The renin–angiotensin system and diabetes: An update

Antônio Ribeiro-Oliveira Jr¹, Anelise Impeliziere Nogueira¹, Regina Maria Pereira², Walkiria Wingester Vilas Boas³, Robson Augusto Souza dos Santos⁴, Ana Cristina Simões e Silva⁵

¹Laboratório de Endocrinologia, Departamento de Clínica Médica, ²Departamento de Ciências Biológicas, Centro Universitário de Belo Horizonte, UNIBH, Belo Horizonte, MG, Brazil; ³Hospital Life Center, Belo Horizonte, MG, Brazil; ⁴Laboratório de Hipertensão, Departamento de Fisiologia e Biofísica, Instituto de Ciências Biológicas, UFMG, Belo Horizonte, MG, Brazil; ⁵Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil

Abstract: In the past few years the classical concept of the renin–angiotensin system (RAS) has experienced substantial conceptual changes. The identification of the renin/prorenin receptor, the angiotensin-converting enzyme homologue ACE2 as an angiotensin peptide processing enzyme, Mas as a receptor for Ang-(1-7) and the possibility of signaling through ACE, have contributed to switch our understanding of the RAS from the classical limited-proteolysis linear cascade to a cascade with multiple mediators, multiple receptors, and multi-functional enzymes. In this review we will focus on the recent findings related to RAS and, in particular, on its role in diabetes by discussing possible interactions between RAS mediators, endothelium function, and insulin signaling transduction pathways as well as the putative role of ACE2-Ang-(1-7)-Mas axis in disease pathogenesis.

Keywords: renin–angiotensin system, diabetes, angiotensin II, angiotensin-(1-7), insulin, endothelium