Renin- angiotensin system

RENIN- ANGIOTENSIN SYSTEM

Q. 1

Angiotensin II causes all of the following except:

 A

Stimulation of thirst

 B

Aldosterone secretion

 C

Increased ADH secretion

 D

Vasodilation

Q. 1

Angiotensin II causes all of the following except:

 A

Stimulation of thirst

 B

Aldosterone secretion

 C

Increased ADH secretion

 D

Vasodilation

Ans. D

Explanation:

Vasodilation [Ref: Ganong 23/e p672J

“It is one of the most potent vasoconstrictors known, being four to eight times as active as norepinephrine on a weight basis in normal individuals.”- Ganong

Also know,

  • The pressor activity of angiotensin II is decreased in Na2+depleted individuals and in patients with cirrhosis and some other diseases. In these conditions, circulating angiotensin II is increased, and this down-regulates the angiotensin receptors in vascular smooth muscle. Consequently, there is less response to injected angiotensin II.
  • Angiotensin II does not penetrate the blood–brain barrier; it carries out its actions by acting on the circumventricular organs.
  • Angiotensin I appears to function solely as the precursor of angiotensin II and does not have any other established action.
  • Angiotensin III, a breakdown product of angiotensin II,has about 40% of the pressor activity of angiotensin II, but 100% of the aldosterone-stimulating activity.

Q. 2

Shortest peptide is:

 A

Angiotensin-III

 B

Vasopressin

 C

Angiotensin-II

 D

Angiotensin-I

Q. 2

Shortest peptide is:

 A

Angiotensin-III

 B

Vasopressin

 C

Angiotensin-II

 D

Angiotensin-I

Ans. A

Explanation:

Angiotensin III is the shortest peptide among the given options. Angiotensin III is a hexapeptide while angiotensin I consists of ten peptides and angiotensin II is a octapeptide. Vasopressin is made of nine aminoacids.

 
Peptide hormone of involved in blood pressure regulation:
Angiotensinogen – A peptide synthesized in the liver which is released into the bloodstream to be the substrate for the enzyme renin which converts it to angiotensin I, a moderately effective hyperensive control substance, but more importantly angiotensin I is, itself, the precursor to angiotensin II ; these vasoactive peptide products can also stimulate aldosterone release from the adrenal cortex, ADH/vasopressin from the posterior pituitary, and stimulate the hypothalamic thirst center.
 
Angiotensin I – The peptide product of the circulating enzyme renin which converts the inactive precursor angiotensinogen to angiotensin I, a moderately effective hypertensive regulatory substance, but more importantly, the precursor to angiotensin II.
 
Angiotensin II – The peptide product of the lung enzyme angiotensin-converting enzyme (ACE) which converts the angiotensin I into angiotensin II, a highly effective hypertensive regulatory substance which targets the adrenal cortex for aldosterone release, the anterior pituitary for ADH/vasopressin release, the hypothalamic thirst center, and the smooth muscle in arterial walls for contraction.
 
Vasopressin – the neurohypophyseal peptide hormone which stimulates contraction of smooth muscle in blood vessel walls and stimulates the kidney tubules to reabsorb water; both target responses tend to increase blood pressure.
 
Atrial natriuretic peptide = ANP – The peptide hormone released from special endocrine cells in the walls of atria of the heart in response to the stretching of the chamber walls due to increased blood volume or increased blood pressure; ANP is the antagonist to aldosterone and thus triggers salt (NaCl) and water excretion and potassium ion reabsorption at the kidney tubules.
 
Ref: Medicinal Chemistry: A Molecular and Biochemical Approach, By Thomas Nogrady, Donald F. Weaver, Page 371.

Q. 3

Which of the following enzymes inhibit the production of cAMP?

 A

Glucagon

 B

Angiotensin II

 C

ACTH

 D

Beta-Adrenergics

Q. 3

Which of the following enzymes inhibit the production of cAMP?

 A

Glucagon

 B

Angiotensin II

 C

ACTH

 D

Beta-Adrenergics

Ans. B

Explanation:

Cyclic AMP was the first intracellular second messenger signal identified in mammalian cells. 

Different peptide hormones can either stimulate (s) or inhibit (i) the production of cAMP from adenylyl cyclase, which is encoded by at least nine different genes.
 
Hormones that Inhibit Adenylyl Cyclase (HI) and the production of cAMP:
Acetylcholine
Alpha 2-Adrenergics
Angiotensin II
Somatostatin
 
Hormones that stimulate Adenylyl Cyclase (HI) and the production of cAMP:
ACTH
ADH
Beta -Adrenergics
Calcitonin
CRH
FSH
Glucagon
hCG
LH
LPH
MSH
PTH
TSH
 
Ref: Weil P. (2011). Chapter 42. Hormone Action & Signal Transduction. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper’s Illustrated Biochemistry, 29e.

Q. 4

A 55 year old male presented with history suggestive of FUO. He had mutiple firm discrete cervical lymphadenopathy. Serum angiotensin converting enzyme was elevated in this patient. It point to the diagnosis of:

 A

Non hodgkins lymphoma

 B

Kikuchi disease

 C

Sarcoidosis

 D

Chronic lymphocytic leukemia

Q. 4

A 55 year old male presented with history suggestive of FUO. He had mutiple firm discrete cervical lymphadenopathy. Serum angiotensin converting enzyme was elevated in this patient. It point to the diagnosis of:

 A

Non hodgkins lymphoma

 B

Kikuchi disease

 C

Sarcoidosis

 D

Chronic lymphocytic leukemia

Ans. C

Explanation:

Elevated level of serum angiotensin converting enzyme may point to the diagnosis of sarcoidosis in patients with FUO and lymphadenopathy.

Ref: Harrison, Edition-18, Page-162.


Q. 5

All of the following are functions of Angiotensin II, EXCEPT:

 A

Vasodilation

 B

Stimulation of thirst

 C

Aldosterone secretion

 D

Increased ADH secretion

Q. 5

All of the following are functions of Angiotensin II, EXCEPT:

 A

Vasodilation

 B

Stimulation of thirst

 C

Aldosterone secretion

 D

Increased ADH secretion

Ans. A

Explanation:

Angiotensin II causes vasoconstriction, not vasodilation. Angiotensin ll causes vasoconstriction by increasing the amount of Ca+ ions in the vascular smooth muscle cells. This rise in intracellular calcium complexes with calmodulin, which in turn activates myosin light chain kinase. which results in phosphorylating the light chain of myosin to stimulate cross bridge cycling which in turn causes vasoconstriction.

Ref: Review of Medical Physiology By William F Ganong, 22nd Edition, Page 456; Textbook of Medical Physiology By Guyton and Hall, 10th Edition, Pages 201-203


Q. 6

Major amount of angiotensin I is converted to angiotensin II in:

 A

Liver

 B

Kidney

 C

Lung

 D

None of the above

Q. 6

Major amount of angiotensin I is converted to angiotensin II in:

 A

Liver

 B

Kidney

 C

Lung

 D

None of the above

Ans. C

Explanation:

The lungs also activate one hormone; the physiologically inactive decapeptide angiotensin I is converted to the pressor, aldosterone-stimulating octapeptide angiotensin II in the pulmonary circulation. The reaction occurs in other tissues as well, but it is particularly prominent in the lungs.

Large amounts of the angiotensin-converting enzyme responsible for this activation are located on the surface of the endothelial cells of the pulmonary capillaries. The converting enzyme also inactivates bradykinin.

Circulation time through the pulmonary capillaries is less than 1 s, yet 70% of the angiotensin I reaching the lungs is converted to angiotensin II in a single trip through the capillaries.

Ref: Ganong’s Review of Medical Physiology 23rd edition, Chapter 35.

 


Q. 7

Renin is synthesized as a large preprohormone. It is secreted by:

 A

PCT

 B

DCT

 C

Collecting duct

 D

Juxtaglomerular apparatus

Q. 7

Renin is synthesized as a large preprohormone. It is secreted by:

 A

PCT

 B

DCT

 C

Collecting duct

 D

Juxtaglomerular apparatus

Ans. D

Explanation:

Active renin is formed in the secretory granules of the granular cells in the juxtaglomerular apparatus. Active renin has a half-life in the circulation of 80 min or less. Its only known function is to cleave the decapeptide angiotensin I from the amino terminal end of angiotensinogen (renin substrate).

Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 38. Regulation of Extracellular Fluid Composition & Volume. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong’s Review of Medical Physiology, 24e.

Q. 8

Angiotensin II causes all of the following, EXCEPT:

 A

Stimulation of thirst

 B

Aldosterone secretion

 C

Increased ADH secretion

 D

Vasodilation

Q. 8

Angiotensin II causes all of the following, EXCEPT:

 A

Stimulation of thirst

 B

Aldosterone secretion

 C

Increased ADH secretion

 D

Vasodilation

Ans. D

Explanation:

“Angiotensin II is one of the most potent vasoconstrictors known, being four to eight times as active as norepinephrine on a weight basis in normal individuals”. It produces arteriolar constriction and a rise in systolic and diastolic blood pressure. – Ganong

It also acts on the adrenal cortex to increase secretion of aldosterone. 

It facilitates the release of norepinephrine by a direct action on postganglionic sympathetic neurons, contraction of mesangial cells with a resultant decrease in GFR and a direct effect on the renal tubules to increase Na+ reabsorption.
 
It acts on the brain to increase water intake (through subfornicial organ) and increase the secretion of vasopressin and ACTH.


Q. 9

All of the following statements about angiotensin II are TRUE, EXCEPT:

 A

Autoregulation of GFR

 B

Release aldosrerone

 C

Secreted from endothelium

 D

Constriction of afferent arteriole

Q. 9

All of the following statements about angiotensin II are TRUE, EXCEPT:

 A

Autoregulation of GFR

 B

Release aldosrerone

 C

Secreted from endothelium

 D

Constriction of afferent arteriole

Ans. C

Explanation:

Angiotensinogen is the circulating protein substrate from which renin cleaves angiotensin I. It is synthesized in the liver within a few seconds to minutes after formation of angiotensin I, two additional amino acid are split from the angiotensin I to from the 8-amino acid peptide angiotensin II. This conversation occurs almost entirely in the lungs while the blood flows through the small vessels of lungs, catalyzed by an enzyme called angiotensin converting enzyme (ACE) that is present in the endothelium of the lungs vessels. 

 
FUNCTION:
Angiotensin II is an extremely powerful vasoconstrictor. Vasoconstrictor occurs intensely in the arterioles and much less so in the veins. It decrease excretion of both slowly salt and water by the kidneys. This slowly increases the extracellular fluid volume, which then increase the arterial pressure during subsequent hours and days. It exerts important actions at vascular smooth muscle, adrenal cortex, kidney, heart and brain.
 
Act directly on the zona glomerulosa of the adrenal cortex to stimulate aldosterone biosynthesis. At higher concentrations, angiotensin II also stimulates glucocorticoid biosynthesis. Angiotensin II act on the kidney to cause renal vasoconstriction, contraction of mesangial cells with a resultant decrease in GFR increase proximal tubular sodium reabsorption, and inhibit the secretion of renin. In addition to its central effects on blood pressure, angiotensin II acts on the central nervous system to stimulate drinking (dipsogenic effect ) and increase the secretion of vasopressin and adrenocorticotropic hormone (ACTH).
 
Ref: Ganong 23/e, page 670 ; Guyton 11/e, page 201-02,223-24,907

Q. 10

Which part of the renal system produces and secretes renin?

 A

JG cells

 B

Macula densa

 C

Tubular cells

 D

All of the above

Q. 10

Which part of the renal system produces and secretes renin?

 A

JG cells

 B

Macula densa

 C

Tubular cells

 D

All of the above

Ans. A

Explanation:

The renin is produced by the juxtaglomerular cells (JG cells). These epitheloid cells are located in the media of the afferent arterioles as they enter the glomeruli. Renin is also found in agranular lacis cells that are located in the junction between the afferent and efferent arterioles. This enzyme acts in concert with angiotensin-converting enzyme (ACE) to form angiotensin II.

Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 38. Regulation of Extracellular Fluid Composition & Volume. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong’s Review of Medical Physiology, 24e.

Q. 11

Which of the following peptides are not produced by the renal system?

 A

Renin

 B

Angiotensin I

 C

Erythropoietin

 D

1,25DHCC

Q. 11

Which of the following peptides are not produced by the renal system?

 A

Renin

 B

Angiotensin I

 C

Erythropoietin

 D

1,25DHCC

Ans. B

Explanation:

The hormones produced in the kidneys are 1,25 Dihyrocholecalciferol, Renin and Erythropoetin. 

Angiotensin is an oligopeptide and is a hormone and a powerful dipsogen. It is derived from the precursor molecule angiotensinogen, a serum globulin produced in the liver. It plays an important role in the renin-angiotensin system.

Ref: The Local Cardiac Renin-Angiotensin Aldosterone System By Edward D. Frohlich, Richard N. ; Ganong’s Review of Medical Physiology, 22nd Edition, Pages 455, 459


Q. 12

Which of the following best describes angiotensin converting enzyme?

 A

It is a Zinc containing enzyme and cleaves C-terminal of AT 1

 B

It is a Zinc containing enzyme and cleaves the signal portion of AT-1

 C

It is a Copper containing enzyme and cleaves C-terminal of AT 1

 D

It is a Copper containing enzyme and cleaves the signal portion of AT-1

Q. 12

Which of the following best describes angiotensin converting enzyme?

 A

It is a Zinc containing enzyme and cleaves C-terminal of AT 1

 B

It is a Zinc containing enzyme and cleaves the signal portion of AT-1

 C

It is a Copper containing enzyme and cleaves C-terminal of AT 1

 D

It is a Copper containing enzyme and cleaves the signal portion of AT-1

Ans. A

Explanation:

Angiotensin converting enzyme is a zinc containing protease that cleaves carboxy terminus dipeptides from from angiotensin I and bradykinin.

Also know:
  • Angiotensin converting enzyme is a dipeptidyl carboxypeptidase which splits off histidyl-leucine from the physiologically inactive angiotensin I forming the octapeptide angiotensin II. It also inactivates bradykinin. 
  • ACE is an ectoenzyme which exists in two forms i.e a somatic form found throughout the body and a germinal form found in postmeiotic spermatogenic cells and spermatozoa. Germinal ACE is a 90-kDa protein that has only one extracellular domain and active site. Somatic ACE is a 170-kDa protein with two homologous extracellular domains, each containing an active site.
Ref: Ganong’s Review of Medical Physiology, 24e, chapter 38

 


Q. 13

Which of the following is the best-known metabolic function of the lung:

 A

Inactivation of serotonin

 B

Conversion of angiotensin-I to angiotensin-II

 C

Inactivation of bradykinin

 D

Metabolism of basic drugs by cytochrome P450 system

Q. 13

Which of the following is the best-known metabolic function of the lung:

 A

Inactivation of serotonin

 B

Conversion of angiotensin-I to angiotensin-II

 C

Inactivation of bradykinin

 D

Metabolism of basic drugs by cytochrome P450 system

Ans. B

Explanation:

B i.e. Conversion of angiotensin – Ito angiotension II.


Q. 14

Several hormones regulate the tubular reabsorption of water and electrolytes at different sites in the nephron. Which of the following combination is correct?

 A

Angiotensin in distal tubule

 B

Aldosterone in collecting ducts

 C

ADH in proximal tubule

 D

ANP in loop of Henle

Q. 14

Several hormones regulate the tubular reabsorption of water and electrolytes at different sites in the nephron. Which of the following combination is correct?

 A

Angiotensin in distal tubule

 B

Aldosterone in collecting ducts

 C

ADH in proximal tubule

 D

ANP in loop of Henle

Ans. B

Explanation:

B i.e. Aldosterone in collecting duct

Hormones

Site of action in kidney

Angiotensin 11

Constricts afferent arterioles, helps to reduce GFR.

Aldosterone

Cortical collecting duct & Distal tubulesQ.

ADH

Medullary collecting ductQ.

ANP

Collecting duct.


Q. 15

True about function of Angiotensin II:

 A

Constriction of afferent arteriole

 B

Autoregulation of GFR

 C

Secreted from endothelial

 D

All

Q. 15

True about function of Angiotensin II:

 A

Constriction of afferent arteriole

 B

Autoregulation of GFR

 C

Secreted from endothelial

 D

All

Ans. D

Explanation:

A, B, C  i.e. Constriction of afferent arteriole, Autoregulation of GFR, Secreted from endothelial


Q. 16

Angiotensin H causes all of the following, Except:

 A

Stmulation of Thirst

 B

Increased ADH secretion

 C

Vasodilatation

 D

Aldosterone secretion

Q. 16

Angiotensin H causes all of the following, Except:

 A

Stmulation of Thirst

 B

Increased ADH secretion

 C

Vasodilatation

 D

Aldosterone secretion

Ans. C

Explanation:

C i.e. Vasodilatation

Angiotensin II increases secretion of ADH, (Vasopressin), ACTH, Aldosterone, increases thirst and vasoconstriction (most potent or ‘- 4-8 times more than noradrenaline on weight basis). It decreases rennin secretion.


Q. 17

True regarding rennin angiotensin system is A/E

 A

Angiotonin is octapeptide

 B

ACE splits Leucine- valine bond

 C

Aspartic acid is essential for rennin activity

 D

All

Q. 17

True regarding rennin angiotensin system is A/E

 A

Angiotonin is octapeptide

 B

ACE splits Leucine- valine bond

 C

Aspartic acid is essential for rennin activity

 D

All

Ans. B

Explanation:

B  i.e. ACE splits Leucine- valine bond


Q. 18

Physiologically inactive form is

 A

Angiotensin I

 B

Angiotensin II

 C

Angiotensin III

 D

Angiotensin TV

Q. 18

Physiologically inactive form is

 A

Angiotensin I

 B

Angiotensin II

 C

Angiotensin III

 D

Angiotensin TV

Ans. A

Explanation:

A i.e. Angiotensin I


Q. 19

A/E one results in increased secretion of Renin

 A

Renal ischaemia

 B

Decreased amount of Na+ in DCT

 C

Decreased amount of Na+ in PCT

 D

Narrowing of afferent arterioles

Q. 19

A/E one results in increased secretion of Renin

 A

Renal ischaemia

 B

Decreased amount of Na+ in DCT

 C

Decreased amount of Na+ in PCT

 D

Narrowing of afferent arterioles

Ans. C

Explanation:

C i.e. Decreased amount of Na+ in PCT


Q. 20

Plasma protein, which is NOT normally synthesized in liver:       

September 2012

 A

Angiotensin

 B

Angiotensinogen II converting enzyme

 C

C-reactive protein

 D

Albumin

Q. 20

Plasma protein, which is NOT normally synthesized in liver:       

September 2012

 A

Angiotensin

 B

Angiotensinogen II converting enzyme

 C

C-reactive protein

 D

Albumin

Ans. B

Explanation:

Ans. B i.e. Angiotensinogen II converting enzyme

Most of the converting enzyme that forms angiotensin 11 in the circulation is located in endothelial cells.


Q. 21

Action of renin:

March 2013

 A

Erythropoiesis

 B

Contols secretion of melatonin

 C

Converts angiotensinogen to angiotensin I

 D

Converts angiotensinogen Ito angiotensinogen II

Q. 21

Action of renin:

March 2013

 A

Erythropoiesis

 B

Contols secretion of melatonin

 C

Converts angiotensinogen to angiotensin I

 D

Converts angiotensinogen Ito angiotensinogen II

Ans. C

Explanation:

Ans. C i.e. Converts angiotensiogenogen to angiotensin I

Renin/Angiotensinogenase

  • It is an enzyme that participates in the body’s renin-angiotensin system (RAS) — also known as the renin-angiotensin­aldosterone axis—that mediates extracellular volume (i.e., that of the blood plasma, lymph and interstitial fluid), and arterial vasoconstriction.
  • Thus, it regulates the body’s mean arterial blood pressure.
  • The renin enzyme circulates in the blood stream and breaks down (hydrolyzes) angiotensinogen secreted from the liver into the peptideangiotensin I.
  • Angiotensin I is further cleaved in the lungs by endothelial-bound angiotensin-converting enzyme (ACE) into angiotensin II, the most vasoactive peptide.

 


Q. 22

Maximum absorption of NaC1 in proximal convoluted tubule occurs due to the effect of: 

March 2009

 A

ADH

 B

Aldosterone

 C

Atrial natriuretic peptide

 D

Angiotensin II

Q. 22

Maximum absorption of NaC1 in proximal convoluted tubule occurs due to the effect of: 

March 2009

 A

ADH

 B

Aldosterone

 C

Atrial natriuretic peptide

 D

Angiotensin II

Ans. D

Explanation:

Ans. D: Angiotensin II

Angiotensin II acts at the PCT,Thick ascending loop of Henle/distal tubule, collecting tubule and leads to increased absorption of NaC1 and water and increased H+ secretion.

ADH, Aldosterone and ANP acts at the collecting tubule and duct


Q. 23

Vasoconstrictor anong these ‑

 A

NO

 B

PGI2

 C

Angiotensin-II

 D

ANP

Q. 23

Vasoconstrictor anong these ‑

 A

NO

 B

PGI2

 C

Angiotensin-II

 D

ANP

Ans. C

Explanation:

Ans. is ‘c’ i.e., Angiotensin-II

Important chemical regulator of CVS are :

  1. Vasoconstrictors : Noradrenaline, Adrenaline, ADH (vasopressin), angiotension II, Endothelins, PGF2, thromboxane A2.
  2. Vasodilators : Kinins (Bradykinin, lysyl-bradykinin), PGE„ PGL (prostacyclin), VIP, ANP, Nitric oxide (NO)

Q. 24

Hormone involved in regulation of BP ‑

 A

Serotonin

 B

Angiotensin- II

 C

Dopamine

 D

Prostaglandin

Q. 24

Hormone involved in regulation of BP ‑

 A

Serotonin

 B

Angiotensin- II

 C

Dopamine

 D

Prostaglandin

Ans. B

Explanation:

Ans. is ‘b’ i.e., Angiotensin- II


Q. 25

Conversion of angiotensin-I to angiotensin-II occurs in ‑

 A

Kidney

 B

Lung

 C

Liver

 D

RBCs

Q. 25

Conversion of angiotensin-I to angiotensin-II occurs in ‑

 A

Kidney

 B

Lung

 C

Liver

 D

RBCs

Ans. B

Explanation:

Ans. is ‘b’ i.e., Lung

Angiotensinogen (a2 – globulin) is produced in liver and is converted to angiotensin I (A-I) with the help of renin which is secreted by juxtaglomerular cells of afferent arterioles of kidney and lacis cells (located in the junction between the afferent and efferent arterioles).

Angiotensin 1 is converted to Angiotensin II (A-II) by angiotensin converting enzyme (ACE). Which is located primarily on the luminal surface of vascular endothelial cells, especially in lungs.

Most of actions of this system are due to angiotensin II.

Angiotensin II has a very short tY2 (1 minute), it is degraded into angiotensin-III by aminopeptidase.

Angiotensin-III is further acted upon by angiotensinases to inactive fragments.


Q. 26

Which of the following hormone is not secreted by the kidney ‑

 A

Renin

 B

Angiotensin I

 C

Erythropoietin

 D

1, 25 DHCC

Q. 26

Which of the following hormone is not secreted by the kidney ‑

 A

Renin

 B

Angiotensin I

 C

Erythropoietin

 D

1, 25 DHCC

Ans. B

Explanation:

Ans. is ‘b’ i.e., Angiotensin-I

Angiotensin I is formed by angiotensinogen (which is produced in liver).

Endocrine function of kidney

  • Hormones secreted by kidney :- 1-25 (OH)2 Vit D3, Renin, Erythropoietin
  • Hormones secreted eleswhere and act on kidney :- Natriuretic peptide (ANP, BNP), ADH, Aldosterone, Parathyroid.

Q. 27

Angiotensinogen is secreted by ‑

 A

Kidney

 B

Lung

 C

Liver

 D

Brain

Q. 27

Angiotensinogen is secreted by ‑

 A

Kidney

 B

Lung

 C

Liver

 D

Brain

Ans. C

Explanation:

Ans. is ‘c’ i.e., Liver

Angiotensinogen (a, – globulin) is produced in liver and is converted to angiotensin I (A-I) with the help of renin which is secreted by juxtaglonierular cells of afferent arterioles of kidney and lacis cells (located in the junction between the afferent and efferent arterioles).

Angiotensin I is converted to Angiotensin II (A-II) by angiotensin converting enzyme (ACE). Which is located primarily on the luminal surface of vascular endothelial cells, especially in lungs.



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