Angiotensin/renin modulators

Autonomic and hormonal control of cardiovascular function. Note that two feedback loops are present the autonomic nervous system loop and the hormonal loop. The sympathetic nervous system directly influences four major variables peripheral vascular resistance, heart rate, force, and venous tone. It also directly modulates renin production (not shown). The parasympathetic nervous system directly influences heart rate. In addition to its role in stimulating aldosterone secretion, angiotensin II directly increases peripheral vascular resistance and facilitates sympathetic effects (not shown). The net feedback effect of each loop is to compensate for changes in arterial blood pressure. Thus, decreased blood pressure due to blood loss would evoke increased sympathetic outflow and renin release. Conversely, elevated pressure due to the administration of a vasoconstrictor drug would cause reduced sympathetic outflow, reduced renin release, and increased parasympathetic (vagal) outflow. 

Lacourciere Y, Brunner H, Irwin R, Karlberg BE, Ramsay LE, Snavely DB, Dobbins TW, Faison EP, Nelson EB. Effects of modulators of the renin-angiotensin-aldosterone system on cough. Losartan Cough Study Group. J Hypertens 1994 12(12) 1387-93. 

Lacourciere Y, Lefebvre J. Modulation of the renin-angiotensin-aldosterone system and cough. Can J Cardiol 1995 ll(Suppl F) F33-9. 

Renin is an enzyme that is stored in the juxtaglomerular cells, which are located in the afferent arterioles of the kidney. The release of renin is modulated by several factors intrarenal factors (e.g., renal perfusion pressure, catecholamines, and angiotensin II) and extrarenal factors (e.g., sodium, chloride, and potassium). 

Robbins ME, Diz D1 (2006) Pathogenic role of the renin-angiotensin system in modulating radiation-induced late effects. Int J Radiat Oncol Biol Phys 64 6-12 Roberts AB (1999) TGF-beta signaling from receptors to the nucleus. Microbes Infect 1 1265-1273 Robertson JM, Ten Haken RK, Hazuka MB et al. (1997) Dose escalation for non-small cell lung cancer using conformal radiation therapy. Int J Radiat Oncol Biol Phys 37 1079-1085... 

Cheng, Q., Li, Y. C., Boucher, B. J., Leung, P. S. 2011. A novel role for vitamin D Modulation of expression and function of the local renin-angiotensin system in mouse pancreatic islets. Diabetologia, 54 2077-81. 

To date the most effective treatments for diabetic nephropathy target the RAS. It is clearly evident that the RAS play a fundamental role in the development of diabetic complications, specifically diabetic nephropathy. The introduction of ARBs and RAS antagonists into the treatment regimen of diabetic patients has markedly improved the rates of progression of diabetic nephropathy and subsequent end-stage renal disease. The renin-angiotensin system (RAS) is a co-ordinated hormonal cascade, which modulates vasoconstriction and facilitates renal-sodium absorption to maintain blood... 

---