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The binding of prorenin to PRR triggers the phosphorylation of mitogen-activated protein kinases/extracellular regulated kinases 1/2 (MAPK/ERK1/2), which is demonstrated to be an ANG II-independent mechanism involved in the development of diabetic nephropathy ( The ANGIV/AT4/IRAP cascade: ANG IV (derived from the metabolization of ANG II through aminopeptidases A and N) binds the AT4 receptor, which has been identified as the insulin-regulated aminopeptidase (IRAP), but the role of this pathway in the blood pressure and renal regulation is still uncertain ( These new axes have raised great interest because their targeting could provide novel therapeutic strategies for hypertension, cardiovascular and kidney diseases

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Rare but serious risks include pancreatitis symptoms (severe abdominal pain), gallbladder issues, and thyroid concerns in susceptible individuals

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