FGF21 Prevents Angiotensin II-Induced Hypertension and Vascular Dysfunction by Activation of ACE2/Angiotensin-(1-7) Axis in Mice

Cell Metab. 2018 Jun 5;27(6):1323-1337.e5. doi: 10.1016/j.cmet.2018.04.002. Epub 2018 Apr 26.


Fibroblast growth factor 21 (FGF21) is a metabolic hormone with pleiotropic effects on glucose and lipid metabolism and insulin sensitivity. However, the role of FGF21 in hypertension remains elusive. Here we show that FGF21 deficiency significantly exacerbates angiotensin II-induced hypertension and vascular dysfunction, whereas such negative effects are reversed by replenishment of FGF21. Mechanistically, FGF21 acts on adipocytes and renal cells to promote induction of angiotensin-converting enzyme 2 (ACE2), which in turn converts angiotensin II to angiotensin-(1-7), then inhibits hypertension and reverses vascular damage. In addition, ACE2 deficiency strikingly abrogates these beneficial effects of FGF21 in mice, including alleviation of angiotensin II-associated hypertension and vascular damage. Otherwise, pharmaceutical inhibition of angiotensin-(1-7) attenuates the protective effect of FGF21 on angiotensin II-induced vascular dysfunction, but not on hypertension. Thus, FGF21 protects against angiotensin II-induced hypertension and vascular impairment by activation of the ACE2/angiotensin-(1-7) axis via fine-tuning the multi-organ crosstalk between liver, adipose tissue, kidney, and blood vessels.

Keywords: ACE2; FGF21; angiotensin II; angiotensin-(1–7); hypertension.

MeSH terms

  • Adipose Tissue / drug effects
  • Adipose Tissue / metabolism
  • Angiotensin I / antagonists & inhibitors
  • Angiotensin I / metabolism*
  • Angiotensin II* / administration & dosage
  • Angiotensin II* / metabolism
  • Angiotensin-Converting Enzyme 2
  • Animals
  • Blood Pressure / drug effects
  • Cardiovascular System / drug effects
  • Cardiovascular System / metabolism*
  • Fibroblast Growth Factors* / genetics
  • Fibroblast Growth Factors* / physiology
  • Hypertension / metabolism*
  • Kidney / drug effects
  • Kidney / metabolism
  • Loss of Function Mutation
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Peptide Fragments / antagonists & inhibitors
  • Peptide Fragments / metabolism*
  • Peptidyl-Dipeptidase A / genetics
  • Peptidyl-Dipeptidase A / metabolism*


  • Peptide Fragments
  • fibroblast growth factor 21
  • Angiotensin II
  • Fibroblast Growth Factors
  • Angiotensin I
  • Peptidyl-Dipeptidase A
  • Ace2 protein, mouse
  • Angiotensin-Converting Enzyme 2
  • angiotensin I (1-7)