Research progress on renin-angiotensin system in ALI/ARDS / 中国职业医学

ABSTRACT

Acute lung injury(ALI) is an acute hypoxic respiratory insufficiency syndrome. It tends to develop into acute respiratory distress syndrome(ARDS). Renin angiotensin system(RAS) has been proved to be closely related to the development of ALI/ARDS. The classic axis of RAS, angiotensin converting enzyme(ACE)-angiotensin(Ang) Ⅱ-Ang Ⅱtype 1 receptor(AT1R) axis, induces ALI/ARDS by inducing excessive inflammatory response, damaging alveolar barrier function, triggering coagulation dysfunction and other mechanisms. ACE2-Ang(1-7)-MAS axis of RAS can antagonize ACE-Ang Ⅱ-AT1R axis, and improve ALI/ARDS by inhibiting inflammatory response, antagonizing oxidative stress and reducing pulmonary vascular permeability. ACE inhibitors, drugs to reduce the level of Ang Ⅱ, AT1R blockers, AT2R stimulants, recombinant ACE2,mesenchymal stem cells with ACE2 overexpression, Ang1-7 and lipoxin A4 have been proved to improve ALI/ARDS in animal experiments. These results provide a new target for prevention and treatment of ALI/ARDS and improvement of prognosis.