Angiotensinase Inhibitors Research Articles

The Renin-Angiotensin System: New Insight into Old Therapies

Although the renin-angiotensin system (RAS) is already an old acquaintance, there are often exciting discoveries that improve our knowledge of it and open new therapeutic possibilities. Moreover, well-established drugs, such as angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), or beta-blockers, show that their mechanism of action may be the result of parallel pathways other than the ones initially established. A detailed analysis of the RAS can be carried out in part through the study of the enzymes, named angiotensinases, involved in its cascade, whose activity is a reflection of the functionality of their peptide substrates. The study of these enzymes offers the possibility of controlling the effects of angiotensins through various pharmacological manipulations. For example, angiotensinase inhibitors or activators are being used or have been proposed as antihypertensive agents. They have also been suggested as analgesic and antidepressant drugs or targets for drug development against different pathologies such as Alzheimer's disease, epilepsy or ischemia. On the other hand, the analysis of brain asymmetry has revealed surprising results about the laterality of central and peripheral components of the RAS. Such studies indicate that the neurovisceral integration, already proposed by Claude Bernard (1867) should also be analyzed from a bilateral perspective. In this review, the RAS and the role of various angiotensinases implicated in the cascade are revisited. Therapeutic strategies involving some components of the RAS with an unusual vision resulting from a bilateral perspective added to their study are discussed.

Renin, Prorenin and the Putative (Pro)renin Receptor

Renin is an aspartic protease that consists of 2 homologous lobes. The cleft in between contains the active site with 2 catalytic aspartic residues.1 Unlike other aspartic proteases such as pepsin or cathepsin D, renin is monospecific and only cleaves angiotensinogen, to generate angiotensin (Ang) I. Ang I is the precursor of the active end-product of the renin-angiotensin system (RAS), Ang II. Renin has also been called active renin to underline that an enzymatically inactive form of renin exists. In 1971, Lumbers found that amniotic fluid, left at low pH in the cold, acquired renin activity.2 Later, Skinner described a similar phenomenon in plasma.3 Acidification was not strictly necessary for this increase in Ang I-generating activity, because incubation at low temperature also increased renin activity, albeit to only 15% of activity after acidification. Soon it was postulated that this inactive, but activatable “big” renin (its molecular weight was 5 kDa higher than that of renin) was the biosynthetic precursor of renin. Hence, it was named prorenin. Only with the cloning of the renin gene in 1984 was prorenin definitively proved to be the precursor of renin.4 For reasons that are unknown, prorenin circulates in human plasma in excess to renin, sometimes at concentrations that are 100-times higher.5 Prorenin has also been demonstrated in plasma of cat, dog, cattle, pig, horse, sheep, rabbit, rat, and mouse. A 43-amino acid N-terminal propeptide explains the absence of enzymatic activity of prorenin. This propeptide covers the enzymatic cleft and obstructs access of angiotensinogen to the active site of renin. (Pro)renin is synthesized as a preprohormone. It contains a signal peptide that directs the protein to the endoplasmic reticulum and ultimately to the exterior of the cell. Both renin and prorenin can be fractionated into multiple species by isoelectric focusing. …

Angiotensinases restrict locally generated angiotensin II to the blood vessel wall.

We tested the hypothesis that angiotensinases limit the spillover of locally formed angiotensin II into the circulation. The release of angiotensin peptides from isolated rat hindquarters perfused with an artificial medium was measured by high-performance liquid chromatography and radioimmunoassay. The spontaneous release of angiotensins was increased by the angiotensinase inhibitors phenanthroline (850+/-195 versus 95+/-33 fmol of angiotensin I per 30 minutes in controls, P<.05, n=5 each) and amastatin (P<.05, n=5 each). Infusion of renin induced sustained local angiotensin I formation, which was also increased by phenanthroline. Stimulation of local angiotensin formation by renin infusion was compared with infusion of exogenous angiotensin II. Renin caused similar increases of perfusion pressure (11.1+/-2.2 versus 7.6+/-1.9 mm Hg after angiotensin II, P>.05) despite lower angiotensin II levels in the venous effluent than during infusion of exogenous angiotensin II (65+/-2 versus 482+/-33 fmol/mL, P<.05, n=7 each). Thus, renin must have caused higher angiotensin II tissue levels than indicated by the measurements in the venous effluent. The pressor response to renin was abolished by the type 1 angiotensin II receptor antagonist losartan. We conclude that the major part of locally generated angiotensins is not released into the circulation but degraded by angiotensinases within the tissue compartment.

Effects of Angiotensinase Inhibitors on Plasma Protein Binding and IC50 Determinations of Renin Inhibitors

To establish whether the use of proteinase inhibitors in the routine determination of in vitro plasma renin activity overestimates the potency of renin inhibitors in vivo, we examined the effects of phenylmethylsulfonyl fluoride and 8-hydroxyquinoline sulfate on the binding to plasma proteins and the respective IC50 values (50% inhibiting concentrations) of three renin inhibitors. All three renin inhibitors, A-64662, A-65317, and A-74273, bound (> 60%) to plasma proteins at both pH 6.0 and 7.4, with slightly greater binding at pH 7.4. Phenylmethylsulfonyl fluoride (1.45 mmol/L) had no significant effect on the protein binding at either pH 6.0 or 7.4; 8-hydroxyquinoline sulfate (3.4 mmol/L) caused a modest dissociation (10-30%) of the renin inhibitors from plasma proteins at both pH values; and the effects of both proteinase inhibitors together were similar to those of 8-hydroxyquinoline alone. At pH 7.4, phenylmethylsulfonyl fluoride increased the potencies of the three renin inhibitors slightly (< or = 43%), whereas IC50 values determined in the presence of 8-hydroxyquinoline decreased by 1.5- to 3.7-fold. The greatest increase in potency occurred with the most hydrophilic compound, and with both angiotensinase inhibitors the effect was no greater than that of 8-hydroxyquinoline alone. The results show that any dissociation of the hypotensive activity measured in vivo from the plasma renin activity measured in vitro is not simply an artifact in the plasma renin activity assay stemming from the use of these angiotensinase inhibitors, especially if only phenylmethylsulfonyl fluoride is used.

Nonparallel Effects of Renin Inhibitor Treatment on Plasma Renin Activity and Angiotensins I and II in Hypertensive Subjects

Nonparallel effects of renin inhibitor treatment on plasma renin activity (PRA) and the plasma levels of angiotensins (ANG), as well as on blood pressure, have been observed in subjects with hypertension. This study addresses the possibility that renin inhibitors may show a high degree of plasma protein binding in vivo and that displacement of protein-bound inhibitor during the assay of PRA in vitro may lead to overestimation of renin inhibition. Indeed, with the ultrafiltration technique it was found that 96% of the novel renin inhibitor Ro 42-5892, when added to EDTA plasma, was bound to protein. The angiotensinase inhibitors phenylmethylsulfonyl fluoride (PMSF) and 8-hydroxy-quinoline sulfate (8-OHQ), which are currently used in PRA assays, caused a displacement of protein-bound inhibitor, thereby increasing its free concentration. This displacement was sufficient to explain the reduction in IC 50 of Ro 42-5892, which was seen in the PRA assay when PMSF and 8-OHQ were added to plasma. Such reductions in IC 50 were also seen with the renin inhibitors CGP 29-287, CGP 38-560A, and SR 43-845. When Ro 42-5892 was given, 1 mg/kg intravenously in 10 min, to subjects with hypertension, it appeared that plasma ANG I and II returned to baseline after 6-8 h, whereas PRA measured in the presence of PMSF and 8-OHQ was still suppressed. However, when PRA was measured without these angiotensinase inhibitors, the inhibition of PRA was parallel to the suppression of ANG I and II.(ABSTRACT TRUNCATED AT 250 WORDS)

Development and application of a superfusion technique for the study of renin secretion in rat renal cortical cells.

A dynamic column superfusion system has been developed for the study of renin secretion in rat renal cortical cells. Cells were isolated by collagenase digestion and mechanical dispersion, before suspension with polyacrylamide beads and superfusion with oxygenated physiological medium. Renin was detected in the superfusate by incubation of fractions with excess nephrectomized sheep substrate in the presence of angiotensinase inhibitors followed by radioimmunoassay of the angiotensin I generated. Optimized methodology included a purpose-built polytetrafluorethylene flow cell, a 1 h equilibration to achieve a steady state, 5 min eluate collections, a 15 min stimulatory and a 30 min recovery period, and duration of perfusion of up to 270 min. Significant increments above baseline renin release were seen with the stimuli of adrenaline, noradrenaline and isoprenaline. These could be demonstrated with concentrations of 10(-9) mol/l (adrenaline), 5 X 10(-10) mol/l (noradrenaline) and 10(-9) mol/l (isoprenaline). This technique has significant advantages over previous methods for the study of renin secretion in vitro at the cellular level. It is reproducible and sensitive, and avoids many of the limitations of static cell suspension and kidney slice methods.

Differences in the kinetic rate constants of normal and high molecular weight renin substrate from term pregnancy human plasma.

We have previously reported on the differences in physical and chemical characteristics between the high-molecular weight renin substrate (HMS greater than 150,000 daltons) and the normal substrate (NMS = 60,000). In this study, the kinetic constants were determined in both HMS and NMS which were prepared by gel exclusion chromatography from the plasma of pregnant women at term. Renin substrate (angiotensinogen) levels were expressed by radioimmunoassay of angiotensin I after incubation of samples with added semi-purified human kidney renin in the presence of angiotensinase inhibitors. The kinetic constants (Km and Vmax) were determined by the method of Line-weaver-Burk plots and also the method of Wilkinson. The Km for the HMS was 1.79 micrograms angiotensin 1 equivalents ( AIeq )/ml and the Vmax = 41.2 ngAIeq /ml/h, and the Km for the NMS was 3.52 micrograms AIeq /ml and the Vmax = 138 ng/ml/h. When adding small amounts of the HMS to the NMS, the production of angiotensin I was found to increase more than that in the NMS alone. It was also observed that the renin substrate reactivities of the plasma of pregnant women, which contained small amounts of the HMS, were higher than that found in the plasma of normotensive women not taking oral contraceptives. It is suggested that the existence of small amounts of the HMS may therefore contribute to the elevation in blood pressure under the influence of estrogens.

Generation of Inactive Renin in Vitro and in Vivo: Reversible Inactivation of the Active Plasma Enzyme in Rats

1. Active and total (trypsin treatment) plasma renins were measured in normal Wistar rats and in rats in which the renin-angiotensin system was stimulated by ether anaesthesia. 2. After incubation of normal plasma in vitro in the absence of angiotensinase inhibitors, active renin declined. This decline was shown to be due to the conversion of active renin into an inactive form, which could be re-activated by trypsin. 3. In plasma from renin-stimulated rats, the rate of decline of active renin in vitro was accelerated; however, the relative amount of inactive renin generated was decreased. 4. Ligation of the kidneys of the ether-anaesthetized animal resulted in a build-up in vivo of inactive renin concomitant with the decline of active renin. 5. These data demonstrate the conversion of active into inactive renin in vitro and indicate that inactive renin can also be generated in vivo from the active form of the enzyme. 6. Multiple forms of inactive renin may exist; some may be true ‘prorenins’ (renin zymogens) produced in the kidney, and others may result from post-biosynthetic modifications of the active plasma enzyme.

In vitro generation of inactive renin in hypertensive human plasma.

When plasma from normal and hypertensive human subjects is incubated at pH 7.4 in the absence of angiotensinase inhibitors, a significant decline of active plasma renin occurs. The fall of active renin was more pronounced in the plasma from normotensive controls and was accompanied by a fall of total renin without change of inactive renin. In hypertensive subjects total renin levels (trypsin treatment) did not change. The fall of active renin in plasma from hypertensive subjects was due therefore to its in vitro conversion to an inactive form of renin which could be reactivated by trypsin. If reversible inactivation of active plasma renin occurs in vivo, inactivated active renin may contribute to a portion of the plasma pool of inactive renin. This form of inactive renin which may be activable in vivo would not therefore represent a renin precursor or "prorenin" of renal origin.

Angiotensin I recovery from plasma incubated with organic reagents

(1) In order to explore the possible mechanism that organic reagents used in the incubation step of the plasma renin activity (PRA) analysis act as a angiotensinase inhibitors we did angiotensin I (AI) recovery studies from plasma with such reagents. The organic acids and their mean difference in percent recovery of AI as compared to that for hydrochloric acid (HCI) are respectively as follows for one and a three hour incubation time: maleic (0.7%, 4.5%); and potassium hydrogen phthalate (KHphthalate) (7.2%, 9.6%). The tris(hydroxymethyl)aminomethane (Tris) organic acid salts and their mean difference in percent recovery of AI as compared to that for Tris-HCl are as follows for a one hour incubation: Tris-acetylsalicylate (3.6%), Tris-phenoxyacetate (3.6%), Tris-benzoate (2.6%), and Tris-salicylate (4.9%). (2) Of the reagents studied KHphthalate after a three hour incubation produced a statistically significant difference from the HCl reagent. The recovery data for all the organic reagents suggested that the primary mechanism of action was not that of an angiotensinase inhibitory one.

Effect of sulfhydryl reagents on the enzymatic activity of human renin: Implications for renin assay

Sulfhydryl (SH) reagents are sometimes used in renin assays, yet their effects on the enzymatic activity of human renin are not clearly understood. We have employed radioimmunoassay of angiotensin I (AI) to assess the effects of dithiothreitol (DTT) and of dimerecaptopropanol (DMP) on the formation of AI at pH 5.5 and at pH 7.4. When ethylenediamine tetra-acetate, phenylmethylsulfonyl fluoride, and 8-hydroxyquinoline were used as angiotensinase inhibitors, both DTT and DMP decreased the rate of AI formation in each of two human plasma pools at both pH values. In contrast, in a system of semi-purified human kidney renin and hog renin substrate, DTT enhanced the formation of AI, increasing V max without changing K m at both pH values. The reaction of human kidney renin with synthetic tetradecapeptide renin substrate was stimulated by DTT at pH 7.4 but inhibited by DTT at pH 5.5. In all three systems, SH reagents altered the ratio of reaction velocity at pH 5.5 to reaction velocity at pH 7.4. We conclude that SH reagents affect the assay of human renin in complex ways which depend upon the pH of incubation and upon the substrate utilized. Although the mechanism of these effects is not known, such effects probably contribute to the lack of agreement among many of the procedures for renin assay.

Identification of “Angiotensin Immunoreactive Material” in Rat Kidney1

The reported presence of large quantities of a high molecular weight form of angiotensin I and II in renin granules from rat kidney cortex was investigated. Subcellular fractionation by differential centrifugation and isopycnic gradient centrifugation confirmed the presence of 'angiotensin I immunoreactive material,' but the distribution resembled that of lysosomes rather than renin granules, mitochondria or protein. The material did not possess pressor properties, was stable to incubation at 37 C and was precipitated by ethanol. Incubation of subcellular fractions with peptidase inhibitors known to inhibit the activity of renal angiotensinases (EDTA, diisopropyl phosphorofluoridate and 2,3-dimercaptopropanol) decreased the level of 'angiotensin I immunoreactive material' in kidney fractions treated by radioimmunoassay. By paper chromatography it was apparent that subcellular fractions were capable of degrading 125I-labelled angiotensin I used as tracer in the radioimmunoassay. The degree of degradation followed the distribution of lysosomes among the fractions and was decreased by the angiotensinase inhibitors. The apparent molecular weight of the major portion of angiotensinase activity persisting despite the presence of angiotensinase inhibitors was 75,000, a value similar to that of 'angiotensin immunoreactive material'inkidney fractions treated with non-ionic detergent. On the basis of the present findings it is suggested that 'angiotensin immunoreactive material' may be largely artifactual, beingcreated by the hydrolysis of tracer by angiotensinase enzymes during radioimmunoassay to form fragments that are no longer capable of binding to the specific antibody. This would produced results that would appear the same as those produced had genuine angiotensin immunoreactivity indeed been present in the samples. Such an effect could, in principle, occur in any competitive protein binding assay and should be tested.

Methodologic problems in plasma renin activity measurements

The influence of pH and angiotensinase inhibitors on the in vitro generation of angiotensin I during PRA measurements has been investigated. PRA values obtained at pH 5.7 are higher than those obtained at pH 7.4. At pH 5.7, values obtained using diisopropyl-fluorophosphate (DFP 9 mM) as an angiotensinase inhibitor are higher than values obtained with a mixture of dimercaprol (BAL, 1.6 mM) and hydroxyquinoline (8-OHQ, 3 to 4 mM). Since the two methods for inhibiting angiotensinase are completely and equally efficient, it is suggested that these inhibitors might interfere with the renin angiotensinogen reaction. Significant correlations are observed between the PRA values obtained by the different methods which have been studied. Using an incubation pH of 5.7, and BAL and 8-OH quinoline as angiotensinase inhibitors, the distribution of PRA values in a population of 124 hospitalized hypertensive patients ingesting a normal sodium diet has been studied, and it has been demonstrated that the sensitivity of this method of measurement can detect small changes in PRA in patients with low renin activity.

Influence of angiotensinase inhibitors on the enzymatic activity of renin

Asp 1-Ileu 5-angiotensin I, added to pooled normal human plasma at pH 5.5 or at 7.4, was shown to be fully protected from enzymatic degradation and conversion to angiotensin II by addition to plasma of a combination of angiotensinase inhibitors including ethylenediaminetetraacetic acid, diisopropylfluorphosphate, dimercaptopropanol, and 8-hydroxyquinoline hemisulfate. Addition of Dowex resin to the incubation media (pH 5.5) did not increase the protection of angiotensin I afforded by this combination of inhibitors. For these studies, both bioassay and radioimmunoassay were employed, which allowed for evaluation of N-terminal and C-terminal alteration of the peptide. In the presence of Dowex resin (pH 5.5), plasma renin activity was shown to be depressed. By the use of an angiotensinase-free isolated system of human angiotensinogen and homologous renin, this decrease in activity was found to be due to binding of renin, and not of the renin substrate, to the resin. At pH 5.5, although 3.4 m m 8-hydroxyquinoline was shown to exert maximal inhibition of angiotensin degradation, yielding an increase in measured plasma renin activity, at higher concentrations of 8-hydroxyquinoline an overall inhibition of angiotensin generation was observed. At pH 7.4, on the other hand, 8-hydroxyquinoline inhibited renin activity at all concentrations studied. The inhibition of renin activity at pH 7.4 was minimized by reduction of the 8-hydroxyquinoline concentration to 1.7 m m. This latter concentration was of equal effectiveness in preventing angiotensin degradation. Although protection of angiotensin I was complete at pH 5.5 and 7.4, it was found that plasma renin activity was increased at pH 7.4. It was concluded that maximization of angiotensin I generation in plasma, by endogenous renin, was dependent not only on the pH of incubation, but also upon the type and concentration of angiotensinase inhibitors employed which affect the renin reaction itself.

Plasma renin concentration: comparison of angiotensinase inhibitors and correlation with plasma renin activity and aldosterone.

Abstract There are wide variations between laboratories in the results obtained for the estimation of the renin content of plasma. Much of this is due to the many different methods employed for inhibiting angiotensinases. In comparing those different methods in the context of a plasma renin concentration assay, phenylmethylsulfonylfluoride was found to be superior to dimercaprol, 8-hydroxyquinoline, and acidification in preserving angiotensin I. In the presence of adequate angiotensinase inhibition there was an excellent correlation between plasma renin activity and plasma renin concentration determined in plasma from 30 male hypertensive patients with low or normal levels of renin. The plasma renin concentration assay method can also be used for samples with high levels of renin. Plasma renin concentration and plasma renin activity correlated equally well with plasma aldosterone. This suggests that in routine clinical screening the plasma renin activity assay gives adequate information and the more complex plasma renin concentration assay need not be done unless aberrations in renin substrate, which could be responsible for dissociation of renin concentration from renin activity, are suspected.

Measurement of renin activity in human plasma.

A method is described for estimating plasma renin activity by using renin substrate present in plasma. This method differs from other indirect renin assay methods by (1) incubation in the absence of ions thus establishing conditions for zero order kinetics for the reaction between endogeneous renin and substrate and (2) the use of angiotensinase inhibitors di-sodium ethylenediamine tetraacetic acid ( EDTA ) and d-isopropylfluorophosphate (DFP). Recoveries of renin added to plasma in levels similar to those occurring in plasma are 85% SD ±7%. The incubation was done at pH 5.5 which was shown to be the optimum for human renin reacting with human substrate. By incubating human plasma samples with known quantities of human renin, evidence was obtained suggesting that factors other than enzyme or total substrate concentrations affect the velocity of angiotensin formation. This variability of reaction rate may be explained by the existence of an inhibitor or activator in this system or by a variation in the type of substrate.