Abstract
The renin-angiotensin system is highly conserved through evolutionary history, and has multiple functions in addition to maintaining cardiovascular homeostasis: these include the regulation of renal cell survival and cell death, and development of the kidney. The importance of angiotensin (ANG) in normal kidney development was first recognized in infants with renal maldevelopment born to mothers treated with angiotensin converting enzyme (ACE) inhibitors or with ANG AT1 receptor blockers. The molecular role of ANG in renal development has been elucidated using gene targeting in mice, revealing major effects in branching morphogenesis, vasculogenesis, development of the papilla and renal concentrating mechanism. Although exposure of the fetus to ANG inhibitors is potentially harmful throughout pregnancy, effects are greater in late compared to early gestation. Significant differences between humans and rodents in placental transfer of ANG and timing of renal development contributed to initial delays in recognizing the teratogenic effects of ANG inhibitors. Although administration of ACE or AT1 receptor inhibitors can slow progression of renal disease in older children, ANG inhibition in the neonatal period can aggravate renal injury due to congenital urinary tract obstruction. Neonates are also far more sensitive than older children to the hypotensive actions these agents and doses must be markedly reduced to avoid precipitating oliguria. Understanding the complex interactions of the maturing renin-angiotensin system in the perinatal period is essential in the use of ANG or renin inhibitors in women during childbearing years or in neonates with cardiovascular or renal disease.
Keywords: Angiotensin, anomalies, development, fetus, hypertension, kidney, neonate, Renal Impairment, Pharmacologic Inhibition, renin-angiotensin.
Current Medicinal Chemistry
Title:Mechanisms of Fetal and Neonatal Renal Impairment by Pharmacologic Inhibition of Angiotensin
Volume: 19 Issue: 27
Author(s): Robert L. Chevalier
Affiliation:
Keywords: Angiotensin, anomalies, development, fetus, hypertension, kidney, neonate, Renal Impairment, Pharmacologic Inhibition, renin-angiotensin.
Abstract: The renin-angiotensin system is highly conserved through evolutionary history, and has multiple functions in addition to maintaining cardiovascular homeostasis: these include the regulation of renal cell survival and cell death, and development of the kidney. The importance of angiotensin (ANG) in normal kidney development was first recognized in infants with renal maldevelopment born to mothers treated with angiotensin converting enzyme (ACE) inhibitors or with ANG AT1 receptor blockers. The molecular role of ANG in renal development has been elucidated using gene targeting in mice, revealing major effects in branching morphogenesis, vasculogenesis, development of the papilla and renal concentrating mechanism. Although exposure of the fetus to ANG inhibitors is potentially harmful throughout pregnancy, effects are greater in late compared to early gestation. Significant differences between humans and rodents in placental transfer of ANG and timing of renal development contributed to initial delays in recognizing the teratogenic effects of ANG inhibitors. Although administration of ACE or AT1 receptor inhibitors can slow progression of renal disease in older children, ANG inhibition in the neonatal period can aggravate renal injury due to congenital urinary tract obstruction. Neonates are also far more sensitive than older children to the hypotensive actions these agents and doses must be markedly reduced to avoid precipitating oliguria. Understanding the complex interactions of the maturing renin-angiotensin system in the perinatal period is essential in the use of ANG or renin inhibitors in women during childbearing years or in neonates with cardiovascular or renal disease.
Export Options
About this article
Cite this article as:
L. Chevalier Robert, Mechanisms of Fetal and Neonatal Renal Impairment by Pharmacologic Inhibition of Angiotensin, Current Medicinal Chemistry 2012; 19 (27) . https://dx.doi.org/10.2174/092986712803306411
DOI https://dx.doi.org/10.2174/092986712803306411 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
Call for Papers in Thematic Issues
Advances in Medicinal Chemistry: From Cancer to Chronic Diseases.
The broad spectrum of the issue will provide a comprehensive overview of emerging trends, novel therapeutic interventions, and translational insights that impact modern medicine. The primary focus will be diseases of global concern, including cancer, chronic pain, metabolic disorders, and autoimmune conditions, providing a broad overview of the advancements in ...read more
Approaches to the treatment of chronic inflammation
Chronic inflammation is a hallmark of numerous diseases, significantly impacting global health. Although chronic inflammation is a hot topic, not much has been written about approaches to its treatment. This thematic issue aims to showcase the latest advancements in chronic inflammation treatment and foster discussion on future directions in this ...read more
Cellular and Molecular Mechanisms of Non-Infectious Inflammatory Diseases: Focus on Clinical Implications
The Special Issue covers the results of the studies on cellular and molecular mechanisms of non-infectious inflammatory diseases, in particular, autoimmune rheumatic diseases, atherosclerotic cardiovascular disease and other age-related disorders such as type II diabetes, cancer, neurodegenerative disorders, etc. Review and research articles as well as methodology papers that summarize ...read more
Chalcogen-modified nucleic acid analogues
Chalcogen-modified nucleosides, nucleotides and oligonucleotides have been of great interest to scientific research for many years. The replacement of oxygen in the nucleobase, sugar or phosphate backbone by chalcogen atoms (sulfur, selenium, tellurium) gives these biomolecules unique properties resulting from their altered physical and chemical properties. The continuing interest in ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Association Between Heart Rate Variability and Parkinson’s Disease: A Meta-analysis
Current Pharmaceutical Design Artemia species: An Important Tool to Screen General Toxicity Samples
Current Pharmaceutical Design The Pharmacogenetics of CYP2C9 and CYP2C19: Ethnic Variation and Clinical Significance
Current Clinical Pharmacology New Patents on Topical Anesthetics
Recent Patents on Inflammation & Allergy Drug Discovery Regulation of Adrenomedullin and its Family Peptide by RAMP System – Lessons from Genetically Engineered Mice
Current Protein & Peptide Science Selective Serotonin Reuptake Inhibitors (SSRIs): Therapeutic Drug Monitoring and Pharmacological Interactions
Current Medicinal Chemistry Acute Human Toxicity of Macrocyclic Lactones
Current Pharmaceutical Biotechnology Chemoradiotherapy in Locally Advanced, Unresectable Non-Small Cell Lung Cancer
Reviews on Recent Clinical Trials Using Structural and Mechanistic Information to Design Novel Inhibitors/Substrates of P-Glycoprotein
Current Topics in Medicinal Chemistry Synthesis of New α-Amino Phosphonates Containing 3-Amino-4(3H) Quinazolinone Moiety as Anticancer and Antimicrobial Agents: DFT, NBO, and Vibrational Studies
Current Organic Synthesis Pharmacologic Treatment of Pulmonary Arterial Hypertension
Current Pharmaceutical Design Tubulin Colchicine Binding Site Inhibitors as Vascular Disrupting Agents in Clinical Developments
Current Medicinal Chemistry New Developments in the Diagnosis and Management of Resistant Hypertension
Current Medicinal Chemistry Integrative Control of Gastrointestinal Motility by Nitric Oxide
Current Medicinal Chemistry The Activated Endocannabinoid System in Atherosclerosis: Driving Force or Protective Mechanism?
Current Drug Targets Treating Hypertension in the Elderly: Common Problems and Solutions
Current Hypertension Reviews Structural Development, Haematological Immunological and Pharmacological Effects of Quinolones
Recent Patents on Anti-Infective Drug Discovery Monoamino Oxidase A: An Interesting Pharmacological Target for the Development of Multi-Target QSAR
Mini-Reviews in Medicinal Chemistry Regular Physical Activity and Vascular Aging
Current Pharmaceutical Design Medicinal Chemistry of Antimigraine Drugs
Current Medicinal Chemistry