2014 Angiotensin Gordon Research Conference and Gordon Research Seminar

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DESCRIPTION (provided by applicant): The renin-angiotensin system (RAS) plays a vital role in virtually every cardiovascular disease, and drugs blocking this system are currently widely used. Three classes can be distinguished (renin inhibitors, ACE inhibitors and angiotensin II type 1 (AT1) receptor antagonists), which in essence all block the same renin- angiotensin-AT1 receptor pathway. Although for many years it was argued 'the more blockade, the better', recent trials (ONTARGET, ALTITUDE) have shown that this is not the case. In fact, at perhaps slightly more benefit, there are also more side effects (hypotension, hyperkalemia, renal dysfunction). Clearly therefore, we have reached the maximum benefit that can be obtained from blocking this pathway, and we need new pathways to interfere with. Indeed, in the last few years multiple new RAS pathways have emerged that are worth exploring: the (pro) renin receptor, the AT2 receptor (which appears to be stimulated by an angiotensin II metabolite, angiotensin-(2-8)) and the ACE2-angiotensin-(1-7)-Mas receptor pathway. In addition, angiotensin II stimulates the synthesis and release of aldosterone (hence the system is also called the renin-angiotensin- aldosterone system, RAAS). Aldosterone receptor antagonists are now important tools in resistant hypertension, whereas simultaneously new aldosterone receptors emerge (e.g., GPR30), and aldosterone synthase inhibitors are being tested as potential treatment modalities. The first AT2 receptor (ant) agonists are currently being evaluated clinically, and this is also tre for various drugs interfering with the ACE2- angiotensin-(1-7)-Mas receptor pathway (e.g., in acute respiratory stress syndrome). Clearly, at present, the RA(A)S field is rapidly moving ''beyond'' angiotensin II, the classical end-product of this system, and many new drugs start to emerge, also including drugs that acts on one specific signaling pathway of angiotensin II (''biased AT1 receptor agonists''). The Angiotensin GRC is the only meeting where these topics come together in one meeting. It is THE discussion place for the latest discoveries in the RAS, involving basic scientists and clinicians, and combined with a GRS Seminar also attracts a lot of young investigators from academia and industry. Allowing their interaction will help to move the field forward, thus making multiple new drugs available to patients ASAP.