The Role of the Renin-Angiotensin-Aldosterone System in Preeclampsia: a Review
- PDF / 365,216 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 88 Downloads / 162 Views
PREECLAMPSIA (V GAROVIC, SECTION EDITOR)
The Role of the Renin-Angiotensin-Aldosterone System in Preeclampsia: a Review Premjith Gathiram 1 & Jagidesa Moodley 2,3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Preeclampsia (PE) is a complex human pregnancy-specific condition and is clinically characterized by new onset hypertension and proteinuria in the second half of pregnancy. The precise etiology of PE is unknown, but much of the pathophysiology has been elucidated, and it is accepted that the disorder is multifactorial in nature. Historically, because of the presence of proteinuria, the role of the renin-angiotensin-aldosterone system (RAAS) has been considered in the etiology of PE. However, the results of studies (including maternal circulatory angiotensin II, urinary angiotensinogen, plasma renin and prorenin, AT1 receptor antibodies, and gene polymorphisms) on the role of the RAAS in the etiology of PE have proved controversial. The purpose of this narrative review was to evaluate the contemporary literature on the RAAS and its role in the pathophysiology of pregnancy. Recent Findings The current review shows that although the RAAS has a role in the development of normal pregnancy, it does not have a significant role in the pathophysiology of PE except for the AT1-AA components. Despite many researchers having measured increases in s[P}RR and [P]RR, this may be independent of the RAAS. Summary Our view is in keeping with contemporary thinking that the placenta rather than the RAAS plays a central role in elaborating pro-inflammatory factors (antiangiogenic and angiogenic) into the maternal circulation resulting in widespread endothelial dysfunction in all organ systems including the renal system. Keywords Renin . Angiotensin . Aldosterone . Preeclampsia . Renin . Prorenin
Abbreviations ACE Angiotensin converting enzyme ANG II Angiotensin II AGT Angiotensinogen AT1 Angiotensin 1 Premjith Gathiram and Jagidesa Moodley contributed equally to this work. This article is part of the Topical Collection on Preeclampsia * Jagidesa Moodley [email protected] 1
Department of Family Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
2
Department of Obstetrics and Gynaecology, Women’s Health and HIV Research Group, University of KwaZulu-Natal, Durban, South Africa
3
College of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
AT1R AT2R AT1-AA Eng EOPE FGR IUGR JGC LOPE mRNA PE PlGF P(RR) RAAS RAS RGSG2 sFlt-1 s(P)RR VEGF
Angiotensin 1 receptors Angiotensin 2 receptors AT1 receptor autoantibodies Endoglin Early-onset preeclampsia Fetal growth restriction Intrauterine growth restriction Juxtaglomerular cells Late-onset preeclampsia Messenger ribonucleic acid Preeclampsia Placental growth factors Prorenin receptors Renin-angiotensin-aldosterone system Renin-angiotensin system Regulator G protein signaling 2 gene Soluble fms-like tyrosine kinase-1 Soluble pro-renin receptors Vascular endoth
Data Loading...
