Can Regular Exercise Before COVID-19 Disease Upregulate ACE2 and Downregulate TMPRSS2 in Patient’s Cells?

Abstract

The recent pandemic was caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which enters cells through a known enzyme angiotensin-converting enzyme 2 (ACE2) and a protease transmembrane protease serine-2 (TMPRSS2). ACE2 and its expression at the cellular level play a vital role in dilating arteries and preventing hypertension, protecting against lung lesions, and anti-inflammatory, and antifibrotic effects. However, TMPRSS2 is an enzyme that in humans is encoded by TMPRSS2. Increased expression of this protease further activates the Coronavirus 2019 (COVID-19) virus and increases its presence in virus-infected cells. The regulation and expression of these cell surface receptors are effective in COVID-19 infection. According to the literature, various factors, such as exercise can affect the expression of these receptors. The positive effect of regular exercise on ACE2 and TMPRSS2 levels in other diseases has been investigated. At the start of this study, no data were found to indicate that exercise would protect against COVID-19; however, based on previous studies into other diseases, regular exercise before COVID-19 might increase the expression of ACE2, decrease TMPRSS2 expression, and reduce the complications of the disease.