• The Korean Journal of Physiology
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• v.29 no.2
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• pp.259-267
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• 1995

The renin-angiotensin system plays an important role in the regulation of blood pressure and in body fluid homeostasis. There is increasing evidence for generation of endogenous angiotensin II in many organs and for its role in paracrine functions. Studies were designed to investigate whether hemorrhage produces rapid changes in the gene expression of angiotensinogen in peripheral and brain tissues. Wistar rats received saline drinking water for 7 days, were bled at a rate of $3\;ml\;kg^{-1}\;min^{-1}$ for 7 min, and then decapitated 0, 2, 4, 8, or 24 hr after hemorrhage. Hemorrhage produced a produced hypotension with tachycardia at $2{\pm}8\;hr$, but blood pressure and heart rate had not fully recovered to the basal level at 24 hr. Plasma renin concentration was significantly increased at 2, 4, and 8 hr (maximum sixfold increase at 4 hr) and had returned to the basal level at 24 hr. Renal renin content was significantly increased only at 4 hr after hemorrhage. Angiotensinogen mRNA in both the kidney and liver were stimulated at 2 to 8 hrs, but recovered to the basal level at 24 hr. On the other hand, angiotensinogen mRNA levels il the hypothalamus and brainstem were continuously increased from 2 to 24 hrs. The present study demonstrates the presence of angiotensinogen mRNA in both hepatic and extrahepatic tissues, and more importantly, their up-regulation after hemorrhage. These results suggest that the angiotensinogen-generating systems in the liver, kideny and brain are, at least in part, under independent control and play a local physiological role.

• Korean Journal of Clinical Pharmacy
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• v.21 no.4
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• pp.364-375
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• 2011

Given that single blockade with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) can achieve only partial and undurable suppression of the Renin Angiotensin System (RAS), it has been hypothesized that dual blockage would be more beneficial in the management of blood pressure (BP) reduction and prevention of progressive chronic kidney disease (CKD) than either agent alone. Thus, it has been suggested that the combination of an ACEI and an ARB might provide renal benefits to hypertensive patients over and above BP reduction. However, this might also expose patients to additive or synergistic side effects. We attempted to conduct a systematic review to evaluate the benefits and harms of combination therapy in hypertensive patients with or without kidney diseases. MEDLINE and KoreaMed were searched for relevant randomized clinical trials in adult hypertensive patients with or without diabetes (restricted to 1997, limited to trials published in English). Results were summarized using the random-effects model, and between-studies heterogeneity was estimated with $I^2$. A final analysis of ten trials (23,928 patients) revealed that the combination of an ACEI and an ARB reduced blood pressure (SBP/DBP) by 3.95/2.02 mmHg (95% confidence interval [CI], -4.38 to -3.53/-2.33 to -1.71) compared with ACEI monotherapy, and 2.83/2.64 mmHg (95% CI, -3.25 to -2.41/-4.95 to -0.33) compared with ARB monotherapy. Eight trials (391 patients) demonstrated a significant reduction in 24h-proteinuria (weighted mean difference, 0.16 g/day, 95% CI, -0.26-0.05), but they did not translate into an improvement in GFR. Tests for heterogeneity showed no difference in effect among the studies. The combination therapy reduced proteinuria by 30% (95% CI, 23% to 37%) and 39% (95% CI, 31% to 48%) compared with ACEI monotherapy and ARB monotherapy, respectively. However, in patients who had proteinuria more than 0.5 g/day, the combination therapy failed to show significant reduction in urinary protein excretion. The current cumulative evidence suggests that diabetic patients with proteinuria on dual RAS blockade have an increase risk of adverse events such as hyperkalemia, hypotension, and so on, compared with ACEI or ARB alone. It is, therefore, proposed that the combination therapy should not be routinely used for the treatment of hypertension with or without compelling indications.

• The Korean Journal of Food And Nutrition
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• v.36 no.6
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• pp.572-580
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• 2023

Hypertension is characterized by excessive renin-angiotensin system activity, leading to blood vessel constriction. Several synthetic compounds have been developed to inhibit renin and angiotensin-converting enzyme (ACE). These drugs often have adverse side effects, driving the exploration of plant protein-derived peptides as alternative or supplementary treatments. This study assessed the phenolic compound and amino acid content and the antioxidant and antihypertensive activity of 5 South Korean staple crops. Sorghum had the highest phenolic compound content and exhibited the highest antioxidant activity. Millet grains, particularly finger millet (38.86%), showed higher antihypertensive activity than red beans (14.42%) and sorghum (17.16%). Finger millet was found to contain a large proportion of branched-chain, aromatic, and sulfur-containing amino acids, which are associated with ACE inhibition. In particular, cysteine content was positively correlated with ACE inhibition in the crops tested (r=0.696, p<0.01). This study confirmed that the amino acid composition was more correlated with the antihypertensive activity of grains than the phenolic compound content. Finger millet mainly contained amino acids, which have higher ACE inhibitory activity, resulting in the strongest antihypertensive activity. These findings underscore the antihypertensive potential of select crops as plant-based food ingredients, offering insight into their biological functions.

• Clinical and Experimental Pediatrics
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• v.62 no.4
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• pp.144-147
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• 2019

The most common type of refractory hypertension found in children is secondary hypertension, which is a potentially curable disease. Reninoma, a renin-secreting juxtaglomerular cell tumor, is a rare cause of severe hypertension that is usually diagnosed in adolescents and young adults. Surgical resection of the tumor completely cures the hypertension of patients with reninoma. The typical clinical presentation of reninoma includes hypokalemia, metabolic alkalosis, and features secondary to the increased activation of the renin-angiotensin system without renal artery stenosis. We report a case of reninoma in a female adolescent with a typical clinical presentation, in which surgical removal of the tumor completely cured hypertension. We discuss here the clinical features, imaging studies, and immunohistochemical examination of the tumor used to establish the diagnosis of reninoma and for the management of the condition.

• Environmental Analysis Health and Toxicology
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• v.20 no.1
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• pp.39-45
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• 2005

Renin-angiotensin system (RAS)은 혈압 조절에 중요한 역할을 수행하는 생리적 조절계로써, 이 system 을 구성하는 유전자들의 이상은 본태성 고혈압의 발병과 유의하게 관련된 것으로 알려졌다. RAS의 주요한 구성 성분인 angiotensin II는 2종류의 수용체인 angiotensin II type I receptor(AT₁R)와 angiotensin II type I receptor(AT₂R)에 의해 그 효과가 매개되기 때문에, 이 수용체를 암호하는 유전자는 본태성 고혈압의 유력한 후보 유전자라고 볼 수 있다. 현재가지의 연구에 의하면, AT₁R 유전자에 존재하는 유전적 변이와 본태성 고혈압과의 관련성에 관해서는 많은 보고들이 있었지만, AT₂R 유전자에 존재하는 유전적 변이 가 본태성 고혈압에 유의한 효과를 나타내는 지에 관해서는 이렇다할 연구 성과가 별로 없는 실정이다. 이에 본 연구에서는 한국인 집단을 대상으로 하여, AT₂R 유전자에 존재하는 C3123A 다형성이 한국인 집단에서 본태성 고혈압과 유의한 관련성이 있는 지를 분석하였다. 이 유전자는 인간의 X 염색체에 존재하기 때문에, 여성인 경우에는 CC, CA및 AA로 이루어진 3유전자형이 존재하지만, 남성인 경우에는 C와 A로 이루어진 2종류의 대립 유전자로 구성되어 있기 때문에, 본 연구에서는 남성과 여성을 개별적으로 나누어서 분석하였다. 연구 결과, AT₂R 유전자에 존재하는 C3123A 다형성은 남녀 모두에서 본태성 고혈압과 유의한 관련성을 나타내지 않았다(P>0.05). 그렇지만, 이 다형성에 대한 대립 유전자 빈도를 서양인 집단과 비교했을 경우에는, 한국인을 대상으로 한 본 연구에서 A 대립 유전자 빈도가 0.33인 반면에 서양인 집단은 그 빈도가 0.43～0.48로 한국인 집단보다 높은 값을 나타내었다. 따라서, AT₂R 유전자에 존재하는 C3123A 다형성과 본태성 고혈압과의 관련성에 대해서는 한국인과 유전적 배경이 다른 서양인 집단을 대상으로 한 추시가 필요할 것으로 사료된다.

• The Korean Journal of Nuclear Medicine
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• v.13 no.1_2
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• pp.23-29
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• 1979

To evaluate the renin-angiotensin-aldosterone system in diabetes mellitus, basal plasma renin activity (PRA) and its response to intravenous furosemide were determined in 40 diabetic subjects. The diabetics were divided into 4 groups according to the pressence of nephropathy and/or hypertension. Uncomplicated diabetics (Group I) were taken as control group and the results of the ether groups were compared to this group. In diabetics with nephropathy alone (Group II), and with nephropathy and hypertension (Group III), basal PRA values were $0.63{\pm}0.59ng/ml/hr.,\;and\;0.79{\pm}0.62ng/ml/hr.,$ respectively, both significantly lower than control group. ($1.53{\pm}1.09ng/ml/hr.$). (p<0.05) In both of the above groups, the responses to intravenous furosemide tended to be blunted. On the other hand, in diabetics with hypertension only (Group IV), the basal and stimulated PRA were not significantly different from control. Above results suggests that nephropathy may be one of the factors which suppress renin activity in diabetes mellitus.

• Proceedings of the Korean Society of Fisheries Technology Conference
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• 2001.10a
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• pp.183-184
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• 2001

Angiotensin I converting enzyme (ACE) in renin-angiotensin system is a cause of essential hypertension, which covers most hypertension, one of the major adult diseases. Thus, the inhibition of ACE would be indispensable for the prevention and cure of hypertension. Therefore, a lot of studies on the ACE inhibitor have been conducted. Peptides from the protein hydrolysate have been reported as an remarkable inhibitor. Especially, various ACE inhibitory peptides were isolated and identified from marine products for their utilization as value added products. (omitted)

• The Korean Journal of Physiology and Pharmacology
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• v.22 no.2
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• pp.135-143
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• 2018

Tumor necrosis $factor-{\alpha}$ ($TNF{\alpha}$) and the angiotensin system are involved in inflammatory diseases and may contribute to acute kidney injury. We investigated the mechanisms by which $TNF{\alpha}$-converting enzyme (TACE) contributes to lipopolysaccharide (LPS)-induced renal inflammation and the effect of TACE inhibitor treatment on LPS-induced cellular injury in human renal proximal tubule epithelial (HK-2) cells. Mice were treated with LPS (10 mg/kg, i.p.) and HK-2 cells were cultured with or without LPS ($10{\mu}g/ml$) in the presence or absence of a type 1 TACE inhibitor ($1{\mu}M$) or type 2 TACE inhibitor ($10{\mu}M$). LPS treatment induced increased serum creatinine, $TNF{\alpha}$, and urinary neutrophil gelatinase-associated lipocalin. Angiotensin II type 1 receptor, mitogen activated protein kinase (MAPK), and TACE increased, while angiotensin-converting enzyme-2 (ACE2) expression decreased in LPS-induced acute kidney injury and LPS-treated HK-2 cells. LPS induced reactive oxygen species and the down-regulation of ACE2, and these responses were prevented by TACE inhibitors in HK-2 cells. TACE inhibitors increased cell viability in LPS-treated HK-2 cells and attenuated oxidative stress and inflammatory cytokines. Our findings indicate that LPS activates renin angiotensin system components via the activation of TACE. Furthermore, inhibitors of TACE are potential therapeutic agents for kidney injury.

• The Korean Journal of Physiology
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• v.21 no.2
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• pp.291-296
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• 1987

There have been reports on the aberration of the control mechanisms of the blood pressure, hormone secretion, and renal functions in spontaneously hypertensive rats (SHR). However, the contribution of the renin-angiotensin system in the maintenance of high blood pressure in SHR is still controversial. Recently, it has been reported that the negative feedback short loop control mechanism of the renin-angiotensin system may be changed in SHR. In the present experiment, it was attempted to explore the possible alterations in the effect of arginine vasopressin (AVP) on the renal function in SHR. Experiments have been done in anesthetized SHR as well as in normotensive Wistar and Sprague-Dawley rats as control groups. Pharmacologic doses of AVP (10-13 mU/rat/10 min) decreased urine volume, excreted amount of creatinine and para-amino-hippuric acid. No differences in these parameters was observed between normotensive and hypertensive rats. AVP increased sodium and potassium excretion, but the responses in SHR were suppressed as compared with normotensive rats. Intravenous infusion of AVP also increased blood pressure in normotensive and hypertensive rats and a vasopressor effect of AVP was attenuated in SHR. There was a positive correlation between the changes in blood pressure and excreted amount of sodium during AVP infusion. These data suggest that the attenuated natriuretic effect of intravenous infusion of AVP may be due to a difference in renal tubular responsiveness to AVP but not due to a difference in vasopressor responsiveness.

• Korean Journal of Clinical Pharmacy
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• v.30 no.4
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• pp.259-263
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• 2020

Background: Dual-type calcium channel blockers (CCBs), such as efonidipine and cilnidipine, are renoprotective drugs that reportedly reduce proteinuria by dilating afferent and efferent arterioles of the glomerulus. However, studies comparing the effect of dual-type CCB on proteinuria have not been conducted. Therefore, we aimed to compare the effect of dual-type CCB (efonidipine and cilnidipine) usage patterns in hypertensive patients with chronic kidney disease (CKD). Methods: This single-center, retrospective study included 53 patients with CKD who 1) initiated efonidipine or cilnidipine treatment while on a renin-angiotensin system inhibitor and 2) had received efonidipine or cilnidipine for at least one year. We compared usage patterns between the efonidipine and cilnidipine groups during the one-year period and analyzed the following outcomes: urinary protein-to-creatinine ratio, blood pressure, and serum creatinine. Results: The study included 25 patients in the efonidipine group and 28 patients in the cilnidipine group. In both groups, blood pressure and urinary protein-to-creatinine ratios tended to decrease; however, the change during each interval was not significant. Conclusions: In patients with CKD who were on renin-angiotensin system inhibitor therapy, the addition of a dual-type CCB (i.e., efonidipine or cilnidipine) tended to reduce proteinuria; however, the change during each interval was not significant.