Angiotensin II in septic shock

Corrêa, Thiago D; Takala, Jukka; Jakob, Stephan M

doi:10.1186/s13054-015-0802-3

ScienceOpen: research and publishing network

For Publishers

For Researchers

Blog
About

Search
Advanced search

views

recommends

Record: found
Abstract: found
Article: found

Is Open Access

Angiotensin II in septic shock

review-article

Author(s): Thiago D Corrêa , Jukka Takala , Stephan M Jakob

Publication date (Electronic): 16 March 2015

Journal: Critical Care

Publisher: BioMed Central

Read this article at

ScienceOpen Publisher PMC

Bookmark

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2015 and co-published as a series in Critical Care. Other articles in the series can be found online at http://ccforum.com/series/annualupdate2015. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.

Related collections

Most cited references 36

Record: found
Abstract: found
Article: not found

Minireview: overview of the renin-angiotensin system--an endocrine and paracrine system.

Kim Lavoie, Curt Sigmund (2003)

Since the discovery of renin as a pressor substance in 1898, the renin-angiotensin (RAS) system has been extensively studied because it remains a prime candidate as a causative factor in the development and maintenance of hypertension. Indeed, some of the properties of the physiologically active component of the RAS, angiotensin II, include vasoconstriction, regulation of renal sodium and water absorption, and increasing thirst. Initially, its affect on blood pressure was thought to be mediated primarily through the classical endocrine pathway; that is, the generation of blood-borne angiotensin with actions in target tissues. More recently, however, it has become appreciated that a local autocrine or paracrine RAS may exist in a number of tissues, and that these may also play a significant role in regulating blood pressure. Some of the difficulties in studying tissue RAS stem from the limitations of pharmacology in not differentiating between RAS products made systemically from those synthesized locally. However, the development of transgenic animals with highly specific promoters to target the RAS to specific tissues provided important tools to dissect these systems. Thus, this minireview will discuss recent advances in understanding the relationship between endocrine and paracrine (tissue) RAS using transgenic models.

0 comments Cited 142 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Dopamine versus norepinephrine in the treatment of septic shock: a meta-analysis*.

Daniel De Backer, César Aldecoa, Hassane Njimi … (2012)

There has long-been controversy about the possible superiority of norepinephrine compared to dopamine in the treatment of shock. The objective was to evaluate the effects of norepinephrine and dopamine on outcome and adverse events in patients with septic shock. A systematic search of the MEDLINE, Embase, Scopus, and CENTRAL databases, and of Google Scholar, up to June 30, 2011. All studies providing information on the outcome of patients with septic shock treated with dopamine compared to norepinephrine were included. Observational and randomized trials were analyzed separately. Because time of outcome assessment varied among trials, we evaluated 28-day mortality or closest estimate. Heterogeneity among trials was assessed using the Cochrane Q homogeneity test. A Forest plot was constructed and the aggregate relative risk of death was computed. Potential publication bias was evaluated using funnel plots. We retrieved five observational (1,360 patients) and six randomized (1,408 patients) trials, totaling 2,768 patients (1,474 who received norepinephrine and 1,294 who received dopamine). In observational studies, among which there was significant heterogeneity (p < .001), there was no difference in mortality (relative risk, 1.09; confidence interval, 0.84-1.41; p = .72). A sensitivity analysis identified one trial as being responsible for the heterogeneity; after exclusion of that trial, no heterogeneity was observed and dopamine administration was associated with an increased risk of death (relative risk, 1.23; confidence interval, 1.05-1.43; p < .01). In randomized trials, for which no heterogeneity or publication bias was detected (p = .77), dopamine was associated with an increased risk of death (relative risk, 1.12; confidence interval, 1.01-1.20; p = .035). In the two trials that reported arrhythmias, these were more frequent with dopamine than with norepinephrine (relative risk, 2.34; confidence interval, 1.46-3.77; p = .001). In patients with septic shock, dopamine administration is associated with greater mortality and a higher incidence of arrhythmic events compared to norepinephrine administration.

0 comments Cited 99 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Angiotensin-(1-7) protects from experimental acute lung injury.

Stephanie Kaestle, Wolfgang M. Kuebler, Michael Mertens … (2013)

Recently, recombinant angiotensin-converting enzyme 2 was shown to protect mice from acute lung injury, an effect attributed to reduced bioavailability of angiotensin II. Since angiotensin-converting enzyme 2 metabolizes angiotensin II to angiotensin-(1-7), we hypothesized that this effect is alternatively mediated by angiotensin-(1-7) and activation of its receptor(s). To test this hypothesis, we investigated the effects of intravenously infused angiotensin-(1-7) in three experimental models of acute lung injury. Animal research laboratory. Male Sprague-Dawley rats, Balb/c mice, and C57Bl6/J mice. Angiotensin-(1-7) was administered with ventilator- or acid aspiration-induced lung injury in mice or 30 minutes after oleic acid infusion in rats. In vitro, the effect of angiotensin-(1-7) on transendothelial electrical resistance of human pulmonary microvascular endothelial cells was analyzed. Infusion of angiotensin-(1-7) starting 30 minutes after oleic acid administration protected rats from acute lung injury as evident by reduced lung edema, myeloperoxidase activity, histological lung injury score, and pulmonary vascular resistance while systemic arterial pressure was stabilized. Such effects were largely reproduced by the nonpeptidic angiotensin-(1-7) analog AVE0991. Infusion of angiotensin-(1-7) was equally protective in murine models of ventilator- or acid aspiration-induced lung injury. In the oleic acid model, the two distinct angiotensin-(1-7) receptor blockers A779 and D-Pro-angiotensin-(1-7) reversed the normalizing effects of angiotensin-(1-7) on systemic and pulmonary hemodynamics, but only D-Pro-angiotensin-(1-7) blocked the protection from lung edema and protein leak, whereas A779 restored the infiltration of neutrophils. Rats were also protected from acute lung injury by the AT1 antagonist irbesartan; however, this effect was again blocked by A779 and D-Pro-angiotensin-(1-7). In vitro, angiotensin-(1-7) protected pulmonary microvascular endothelial cells from thrombin-induced barrier failure, yet D-Pro-angiotensin-(1-7) or NO synthase inhibition blocked this effect. Angiotensin-(1-7) or its analogs attenuate the key features of acute lung injury and may present a promising therapeutic strategy for the treatment of this disease.

0 comments Cited 61 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Thiago D Corrêa: thiagodct@gmail.com

Jukka Takala: jukka.takala@insel.ch

Stephan M Jakob: stephan.jakob@insel.ch

Journal

Journal ID (nlm-ta): Crit Care

Title: Critical Care

Publisher: BioMed Central (London )

ISSN (Print): 1364-8535

ISSN (Electronic): 1466-609X

Publication date (Electronic): 16 March 2015

Publication date (Print): 2015

Volume: 19

Issue: 1

Electronic Location Identifier: 98

Affiliations

[ ]Hospital Israelita Albert Einstein, Intensive Care Unit, São Paulo, Brazil

[ ]Department of Intensive Care Medicine, Bern University Hospital, Inselspital, Bern, Switzerland

[ ]University of Bern, Bern, Switzerland

Article

Publisher ID: 802

DOI: 10.1186/s13054-015-0802-3

PMC ID: 4360936

PubMed ID: 25886853

SO-VID: 3729216d-765b-4244-8d48-e5e7310e16de

License:

This article is co-published by agreement with Springer-Verlag. Permission for reuse must be sought from the publisher.

History

Custom metadata

ScienceOpen disciplines: Emergency medicine & Trauma

Data availability:

ScienceOpen disciplines: Emergency medicine & Trauma

Comments

Comment on this article

scite_

Smart Citations

Citing PublicationsSupportingMentioningContrasting

View Citations

See how this article has been cited at scite.ai

scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

Cited by 36

See all cited by

Most referenced authors 588

See all reference authors

Angiotensin II in septic shock

Read this article at

Abstract

Related collections

Preventive and Emergency Medicine Insights

Most cited references 36

Minireview: overview of the renin-angiotensin system--an endocrine and paracrine system.

Dopamine versus norepinephrine in the treatment of septic shock: a meta-analysis*.

Angiotensin-(1-7) protects from experimental acute lung injury.

Author and article information

Contributors

Journal

Affiliations

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 25

Cited by 36

Most referenced authors 588