1. Classic and Nonclassic Renin-Angiotensin Systems in the Critically Ill
- Author
-
Louise M Burrell and Laurent Bitker
- Subjects
Male ,Blood Pressure ,Critical Care and Intensive Care Medicine ,Renin-Angiotensin System ,Angiotensin ,0302 clinical medicine ,Septic shock ,Renin ,Homeostasis ,Vasoconstrictor Agents ,Aged, 80 and over ,Respiratory Distress Syndrome ,biology ,Acute respiratory distress syndrome ,Angiotensin II ,General Medicine ,Acute Kidney Injury ,Middle Aged ,Shock, Septic ,Shock (circulatory) ,Female ,medicine.symptom ,Angiotensin-converting enzyme ,Adult ,medicine.medical_specialty ,Critical Illness ,Article ,Sepsis ,03 medical and health sciences ,Paracrine signalling ,Internal medicine ,Renin–angiotensin system ,medicine ,Humans ,Aged ,Inflammation ,business.industry ,030208 emergency & critical care medicine ,medicine.disease ,Peptide Fragments ,Endocrinology ,030228 respiratory system ,biology.protein ,Angiotensin I ,business - Abstract
Classic and nonclassic renin-angiotensin systems (RAS) are 2 sides of an ubiquitous endocrine/paracrine cascade regulating blood pressure and homeostasis. Angiotensin II and angiotensin-converting enzyme (ACE) levels are associated with severity of disease in the critically ill, and are central to the physiology and the pathogenesis of circulatory shock. Angiotensin (1-7) and ACE2 act as an endogenous counterregulatory arm to the angiotensin II/ACE axis. The tissue-based RAS has paracrine effects dissociated from those of the circulating RAS. Exogenous angiotensin II or ACE2 may improve the outcome of septic shock and acute respiratory distress syndrome, respectively.
- Published
- 2019