Influence of intracellular renin on heart cell communication

Angiotensin dependent and angiotensin independent protective effects of renin-b in H9c2 cells after anoxia

The renin-angiotensin system is known to regulate blood pressure as well as water- and electrolyte balance. An activated RAS is involved in the development of hypertension and hypertension-related organ damage. Thus, inhibitors of the RAS are protective and markedly increasing the life span of patients. In contrast, renin transcripts have been discovered encoding a cytoplasmatic renin isoform, termed renin-b, which is not harmful but may be even protective. Here we demonstrate that depletion of renin-b encoding transcripts by small interference RNA decreased ATP levels and increased basal necrosis as well as apoptosis rates. Furthermore, renin-b depletion potentiated the anoxia-induced increase of necrosis rates. Vice versa, overexpression of renin-b prevented the anoxia-induced increase of caspase-mediated apoptosis rates. Besides, cells overexpressing renin-b exhibited even reduced mitochondrial mediated apoptosis rates under anoxia, when compared with normoxic conditions, as indicated by Annexin V labeling. However, whereas the protective effect of renin-b on caspase-mediated apoptosis was completely blocked by the renin inhibitor CH732, the effect on mitochondrial-mediated apoptosis was not affected by CH732 at all. From these data we conclude that renin-b overexpression mediates cardioprotective effects under anoxia with respect to mitochondrial induced apoptosis angiotensin-independently, but with respect to caspase induced apoptosis likely in an angiotensin-dependent manner.

Angiotensins and Huntington's Disease: A Study on Immortalized Progenitor Striatal Cell Lines

Neurons from mouse models of Huntington's disease (HD) exhibit altered electrophysiological properties, potentially contributing to neuronal dysfunction and neurodegeneration. The renin-angiotensin system (RAS) is a potential contributor to the pathophysiology of neurodegenerative diseases. However, the role of angiotensin II (Ang II) and angiotensin (1-7) has not been characterized in HD. We investigated the influence of Ang II and angiotensin (1-7) on total potassium current using immortalized progenitor mutant huntingtin-expressing (Q111) and wild-type (Q7) cell lines. Measurements of potassium current were performed using the whole cell configuration of pCLAMP. The results showed that (1) the effect of Ang II administered to the bath caused a negligible effect on potassium current in mutant Q111 cells compared with wild-type Q7 cells and that intracellular administration of Ang II reduced the potassium current in wild type but not in mutant cells; (2) the small effect of Ang II was abolished by losartan; (3) intracellular administration of Ang II performed in mutant huntingtin-expressing Q111 cells revealed a negligible effect of the peptide on potassium current; (4) flow cytometer analysis indicated a low expression of Ang II AT1 receptors in mutant Q111 cells; (5) mutant huntingtin-expressing striatal cells are highly sensitive to Ang (1-7) and that the effect of Ang (1-7) is related to the activation of Mas receptors. In conclusion, mutant huntingtin-expressing cells showed a negligible effect of Ang II on potassium current, a result probably due to the reduced expression of AT1 receptors at the surface cell membrane. In contrast, administration of Ang (1-7) to the bath showed a significant decline of the potassium current in mutant cells, an effect dependent on the activation of Mas receptors. Ang II had an intracrine effect in wild-type cells and Ang (1-7) exerted a significant effect in mutant huntingtin-expressing striatal cells.

Intracellular renin increases the inward calcium current in smooth muscle cells of mesenteric artery of SHR. Implications for hypertension and vascular remodeling

The influence of intracellular renin on the inward calcium current in isolated smooth muscle cells from SHR mesenteric arteries was investigated. Measurements of calcium current were performed using the whole cell configuration of pCLAMP. The results indicated that: 1) renin (100nM) dialyzed into smooth muscle cells, increased the inward calcium current; 2) verapamil (10-9M) administered to the bath inhibited the effect of renin on the inward calcium current; 3) concurrently with the increase of calcium current a depolarization of 6.8+/-2.1mV (n=16)(P<0.05) was found in cells dialyzed with renin; 4) intracellular dialysis of renin (100nM) into smooth muscle cells isolated from mesenteric arteries of normal Wystar Kyoto rats showed no significant change on calcium current; 5) aliskiren (10-9M) dialyzed into the cell together with renin (100nM) abolished the effect of the enzyme on the calcium current in SHR; 6) Ang II (100nM) dialyzed into the smooth muscle cell from mesenteric artery of SHR in absence of renin, decreased the calcium current-an effect greatly reduced by valsartan (10-9M) added to the cytosol; 7) administration of renin (100nM) plus angiotensinogen (100nM) into the cytosol of muscles cells from SHR rats reduced the inward calcium current; 8) extracellular administration of Ang II (100nM) increased the inward calcium current in mesenteric arteries of SHR.

CONCLUSIONS

intracellular renin in vascular resistance vessels from SHR due to internalization or expression, contributes to the regulation of vascular tone and control of peripheral resistance-an effect independently of Ang II. Implications for hypertension and vascular remodeling are discussed.

Intracrine angiotensin II functions originate from noncanonical pathways in the human heart

Although it is well-known that excess renin angiotensin system (RAS) activity contributes to the pathophysiology of cardiac and vascular disease, tissue-based expression of RAS genes has given rise to the possibility that intracellularly produced angiotensin II (Ang II) may be a critical contributor to disease processes. An extended form of angiotensin I (Ang I), the dodecapeptide angiotensin-(1-12) [Ang-(1-12)], that generates Ang II directly from chymase, particularly in the human heart, reinforces the possibility that an alternative noncanonical renin independent pathway for Ang II formation may be important in explaining the mechanisms by which the hormone contributes to adverse cardiac and vascular remodeling. This review summarizes the work that has been done in evaluating the functional significance of Ang-(1-12) and how this substrate generated from angiotensinogen by a yet to be identified enzyme enhances knowledge about Ang II pathological actions.

Exchange of chemical signals between cardiac cells. Fundamental role on cell communication and metabolic cooperation

The exchange of chemical signals between cardiac cells and its relevance for cell communication and metabolic cooperation was reviewed. The role of gap junctions on the transfer of chemical information was discussed as well as the different factors involved in its regulation including changes in cell volume, high glucose, activation of the renin angiotensin aldosterone system including the intracrine effect of renin and angiotensin II on chemical coupling and cardiac energetics. Finally, the possible role of epigenetic changes of the renin angiotensin aldosterone system (RAAS) on the expression of components of the RAAS was discussed. The evidence available leads to the conception of the heart as a metabolic syncytium in which glucose as well nucleotides and hormones can flow from cell-to-cell though gap junctions, providing a new vision of how alterations in metabolic cooperation can induce cardiac diseases. These findings represent a stimulus for future research in this important area of cardiac physiology and pathology.

Intracellular angiotensin II as a regulator of muscle tone in vascular resistance vessels. Pathophysiological implications

The influence of intracellular angiotensin II on the regulation of potassium current and membrane potential of smooth muscle cells of mesenteric arteries and its relevance for the regulation of vascular tone was reviewed. The presence of components of the renin angiotensin system (RAS) in different cells of the cardiovascular system, was discussed including their presence in the nuclei and mitochondria. Emphasis was given to the opposite effects of intracellular and extracellular angiotensin II (Ang II) on the regulation of potassium current, membrane potential and contractility of vascular resistance vessels and its implication to vascular physiology and pathology and the possible role of epigenetic factors on the expression of angiotensin II (Ang II) and renin in vascular resistance vessels as well as its possible pathophysiological role in hypertension and other cardiovascular diseases.

Chemical Communication between Heart Cells is Disrupted by Intracellular Renin and Angiotensin II: Implications for Heart Development and Disease

HighlightsIntracellular renin and angiotensin disrupts chemical communication in heart.Epigenetic modification of renin angiotensin aldosterone system (RAAS) and heart disease.Intracrine renin angiotensin and metabolic cooperation.Gap junction, intracellular renin and angiotensin, cellular patterns, and heart development. The finding that intracellular renin and angiotensin II (Ang II) disrupts chemical communication and impairs metabolic cooperation between cardiomyocytes induced by aldosterone, hyperglycemia, and pathological conditions like myocardial ischemia is discussed. The hypothesis is presented that epigenetic changes of the renin angiotensin aldosterone system (RAAS) are responsible for cardiovascular abnormalities, including the expression of RAAS components inside cardiac myocytes (intracrine RAAS) with serious consequences including inhibition of electrical and chemical communication in the heart, resulting in metabolic disarrangement and cardiac arrhythmias. Moreover, the inhibition of gap junctional communication induced by intracellular Ang II or renin can contribute to the selection of cellular patterns during heart development.

Intracellular Renin Disrupts Chemical Communication between Heart Cells. Pathophysiological Implications

HighlightsIntracellular renin disrupts chemical communication in the heartAngiotensinogen enhances the effect of reninIntracellular enalaprilat reduces significantly the effect of reninIntracellular renin increases the inward calcium currentHarmful versus beneficial effect during myocardial infarction The influence of intracellular renin on the process of chemical communication between cardiac cells was investigated in cell pairs isolated from the left ventricle of adult Wistar Kyoto rats. The enzyme together with Lucifer yellow CH was dialyzed into one cell of the pair using the whole cell clamp technique. The diffusion of the dye in the dialyzed and in non-dialyzed cell was followed by measuring the intensity of fluorescence in both cells as a function of time. The results indicated that; (1) under normal conditions, Lucifer Yellow flows from cell to cell through gap junctions; (2) the intracellular dialysis of renin (100 nM) disrupts chemical communication - an effect enhanced by simultaneous administration of angiotensinogen (100 nM); (3) enalaprilat (10(-9) M) administered to the cytosol together with renin reduced drastically the uncoupling action of the enzyme; (4) aliskiren (10(-8) M) inhibited the effect of renin on chemical communication; (5) the possible role of intracellular renin independently of angiotensin II (Ang II) was evaluated including the increase of the inward calcium current elicited by the enzyme and the possible role of oxidative stress on the disruption of cell communication; (6) the possible harmful versus the beneficial effect of intracellular renin during myocardial infarction was discussed; (7) the present results indicate that intracellular renin due to internalization or in situ synthesis causes a severe impairment of chemical communication in the heart resulting in derangement of metabolic cooperation with serious consequences for heart function.

Clinical perspectives and fundamental aspects of local cardiovascular and renal Renin-Angiotensin systems

Evidence for the potential role of organ specific cardiovascular renin-angiotensin systems (RAS) has been demonstrated experimentally and clinically with respect to certain cardiovascular and renal diseases. These findings have been supported by studies involving pharmacological inhibition during ischemic heart disease, myocardial infarction, cardiac failure; hypertension associated with left ventricular ischemia, myocardial fibrosis and left ventricular hypertrophy; structural and functional changes of the target organs associated with prolonged dietary salt excess; and intrarenal vascular disease associated with end-stage renal disease. Moreover, the severe structural and functional changes induced by these pathological conditions can be prevented and reversed by agents producing RAS inhibition (even when not necessarily coincident with alterations in arterial pressure). In this review, we discuss specific fundamental and clinical aspects and mechanisms related to the activation or inhibition of local RAS and their implications for cardiovascular and renal diseases. Fundamental aspects involving the role of angiotensins on cardiac and renal functions including the expression of RAS components in the heart and kidney and the controversial role of angiotensin-converting enzyme 2 on angiotensin peptide metabolism in humans, were discussed.

Intracellular angiotensin II increases the total potassium current and the resting potential of arterial myocytes from vascular resistance vessels of the rat. Physiological and pathological implications

The influence of intracellular and extracellular administration of angiotensin II (Ang II; 10(-9) M) on total potassium current of arterial myocytes isolated from mesenteric arteries of Sprague Dawley rats was investigated. Measurements of total potassium current were performed using the voltage clamp whole cell configuration while the effect of intracellular Ang II on the resting potential of arterial myocytes was measured using the current clamp configuration of pCLAMP. The results indicated that: 1) intracellular Ang II (10(-9) M) increased the total potassium current by 73% ± 2.6% (n = 22; P < .05) within 5 minutes; 2) concurrently with the increment of potassium current, the resting potential was increased by 7 ± 1.5 mV (n = 23; P < .05); 3) extracellular administration of Ang II (10(-9) M) reduced the total potassium current by 20% ± 1.6% (n = 21; P < .05) within 5 minutes and depolarized the smooth muscle cells by 9 ± 2.3 mV (n = 26; P < .05); 4) the effects of intracellular Ang II on potassium current and membrane potential were inhibited by dialyzing a PKA inhibitor (10(-9) M) inside the cell together with Ang II (10(-9) M; P > .05); 5) valsartan (10(-9) M) dialyzed into the cell together with Ang II (10(-9) M) abolished the effect of the peptide on potassium current and membrane potential. The presence of endogenous or internalized intracellular Ang II in vascular resistance vessels and its effect on potassium current and resting potential indicates that the peptide present inside the arterial myocytes plays an important role on the regulation of vascular tone and consequently on peripheral resistance, which is a determining factor in the regulation of arterial blood pressure.

Intracellular renin alters the electrical properties of the intact heart ventricle of adult Sprague Dawley rats

The influence of intracellular renin injection on the electrical properties of the intact left ventricle from adult Sprague Dawley rat heart was investigated. Intracellular renin injection was performed using intracellular microelectrodes filled with solution containing renin (120pM). Pressure pulses (40-70psi) for short periods of time (20ms), were applied to the micropipette while recording the action potential simultaneously from the same fiber. The results indicated that intracellular renin caused a depolarization of ventricular fibers of 7.3±2±mV (n=38) (4 animals) (P<0.05) and a decrease of the action potential duration at 50% and at 90% repolarization, respectively. Moreover, the refractoriness was significantly decreased with consequent generation of triggered activity. The effect of intracellular renin was seen within 3min of enzyme injection. The shortening of the action potential was related to an increase of potassium current which was measured in isolated ventricular myocytes before and after intracellular dialysis of renin (10(-9)M) using a voltage whole cell clamp configuration. Valsartan (10(-8)M) dialyzed together with renin (120pM) into the cell decreased drastically the effect of renin on potassium current. An increment of potassium current was also found when intracellular renin was dialyzed into cardiomyocytes exposed to Krebs solution containing valsartan (10(-8)M) for 10min prior to renin administration. Bis-1 which is a specific inhibitor of PKC, abolished the effect of intracellular renin on potassium current.

IN CONCLUSION

intracellular renin decreases the action potential duration and cardiac refractoriness in the intact left ventricle of adult Sprague Dawley rats. The shortening of the action potential was related to an increase in total potassium current. The effect of renin on total potassium currents was inhibited by valsartan and by Bis-1. Implication for cardiac arrhythmias was discussed.

Subcellular characteristics of functional intracellular renin-angiotensin systems

The renin-angiotensin system (RAS) is now regarded as an integral component in not only the development of hypertension, but also in physiologic and pathophysiologic mechanisms in multiple tissues and chronic disease states. While many of the endocrine (circulating), paracrine (cell-to-different cell) and autacrine (cell-to-same cell) effects of the RAS are believed to be mediated through the canonical extracellular RAS, a complete, independent and differentially regulated intracellular RAS (iRAS) has also been proposed. Angiotensinogen, the enzymes renin and angiotensin-converting enzyme (ACE) and the angiotensin peptides can all be synthesized and retained intracellularly. Angiotensin receptors (types I and 2) are also abundant intracellularly mainly at the nuclear and mitochondrial levels. The aim of this review is to focus on the most recent information concerning the subcellular localization, distribution and functions of the iRAS and to discuss the potential consequences of activation of the subcellular RAS on different organ systems.

The intracrine renin-angiotensin system

The RAS (renin-angiotensin system) is one of the earliest and most extensively studied hormonal systems. The RAS is an atypical hormonal system in several ways. The major bioactive peptide of the system, AngII (angiotensin II), is neither synthesized in nor targets one specific organ. New research has identified additional peptides with important physiological and pathological roles. More peptides also mean newer enzymatic cascades that generate these peptides and more receptors that mediate their function. In addition, completely different roles of components that constitute the RAS have been uncovered, such as that for prorenin via the prorenin receptor. Complexity of the RAS is enhanced further by the presence of sub-systems in tissues, which act in an autocrine/paracrine manner independent of the endocrine system. The RAS seems relevant at the cellular level, wherein individual cells have a complete system, termed the intracellular RAS. Thus, from cells to tissues to the entire organism, the RAS exhibits continuity while maintaining independent control at different levels. The intracellular RAS is a relatively new concept for the RAS. The present review provides a synopsis of the literature on this system in different tissues.

Local renin-angiotensin systems in the adrenal gland

In the adrenal gland all components of the renin-angiotensin system (RAS) are expressed in both the adrenal cortex and the adrenal medulla. In this review evidence shall be presented that a local secretory RAS exists in the adrenal cortex that stimulates aldosterone production and serves as an amplification system for circulating angiotensin (ANG) II. The regulation of the secretory adrenal RAS clearly differs from the regulation of the circulatory RAS in terms of renin expression as well as of renin secretion. For example under potassium load the activity of the renal and circulatory RAS is suppressed whereas the activity of the adrenal RAS is stimulated. Thus the activity of the adrenal RAS but not of the circulating RAS correlates well with the regulation of aldosterone production by potassium. The present review also summarizes the knowledge about the expression and functions of an additional renin transcript that has recently been discovered. This transcript encodes for a non-secretory cytosolic renin isoform. The cytosolic renin may be a basis for the existence of an intracellular renin system in the adrenal gland that has long been proposed. The present state of knowledge shall be discussed indicating that such an intracellular system modulates cell survival and cell death such as apoptosis and necrosis or cell functions such as aldosterone production.

Intracardiac intracellular angiotensin system in diabetes

The renin-angiotensin system (RAS) has mainly been categorized as a circulating and a local tissue RAS. A new component of the local system, known as the intracellular RAS, has recently been described. The intracellular RAS is defined as synthesis and action of ANG II intracellularly. This RAS appears to differ from the circulating and the local RAS, in terms of components and the mechanism of action. These differences may alter treatment strategies that target the RAS in several pathological conditions. Recent work from our laboratory has demonstrated significant upregulation of the cardiac, intracellular RAS in diabetes, which is associated with cardiac dysfunction. Here, we have reviewed evidence supporting an intracellular RAS in different cell types, ANG II's actions in cardiac cells, and its mechanism of action, focusing on the intracellular cardiac RAS in diabetes. We have discussed the significance of an intracellular RAS in cardiac pathophysiology and implications for potential therapies.

New insights into target organ involvement in hypertension

Hypertension and its sequelae are complex processes. Optimization of the care of the hypertensive patient requires not only attention to the regulation of arterial pressure but also attention to blunting the hypertension-related processes that lead to vascular disease. It is clear that the regulation of these processes is much more complex than previously understood. Here several new insights into the pathogenesis of hypertension-related vascular disease have been explored. While this review is not exhaustive, it does serve to point out the varied nature of the biologic processes that must be taken into account and it points to new avenues for the development of therapeutic agents.

Oxidative-dependent integration of signal transduction with intercellular gap junctional communication in the control of gene expression

Research on oxidative stress focused primarily on determining how reactive oxygen species (ROS) damage cells by indiscriminate reactions with their macromolecular machinery, particularly lipids, proteins, and DNA. However, many chronic diseases are not always a consequence of tissue necrosis, DNA, or protein damage, but rather to altered gene expression. Gene expression is highly regulated by the coordination of cell signaling systems that maintain tissue homeostasis. Therefore, much research has shifted to the understanding of how ROS reversibly control gene expression through cell signaling mechanisms. However, most research has focused on redox regulation of signal transduction within a cell, but we introduce a more comprehensive-systems biology approach to understanding oxidative signaling that includes gap junctional intercellular communication, which plays a role in coordinating gene expression between cells of a tissue needed to maintain tissue homeostasis. We propose a hypothesis that gap junctions are critical in modulating the levels of second messengers, such as low molecular weight reactive oxygen, needed in the transduction of an external signal to the nucleus in the expression of genes. Thus, any comprehensive-systems biology approach to understanding oxidative signaling must also include gap junctions, in which aberrant gap junctions have been clearly implicated in many human diseases.

Mechanisms of Disease: intracrine physiology in the cardiovascular system

The field of intracrine physiology attempts to codify the biological actions of intracrines--extracellular signaling proteins or peptides that also operate in the intracellular space, either because they are retained in their cells of synthesis or because they have been internalized by a target cell. Intracrines are structurally diverse; hormones, growth factors, DNA-binding proteins and enzymes can all display intracrine functionality. Here, we review the role of intracrines in the heart and vasculature, including the intracrine actions of renin-angiotensin-system components in cardiac pathology, dynorphin B in cardiac development, and a variety of factors in pathologic and therapeutic angiogenesis. We argue that principles of intracrine physiology can inform our understanding of important pathologic processes such as left ventricular hypertrophy, diabetic cardiomyopathy and arrythmogenesis, and can aid the development of more-effective therapeutic interventions in cardiovascular disease.

Renin increments the inward calcium current in the failing heart

BACKGROUND

Evidence is available that activation of the renin-angiotensin system is involved in cardiac remodeling. It is unknown whether renin can change the inward calcium current (ICa) in the failing heart. This problem was investigated in the present study.

METHODS

Cardiomyocytes were isolated from the ventricle of 4-month-old cardiomyopathic hamsters and measurements of the L-type ICa were performed using the patch-clamp technique in a whole-cell configuration.

RESULTS

Extracellular renin (128 pmol Ang I/ml per min) plus angiotensinogen (110 pmol angiotensin I generated by renin to exhaustion) incremented the peak ICa density significantly, an effect suppressed by enalapril maleate (10 mol/l) or by losartan (10 mol/l) added to the bath, indicating that the effect of renin plus angiotensinogen was related to the formation of angiotensin I and its conversion to angiotensin II at the surface cell membrane. Renin internalization seems to increment the ICa because intracellular dialysis of renin (128 pmol Ang I/ml per min) plus angiotensinogen (110 pmol angiotensin I generated by renin to exhaustion) also increased the peak ICa density significantly, an effect suppressed by intracellular losartan (10 mol/l) but not by extracellular losartan (10 mol/l).

CONCLUSIONS

Extracellular renin plus angiotensinogen increases the ICa in isolated myocytes from the failing heart of cardiomyopathic hamsters through the formation of angiotensin II and the activation of angiotensin type 1 receptors at the surface cell membrane. A similar increment of ICa was found with intracellular administration of renin plus angiotensinogen. This finding might indicate that renin internalization is involved in control of inward calcium current in the failing heart.

Differential expression of nuclear AT1 receptors and angiotensin II within the kidney of the male congenic mRen2. Lewis rat

We established a new congenic model of hypertension, the mRen(2). Lewis rat and assessed the intracellular expression of angiotensin peptides and receptors in the kidney. The congenic strain was established from the backcross of the (mRen2)27 transgenic rat that expresses the mouse renin 2 gene onto the Lewis strain. The 20-wk-old male congenic rats were markedly hypertensive compared with the Lewis controls (systolic blood pressure: 195 +/- 2 vs. 107 +/- 2 mmHg, P < 0.01). Although plasma ANG II levels were not different between strains, circulating levels of ANG-(1-7) were 270% higher and ANG I concentrations were 40% lower in the mRen2. Lewis rats. In contrast, both cortical (CORT) and medullary (MED) ANG II concentrations were 60% higher in the mRen2. Lewis rats, whereas tissue ANG I was 66 and 84% lower in CORT and MED. For both strains, MED ANG II, ANG I, and ANG-(1-7) were significantly higher than CORT levels. Intracellular ANG II binding distinguished nuclear (NUC) and plasma membrane (PM) receptor using the ANG II radioligand 125I-sarthran. Isolated CORT nuclei exhibited a high density (Bmax >200 fmol/mg protein) and affinity for the sarthran ligand (KD<0.5 nM); the majority of these sites (>95%) were the AT1 receptor subtype. CORT ANG II receptor Bmax and KD values in nuclei were 75 and 50% lower, respectively, for the mRen2. Lewis vs. the Lewis rats. In the MED, the PM receptor density (Lewis: 50 +/- 4 vs. mRen2. Lewis: 21 +/- 5 fmol/mg protein) and affinity (Lewis: 0.31 +/- 0.1 vs. 0.69 +/- 0.1 nM) were lower in the mRen2. Lewis rats. In summary, the hypertensive mRen2. Lewis rats exhibit higher ANG II in both CORT and MED regions of the kidney. Evaluation of intracellular ANG II receptors revealed lower CORT NUC and MED PM AT1 sites in the mRen2. Lewis. The downregulation of AT1 sites in the mRen2. Lewis rats may reflect a compensatory response to dampen the elevated levels of intrarenal ANG II.

Working outside the system: an update on the unconventional behavior of the renin–angiotensin system components

The renin-angiotensin system (RAS) plays an important role in regulating arterial pressure, blood volume, thirst, cardiac function, and cellular growth. Both a circulating and multiple tissue-localized systems have been identified, and are generally portrayed as a series of reactions that occur sequentially with a single outcome: angiotensinogen is cleaved by renin to form angiotensin I, which in turn is processed by angiotensin-converting enzyme (ACE) to angiotensin II, which then activates either the AT1 or the AT2 plasma membrane receptor. Evidence has emerged, however, showing that some RAS components play important roles outside of this canonical scheme. This article provides an overview of some recently identified extra-system functions. In addition to forming angiotensin II, ACE is a multifunctional enzyme equally important in the metabolism of vasodilator and antifibrotic peptides. As the membrane-bound form, ACE functions as a "receptor" that initiates intracellular signaling leading to gene expression. Both angiotensin I and II may lead to actions that are independent of, or even oppose, those of the RAS via their metabolism by the novel ACE-homologue ACE2. The two angiotensin II receptor types have ligand-independent roles that influence cellular signaling and growth, some of which may result from the ability to form hetero-dimers with other 7-transmembrane receptors. Finally, intracellular angiotensin II has been demonstrated to have actions on cell-communication, gene expression, and cellular growth, through both receptor-dependent and independent means. A greater understanding of these extra-system functions of the RAS components may aid in the development of novel treatments for hypertension, myocardial ischemia, and heart failure.

Evidence of a novel intracrine mechanism in angiotensin II-induced cardiac hypertrophy

Angiotensin II (Ang II) has a significant role in regulating cardiac homeostasis through humoral, autocrine and paracrine pathways, via binding to the plasma membrane AT1 receptor. Recent literature has provided evidence for intracrine growth effects of Ang II in some cell lines, which does not involve interaction with the plasma membrane receptor. We hypothesized that such intracrine mechanisms are operative in the heart and likely participate in the cardiac hypertrophy induced by Ang II. Adenoviral and plasmid vectors were constructed to express Ang II peptide intracellularly. Neonatal rat ventricular myocytes (NRVMs) infected with the adenoviral vector showed significant hypertrophic growth as determined by cell size, protein synthesis and enhanced cytoskeletal arrangement. Adult mice injected with the plasmid vector developed significant cardiac hypertrophy after 48 h, without an increase in blood pressure or plasma Ang II levels. This was accompanied by increased transcription of transforming growth factor-beta (TGF-beta) and insulin-like growth factor-1 (IGF-1) genes. Losartan did not block the growth effects, excluding the involvement of extracellular Ang II and the plasma membrane AT1 receptor. These data demonstrate a previously unknown growth mechanism of Ang II in the heart, which should be considered when designing therapeutic strategies to block Ang II actions.

Mechanisms of Disease: local renin–angiotensin–aldosterone systems and the pathogenesis and treatment of cardiovascular disease

Accumulating evidence has made it clear that not only does the renin-angiotensin-aldosterone system (RAAS) exist in the circulation where it is driven by renal renin, but it is also active in many tissues-and likely within cells as well. These systems might not be completely independent of each other, but rather interact. These local RAASs affect tissue and cellular angiotensin II concentrations and appear to be associated with clinically relevant physiologic and pathophysiologic actions in the cardiovascular system and elsewhere. Evidence in support of this possibility is reviewed here. In addition, direct (pro)renin action after binding to its specific receptor, the existence of renin transcripts, which apparently encode an intracellular renin, the discovery of an angiotensin-converting-enzyme homologue (ACE2), which leads to enhanced generation of angiotensin-(1-7) and the newly appreciated role of angiotensin-receptor dimerization in the regulation of angiotensin activity, all point to the conclusion that the RAASs are complexly regulated, multifunctional systems with important roles both within and outside the cardiovascular system.

Tissue renin angiotensin systems

The RAAS is a powerful regulator of vascular tone and intravascular volume and of tissue architecture and a variety of other functions. The recent appreciation of the immunoregulatory role of angiotensin II and its possible involvement in the genesis of atherosclerosis and in plaque rupture all speak to the wide-ranging physiologic and pathophysiologic activities of the peptide. So do its actions in fat cell differentiation and in neuromodulation. The system exists in the circulation, and RAASs, whole or partial, exist in many tissues. These systems are regulated at many levels ranging from the synthesis of renin to the dimerization of angiotensin receptors. Regulation occurs in multiple tissues and, as a result, tissue concentrations of angiotensin II and the concentration of other RAS components and their active metabolites can vary independently of the circulating system in these tissues. An RAS seems also to function within certain cells. Therapeutic interventions involving ACEIs and ARBs seem likely to provide benefit at least in part through the interruption of local systems. It is to be expected that with enhanced understanding of the biology of the multiple RASs, new suggestions for therapeutic interventions will be forthcoming.

Further studies on the effect of intracellular angiotensins on heart cell communication: on the role of endogenous angiotensin II

The influence of intracellular angiotensin I (Ang I) and angiotensin II (Ang II) on the process of cell communication was investigated in isolated cell pairs from the failing heart of cardiomyopathic hamsters at 2 and at 6 months of age. Measurements of junctional conductance were performed on weekly coupled ventricular cells (4-5.3 nS) using two separated voltage clamp circuits. The results indicated that at 2 months of age, when no signs of heart failure are detected, the angiotensin converting enzyme (ACE) activity is low and similar to controls (0.26 nmol/mg/min). Here the intracellular dialysis of angiotensin I (10(-8) M) caused a decline of junctional conductance of 33+/-3.6% (n=35) (P<0.05) within 10 min while the administration of the same concentration of Ang I elicited cell uncoupling in cell pairs of 6-month-old cardiomyopathic hamsters in which the ACE activity was enhanced (0.41+/-0.05 nmol/mg/min) (P<0.05). Intracellular administration of angiotensin II in cell pairs of 2-month-old hamsters caused a decline of junctional conductance of only 25+/-4.5% (n=35) (P<0.05) compared to cell uncoupling in 6-month-old cardiomyopathic hamsters. Intracellular losartan(10(-8) M) reduced the effect of intracellular Ang II by 68+/-3.5% (n=28) on 2-month-old hamsters and abolished the effect of the peptide on 6-month-old hamsters. To investigate the influence of endogenous angiotensin II on the regulation of cell coupling, enalapril maleate (10(-8) M) or enalaprilat (10(-9) M) was used. The results indicated that at 2 months of age, no change in cell coupling was elicited by the ACE inhibitor while at 6 months of age, there was an increment of cell coupling of 72+/-6.2% (P<0.05). Similar results were found with intracellular losartan (10(-8) M). These results support the view that endogenous angiotensin II is involved in the regulation of cell communication at an advanced stage of heart failure when the ACE activity is enhanced and the cardiac renin angiotensin system (RAS) is activated.

Effect of extracellular and intracellular angiotensins on heart cell function; on the cardiac renin-angiotensin system

In this manuscript, I presented up-to-date evidence that intracellular and extracellular angiotensins have an important regulatory effect on the processes of heart cell communication and inward calcium current and that aldosterone modulates the effect of angiotensin II (Ang II) on the electrical properties of the heart. Moreover, I discussed the most relevant information about the origin of cardiac renin, the presence of a cardiac renin-angiotensin aldosterone system and its possible relevance for heart cell physiology and pathology.

Intracellular angiotensin II increases the long isoform of PDGF mRNA in rat hepatoma cells

Our recent published studies suggest that angiotensin II (AII), generated and retained intracellularly, enhances growth of H4-II-E-C3 rat hepatoma cells, an average of 33%. Proliferation conferred by introduction of a plasmid [ Ang(-S)Exp/pSVL ] encoding a signal sequence-depleted angiotensinogen [Ang(-S)Exp] into these cells (which we have shown possess ACE and renin mRNAs) is mediated, at least in part, by enhanced PDGF-A chain mRNA production and protein secretion. The mitogenic effect is inhibited by losartan suggesting that it involves AII interaction with an AT(1)-like receptor. Introduction of anti-AII antibodies into the medium of these transfected cells has no effect upon growth of the cells, suggesting that AII is retained by the cells and that intracellular AII is growth stimulatory. In the present study, we sought to further characterize the intracellular localization and mode of action of Ang(-S)Exp. Consistent with our expectations, we now show that a fusion product of Ang(-S)Exp with green fluorescent protein [Ang(-S)Exp/EGFP], generated from an expression plasmid, is abundant and primarily cytoplasmic. Wild-type angiotensinogen/EGFP, in contrast, is only detectable following a cold-block (which acts to enhance folding-kinetics and slow secretion) and is largely restricted to the secretory pathway. We further show, using semi-quantitative RT/PCR that the long isoform of PDGF mRNA is elevated in Ang(-S)Exp transfected cells and in AII-treated naive cells but not in losartan-treated Ang(-S)Exp transfected cells. We identify C-terminal amidation recognition sites within the long-form protein (that are not present in the short-form) and show that these cells possess PAM (amidating enzyme precursor) and carboxypeptidase E mRNAs (the corresponding proteins of which are sufficient for amidation). Inhibitors of amidation inhibit growth of naive and Ang(-S)Cntr/ pSVL -transfected cells (2.6-fold for phenylbutenoic acid and 3.5-fold for disulfiram treatment) but more profoundly inhibit growth of Ang(-S)Exp/pSVL -transfected cells (6.7-fold for phenylbutenoic acid and 13-fold for disulfiram). In conclusion, these data confirm that signal sequence-depleted Ang(-S)Exp is retained within cells and is largely cytoplasmic. Because C-terminal amidation is absolutely required for full biological potency of a number of peptide hormones (including oxytocin, gastrin and calcitonin), we postulate that growth effects of both intracellular AII and exogenous AII can be conferred by PDGF long-form, possibly through an amidation-dependent mechanism.

The cardiac renin-angiotensin system: novel signaling mechanisms related to cardiac growth and function

Angiotensin II, the effector peptide of the renin-angiotensin system, has been demonstrated to be involved in the regulation of cellular growth of several tissues in response to developmental, physiological, and pathological processes. The recent identification of renin-angiotensin system components and localization of angiotensin II receptors in cardiac tissue suggests that locally synthesized Ang II can modulate functional and growth responses in cardiac tissue. In this review, regulation of the cardiac RAS is discussed, with an emphasis on growth-related Ang II signal transduction systems.

The antiarrhythmic potential of angiotensin II antagonism: experience with losartan

A large body of literature accumulated over the past several years supports the notion that inhibition of the renin-angiotensin system protects the heart and other target organs from hypertensive complications. Various studies have shown that angiotensin-converting enzyme inhibitors reduce morbidity and mortality in the setting of ischemic heart disease and/or congestive heart failure. The improvement in survival has been attributed in part to a significant decrease in the incidence of sudden deaths, possibly due to a decrease in complex arrhythmia episodes. Recently, the angiotensin II type 1 receptor antagonist losartan was shown to reduce mortality by 46% compared with captopril in older patients with chronic congestive heart failure. This paper briefly reviews the arrhythmogenic properties of angiotensin II and the possible pharmacologic mechanisms for the antiarrhythmogenic potential of losartan.

Cell coupling and impulse propagation in the failing heart

Cell coupling and impulse propagation were investigated in the ventricle of cardiomyopathic hamsters at an advanced stage of heart failure. An appreciable decline in junctional conductance was found, a phenomenon in part related to activation of the plasma and cardiac renin-angiotensin systems. Decreased expression of connexin43 or an alteration of junctional proteins also might be implicated in the decreased cell coupling. Morphologic abnormalities such as fibrosis, necrosis, and rupture of cell contacts contribute to the decline of conduction velocity or to the blockade of impulse propagation in some areas of the ventricle, creating the conditions for anisotropic conduction and cardiac arrhythmias. The decrease in membrane potential found in myopathic cells is related in part to depression of Na-KATPase activity, and the lack of action of beta-adrenergic agonists on junctional conductance is explained by down-regulation of beta receptors and an abnormality of adenyl cyclase.

Electrophysiologic and morphologic abnormalities in the failing heart: effect of enalapril on the electrical properties

BACKGROUND

Knowledge of the electrophysiologic abnormalities in the failing heart is meager. In this work morphologic and electrophysiologic changes were investigated in the cardiomyopathic hamster (BIO TO-2) at 11 months of age. The results were compared with control hamsters (F1B) of the same age.

METHODS AND RESULTS

Conventional KCl microelectrodes were used to measure membrane potential, conduction velocity, and refractoriness. Histologic studies consisted of Harris' hematoxylin and eosin, Masson trichrome, and von Kossa's calcium stain. The resting potential of myopathic fibers (-67.8 mV; SEM 1 0.83) in the cardiomyopathic hamsters was less negative than the control subjects' potential (-78.5 V; SEM + 1), and the action potential duration measured at 50% of repolarization was increased by 213%. The conduction velocity (36.9 cm/s) was 15.7% lower than that of the control subjects. Enalapril (50 micrograms/mL) caused a hyperpolarization of 6.8 mV, it increased the action potential duration at 90% of repolarization by 110%, and the conduction velocity of the myopathic fibers was appreciably increased compared to the control hamsters'. The refractoriness of myopathic and normal ventricular fibers was also increased by enalapril. Histologic studies performed on the right and left ventricular wall indicated interstitial fibrosis, necrotic foci, and extensive calcification.

CONCLUSIONS

The results indicate severe morphologic and electrophysiologic abnormalities in the failing ventricular muscle. The effect of enalapril on membrane potential and conduction velocity might indicate that the activation of the cardiac renin-angiotensin system during the process of heart failure is, in part, responsible for the abnormalities described here. The improvement of impulse propagation and the increase in refractoriness seem to represent important factors involved in the antiarrhythmic action of enalapril.