Key result
The local cutaneous renin-angiotensin system drives pathological scarring, and targeting this pathway with ACE inhibitors and angiotensin receptor blockers shows significant therapeutic potential.
Why the study?
Pathological scarring imposes a substantial burden, prompting an exploration of the role of the local cutaneous renin-angiotensin system in its pathogenesis and therapeutic potential.
Do renin-angiotensin system inhibitors (ACEIs and ARBs) improve or prevent pathological scarring?
Do renin-angiotensin system inhibitors (ACEIs and ARBs) improve or prevent pathological scarring?
This review highlights the role of the local cutaneous renin-angiotensin system in pathological scarring and the potential of topical ACEIs and ARBs as novel anti-fibrotic therapies.
May warrant topical ACEI use in keloids; extends RAS inhibition beyond cardiovascular disease.
Pathological scarring, a fibroproliferative disorder, imposes a substantial burden on affected individuals. This review explores the pivotal role of the local cutaneous renin-angiotensin system (RAS) in the pathogenesis of pathological scarring. We summarize evidence demonstrating how the pro-fibrotic angiotensin II/angiotensin II type 1 receptor (Ang II/AT1R) axis drives scar formation by promoting fibroblast proliferation, inflammation, and excessive extracellular matrix (ECM) deposition. Concurrently, we examine the interactions between RAS and other fibrotic pathways, as well as inflammation and reactive oxygen species (ROS). Importantly, the review highlights the significant therapeutic potential of targeting this pathway with RAS inhibitors—specifically angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs)—particularly in topical formulations. We also outline recent advances in next-generation RAS therapies. Finally, we summarize current limitations and challenges in clinical translation, emphasizing the need for advanced clinical trials and precision medicine strategies to facilitate its clinical adoption.
No takes yet. Share an insight, caveat, or question.
Shi et al. (2026) conducted a review in Pathological scarring (hypertrophic scars and keloids). RAS inhibitors (ACEIs and ARBs) was evaluated. The local cutaneous renin-angiotensin system drives pathological scarring, and targeting this pathway with ACE inhibitors and angiotensin receptor blockers shows significant therapeutic potential.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: