Background:
The Renin-Angiotensin System (RAS) comprises a complex molecular cascade with two counter-regulatory axes, the classical and the alternative. Angiotensin II and Angiotensin-(1-7), the main peptides of the RAS, exert opposite effects in multiple organs and systems, including the cardiovascular, renal, pulmonary and immune systems. Strong evidence supports the hypothesis of a local RAS in the Central Nervous System (CNS) and its modulatory roles in neuroendocrinology and neurotransmission.
Objective:
In this narrative review, we provide a comprehensive approach on experimental and clinical data regarding RAS molecules expression and possible roles in physiology and physiopathology of CNS diseases.
Methods:
This non-systematic review summarizes evidence on RAS implications in CNS diseases and its possible relationships with COVID-19.
Results:
We divided the possible RAS mechanisms in distinct conditions during lifespan, approaching from congenital infections to neurodegenerative alterations, passing through mood disorders and cerebrovascular diseases. We also gathered current evidence about the possible effects of RAS in Covid-19, particularly the described cases that course with neurological manifestations.
Conclusion:
Although there are limitations and controversies, the analysis of RAS mechanisms in the CNS certainly represents an interesting field of research. However, further investigation is necessary to support the noteworthy interactions and provide a better comprehension of the cross-talk between RAS and the CNS. Investigations in this research field may shed lights to novel therapeutic targets.
Pathobiological Interactions of Local Bone Marrow Renin-Angiotensin System and Central Nervous System in Systemic Arterial Hypertension