Abstract
SARS-CoV-2 propagation in the world has led to rapid growth and an acceleration in the discoveries and publications of various interests. The main focus of a consistent number of studies has been the role of angiotensin-converting enzyme 2 (ACE2) in binding the virus and its role in expression of the inflammatory response after transmission. ACE2 is an enzyme involved in the renin–angiotensin system (RAS), whose key role is to regulate and counter angiotensin-converting enzyme (ACE), reducing the amount of angiotensin II and increasing angiotensin 1–7 (Ang1–7), making it a promising drug target for treating cardiovascular diseases. The classical RAS axis, formed by ACE, angiotensin II (Ang II), and angiotensin receptor type 1 (AT1), activates several cell functions and molecular signalling pathways related to tissue injury and inflammation. In contrast, the RAS axis composed of ACE2, Ang1–7, and Mas receptor (MasR) exerts the opposite effect concerning the inflammatory response and tissue fibrosis. Recent studies have shown the presence of the RAS system in periodontal sites where osteoblasts, fibroblasts, and osteoclasts are involved in bone remodelling, suggesting that the role of ACE2 might have a fundamental function in the under- or overexpression of cytokines such as interleukin-6 (IL-6), interleukin-7 (IL-7), tumour necrosis factor alpha (TNF-α), interleukin-2 (IL-2), interleukin-1 beta (IL-1β), monocyte chemoattractant protein-1 (MCP-1), and transforming growth factor-beta (TGF-β), associated with a periodontal disorder, mainly during coinfection with SARS-CoV-2, where ACE2 is underexpressed and cannot form the ACE2–Ang1–7–MasR axis. This renders the patient unresponsive to an inflammatory process, facilitating periodontal loss.
Highlights
SARS-CoV-2 is a novel coronavirus [1]
angiotensin II (Ang II) enhances the inflammation process and blood pressure with the release of vasopressin and catecholamine. This hypothesis aimed to open a new field of interest concerning the role of angiotensin-converting enzyme 2 (ACE2), and of the renin–angiotensin system (RAS) system, in periodontal disease, and at the same time examine how the presence of a viral infection such as SARS-CoV-2 might play a key role in the onset or progression of periodontal disease
The outbreak of COVID-19; ACE2 as a key factor in the SARS-CoV-2 infection pathway; Cytokine overexpression in a patient affected by COVID-19; ACE2 and cytokines in a periodontal patient; Possible correlation between COVID-19 and periodontitis
Summary
SARS-CoV-2 is a novel coronavirus [1]. The spike proteins of this RNA virus bind to the cellular receptors of cells to mediate infection of their target cells, after which viral replication begins in the cytoplasm. [12], which is, convincingly, the functional for SARS-CoV-2 Another origin might affect the infection response; ,receptor recent studies showed a higher susceptibility in Asia, mainly in males, than in other continents such as Europe and. Ang II enhances the inflammation process and blood pressure with the release of vasopressin and catecholamine This hypothesis aimed to open a new field of interest concerning the role of ACE2, and of the RAS system, in periodontal disease, and at the same time examine how the presence of a viral infection such as SARS-CoV-2 might play a key role in the onset or progression of periodontal disease
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