Renin-angiotensin-system and clear cell renal carcinoma:research advances and future perspectives  

作　　者：Guang Yang Yan Wang Zhi-Wei Lai Hua Zhang Yue Zhang Fei Song 

机构地区：[1]Division of Renal Medicine,Peking University Shenzhen Hospital,Peking University,Shenzhen 518036,Guangdong,China [2]Clinical Medical Research Center for Urology and Nephrology,Shenzhen 518036,Guangdong,China [3]Department of Urology,Peking University Shenzhen Hospital,Peking University,Shenzhen 518036,Guangdong,China [4]Shenzhen Medical Academy of Research and Translation,Shenzhen 518107,Guangdong,China

出　　处：《Journal of Cancer Metastasis and Treatment》2024年第1期81-95,共15页癌症转移与治疗(英文版)

基　　金：supported by Shenzhen Science and Technology Innovation Commission(JCYJ20220530150412026);Guangdong Basic and Applied Basic Research Foundation(2023A1515111112);Shenzhen Clinical Medical Research Center for Urology and Nephrology。

摘　　要：Hypertension is a known risk factor for clear cell renal cell carcinoma(ccRCC),yet the underlying mechanisms remain elusive.Studies have confirmed that the renin-angiotensin system(RAS)plays a role beyond regulating blood pressure,influencing various aspects of tumor development and metastasis.Generally,activation of the angiotensin-converting enzyme(ACE)/angiotensin II(Ang II)/angiotensin type 1 receptor(AT1R)axis elevates blood pressure and promotes tumor progression,while the activation of the angiotensin-converting enzyme 2(ACE2)/[Ang-(1-7)]/Mas receptor(MasR)axis antagonizes these effects.Consequently,many cardiovascular drugs targeting the RAS may possess both hypotensive and antitumor properties.However,the role of RAS in ccRCC is controversial.To explore this,we reviewed the relevant literature.Surprisingly,apart from ACE2,the activation of RAS may facilitate the progression and metastasis of ccRCC.This unexpected finding suggests caution when using RAS inhibitors in ccRCC patients.This review provides an overview of the RAS,highlights research advances in RAS for ccRCC,elucidates the current status of RAS-targeted drugs in the treatment of ccRCC,and discusses the current challenges and future research directions in this field.In conclusion,the upregulation of other effector peptides and the activation of receptors in the RAS,apart from ACE2,may expedite ccRCC progression.Therefore,careful consideration is needed when using relevant drugs in ccRCC patients with hypertension.This synthesis of available evidence is crucial for informing the clinical management of ccRCC and guiding the development of novel therapeutic strategies.

关 键 词：RENIN-ANGIOTENSIN-SYSTEM ccRCC HYPERTENSION KIDNEY MACROPHAGE CANCER tumor microenvironment 

分 类 号：R73[医药卫生—肿瘤]