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LA ANGIOTENSINA II Y LA INFLAMACION: EL EFECTO DE LOS INHIBIDORES DE LA ECA Y DE LOS BLOQUEANTES DEL RECEPTOR DE ANGIOTENSINA II

(especial para SIIC © Derechos reservados)
Los bloqueantes de los receptores de angiotensina II podrían ser útiles para reducir la incidencia de eventos cardiovasculares y de la diabetes mellitus tipo 2 debido al rápido efecto antiinflamatorio y la supresión de las especies reactivas de oxígeno.
dandona9.jpg Autor:
Paresh Dandona
Columnista Experto de SIIC

Institución:
Diabetes-Endocrinology Center of WNY


Artículos publicados por Paresh Dandona
Coautores
Sandeep Dhindsa*  Rajesh Garg* 
MD, Kaleida Health, Buffalo, EE.UU.*
Recepción del artículo
14 de Septiembre, 2004
Aprobación
30 de Septiembre, 2004
Primera edición
28 de Octubre, 2005
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Recientemente se demostró que la angiotensina II ejerce un efecto proinflamatorio en los leucocitos, células endoteliales y células del músculo liso vascular. Esta reseña analiza el efecto de la angiotensina II en la inflamación y el estrés oxidativo; así como la acción antiinflamatoria de los inhibidores de la enzima convertidora de angiotensina (ECA) y de los bloqueantes del receptor de angiotensina II (BRA). La angiotensina II por medio del receptor AT tipo 1 activa la transcripción y expresión genética mediada por el factor nuclear κB (FN-κB, un factor de transcripción de la inflamación) e incrementa las moléculas de adhesión y las quimiocinas, lo que predispone a un estado protrombótico y a la ruptura de placas ateromatosas. También la angiotensina II estimula la NADPH (fosfato de nicotinamida adenina dinucleótido reducido) oxidasa y aumenta la producción de especies reactivas de oxígeno (ERO). Esto disminuye la biodisponibilidad de óxido nítrico y provoca trastornos en la función endotelial. El valsartán suprime la producción de ERO (O2) en los leucocitos y la actividad ligadora intranuclear del FN-κB; aumenta la expresión del inhibidor de κB (IκB) mientras que disminuye los niveles plasmáticos de la proteína C-reactiva (PCR) en plasma. Esta acción podría contribuir al efecto beneficioso de los BRA sobre los eventos cardiovasculares observado en los resultados de los estudios clínicos.

Palabras clave
Inflamación, estrés oxidativo, angiotensina II, FNκB, ERO, valsartán


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Abstract
It has recently been shown that angiotensin II (Ang II) exerts a pro-inflammatory effect on leucocytes, endothelial cells and vascular smooth muscle cells. This review discusses the effect of Ang II on inflammation and oxidative stress and the anti-inflammatory effects of ACE inhibitors and Ang II receptor blockers (ARBs). Ang II, acting via at type1 receptor, activates nuclear factor κB (NF-κB, an inflammatory transcription factor) mediated transcription and gene expression and increases adhesion molecules and chemokines, thereby predisposing to a pro-thrombotic state as well as plaque rupture. Ang II also stimulates NADPH oxidase and enhances ROS production. This decreases nitric oxide bioavailability and causes endothelial dysfunction. Valsartan suppresses ROS (O2) generation by leucocytes and intranuclear NF-κB binding activity; it increases inhibitory κB (IκB) expression while decreasing plasma CRP concentrations. It is likely that this action of ARBs contributes to their beneficial effects on cardiovascular events in clinical outcome studies.

Key words
Inflammation, oxidative stress, angiotensin II, NF-κB, ROS, valsartan


Full text
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Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Cardiología
Relacionadas: Atención Primaria, Endocrinología y Metabolismo, Farmacología, Medicina Farmacéutica, Medicina Interna, Salud Pública



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Bibliografía del artículo
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