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The renin-angiotensin system in the eye
Angiotensin: From the Kidney to Coronavirus ; : 419-447, 2023.
Article in English | Scopus | ID: covidwho-2291707
ABSTRACT
The reninangiotensin system is major endocrine, paracrine, and autocrine system that has a notorious role in regulating hemodynamics and electrolyte balance, thus controlling blood pressure. Nonetheless, the functions of RAS are multiple and continue to expand, as its receptors, enzymes, and peptides have been identified in different organs/tissues, implying novel local effects of RAS and participation in the pathogenesis of different diseases in multiple organs, including the eyes. Vascularized, fibrous, and nervous structures of the eyes and their fluids express several RAS components including angiotensinogen, prorenin, renin, (P)RR, ACE, Ang II, AT1R, AT2R, ACE2, Ang 1-7, and Mas. Additionally, abundant RAS hormones are present in intraocular tissues implicating local production. Ocular RAS functions seem to be diverse;first, RAS is proposed to modulate aqueous humor biosynthesis and drainage, consequently regulating IOP. Exacerbation of ACE/ Ang II/ AT1R actions is observed in glaucoma, and blockage of this axis with ACEIs and ARBs is a feature that can be explored to reduce IOP and treat glaucoma. Second, impairment of RAS with exacerbation of ACE/ Ang II/ AT1R and depletion of ACE2/ Ang 1-7/ Mas culminate in an angiogenic, inflammatory, proliferative, and oxidative phenotype, which is tightly related to retinal vascular disorders such as diabetic retinopathy, age-related macular degeneration, and retinopathy of prematurity. Indeed, treatments blocking ACE/ Ang II/ AT1R or enhancing ACE2/ Ang 1-7/ Mas are reported to be beneficial to prevent or restrain the progression of these diseases. Finally, clinical manifestations of COVID-19 include ocular disorders such as conjunctivitis, dry eyes, eye pain, discharge, and blurred vision. ACE2 expression in ocular tissues may define ophthalmic susceptibility to SARS-CoV-2 infection. Moreover, SARS-CoV-2 entry mechanisms may cause depletion of ACE2 biological effects, which can contribute to RAS dysregulation and the ocular disorders observed in COVID-19. This chapter focuses on reviewing the components and functions of the ocular RAS, its implications for eye homeostasis, and the potential of RAS as a therapeutic target to treat ocular disorders, including glaucoma, diabetic retinopathy, age-related macular degeneration, and retinopathy of prematurity. © 2023 Elsevier Inc. All rights reserved.
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Full text: Available Collection: Databases of international organizations Database: Scopus Language: English Journal: Angiotensin: From the Kidney to Coronavirus Year: 2023 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: Scopus Language: English Journal: Angiotensin: From the Kidney to Coronavirus Year: 2023 Document Type: Article