The renin-angiotensin system (RAS) and arthritic diseases: therapeutic potential for RAS inhibitors.

IF 5.3 2区医学 Q2 IMMUNOLOGY

Inflammopharmacology Pub Date : 2025-09-01 Epub Date: 2025-08-12 DOI:10.1007/s10787-025-01890-z

Yasser H Habib, Mahmoud Khattab, Mennatallah A Gowayed

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Abstract

The renin-angiotensin system (RAS) is a pivotal hormonal regulator of cardiovascular and renal homeostasis, recently implicated in the etiology and progression of inflammatory arthritis, including rheumatoid arthritis (RA) and osteoarthritis (OA). This review explores the dual nature of RAS, highlighting its classical axis (ACE/Ang II/AT1R), which promotes inflammation and tissue damage, and its counter-regulatory axis (ACE2/Ang-(1-7)/MasR), which exhibits anti-inflammatory and protective effects. Elevated levels of RAS components in synovial fluid of arthritis patients emphasize its role in local joint pathology. The potential of RAS inhibitors, including angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs), is discussed, demonstrating their efficacy in reducing inflammatory cytokines, oxidative stress, and immune dysregulation. Emerging research also underscores the protective effects of the counter-regulatory axis in mitigating inflammation, oxidative stress, and angiogenesis, which are crucial in arthritis progression. The review further explores innovative therapeutic strategies, such as AI-powered personalized and tailored medicine, to optimize RAS-targeted therapies for enhanced efficacy and patient-specific outcomes. This evolving field highlights the promise of integrating RAS modulation with advanced diagnostic and therapeutic technologies to revolutionize arthritis treatment, offering hope for better disease management and improved quality of life.

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肾素-血管紧张素系统（RAS）和关节炎疾病：RAS抑制剂的治疗潜力。

肾素-血管紧张素系统（RAS）是心血管和肾脏稳态的关键激素调节因子，最近涉及炎性关节炎的病因和进展，包括类风湿关节炎（RA）和骨关节炎（OA）。本文综述了RAS的双重性质，重点介绍了其促进炎症和组织损伤的经典轴（ACE/Ang II/AT1R）和具有抗炎和保护作用的反调节轴（ACE2/Ang-(1-7)/MasR）。关节炎患者滑液中RAS成分的升高强调了其在局部关节病理中的作用。RAS抑制剂的潜力，包括血管紧张素受体阻滞剂（ARBs）和血管紧张素转换酶抑制剂（ACEIs），被讨论，证明其在减少炎症细胞因子，氧化应激和免疫失调的功效。新兴的研究也强调了反调节轴在减轻炎症、氧化应激和血管生成方面的保护作用，这些在关节炎的进展中是至关重要的。该综述进一步探讨了创新的治疗策略，如人工智能驱动的个性化和量身定制的药物，以优化ras靶向治疗，以提高疗效和患者特异性结果。这一不断发展的领域强调了将RAS调节与先进的诊断和治疗技术相结合，以彻底改变关节炎治疗的前景，为更好的疾病管理和提高生活质量提供了希望。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Inflammopharmacology IMMUNOLOGYTOXICOLOGY-TOXICOLOGY

CiteScore

8.00

自引率

3.40%

发文量

200

期刊介绍： Inflammopharmacology is the official publication of the Gastrointestinal Section of the International Union of Basic and Clinical Pharmacology (IUPHAR) and the Hungarian Experimental and Clinical Pharmacology Society (HECPS). Inflammopharmacology publishes papers on all aspects of inflammation and its pharmacological control emphasizing comparisons of (a) different inflammatory states, and (b) the actions, therapeutic efficacy and safety of drugs employed in the treatment of inflammatory conditions. The comparative aspects of the types of inflammatory conditions include gastrointestinal disease (e.g. ulcerative colitis, Crohn''s disease), parasitic diseases, toxicological manifestations of the effects of drugs and environmental agents, arthritic conditions, and inflammatory effects of injury or aging on skeletal muscle. The journal has seven main interest areas: -Drug-Disease Interactions - Conditional Pharmacology - i.e. where the condition (disease or stress state) influences the therapeutic response and side (adverse) effects from anti-inflammatory drugs. Mechanisms of drug-disease and drug disease interactions and the role of different stress states -Rheumatology - particular emphasis on methods of measurement of clinical response effects of new agents, adverse effects from anti-rheumatic drugs -Gastroenterology - with particular emphasis on animal and human models, mechanisms of mucosal inflammation and ulceration and effects of novel and established anti-ulcer, anti-inflammatory agents, or antiparasitic agents -Neuro-Inflammation and Pain - model systems, pharmacology of new analgesic agents and mechanisms of neuro-inflammation and pain -Novel drugs, natural products and nutraceuticals - and their effects on inflammatory processes, especially where there are indications of novel modes action compared with conventional drugs e.g. NSAIDs -Muscle-immune interactions during inflammation [...]