New aspects of the renin-angiotensin system: Angiotensin-converting enzyme 2 - A potential target for treatment of hypertension and diabetic nephropathy

Daniel Batlle*, María José Soler, Jan Wysocki

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

30 Scopus citations

Abstract

PURPOSE OF REVIEW: Whereas angiotensin-converting enzyme promotes the formation of angiotensin II, angiotensin-converting enzyme 2 promotes the degradation of angiotensin II to angiotensin-(1-7). We review recent studies dealing with angiotensin-converting enzyme 2 in kidney disease and hypertension, and discuss the potential therapeutic benefit of increasing angiotensin-converting enzyme 2 activity in the treatment of these diseases. RECENT FINDINGS: In glomeruli from diabetic mice, angiotensin-converting enzyme 2 expression is downregulated, and pharmacological inhibition of angiotensin-converting enzyme 2 leads to worsening of albuminuria, increased mesangial matrix deposition and fibronectin expression. The deletion of the angiotensin-converting enzyme 2 gene in mice leads to worsening of angiotensin II-induced hypertension and has also been shown to cause glomerulosclerosis in aging male mice. SUMMARY: Angiotensin-converting enzyme 2 is a key enzyme in the renin-angiotensin system that favors the degradation of angiotensin I and angiotensin II. Angiotensin-converting enzyme 2 inhibition by pharmacological means and by genetic deletion worsens kidney disease in diabetic mice. Strategies geared to increasing angiotensin-converting enzyme 2 activity may provide a novel therapeutic target within the renin-angiotensin system by enhancing angiotensin II degradation that may complement the current approach of inhibiting angiotensin II formation and action. Amplifying angiotensin- converting enzyme 2 activity may have a potential therapeutic role for kidney disease and hypertension.

Original languageEnglish (US)
Pages (from-to)250-257
Number of pages8
JournalCurrent opinion in nephrology and hypertension
Volume17
Issue number3
DOIs
StatePublished - May 1 2008

Keywords

  • Angiotensin-converting enzyme
  • Angiotensin-converting enzyme 2
  • Diabetic nephropathy
  • Hypertension

ASJC Scopus subject areas

  • Internal Medicine
  • Nephrology

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