Peptide Hormones of the Kidney Renin-Angiotensin System

21 PEPTIDE HORMONES OF THE KIDNEY (RENIN-ANGIOTENSIN SYSTEM) 

There are several points in the renin-angiotensin system that have proven to be amenable to inhibition. Renin, angiotensin-converting enzyme, and the angiotensin receptors are the most important sites of regulation. 

Renin inhibitors have been found among naturally occurring phospholipids and synthetic phosphatidylethanolamine derivatives. Pepstatin (5.131), isolated from Streptomyces strains, is a pentapeptide with an acylated N-terminus and the unusual 4-amino-3-hydroxy-6-methylheptanoic acid (AHMH) residues. It is a general protease 

Although the sulfhydryl group of captopril produced superb ACE inhibition, it also caused two side effects which are sometimes seen with sulphur-containing drugs skin rashes and a metallic taste disturbance. In an attempt to overcome these side effects. 

The success of enalapril led to a variety of other additional dicarboxylate inhibitors. The first of these was lisinopril (5.138). This agent was developed at the same time as 

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