Angiotensin-II and the oesophagus

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In summary, according to what I've been able to find in published papers, the effects of angiotensin II receptor antagonists (such as losartan) on the oesophagus seem to be poorly understood. Some studies[1][2] suggest that as well as the desirable effect of relaxing the smooth muscles of blood vessels to reduce blood pressure, they may have the undesirable effect of relaxing the smooth muscles of the oesophagus and the lower oesophageal sphincter, increasing the chance of gastro-oesophageal reflux and heartburn symptoms. Another study[3] failed to show such a connection, while demonstrating that a calcium channel antagonist does have this effect but a beta-block
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DrGreg
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According to what I've been able to find in published papers, the effects of angiotensin II receptor antagonists (such as losartan) on the oesophagus seem to be poorly understood. Some studies[1][2] suggest that as well as the desirable effect of relaxing the smooth muscles of blood vessels to reduce blood pressure, they may have the undesirable effect of relaxing the smooth muscles of the oesophagus and the lower oesophageal sphincter, increasing the chance of gastro-oesophageal reflux and heartburn symptoms. Another study[3] failed to show such a connection, while demonstrating that a calcium channel antagonist does have this effect but a beta-blocker has the opposite effect.

I have failed to find any studies into similar effects of ACE inhibitors (such as perindopril). Both types of drug are similar in that they reduce stimulation of AT1 receptors, but do so by different mechanisms. Ang-II receptor antagonists work by directly blocking the AT1 receptors (to which the body responds by increasing Ang-II production) whereas ACE inhibitors work by decreasing the production of Ang-II. So you might expect some similarities between the effects of the two drug types but also some differences.

So my question is, does anyone have any information on the effect of ACE inhibitors on oesophageal function, and any comparison with the effects of angiotensin II receptor antagonists?



References

[1] Casselbrant et al, "Actions by angiotensin II on esophageal contractility in humans", Gastroenterology. 2007 Jan; 132 (1):249-60. Epub 2006 Nov 10.

[2] Casselbrant et al, "Angiotensin II receptors are expressed and functional in human esophageal mucosa", AJP - GI November 1, 2009 vol. 297 no. 5 G1019-G1027

[3] Yoshida et al, "Effects of anti-hypertensive drugs on esophageal body contraction", World J Gastroenterol. 2010 February 28; 16(8): 987–991.

[4] Rattan et al, "Comparison of angiotensin II (Ang II) effects in the internal anal sphincter (IAS) and lower esophageal sphincter smooth muscles", Life Sciences Volume 70, Issue 18, 22 March 2002, Pages 2147–2164

[5] Spak et al, "Angiotensin II-induced contractions in human jejunal wall musculature in vitro", Acta Physiol (Oxf). 2008 Jun; 193(2):181-90. Epub 2007 Dec 10.
 
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1. What is the role of angiotensin-II in the oesophagus?

Angiotensin-II is a hormone that plays a key role in regulating blood pressure and fluid balance in the body. In the oesophagus, it has been found to contribute to the contraction of smooth muscle cells, which helps to move food down the digestive tract.

2. How does angiotensin-II affect oesophageal function?

Angiotensin-II has been shown to increase the tone and contractions of the oesophageal muscle, which can help to improve the efficiency of swallowing and digestion. It also promotes the secretion of mucus in the oesophagus, which helps to protect the lining from irritation and damage.

3. Is there a link between angiotensin-II and oesophageal diseases?

Some studies have suggested that excessive levels of angiotensin-II in the oesophagus may be associated with certain conditions, such as gastroesophageal reflux disease (GERD) and oesophageal cancer. However, more research is needed to fully understand the role of angiotensin-II in these diseases.

4. Can angiotensin-II be used as a treatment for oesophageal disorders?

While angiotensin-II has been shown to have beneficial effects on oesophageal function, it is not currently used as a treatment for oesophageal disorders. This is because it can have negative effects on other parts of the body, such as increasing blood pressure, and there are other more effective treatments available.

5. How can the effects of angiotensin-II on the oesophagus be studied?

Researchers often use animal models or cell cultures to study the effects of angiotensin-II on the oesophagus. They may also use imaging techniques, such as endoscopy, to observe changes in the oesophagus after administration of angiotensin-II. Additionally, clinical studies can be conducted to investigate the role of angiotensin-II in oesophageal diseases in humans.

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