ABSTRACT
Diabetic retinopathy (DR) is a complication of diabetes with a complex pathophysiology and multiple factors involved. Recently, it has been found that the upregulation of the renin-angiotensin-aldosterone system (RAAS) leads to overexpression of angiotensin II (Ang II), which induces oxidative stress, inflammation, and angiogenesis in the retina. Therefore, RAAS may be a promising therapeutic target in DR. Notably, RAAS inhibitors are often used in the treatment of hypertension. Still, the potential role and mechanism of DR must be further studied. In this review, we discuss and summarize the pathology and potential therapeutic goals of RAAS in DR.
Keywords
Diabetic retinopathy; renin-angiotensin-aldosterone system; renin; prorenin
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Abbreviations: DR, diabetic retinopathy; RAAS, renin-angiotensin-aldosterone system; Ang I, angiotensin I, Ang II, angiotensin II; ACE, angiotensin-converting enzyme; ACE2, angiotensin-converting enzyme type 2; (P)RR, (pro)renin receptor; AT1R, angiotensin II type 1 receptors; AT2R, angiotensin II type 2 receptors; ERK 1/2, extracellular signal-regulated kinase 1/2; MAPK, mitogen-activated protein kinase; VEGF, vascular endothelial growth factor; AGE, advanced glycation end product; TGF-β, transforming growth factor-β; ICAM-1, intracellular adhesion molecule-1; NF-κB, nuclear factor-kappa B; PAI-1, plasminogen activator inhibitor-1; DAG/PK-C, diacylglycerol/protein kinase-C; IP3, inositol-1,4,5-triphosphate; NO, nitric oxide; PL-A2, phospholipase A2; PL-C, phospholipase C; cGMP, cyclic guanosine monophosphate.