型并实施有针对性的干预措施.
    Recent years have seen a resurgence of interest for the renin-angiotensin-aldosterone system in critically ill patients. Emerging data suggest that this vital homeostatic system, which plays a crucial role in maintaining systemic and renal hemodynamics during stressful conditions, is altered in septic shock, ultimately leading to impaired angiotensin II-angiotensin II type 1 receptor signaling. Indeed, available evidence from both experimental models and human studies indicates that alterations in the renin-angiotensin-aldosterone system during septic shock can occur at three distinct levels: 1. Impaired generation of angiotensin II, possibly attributable to defects in angiotensin-converting enzyme activity; 2. Enhanced degradation of angiotensin II by peptidases; and/or 3. Unavailability of angiotensin II type 1 receptor due to internalization or reduced synthesis. These alterations can occur either independently or in combination, ultimately leading to an uncoupling between the renin-angiotensin-aldosterone system input and downstream angiotensin II type 1 receptor signaling. It remains unclear whether exogenous angiotensin II infusion can adequately address all these mechanisms, and additional interventions may be required. These observations open a new avenue of research and offer the potential for novel therapeutic strategies to improve patient prognosis. In the near future, a deeper understanding of renin-angiotensin-aldosterone system alterations in septic shock should help to decipher patients\' phenotypes and to implement targeted interventions.
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