TY - JOUR

T1 - The ACE-2 in COVID-19: Foe or Friend?

AU - Dalan, Rinkoo

AU - Bornstein, Stefan R.

AU - El-Armouche, Ali

AU - Rodionov, Roman N

AU - Markov, Alexander G

AU - Wielockx, Ben

AU - Beuschlein, Felix

AU - Boehm, Bernhard O.

N1 - Publisher Copyright: © 2020 Georg Thieme Verlag. All rights reserved.

PY - 2020/5/1

Y1 - 2020/5/1

N2 - COVID-19 is a rapidly spreading outbreak globally. Emerging evidence demonstrates that older individuals and people with underlying metabolic conditions of diabetes mellitus, hypertension, and hyperlipidemia are at higher risk of morbidity and mortality. The SARS-CoV-2 infects humans through the angiotensin converting enzyme (ACE-2) receptor. The ACE-2 receptoris a part of the dual system renin-angiotensin-system (RAS) consisting of ACE-Ang-II-AT 1 R axis and ACE-2-Ang-(1–7)-Mas axis. In metabolic disorders and with increased age, it is known that there is an upregulation of ACE-Ang-II-AT 1 R axis with a downregulation of ACE-2-Ang-(1–7)-Mas axis. The activated ACE-Ang-II-AT1R axis leads to pro-infl ammatory and pro-fibrotic eff ects in respiratory system, vascular dysfunction, myocardialfi brosis, nephropathy, and insulin secretory defects with increased insulin resistance. On the other hand, the ACE-2-Ang-(1–7)-Mas axis has anti-inflammatory and antifi brotic effects on the respiratory system and anti-inflammatory, antioxidative stress, and protective eff ects on vascular function, protects against myocardial fi brosis, nephropathy, pancreatitis, andinsulin resistance. In eff ect, the balance between these two axes may determine the prognosis. The already strained ACE-2-Ang-(1–7)-Mas in metabolic disorders is further stressed due to the use of the ACE-2 by the virus for entry, which aff ects the prognosis in terms of respiratory compromise. Further evidence needs to be gathered on whether modulation of the renin angiotensin system would be advantageous due to upregulationof Mas activation or harmful due to the concomitant ACE-2 receptor upregulation in the acute management of COVID-19.

AB - COVID-19 is a rapidly spreading outbreak globally. Emerging evidence demonstrates that older individuals and people with underlying metabolic conditions of diabetes mellitus, hypertension, and hyperlipidemia are at higher risk of morbidity and mortality. The SARS-CoV-2 infects humans through the angiotensin converting enzyme (ACE-2) receptor. The ACE-2 receptoris a part of the dual system renin-angiotensin-system (RAS) consisting of ACE-Ang-II-AT 1 R axis and ACE-2-Ang-(1–7)-Mas axis. In metabolic disorders and with increased age, it is known that there is an upregulation of ACE-Ang-II-AT 1 R axis with a downregulation of ACE-2-Ang-(1–7)-Mas axis. The activated ACE-Ang-II-AT1R axis leads to pro-infl ammatory and pro-fibrotic eff ects in respiratory system, vascular dysfunction, myocardialfi brosis, nephropathy, and insulin secretory defects with increased insulin resistance. On the other hand, the ACE-2-Ang-(1–7)-Mas axis has anti-inflammatory and antifi brotic effects on the respiratory system and anti-inflammatory, antioxidative stress, and protective eff ects on vascular function, protects against myocardial fi brosis, nephropathy, pancreatitis, andinsulin resistance. In eff ect, the balance between these two axes may determine the prognosis. The already strained ACE-2-Ang-(1–7)-Mas in metabolic disorders is further stressed due to the use of the ACE-2 by the virus for entry, which aff ects the prognosis in terms of respiratory compromise. Further evidence needs to be gathered on whether modulation of the renin angiotensin system would be advantageous due to upregulationof Mas activation or harmful due to the concomitant ACE-2 receptor upregulation in the acute management of COVID-19.

KW - covid

KW - рецептор

KW - инфекция

KW - вирус

KW - ангиотензин-превращающий фактор

KW - ACE-2

KW - COVID-19

KW - renin angiotensin system

KW - Pneumonia, Viral/physiopathology

KW - Pandemics

KW - Prognosis

KW - Peptidyl-Dipeptidase A/genetics

KW - Humans

KW - Coronavirus Infections/physiopathology

KW - Angiotensin-Converting Enzyme 2

KW - Betacoronavirus/isolation & purification

KW - Renin-Angiotensin System/genetics

KW - SARS-CoV-2

KW - Metabolic Diseases/physiopathology

KW - CONVERTING ENZYME 2

KW - SARS CORONAVIRUS

KW - RECEPTOR

KW - RENIN-ANGIOTENSIN SYSTEM

KW - INFLAMMATION

KW - DIFFERENTIATION

KW - STRESS

UR - http://www.scopus.com/inward/record.url?scp=85084617426&partnerID=8YFLogxK

UR - https://www.mendeley.com/catalogue/db7e36ad-b309-3c42-b02c-ddee7d1a8f00/

U2 - 10.1055/a-1155-0501

DO - 10.1055/a-1155-0501

M3 - Article

C2 - 32340044

VL - 52

SP - 257

EP - 263

JO - Hormone and Metabolic Research

JF - Hormone and Metabolic Research

SN - 0018-5043

IS - 5

ER -