ABSTRACT

The renin-angiotensin system (RAS) operates within adipose tissue. Obesity-related changes can affect adipose RAS, predisposing to hypertension, type 2 diabetes, and possibly severe COVID-19. We evaluated the in vitro research on human adipose RAS and identified gaps in the literature. Medline (Ovid), Embase (Ovid), Web of Science, Scopus, and 1findr were searched to identify relevant studies. Fifty primary studies met our inclusion criteria for analysis. Expression of RAS components (n = 14), role in differentiation (n = 14), association with inflammation (n = 15) or blood pressure (n = 7) were investigated. We found (1) obesity-related changes in RAS were frequently studied (30%); (2) an upswing of articles investigating adipose ACE-2 expression since the COVID-19 pandemic; (3) a paucity of papers on AT2R and Ang (1–7)/MasR which counterbalance Ang II/ART1; (4) weight loss lowered adipose ACE-2 mRNA expression; and (5) angiotensin receptor blockers (ARBs) reduced deleterious effects of angiotensin II. Overall, these studies link Ang II/ATR1 signalling to impaired adipogenesis and a pro-inflammatory dysfunctional adipose tissue, with ATR1 blockade limiting these responses. ACE-2 may mitigate Ang II effects by converting it to Ang(1–7) which binds MasR. More work is needed to understand adipose RAS in various pathologic states such as obesity and COVID-19 infection.T.

摘要

肾素-血管紧张素系统 (RAS) 在脂肪组织内运作。肥胖相关的变化会影响脂肪 RAS，导致高血压、2 型糖尿病和可能严重的 COVID-19。我们评估了人体脂肪 RAS 的体外研究，并确定了文献中的空白。搜索了 Medline (Ovid)、Embase (Ovid)、Web of Science、Scopus 和 1findr 以确定相关研究。五十项主要研究符合我们的分析纳入标准。RAS 成分的表达 ( n  = 14)、在分化中的作用 ( n  = 14)、与炎症 ( n  = 15) 或血压的关联 ( n = 7) 进行了调查。我们发现 (1) 经常研究与肥胖相关的 RAS 变化 (30%)；(2) 自 COVID-19 大流行以来，研究脂肪 ACE-2 表达的文章增多；(3) 缺乏关于 AT2R 和 Ang (1-7)/MasR 的论文，它们平衡了 Ang II/ART1；(4) 减肥降低了脂肪中 ACE-2 mRNA 的表达；(5) 血管紧张素受体阻滞剂 (ARB) 可减少血管紧张素 II 的有害作用。总的来说，这些研究将 Ang II/ATR1 信号与受损的脂肪生成和促炎功能失调的脂肪组织联系起来，而 ATR1 阻断限制了这些反应。ACE-2 可以通过将其转化为与 MasR 结合的 Ang(1–7) 来减轻 Ang II 的影响。需要做更多的工作来了解肥胖和 COVID-19 感染等各种病理状态下的脂肪 RAS。