Am J Physiol Heart Circ Physiol 285: H277-H282, 2003.
First published March 20, 2003; doi:10.1152/ajpheart.01124.2002
0363-6135/03 $5.00
Do angiotensin-converting enzyme inhibitors directly stimulate the kinin B1 receptor?
Jean-Philippe Fortin,1
Fernand Gobeil, Jr,2
Albert Adam,3
Domenico Regoli,4 and
François Marceau1
1Centre de Recherche en Cancérologie de
l'Université Laval, Centre Hospitalier Universitaire de Québec,
Centre de Recherche du Pavillon l'Hôtel-Dieu de Québec, Canada
G1R 2J6; 2Institut de Pharmacologie, Faculté de
Médecine, Université de Sherbrooke, Sherbrooke, Canada J1H 5N4;
3Faculté de Pharmacie, Université de
Montréal, Montréal, Québec, Canada H3C 3J7; and
4Institute of Pharmacology, University of Ferrara,
Ferrara, 44100, Italy
Submitted 23 December 2002
; accepted in final form 17 March 2003
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ABSTRACT
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It has been recently claimed that the human B1 receptors for
kinins bind angiotensin-converting enzyme (ACE) inhibitors via a potential
zinc-binding domain and are pharmacologically stimulated by these drugs. We
verified whether ACE inhibitors stimulate B1 receptors in vitro.
The isolated rabbit aorta or mouse stomach responded by negligible
contractions to the application of captopril, enalaprilat, or zofenoprilat.
The human isolated umbilical vein also failed to respond to enalaprilat. All
of these preparations were responsive to the B1 receptor agonists
des-Arg9-bradykinin (BK) or Lys-des-Arg9-BK.
Furthermore, enalaprilat applied continuously had no significant interaction
with the effects of Lys-des-Arg9-BK on the rabbit aorta.
Enalaprilat failed to stimulate [3H]arachidonate release,
translocate the receptors (confocal microscopy), or stimulate ERK1/2
phosphorylation (immunoblot) in HEK-293 cells stably expressing the rabbit
B1 receptor conjugated to yellow fluorescent protein. The
phospho-ERK1/2 content of arterial smooth muscle cells of human or rabbit
origin was increased by treatment with Lys-des-Arg9-BK but not with
enalaprilat. ACE inhibitors do not act as bona fide agonists of the kinin
B1 receptors.
enalaprilat; angiotensin II; des-Arg9-bradykinin
KININS ARE BLOOD-DERIVED PEPTIDES that stimulate vascular cells
via two types of G protein-coupled receptors (GPCRs) in mammals: the
B1 and B2 receptors
(12,
17). Angiotensin-converting
enzyme (ACE) hydrolyze and inactivate kinins; thus drugs designed to inhibit
ACE not only prevent the formation of the pressor hormone ANG II from ANG I
but also may potentiate endogenous kinins
(22). Because they are
vasodilator and natriuretic agents, endogenous kinins may produce a part of
the antihypertensive effect of ACE inhibitors, depending on the experimental
model (22). A novel claim
about the role of B1 receptors in the therapeutic effect of ACE
inhibitors has been made lately: these drugs have been said to directly bind
to a zinc atom presumably present in a consensus zinc-binding domain
identified in the second extracellular loop of this receptor
(8). This domain, a HEXXH
motif, is conserved in all species for which the B1 receptor is
currently known, and its sequence is perfectly conserved in the rabbit and the
mouse (HEAWH), relative to the human sequence
(11,
16). This type of site is
present in the active site of metallopeptidases such as ACE
(23) but not present in the
B2 receptor sequence. Thus, according to these investigators, ACE
inhibitors at nanomolar concentrations would be able to activate the kinin
B1 receptor with such consequences as calcium signaling and nitric
oxide production in transfected cells expressing the recombinant human
B1 receptors or in endothelial cells
(8). Several years ago, Babiuk
et al. (3) studied the
interaction of the ACE inhibitor captopril with the B1 receptor
agonists des-Arg9-bradykinin (BK) and Lys-des-Arg9-BK on
the B1 receptors mediating the contraction of the rabbit isolated
aorta and have found essentially none. In the present experiments, we
(1,
6) have controlled and extended
these findings using the same preparation and other established smooth muscle
bioassays for the B1 receptor, the mouse isolated stomach, and
human umbilical vein. ACE inhibitors such as enalaprilat (specifically claimed
to activate the B1 receptor, see Ref.
8) have been exploited in the
present experiments. We have also verified the effect of enalaprilat on human
or rabbit smooth muscle cells that express B1 receptors at
physiological densities or on a fusion protein composed of the rabbit
B1 receptor conjugated to the yellow fluorescent protein
(B1R-YFP). The B1R-YFP protein is a fully functional
high-affinity receptor that recently allowed to record phospholipase
A2 activation and a form of subcellular receptor translocation in
response to Lys-des-Arg9-BK
(18).
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Materials and Methods
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Drugs. Enalaprilat (Vasotec IV) was manufactured by Merck.
Zofenoprilat and B-9858 were gifts from Menarini Ricerche (Florence, Italy)
and Laboratoires Fournier (Daix, France), respectively. Des-Arg9-BK
was purchased from Bachem Bioscience (King of Prussia, PA), human recombinant
interleukin-1
(IL-1
) was from R&D Systems (Minneapolis, MN),
and the remaining drugs were from Sigma (St. Louis, MO).
Contractility studies. Exploratory studies were conducted to
compare direct contractile effects of the B1 receptor agonist
des-Arg9-BK to that of selected ACE inhibitors in two smooth muscle
bioassays: the isolated rabbit aorta and mouse stomach. Murine tissues were
obtained either from C57B1/6 mice or from a described mouse strain in which
the B2 receptor gene had been inactivated
(4); they were prepared as
described (1). Rabbit aortic
rings (New Zealand White, 1.52 kg, Charles River, St. Constant, Canada)
were suspended under a tension of 2 g in 5-ml tissue baths containing
oxygenated (95% O2-5% CO2) and warmed (37°C) Krebs
solution as described (9).
Kinins contract the isolated human umbilical vein via preformed
B2 receptors responsive to BK and via inducible B1
receptors responsive to both des-Arg9-BK and
Lys-des-Arg9-BK (6,
13,
20). Further contractility
studies in the rabbit aorta and human umbilical vein preparations (conducted
as described, see Ref. 13)
were based on the construction of cumulative concentration-response curves for
the high-affinity B1 receptor agonist Lys-des-Arg9-BK.
Two cumulative concentration-response curves were constructed at 3 and 6 h
from the beginning of the incubation of the preparations with ample washings
between the interventions. This protocol accounts for the fact that the
maximal response to this kinin increases as a function of the postisolation
incubation time in these preparations, a behavior specific for agonists of
B1 receptors and attributed to the postisolation formation of these
receptors (9,
19,
20). The stimulant drug was
always Lys-des-Arg9-BK for the first curve and this kinin or
enalaprilat for the second one. Some rabbit tissues stimulated with the kinin
twice were continuously treated with either ZnCl2 (100 nM) or
enalaprilat (1 µM) to monitor any effect on the sensitivity, maximal
effect, or sensitization process. Some rabbit tissues acutely stimulated with
enalapril at 6 h had been also treated with ZnCl2. Contractility
results were expressed in grams of tension.
It was verified in separate preparations of isolated rabbit aortas with
intact endothelium that the ACE inhibitor enalaprilat could reduce the
apparent contractile potency of ANG I, largely attributed to the in situ
conversion of this peptide into ANG II
(21). To do so, cumulative
concentration-effect curves for either ANG I or ANG II were established twice
at 1 and 5 h postmounting; enalaprilat (1 µM) was applied 30 min before the
construction of the second curve.
Cellular systems. The derivation of a HEK-293 cell line stably
expressing B1R-YFP and its properties have been described elsewhere
(18). These cells were used in
a phospholipase A2 assay (24-well plates) and confocal microscopy
(35-mm petri dishes), precisely as described
(18), and also in a ERK1/2
phosphorylation assay (see ERK1/2 phosphorylation assay). Primary
cultures of vascular smooth muscle cells from the rabbit aorta and human
umbilical artery were obtained as described
(2,
19).
ERK1/2 phosphorylation assay. To extend the investigation of
cellular responses mediated by B1 receptors, we tested the presence
of phospho-ERK1/2 in resting or drug-treated cells (untransfected HEK-293
cells, HEK-293 cells stably expressing B1R-YFP or primary cultures
of smooth muscle cells from the rabbit aorta or human umbilical artery). These
kinases are known to be activated by the peptide agonist of the B1
receptors des-Arg9-BK in cellular systems
(15). Confluent
75-cm2 HEK-293 cell flasks were cultured overnight with medium
containing a reduced fetal bovine serum concentration (0.5%) to minimize the
background phosphorylation of the tested kinases. Rabbit aortic smooth muscle
cells express kinin B1 receptors in a regulated manner and in
higher abundance following treatment with IL-1
(19). Human umbilical artery
smooth muscle cells were also shown to express the messenger RNA coding for
the kinin B1 receptor in a regulated manner (stimulation by
IL-1
treatment) (2).
Accordingly, the human cells bind the selective B1 receptor
radioligand [3H]Lys-des-Arg9-BK in a more intense manner
if pretreated with IL-1
(T. Sabourin and F. Marceau, unpublished
observations). Smooth muscle cells of either origin (75 cm2 flasks)
were starved in fetal bovine serum (0.5%) 36 h before kinase assay and treated
with recombinant IL-1
(5 ng/ml) 4 h before use to maximize the receptor
abundance. The cells were treated with the stimulants agonist
Lys-des-Arg9-BK (10 nM) or enalaprilat (1 µM; both applied 30
min before extraction in HEK-293 cells or 10 min in muscle cells), the
B1 receptor antagonists Lys-[Leu8]des-Arg9-BK
(1 µM) or B-9858
(Lys-Lys-[Hyp3,Igl5,D-Igl7,Oic8]des-Arg9-BK;
see Ref. 10; 10 nM;
antagonists applied 40 min before extraction in HEK-293 cells or 10 min in
muscle cells), or combinations of these drugs. Total cell extracts applicable
to immunoblots were then prepared as outlined elsewhere
(7). Transferred proteins were
revealed using two types of antibodies for each sample: phospho-ERK1/2
(monoclonal, dilution 1/1,000, New England Biolabs) and total ERK1/2 (to show
comparable loading; polyclonal, dilution 1/1,000, New England Biolabs).
Staining was revealed using the appropriate peroxidase-conjugated secondary
antibodies (1/16,000 for each).
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RESULTS
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Contractility studies. The isolated aorta from the rabbit or
isolated stomach from the mouse, either from control or B2 receptor
gene knockout animals, responded by negligible contractions to the application
of captopril (10-710-5 M),
enalaprilat (10-5 M), or zofenoprilat
(10-5 M) (Table
1). All these preparations were responsive to the B1
receptor agonist des-Arg9-BK.
In another series of experiments, no direct activation of B1
receptors by enalaprilat (1 nM-1 µM, applied at 6 h) was recorded in
tissues previously proven to respond to the alternate B1 receptor
agonist Lys-des-Arg9-BK (Fig.
1). Furthermore, enalaprilat applied continuously had no
significant interaction with the effects of Lys-des-Arg9-BK
(Fig. 1). Because hypothetical
loading of B1 receptors with ZnCl2 has been suggested to
favor the stimulant action of ACE inhibitors, we have continuously treated
some tissues with this salt (100 nM). Zinc preloading is not permissive for a
direct action of enalaprilat nor does it modify the contractile effect of
Lys-des-Arg9-BK (Fig.
1).

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Fig. 1. Enalaprilat fails to contract the isolated rabbit aorta [incubated in vitro
for 6 h (B) to induce a large population of B1 receptors]
and fails to influence the concentration-effect relationship of the
B1 receptor agonist Lys-des-Arg9-bradykinin (BK) [no
significant inhibition, potentiation, or modification of the maximum effect
increase from the time point 3 h (A) to 6 h]. Some tissues had been
preloaded with ZnCl2 to facilitate the hypothetical interaction of
the angiotensin-converting enzyme (ACE) inhibitor with the B1
receptor. Values are means ± SE of the number of replicates
(n).
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Other sets of isolated rabbit aortas have been stimulated with ANG I or ANG
II twice, the second time in the presence of enalaprilat (1 µM;
Fig. 2). The drug produced a
15.8-fold shift to the right of the concentration-effect curve (loss of
apparent potency) for ANG I but exerted negligible effects on the response to
ANG II.

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Fig. 2. Effect of enalaprilat (1 µM) on contractile response to ANG I and ANG II
in the isolated rabbit aorta. Concentration-effect curves were constructed
twice for either peptide: in absence (1 h) and presence (5 h) of enalaprilat.
Values are means ± SE of 5 determinations and expressed as a percentage
of the maximal response for each curve. Maximal effects in absolute force
units (g) were similar at 1 and 5 h.
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As observed with the isolated rabbit aorta, the isolated umbilical vein
incubated for 6 h failed to respond by significant contractions to enalaprilat
(1 nM-1 µM) (Fig. 3). The
human preparation responded to Lys-des-Arg9-BK, but the change of
contractile response to this B1 receptor agonist as a function of
time (from 3 to 6 h postmounting) was less important than for the rabbit aorta
(compare Fig. 3 with
Fig. 1).

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Fig. 3. Enalaprilat fails to contract isolated human umbilical vein (incubated in
vitro for 6 h). Presentation as in Fig.
1. Values are means ± SE of the number of replicates
(n).
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Cellular system expressing B1
receptors. Enalaprilat (11,000 nM) failed to stimulate
[3H]arachidonate release in a phospholipase A2 assay
based on HEK-293 cells stably expressing B1R-YFP
(Fig. 4). In the same series of
experiments, Lys-des-Arg9-BK was highly active in this respect
(Fig. 4). Untransfected HEK-293
cells are unresponsive to this peptide in this assay
(18).

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Fig. 4. [3H]Arachidonate released by HEK-293 cells stably expressing
B1R-yellow fluorescent protein (YFP) and exposed to enalaprilat or
Lys-des-Arg9-BK for 30 min. Results are expressed as means ±
SE (n = 1518). Set of values were statistically heterogeneous
(Kruskall-Wallis test, P < 10-4).
Mann-Whitney U test was applied to compare agonist-stimulated cells
with their appropriate controls (*P < 0.01).
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Confocal fluorescence microscopy reveals that B1R-YFP is
expressed essentially as an evenly distributed membrane protein
(Fig. 5, see Ref.
18). Enalaprilat (1 µM, 30
min) failed to modify the cellular distribution of B1R-YFP, whereas
Lys-des-Arg9-BK (10 nM, 30 min) concentrated fluorescent receptors
in structures that remained close to the membrane surface (previously proposed
to be cholesterol-rich caveolaerelated rafts)
(18).

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Fig. 5. Subcellular localization of B1R-YFP fusion protein in stably
transfected HEK-293 cells maintained in the complete culture medium and
treated with cycloheximide (71 µM) and the indicated concentration of the
agonist Lys-des-Arg9-BK or enalaprilat for 30 min. All
photomicrographs represent rectangular fields with small sides of 16.6 µm.
Selected confocal planes are halfway to the thickness of most cells.
Representative results of several microscopic fields in 2 separate days of
experiments.
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ERK1/2 was phosphorylated in HEK-293 cells stimulated with
Lys-des-Arg9-BK (10 nM) if they expressed B1R-YFP but
not in untransfected cells (Fig.
6, top). The response was further shown to be dependent
on B1 receptor signaling as it was abrogated by the antagonist
B-9858. Enalaprilat (1 µM) failed to stimulate ERK1/2 phosphorylation in
either type of HEK-293 cells (Fig.
6). Similarly, ERK1/2 was phosphorylated in response to
Lys-des-Arg9-BK in smooth muscle cells derived from either the
rabbit aorta or human umbilical artery
(Fig. 6, bottom). This
response was abrogated by the antagonist
Lys-[Leu8]des-Arg9-BK. The phospho-ERK1/2 content of
enalaprilat-treated smooth muscle cells was not different from that of control
cells.

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Fig. 6. ERK1/2 phosphorylation mediated by B1 receptors. Untransfected
HEK-293 cells, HEK-293 cells stably expressing B1R-YFP
(top), or IL-1 pretreated smooth muscle cells from either the
human umbilical artery or rabbit aorta (bottom) were treated with
Lysdes-Arg9-BK (10 nM), enalaprilat (1 µM), an antagonist
[either B-9858 10 nM or Lys-[Leu8]des-Arg9-BK (1g
µM)], or a combinations of the antagonist with the tested stimulants. The
same total cell extracts were immunoblotted for phospho-ERK1/2 and total
ERK1/2 (to assess comparable loading of tracks). Representative results of 2
experiments.
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DISCUSSION
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We failed to reproduce the claim of Ignjatovic et al.
(8): it cannot be generally
supported that ACE inhibitors directly activate B1 receptor
signaling in tissue-based or cellular bioassays in the present experiments,
including in systems based on the human form of the receptor. Especially the
ACE inhibitors failed to contract the smooth muscle preparations responsive to
the conventional peptide agonists (Table
1, Figs. 1 and
3). The B1 receptor
seems to be constitutively expressed in the mouse stomach preparation
(1); neither ACE inhibitors nor
des-Arg9-BK were more active in the stomach isolated from
B2 receptor knockout mice, in which a certain compensatory
upregulation of B1 receptors has been proposed to apply to the
cardiovascular and renal systems
(5). Enalaprilat also failed to
influence the potency, maximal effect, or sensitization behavior of the
response to Lys-des-Arg9-BK in the rabbit aorta
(Fig. 1). The isolated human
umbilical vein is an established bioassay for the human form of the
B1 receptor, and it did not respond to enalaprilat
(Fig. 3). Moreover, preloading
the rabbit or mouse tissues with zinc, a procedure inspired by Ignjatovic et
al. (8), also failed to reveal
an effect of enalaprilat, captopril, or zofenoprilat
(Table 1,
Fig. 1). As reported with the
early ACE inhibitor teprotide
(21), enalaprilat reduced the
apparent potency of ANG I without affecting that of ANG II in the rabbit aorta
contractility assay, providing a positive control for the presence of ACE in
the preparation and for the activity of the drug.
One of the cellular systems that we exploit here, HEK-293 cells expressing
recombinant B1R-YFP, allowed the testing of ACE inhibitors effects
on three additional functional end points different from contractility (Figs.
4,
5,
6). Enalaprilat failed to
stimulate phospholipase A2 activity, ERK1/2 phosphorylation, or
receptor translocation, whereas the peptide agonist Lys-des-Arg9-BK
was active in all cases. Arterial smooth muscle cells of rabbit or human
origin express wild-type B1 receptors at a more physiological
density; these cellular systems respond to Lys-des-Arg9-BK, but not
to enalaprilat, as judged by the phosphorylation of ERK1/2
(Fig. 6). Different
transduction mechanisms, largely unexplored for the B1 receptor,
may link GPCRs to these noncontractile cell responses.
Despite of our discrepant results, we give credit to Ignjatovic et al.
(8) for pointing out a
plausible and well-conserved metal binding site in a B1 receptor
extracellular domain that may assume other roles, such as the formation of
heterodimers with other molecular partners that remain to be identified, an
enzymatic function, or the direct binding of other kallikrein-kinin system
components. It is not clear whether B1 receptor-mediated signaling
has been observed in the cellular systems previously described
(8). One possibility is that a
low endogenous level of kinins is produced in the systems, either because the
cells synthesize components of the kallikrein-kinin system or have taken up
some from the culture media. This type of artifact is probably involved in the
pharmacological actions of human tissue kallikrein in systems that express the
rabbit BK B2 receptors
(7).
Whether B1 receptors are automatically involved in the
therapeutic effects of ACE inhibitors is not supported by the present
experiments. The des-Arg9-kinins that are optimal B1
receptor agonists are low-affinity substrates for ACE; when this enzyme is
blocked, there is clinical evidence that the individual efficacy of alternate
degradation pathways predicts the probability of angioedema, a severe ACE
inhibitor-associated side effect
(14). Therefore, B1
receptors may be associated with the inflammatory side effects of ACE
inhibitors.
In summary, ACE inhibitors do not stimulate cell or tissue responses that
are stimulated with the conventional peptide agonists at the natural or
recombinant B1 receptors.
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ACKNOWLEDGMENTS
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This study was supported by the Canadian Institutes of Health Research
Grants MOP-14077 (to F. Marceau and A. Adam) and MA-4032 (to D. Regoli). J.-P.
Fortin is the recipient of a Studentship from the Fonds de la recherche en
Santé du Québec.
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FOOTNOTES
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Address for reprint requests and other correspondence: F. Marceau, 11
Cote-du-Palais, Centre de recherche en cancérologie de
l'Université Laval, Centre Hospitalier Universitaire de Québec,
Centre de recherche du Pavillon l'Hôtel-Dieu de Québec, Canada
G1R 2J6 (E-mail:
Francois.marceau{at}crhdq.ulaval.ca).
The costs of publication of this article were defrayed in part by the
payment of page charges. The article must therefore be hereby marked
"advertisement" in accordance with 18 U.S.C. Section 1734
solely to indicate this fact.
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J.-P. Fortin, L. Gera, J. Bouthillier, J. M. Stewart, A. Adam, and F. Marceau
Endogenous Aminopeptidase N Decreases the Potency of Peptide Agonists and Antagonists of the Kinin B1 Receptors in the Rabbit Aorta
J. Pharmacol. Exp. Ther.,
September 1, 2005;
314(3):
1169 - 1176.
[Abstract]
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F. G. Pelorosso, P. T. Brodsky, C. L. Zold, and R. P. Rothlin
Potentiation of des-Arg9-Kallidin-Induced Vasoconstrictor Responses by Metallopeptidase Inhibition in Isolated Human Umbilical Artery
J. Pharmacol. Exp. Ther.,
June 1, 2005;
313(3):
1355 - 1360.
[Abstract]
[Full Text]
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J. Xu, O. A. Carretero, Y. Sun, E. G. Shesely, N.-E. Rhaleb, Y.-H. Liu, T.-D. Liao, J. J. Yang, M. Bader, and X.-P. Yang
Role of the B1 Kinin Receptor in the Regulation of Cardiac Function and Remodeling After Myocardial Infarction
Hypertension,
April 1, 2005;
45(4):
747 - 753.
[Abstract]
[Full Text]
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L. M. F. Leeb-Lundberg, F. Marceau, W. Muller-Esterl, D. J. Pettibone, and B. L. Zuraw
International Union of Pharmacology. XLV. Classification of the Kinin Receptor Family: from Molecular Mechanisms to Pathophysiological Consequences
Pharmacol. Rev.,
March 1, 2005;
57(1):
27 - 77.
[Abstract]
[Full Text]
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Copyright © 2003 by the American Physiological Society.