Abstract-We recently reported the presence of angiotensin-converting enzyme (ACE)2 in brain regions controlling cardiovascular function; however, the role of ACE2 in blood pressure regulation remains unclear because of the lack of specific tools to investigate its function. We hypothesized that ACE2 could play a pivotal role in the central regulation of cardiovascular function by regulating other renin-angiotensin system components. To test this hypothesis, we generated an adenovirus expressing the human ACE2 cDNA upstream of an enhanced green fluorescent protein (eGFP) reporter gene . In vitro characterization shows that neuronal cells infected with Ad-hACE2-eGFP (10 to 100 multiplicities of infection), but not Ad-eGFP (100 multiplicities of infection), exhibit dose-dependent ACE2 expression and activity. In addition, an active secreted form was detected in the conditioned medium. In vivo, Ad-hACE2-eGFP infection (2ϫ10 6 plaque-forming units intracerebroventricularly) produced time-dependent expression and activity (with a peak at 7 days) in the mouse subfornical organ. More importantly, 7 days after virus infection, the pressor response to angiotensin (Ang) II (200 pmol intracerebroventricularly) was significantly reduced in Ad-hACE2-eGFP-treated mice compared with controls. Furthermore, subfornical organ-targeted ACE2 overexpression dramatically reduced the Ang II-mediated drinking response. Interestingly, ACE2 overexpression was associated with downregulation of the Ang II type 1 receptor expression both in vitro and in vivo. These data suggest that ACE2 overexpression in the subfornical organ impairs Ang II-mediated pressor and drinking responses at least by inhibiting the Ang II type 1 receptor expression. Taken together, our results show that ACE2 plays a pivotal role in the central regulation of blood pressure and volume homeostasis, offering a new target for the treatment of hypertension and other cardiovascular diseases. (Circ Res. 2008;102:729-736.) Key Words: adenovirus Ⅲ carboxypeptidase Ⅲ brain Ⅲ blood pressure Ⅲ gene therapy T he renin-angiotensin system (RAS) is well known for its effects on the cardiovascular system and fluid homeostasis. Classically, these effects were thought to result primarily from the systemic production of angiotensin (Ang) II. 1 Circulating Ang II stimulates Ang II type 1 (AT 1 ) receptors present in the kidney and the vasculature to produce vasoconstriction but also water and salt reabsorption. Although kidneys and liver are the major endocrine sites of renin and angiotensinogen synthesis, respectively, this view of the RAS has been challenged in the last decade because both genes have been detected in extrarenal and extrahepatic tissues. 2,3 For instance, it has become clear that a local RAS is present in several tissues, for example, the heart, adipose, vasculature, and bone marrow, with similar effects to the endocrine RAS but also more specific functions depending on the individual system. 1 One of these local systems, the brain RAS, has long been considered pivo...