Hypertension. 2001;38:635-638
doi: 10.1161/hy09t1.094234
doi: 10.1161/hy09t1.094234
(Hypertension. 2001;38:635.)
© 2001 American Heart Association, Inc.
Renal Factors |
Angiotensin II and Renal Fibrosis
From the Division of Nephrology School of Medicine, Universidad Austral (S.A.M.), Valdivia, Chile; and Fundación Jiménez Díaz, Universidad Autónoma (M.R.-O., J.E.), Madrid, Spain.
Correspondence to Sergio Mezzano, MD, Department of Nephrology, School of Medicine, Universidad Austral, PO Box 8-D, Valdivia, Chile. E-mail smezzano{at}uach.cl
Abstract
Abstract—— Angiotensin (Ang) II, the main peptide of the renin angiotensin system (RAS), is a renal growth factor, inducing hyperplasia/hypertrophy depending on the cell type. This vasoactive peptide activates mesangial and tubular cells and interstitial fibroblasts, increasing the expression and synthesis of extracellular matrix proteins. Some of these effects seem to be mediated by the release of other growth factors, such as TGF-ß. In experimental models of kidney damage, renal RAS activation, cell proliferation, and upregulation of growth factors and matrix production were described. In some of these models, blockade of Ang II actions by ACE inhibitors and angiotensin type 1 (AT1) antagonists prevents proteinuria, gene expression upregulation, and fibrosis, as well as inflammatory cell infiltration. Interestingly, Ang II could also be involved in the fibrotic process because of its behavior as a proinflammatory cytokine, participating in various steps of the inflammatory response: Ang II (1) activates mononuclear cells and (2) increases proinflammatory mediators (cytokines, chemokines, adhesion molecules, nuclear factor 
B). Finally, Ang II also regulates matrix degradation. These data show that drugs controlling this complex vasoactive peptide are probably one of the best ways of avoiding fibrosis in progressive renal diseases.
Key Words: angiotensin II • fibrosis • proteinuria • transforming growth factor
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