Das Renin-Angiotensin-System als Target für neue antiangiogene Therapiestrategien in der Gynäkologie

Angiogenesis is essential for the functioning of cells in an organism in order to maintain the supply of nourishment, oxygen, and hormones. The main effector of angiogenesis is "vascular endothelial growth factor" (VEGF). In addition to VEGF, several other factors are involved in the regulation of angiogenesis, either as independent angiogenic factors or as regulators of the VEGF system. One such pathway is the renin-angiotensin system (RAS) with its main protein angiotensin II. Angiotensin II has been shown to be a potent angiogenic factor inducing endothelial proliferation via VEGF. Therefore angiotensin II has been proposed as an important regulator of angiogenesis in both physiological and pathological conditions (ovarian cancer, breast cancer, cervical cancer, endometrial cancer). In vitro, it was demonstrated that antagonising angiotensin II suppresses angiogenesis. Clinical data of the above-mentioned tumor entities support the idea of anti-angiogenic treatment by inhibition of angiotensin II. Therefore, especially for the gynecological cancers, inhibition of the angiotensin II effect seems to be an auspicious option for the development of new anti-angiogenic therapies.