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在肾素-血管紧张素系统(RAS)中,血管紧张素转化酶2(ACE2)与血管紧张素(AngⅡ)之间的代谢关系在ACE2-Ang(1-7)-Mas轴保护心房颤动(房颤)的心肌细胞作用中发挥着重要作用。作为ACE的唯一同系物,ACE2可以水解AngⅡ为七肽Ang(1-7),而Ang(1-7)可以特异性激活Mas受体,发挥抗纤维化、抗增殖、抗炎、扩血管及保护内皮等作用,从多方面拮抗RAS系统中AngⅡ的病理性作用。目前研究表明,ACE2-Ang(1-7)-Mas轴中ACE2及Ang(1-7)可以分别通过抑制促分裂原活化蛋白激酶信号通路从而阻断AngⅡ的病理过程,发挥保护心肌细胞的功能。基于目前对房颤治疗的局限性和房颤发病机制的逐渐认识,ACE2-Ang(1-7)-Mas轴对心血管病理过程特别是房颤发生的逆转作用逐渐得到重视,该轴的心肌保护作用有可能成为房颤治疗的一个重要分支。
The metabolic relationship between angiotensin-converting enzyme 2 (ACE2) and angiotensin (Ang II) in the renin-angiotensin system (RAS) is mediated by ACE2-Ang (1-7) -Mas axis protection of atrial fibrillation Atrial fibrillation) play an important role in the role of cardiomyocytes. As the only homologue of ACE, ACE2 can hydrolyze AngII to heptapeptide Ang (1-7), while Ang (1-7) can specifically activate Mas receptor and exert antifibrosis, antiproliferative, antiinflammatory, vasodilator and Protect the endothelium and other effects, in many ways to antagonize the pathological role of Ang Ⅱ RAS system. Recent studies have shown that ACE2 and Ang (1-7) in ACE2-Ang (1-7) -Mas axis can block the pathological process of AngⅡ by inhibiting the mitogen-activated protein kinase signaling pathway and play a role in protecting cardiomyocytes . Based on the current understanding of the limitations of atrial fibrillation therapy and the pathogenesis of atrial fibrillation, the reversal of ACE2-Ang (1-7) -Mas axis on cardiovascular pathology, especially atrial fibrillation, The protective effect may become an important branch of AF treatment.