Physical Exercise and ACE2-Angiotensin-(1-7)-Mas Receptor Axis of the Renin Angiotensin System

Background: Many physiological responses of the Renin Angiotensin System (RAS) are associated with two opposite pathways: (1) a classical one formed by angiotensin-converting enzyme (ACE), Angiotensin II (Ang II) and Angiotensin type 1 (AT1) receptor, which is associated to vasoconstriction, cell proliferation, organ hypertrophy, sodium retention and aldosterone release and (2) a counter-regulatory or vasodilator pathway comprising angiotensin-converting enzyme 2 (ACE2), Angiotensin-(1-7) [Ang-(1-7)] and Mas receptor, which is involved in vasodilation, antiproliferation, anti-hypertrophy, cardioprotective and renoprotective actions.

Objective: This review aimed to bring up-to-date on the interactions between physical exercise and the vasodilator axis of the RAS (ACE2-Ang-(1-7)-Mas receptor axis). We also investigated the relation of acute and chronic exercise with blood pressure regulation and components of the vasodilator axis of the RAS.

Methods: We searched studies with animal models and humans in PUBMED, LILACS and IBECS.

Results: Experimental studies showed that physical training can stimulate ACE2-Ang-(1-7)-Mas receptor axis in parallel with the inhibition of ACE-Ang II-AT1 receptor pathway. However, up to now, the interaction between the counter-regulatory RAS axis and physical training is not investigated in humans.

Conclusion: The activation of ACE2-Ang-(1-7)-Mas receptor axis may have a role in the beneficial effects of physical training in experimental models. Further studies with humans are necessary.