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Am J Physiol Lung Cell Mol Physiol (May 16, 2003). doi:10.1152/ajplung.00313.2002
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Submitted on September 16, 2002
Accepted on May 11, 2003

Angiotensin II and the Fibroproliferative Response to Acute Lung Injury

Richard P. Marshall1*, Peter Gohlke2, Rachel C. Chambers1, David C. Howell1, Steve Bottoms1, Thomas Unger2, Robin J. McAnulty1, and Geoffrey J. Laurent1

1 Centre for Respiratory Research, University College London, London, United Kingdom
2 Institute of Pharmacology, Christian-Albrechts University of Kiel, Kiel, Germany

* To whom correspondence should be addressed. E-mail: richard.marshall{at}ucl.ac.uk.

Angiotensin II (Ang II) generated by the activation of local renin-angiotensin systems is believed to play an important role in tissue repair and remodelling, in part via transforming growth factor beta (TGF{beta}). Angiotensin converting enzyme (ACE) inhibitors have been shown to abrogate experimental lung injury via a number of potential mechanisms, however, a fibroproliferative role for Ang II in the lung has not previously been characterized. We therefore hypothesized that following lung injury, Ang II would stimulate fibroblast procollagen synthesis and promote lung collagen deposition. In vitro, Ang II was a potent inducer of procollagen production in human lung fibroblasts via activation of the type 1 receptor and via the autocrine action of TGF{beta}. Following bleomycin-induced lung injury in rats, an increase in lung Ang II concentration was observed by day three that preceded increases in lung collagen and was maintained until sacrifice at day 21. The administration of an ACE inhibitor (Ramipril) reduced angiotensin converting enzyme activity, Ang II concentration, TGF{beta}expression and collagen deposition. Losartan (a type 1 Ang II receptor antagonist) also attenuated the increase in TGF {beta} expression and lung collagen deposition. These observations suggest that Ang II, possibly generated locally within the lung, may play an important role in the fibrotic response to acute lung injury, at least in part via TGF{beta}. ACE inhibitors and receptor antagonists, already widely used clinically, should be assessed as potential new therapies for fibrotic lung disease.




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