Key result
Multiple pathways of angiotensin production may exist in the blood vessel wall alongside the renin-ACE axis, though their in vivo functionality remains unknown.
Highlights the potential existence and complexity of alternative, non-ACE pathways for angiotensin production in the vascular wall.
Should not alter ACE inhibitor strategies; leaves open the in vivo role and therapeutic relevance of alternative vascular pathways.
In summary, multiple pathways of angiotensin production may exist in the blood vessel wall (Fig. 1), in addition to the well described renin--ACE enzymatic axis. It is not known whether these enzymatic pathways represent in vitro phenomena, or authentic in vivo alternate pathways which are activated only when the renin--ACE pathway is blocked, or whether they are operative at all times in the vessel wall. If these multiple pathways are functional, then the vascular angiotensin system may be very complicated, and may vary in different pathophysiological states. Future research in this area is likely to yield important and novel information on the in vivo pathways of production and function of vascular angiotensin.
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Victor J. Dzau (1989) conducted a review in Vascular angiotensin production. Multiple pathways of angiotensin production was evaluated. Multiple pathways of angiotensin production may exist in the blood vessel wall alongside the renin-ACE axis, though their in vivo functionality remains unknown.
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