Therapeutic Perspectives of Angiotensin-(1-7) in the Treatment ofCardiovascular Disease

摘要

In the last decade, new biologically active components of the renin-angiotensin system were found. Angiotensin-(1-7)(Ang-(1-7)), a metabolite of angiotensin I and angiotensin II (Ang II), is considered the most pleiotropiccomponent of the renin-angiotensin system, acting as a counterregulatory mediator of Ang II. Ang-(1-7) exerts beneficialeffects on the cardiovascular system, including reduction of blood pressure, myocardial antihypertrofic and antifibrotic actions,and reversal of renal dysfunction, among others. Recent discovery of enzymatic pathways involved in Ang-(1-7)synthesis, such as the angiotensin-converting enzyme-2 (ACE2) and the existence of a specific receptor to this heptapeptide,the Mas receptor, have increased interest in the design of therapeutic strategies aimed at increasing the biological actionsof Ang-(1-7). ACE inhibitors, AT1 receptor blockers and aldosterone antagonists enhance Ang-(1-7) levels by differentmechanisms. Actually, non-peptidic Ang-(1-7) agonists and ACE2 activators are under development and couldhave a role in the treatment of cardiovascular diseases. The aim of the present review is to describe the biochemical and physiological actions of Ang-(1-7), the therapeuticstrategies designed to enhance Ang-(1-7) activity foccusing in their possible role and limitations in the treatment of cardiovasculardisease.