A synthetic angiotensin II/ACE2-based hormone shunt controlling experimental hypertension

Nat Commun. 2026 Apr 11;17(1):5116. doi: 10.1038/s41467-026-71796-z.

Abstract

Arterial hypertension is the leading preventable cause of various life-threatening medical conditions and comorbidities that affect over 1.3 billion adults, causing over 7.5 million annual deaths worldwide. Capitalizing on a synthetic biology-inspired engineering approach, we design a fully human, antihypertensive gene circuit called ARCH (autonomous regulator of chronic hypertension), which precisely monitors and efficiently controls angiotensin-dependent, renin-angiotensin system (RAS)-driven hypertension, in which angiotensin II (Ang-II) is persistently elevated, in a reversible, self-sufficient, and closed-loop manner. We utilize the ectopically expressed native type-1 angiotensin receptor (AT1R) to monitor the blood level of the hypertension biomarker Ang-II. We then rewire the AT1R activation during hypertension to a synthetic promoter to coordinate the expression of clinically licensed, secretion-engineered, soluble therapeutic angiotensin-converting enzyme 2 (stACE2), which degrades Ang-II and restores normotension. Implantation of microencapsulated ARCH-transgenic human cells into male hypertensive mice restores and maintains normal blood pressure.

MeSH terms

  • Angiotensin II* / genetics
  • Angiotensin II* / metabolism
  • Angiotensin-Converting Enzyme 2* / genetics
  • Angiotensin-Converting Enzyme 2* / metabolism
  • Animals
  • Blood Pressure
  • Disease Models, Animal
  • Humans
  • Hypertension* / genetics
  • Hypertension* / metabolism
  • Hypertension* / physiopathology
  • Hypertension* / therapy
  • Male
  • Mice
  • Peptidyl-Dipeptidase A* / genetics
  • Peptidyl-Dipeptidase A* / metabolism
  • Promoter Regions, Genetic
  • Receptor, Angiotensin, Type 1 / genetics
  • Receptor, Angiotensin, Type 1 / metabolism
  • Renin-Angiotensin System / genetics

Substances

  • Angiotensin II
  • Angiotensin-Converting Enzyme 2
  • Receptor, Angiotensin, Type 1
  • ACE2 protein, human
  • Peptidyl-Dipeptidase A