SARS-CoV-2 and ACE2: The biology and clinical data settling the ARB and ACEI controversy

Autor: Sadashiva S. Karnik, Feixiong Cheng, Surafel Gebreselassie, John C. Tilton, John Barnard, Scott J. Cameron, Joshua Saef, Alvin H. Schmaier, Mina K. Chung, Keith R. McCrae, James B. Young, Michael M. Lederman, George Thomas, Edward S. Hawkins, Cornelia Bergmann, Lars G. Svensson, Ankur Kalra, Jonathan D. Smith, Neil Mehta, Clifford V. Harding
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
2019-20 coronavirus outbreak
ACE inhibitors
Coronavirus disease 2019 (COVID-19)
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Pneumonia
Viral
ACE2
lcsh:Medicine
Angiotensin-Converting Enzyme Inhibitors
Angiotensin II Receptor Blockers
Review
Peptidyl-Dipeptidase A
Biology
Bioinformatics
General Biochemistry
Genetics and Molecular Biology
Renin-Angiotensin System
Angiotensin Receptor Antagonists
Betacoronavirus
03 medical and health sciences
0302 clinical medicine
Renin–angiotensin system
Kallikrein-kinin system
Animals
Humans
In patient
cardiovascular diseases
ARBs
Pandemics
lcsh:R5-920
SARS-CoV-2
lcsh:R
Spike Protein
COVID-19
General Medicine
In vitro
030104 developmental biology
030220 oncology & carcinogenesis
Angiotensin-Converting Enzyme 2
Coronavirus Infections
lcsh:Medicine (General)
hormones
hormone substitutes
and hormone antagonists
Zdroj: EBioMedicine, Vol 58, Iss, Pp 102907-(2020)
EBioMedicine
ISSN: 2352-3964
Popis: Background SARS-CoV-2 enters cells by binding of its spike protein to angiotensin-converting enzyme 2 (ACE2). Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) have been reported to increase ACE2 expression in animal models, and worse outcomes are reported in patients with co-morbidities commonly treated with these agents, leading to controversy during the COVID-19 pandemic over whether these drugs might be helpful or harmful. Methods : Animal, in vitro and clinical data relevant to the biology of the renin-angiotensin system (RAS), its interaction with the kallikrein-kinin system (KKS) and SARS-CoV-2, and clinical studies were reviewed. Findings and Interpretation SARS-CoV-2 hijacks ACE2to invade and damage cells, downregulating ACE2, reducing its protective effects and exacerbating injurious Ang II effects. However, retrospective observational studies do not show higher risk of infection with ACEI or ARB use. Nevertheless, study of the RAS and KKS in the setting of coronaviral infection may yield therapeutic targets.
Databáze: OpenAIRE
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