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Angiotensin-(1-7)

Abstract

The Renin–Angiotensin System (RAS) has a critical role in kidney function and in the pathophysiology of renal diseases. Recent studies have shown that RAS is a dual function system in which the final effects are primarily driven by the balance between two opposite axes: the first formed by angiotensin converting enzyme (ACE), Angiotensin (Ang) II, and Ang type 1 receptor and the second comprising ACE2, Ang-(1-7), and Mas receptor. In this chapter, we summarize recent studies on the role of ACE2/Ang-(1-7)/Mas axis in regulating renal function and in the pathophysiology of experimental and human renal diseases. In regard to renal physiology, Ang-(1-7) takes part in renal hemodynamic regulation and in tubular handling of sodium and water. The majority of experimental studies suggest an overall renoprotective effect of ACE2/Ang-(1-7)/Mas axis in several models of renal diseases, including subtotal nephrectomy, diabetes nephropathy, adriamycin induced-nephropathy, and acute renal injury. The renoprotection of ACE2/Ang-(1-7)/Mas axis is mainly attributed to reduction of oxidative stress, inflammation, and fibrosis. Few human studies support a compensatory activation of the counter-regulatory RAS axis in renal diseases. Further studies are needed to elucidate the mechanisms by which both RAS axes modulate renal function and take part in the physiopathology of renal diseases in humans. Nevertheless, current knowledge supports the possibility that drugs which mimic or enhance the function of the ACE2/Ang-(1-7)/Mas axis may be beneficial for the treatment of renal diseases.

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Simões e Silva, A.C., Santos, R.A.S. (2019). Kidney. In: Santos, R. (eds) Angiotensin-(1-7). Springer, Cham. https://doi.org/10.1007/978-3-030-22696-1_8

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