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The RAS is a hormonal system playing a pivotal role in the control of blood pressure and electrolyte homeostasis, the alteration of which is associated with different pathologies, including acute respiratory distress syndrome (ARDS). As such, it is not surprising that a number of studies have attempted to elucidate the role and balance of the renin-angiotensin system (RAS) in COVID-19. In this review article, we will describe the evidence collected regarding the two main enzymes of the RAS (i.e., ACE and ACE2) and their principal molecular products (i.e., AngII and Ang1-7) in SARS-CoV-2 infection, with the overarching goal of drawing conclusions on their possible role as clinical markers in association with disease severity, progression, and outcome. Moreover, we will bring into the picture new experimental data regarding the systemic activity of ACE and ACE2 as well as the concentration of AngII and Ang1-7 in a cohort of 47 COVID-19 patients hospitalized at the IRCCS Sacro Cuore-Don Calabria Hospital (Negrar, Italy) between March and April 2020. Finally, we will discuss the possibility of considering this systemic pathway as a clinical marker for COVID-19.
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http://dx.doi.org/10.3390/microorganisms12030583 | DOI Listing |
MedComm (2020)
September 2025
Immunoglobulin A nephropathy (IgAN), the most prevalent primary glomerulonephritis globally, is characterized by mesangial IgA deposition and heterogeneous clinical trajectories. Historically, management relied on renin-angiotensin system inhibition and empirical immunosuppression, yet high lifetime kidney failure risk persists despite optimized care. This review synthesizes advances in molecular pathogenesis, highlighting how the traditional multi-hit hypothesis-while foundational for targeted therapy development-fails to capture IgAN's recurrent, self-amplifying nature.
View Article and Find Full Text PDFClin Kidney J
September 2025
Hypertension is a pervasive and progressive complication in chronic kidney disease (CKD) patients, affecting up to 90% of those in advanced stages or on dialysis. A particularly insidious aspect of this condition is nocturnal hypertension, characterized by high blood pressure (BP) during sleep and a blunted or absent nighttime BP dipping-phenomena associated with accelerated CKD progression and increased cardiovascular risk. Despite its strong prognostic significance, nocturnal hypertension remains underdiagnosed due to limited use of ambulatory BP monitoring.
View Article and Find Full Text PDFRev Cardiovasc Med
August 2025
Department of Nephrology, Akron Nephrology Associates at Cleveland Clinic Akron General Medical Center, Akron, OH 44302, USA.
Cardiovascular assessments in children and adolescents with hypertension are essential for detecting early signs of organ damage and guiding timely interventions. The pathophysiology of pediatric hypertension involves a complex interplay of arterial stiffness, endothelial dysfunction, metabolic disturbances, activation of the renin-angiotensin-aldosterone system, and immune dysregulation. These mechanisms collectively contribute to target organ damage, particularly in the cardiovascular system.
View Article and Find Full Text PDFRen Fail
December 2025
Department of Nephrology, National Clinical Key Specialty Construction Program (2023); Institute of Nephrology; Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-communicable Diseases; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Affil
Sodium-glucose cotransporter 2 inhibitors reduced proteinuria in patients with IgA nephropathy; however, their efficacy in patients at high risk of progression receiving immunosuppressive agents and renin angiotensin-aldosterone system inhibitors remains unclear. After 3 months of low-dose steroid alone or combined with mycophenolate mofetil, as well as renin angiotensin-aldosterone system inhibitors treatment, 105 biopsy-proven IgA nephropathy patients with proteinuria greater than 0.5 g/d were included in this study.
View Article and Find Full Text PDFArch Cardiovasc Dis
September 2025
Department of Orthopaedics, Shaoxing Keqiao Women & Children's Hospital, Shaoxing 312030, Zhejiang, China. Electronic address:
Background: Sacubitril/valsartan is a widely used cardiovascular agent characterized by its dual inhibition of the renin-angiotensin-aldosterone system and neprilysin. However, existing evidence on the safety of sacubitril/valsartan is primarily limited to clinical studies; this results in an inability to provide a timely update on associated adverse events.
Aim: To mine and systematically describe adverse events related to sacubitril/valsartan from September 2015 to June 2024 using the Food and Drug Administration Adverse Event Reporting System (FAERS) database.