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A vaccine for hypertension

In this issue of the journal, there are two papers of particular interest concerning the renin–angiotensin system (RAS) [1,2]. The first is an original paper reporting the successful production of angiotensin II antibodies in rats and humans, using a protein in which the N-terminus of the peptide is fused to a spacer sequence containing a cysteine, leading to conjugation with the surface of the highly repetitive structure of virus-like particles. The authors entitle their work ‘A vaccine for hypertension based on virus-like particles: preclinical efficacy and phase I safety and immunogenicity’ [1]. The second paper is a well-structured review describing anticipated advances in the blockade of the RAS by new therapeutic tools, after angiotensin I-converting enzyme inhibitors and angiotensin II antagonists [2]. These articles raise concerns in several areas: (i) the physiology of the RAS and what is currently known about its blockade; (ii) ethical aspects of trials of vaccines against one of the endogenous peptides or proteins of the RAS; and (iii) the role of vaccination strategies in the treatment of chronic conditions, such as hypertension, in a worldwide context characterized by an increasing potential for the use of vaccines in the ongoing fight against many infectious diseases and in efforts to achieve their global eradication.