Pharmacology and cardiovascular implications of the kinin-kallikrein system

Kinins are peptide hormones that can exert a significant influence on the r egulation of blood pressure and vascular tone due to their vasodilatatory, natriuretic and growth modulating activity. Their cardiovascular involvemen t in physiological and pathophysiological situations has been studied inten sively since inhibitors for angiotensin I-converting enzyme and selective r eceptor antagonists have become available for pharmacologically potentiatin g or inhibiting kinin-mediated reactions. Molecular biological analysis and the establishment of genetically modified animal models have also allowed newer information to be acquired on this subject. In this review, the compo nents and cardiovascularly relevant mechanisms of the kinin-kallikrein syst em shall be described. Organ-specific effects concerning the kidneys, the v ascular system, the heart and nervous tissue shall also be illustrated. On this issue, the physiological functions and pathophysiological implications of the kinin-kallikrein system should be clearly distinguished from the ma ny, mostly endothelium-mediated protective effects which occur during ACE i nhibition due to the potentiation of kinin effects. Finally, a view shall a lso be cast upon newly discovered targets of action, which could be exploit ed for therapeutically altering the kinin-kallikrein system.