Is there a role for bradykinin in the therapeutic and side effects of angiotensin-converting enzyme inhibitors?
F Marceau OBJECTIVE: To review critically the persistent suggestion that at least a part of the beneficial and side effects of angiotensin I converting enzyme inhibitors (ACEIs) is derived from the potentiation of endogenous bradykinin (BK). DATA SOURCES: Selected clinical studies of the pharmacology and analytical biochemistry of the kallikrein-kinin system, current literature on novel drugs binding to receptors for BK and angiotensin II, and a few animal studies when clinical data were not available. DATA EXTRACTION: Current concepts of the kallikrein-kinin system and related analytical/pharmacological tools are briefly reviewed and applied to the analysis of the role of endogenous kinins in the therapeutic and side effects of ACEIs. DATA SYNTHESIS: The development of effective BK antagonists is recent and provides novel opportunities to assess the role of BK in physiology and pathology. The role of BK as an inflammatory mediator is relatively well understood, and current drug develo
