Frontiers in Oncology (Oct 2023)

Unraveling the relationship between the renin–angiotensin system and endometrial cancer: a comprehensive review

  • Nihad Ashraf Khan,
  • Deena Elsori,
  • Gowhar Rashid,
  • Sonia Tamanna,
  • Ananya Chakraborty,
  • Adeeba Farooqi,
  • Ayman Kar,
  • Niti Sambyal,
  • Mohammad Azhar Kamal

DOI
https://doi.org/10.3389/fonc.2023.1235418
Journal volume & issue
Vol. 13

Abstract

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Endometrial cancer (EC), the most common adenocarcinoma, represents 90% of uterine cancer in women with an increased incidence of occurrence attributed to age, obesity, hypertension, and hypoestrogenism. Being the most common gynecological malignancy in women, it shows a relation with the activation of different components of the renin–angiotensin system (RAS), which is predominantly involved in maintaining blood pressure, salt, water, and aldosterone secretion, thereby playing a significant role in the etiology of hypertension. The components of the RAS, i.e., ACE-I, ACE-II, AT1R, AT2R, and Pro(renin) receptor, are widely expressed in both glandular and stromal cells of the endometrium, with varying levels throughout the different phases of the menstrual cycle. This causes the endometrial RAS to implicate angiogenesis, neovascularization, and cell proliferation. Thus, dysfunctioning of the endometrial RAS could predispose the growth and spread of EC. Interestingly, the increased expression of AngII, AGTR1, and AGTR2 showed advancement in the stages and progression of EC via the prorenin/ATP6AP2 and AngII/AGTR1 pathway. Therefore, this review corresponds to unraveling the relationship between the progression and development of endometrial cancer with the dysfunction in the expression of various components associated with RAS in maintaining blood pressure.

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