Abstract
This article reviews the correlation between angiotensin‐converting enzyme 2 (ACE2) and severe risk factors for coronavirus disease 2019 (COVID‐19) and the possible mechanisms. ACE2 is a crucial component of the renin‐angiotensin system (RAS). The classical RAS ACE‐Ang II‐AT1R regulatory axis and the ACE2‐Ang 1‐7‐MasR counter‐regulatory axis play an essential role in maintaining homeostasis in humans. ACE2 is widely distributed in the heart, kidneys, lungs, and testes. ACE2 antagonizes the activation of the classical RAS system and protects against organ damage, protecting against hypertension, diabetes, and cardiovascular disease. Similar to SARS‐CoV, SARS‐CoV‐2 also uses the ACE2 receptor to invade human alveolar epithelial cells. Acute respiratory distress syndrome (ARDS) is a clinical high‐mortality disease, and ACE2 has a protective effect on this type of acute lung injury. Current research shows that the poor prognosis of patients with COVID‐19 is related to factors such as sex (male), age (>60 years), underlying diseases (hypertension, diabetes, and cardiovascular disease), secondary ARDS, and other relevant factors. Because of these protective effects of ACE2 on chronic underlying diseases and ARDS, the development of spike protein‐based vaccine and drugs enhancing ACE2 activity may become one of the most promising approaches for the treatment of COVID‐19 in the future.
Highlights
Combining the results of existing studies, we can conclude that men over 60 years of age with chronic underlying diseases and secondary Acute respiratory distress syndrome (ARDS) carry risk factors affecting the prognosis of COVID‐19
angiotensin‐converting enzyme 2 (ACE2) has a protective effect on many diseases with reduced expression of ACE2, such as hypertension, diabetes, and cardiovascular diseases, because it antagonizes the role of Ang II.[1]
ACE2 is an essential part of the renin‐angiotensin system (RAS), and it has extensive vascular and organ protection functions in hypertension, diabetes, cardiovascular disease, and ARDS
Summary
Recombinant human ACE2 (rhACE2) protein treatment could reduce plasma Ang II levels and reduce acute lung injury in ACE2 KO mice and wild‐type mice. The recent outbreak‐ causing novel coronavirus pneumonia (COVID‐19) virus (2019‐ nCoV, SARS‐CoV‐2) has been shown to invade human alveolar epithelial cells through mainly ACE2.16 COVID‐19 ARDS patients and SARS patients have typical ARDS pathology in the lung.[17] We believe that SARS‐CoV‐2 and SARS‐CoV may share similar pathogenesis and pathological manifestations.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
