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Hypertension . Severe Acute Respiratory Syndrome Coronavirus 2, COVID-19, and the Renin-Angiotensin System: Pressing Needs and Best Research Practi

tetano

Editor, Senior Moderator
Hypertension


. 2020 Sep 28;HYPERTENSIONAHA12015948.
doi: 10.1161/HYPERTENSIONAHA.120.15948. Online ahead of print.
Severe Acute Respiratory Syndrome Coronavirus 2, COVID-19, and the Renin-Angiotensin System: Pressing Needs and Best Research Practices


Matthew A Sparks[SUP] 1 2 3 [/SUP], Andrew M South[SUP] 3 4 5 6 7 8 [/SUP], Andrew D Badley[SUP] 9 [/SUP], Carissa M Baker-Smith[SUP] 10 11 [/SUP], Daniel Batlle[SUP] 12 4 [/SUP], Biykem Bozkurt[SUP] 13 14 15 [/SUP], Roberto Cattaneo[SUP] 16 [/SUP], Steven D Crowley[SUP] 1 2 3 [/SUP], Louis J Dell'Italia[SUP] 17 18 19 [/SUP], Andria L Ford[SUP] 20 21 [/SUP], Kathy Griendling[SUP] 19 22 [/SUP], Susan B Gurley[SUP] 3 23 [/SUP], Scott E Kasner[SUP] 24 21 [/SUP], Joseph A Murray[SUP] 25 [/SUP], Karl A Nath[SUP] 26 [/SUP], Marc A Pfeffer[SUP] 15 27 [/SUP], Janani Rangaswami[SUP] 3 28 29 [/SUP], W Robert Taylor[SUP] 30 31 32 33 [/SUP], Vesna D Garovic[SUP] 26 34 4 [/SUP]



Affiliations

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is associated with significant morbidity and mortality throughout the world, predominantly due to lung and cardiovascular injury. The virus responsible for COVID-19-severe acute respiratory syndrome coronavirus 2-gains entry into host cells via ACE2 (angiotensin-converting enzyme 2). ACE2 is a primary enzyme within the key counter-regulatory pathway of the renin-angiotensin system (RAS), which acts to oppose the actions of Ang (angiotensin) II by generating Ang-(1-7) to reduce inflammation and fibrosis and mitigate end organ damage. As COVID-19 spans multiple organ systems linked to the cardiovascular system, it is imperative to understand clearly how severe acute respiratory syndrome coronavirus 2 may affect the multifaceted RAS. In addition, recognition of the role of ACE2 and the RAS in COVID-19 has renewed interest in its role in the pathophysiology of cardiovascular disease in general. We provide researchers with a framework of best practices in basic and clinical research to interrogate the RAS using appropriate methodology, especially those who are relatively new to the field. This is crucial, as there are many limitations inherent in investigating the RAS in experimental models and in humans. We discuss sound methodological approaches to quantifying enzyme content and activity (ACE, ACE2), peptides (Ang II, Ang-[1-7]), and receptors (types 1 and 2 Ang II receptors, Mas receptor). Our goal is to ensure appropriate research methodology for investigations of the RAS in patients with severe acute respiratory syndrome coronavirus 2 and COVID-19 to ensure optimal rigor and reproducibility and appropriate interpretation of results from these investigations.

Keywords: angiotensin II; blood pressure; cardiovascular disease; coronavirus; hypertension.
 
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