[Frontiers in Bioscience E2, 1054-1064, June 1, 2010]

Prorenin and the (pro)renin receptor: do they have a pathogenic role in the retina?

Jennifer L. Wilkinson-Berka1, Antonia G. Miller1, Erica L. Fletcher2

1Department of Immunology, Monash University, Melbourne, Victoria, Australia, 2Department of Anatomy Cell Biology, The University of Melbourne, Parkville, Victoria, Australia

TABLE OF CONTENTS

1. Abstract
2. Introduction
3. The ocular renin-angiotensin-aldosterone system
4. Angiotensin II's actions in the retina
5. Angiotensin II and retinopathy of prematurity
5.1. Vascular effects
5.2. Neuronal and glial effects
6. Angiotensin II and diabetic retinopathy
6.1. Experimental studies
6.2. Hypertension
6.3. Clinical studies of diabetic retinopathy
7. Angiotensin II and age-related macular degeneration
8. (P)RR
8.1. (P)RR and vacuolar-ATPase
8.2. (P)RR signal transduction pathways that are independent of angiotensin II
9. Functions of (P)RR in the ocular vasculature
10. Functions of (P)RR in retinal neurons and glia
11. Functions of (P)RR in the retinal pigmented epithelium
12. Conclusion
13. Acknowledgements
14. References

1. ABSTRACT

Prorenin, the inactive precursor of renin has been suggested to be an indicator of diabetic complications including retinopathy. This concept was originally based on findings that prorenin is elevated in the plasma and vitreous of patients with diabetic retinopathy. Experimental studies in animal models of diabetic retinopathy and retinopathy of prematurity, have confirmed these reports and localized prorenin to macroglial Müller cells and blood vessels. The identification of a (pro)renin receptor ((P)RR) which binds both prorenin and renin, and influences intracellular signaling pathways independently of angiotensin II, suggests that prorenin-(P)RR may be pathogenic under certain circumstances. Given recent evidence from clinical trials that angiotensin II blockade improves to some extent retinopathy in diabetic patients, the development of (P)RR antagonists could have promise as an adjunct treatment for retinal diseases where prorenin is up-regulated. This review will discuss the cellular location of the renin-angiotensin system in the retina, evidence that angiotensin II blockade is beneficial for both retinal vascular, neuronal and glial pathology and place this information in the context of the development of (P)RR inhibitors.