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Immunol Cell Biol . Angiotensin-Converting Enzyme as a new immunologic target for the new SARS-CoV-2

tetano

Editor, Senior Moderator
Immunol Cell Biol


. 2020 Aug 30.
doi: 10.1111/imcb.12396. Online ahead of print.
Angiotensin-Converting Enzyme as a new immunologic target for the new SARS-CoV-2


Shahin Hallaj[SUP] 1 [/SUP], Anahita Ghorbani[SUP] 1 [/SUP], Seyed Ali Mousavi-Aghdas[SUP] 1 [/SUP], Mohammad Mirza-Aghazadeh-Attari[SUP] 1 [/SUP], Andrey Sevbitov[SUP] 2 [/SUP], Vida Hashemi[SUP] 3 [/SUP], Tooba Hallaj[SUP] 4 [/SUP], Farhad Jadidi-Niaragh[SUP] 5 6 [/SUP]



Affiliations

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has affected the daily lives of millions of people worldwide and had caused significant mortality; hence the assessment of therapeutic options is of great interest. The leading cause of death among COVID-19 patients is acute respiratory distress syndrome caused by hyper inflammation secondary to cytokine release syndrome (CRS). Cytokines, such as tumor necrosis factor (TNF)-α, interleukin (IL)-6, interferon (IFN)-γ, and IL-10, are the main mediators of CRS. Based on recent evidence, the angiotensin-converting enzyme (ACE) II is known to be the target of the COVID-19 spike protein, which enables the virus to penetrate human cells. ACE II also possesses an anti-inflammatory role in many pathologies such as CVD (Cardiovascular Disease), HTN (Hypertension), DM (Diabetes Mellitus), and other conditions, which are the main risk factors of poor prognosis in COVID-19 infection. Changes in tissue ACE II levels are associated with many diseases and hyperinflammatory states, and it is assumed that elevated levels of ACE II could aggravate the course of COVID-19 infection. Therefore, the use of Renin-Angiotensin, Aldosterone System Inhibitors (RASi) in COVID-19 patients could be hypothetically considered, though sufficient evidence is not presented by the scientific community. In the present manuscript, based on the most recent pieces of evidence, the roles of RAS and RASi in immunologic interactions are addressed. Furthermore, the molecular and immunologic aspects of RASi and their potential significance in COVID-19 is discussed.

Keywords: ACE; Angiotensin-converting enzyme; COVID; Coronavirus; Immunology; RAS.
 
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