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10.1111/bph.15082

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32333398!7572451!32333398
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suck abstract from ncbi


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pmid32333398      Br+J+Pharmacol 2020 ; 177 (21): 4825-4844
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  • A hypothesis for pathobiology and treatment of COVID-19: The centrality of ACE1/ACE2 imbalance #MMPMID32333398
  • Sriram K; Insel PA
  • Br J Pharmacol 2020[Nov]; 177 (21): 4825-4844 PMID32333398show ga
  • Angiotensin Converting Enzyme2 is the cell surface binding site for the coronavirus SARS-CoV-2, which causes COVID-19. We propose that an imbalance in the action of ACE1- and ACE2-derived peptides, thereby enhancing angiotensin II (Ang II) signalling is primary driver of COVID-19 pathobiology. ACE1/ACE2 imbalance occurs due to the binding of SARS-CoV-2 to ACE2, reducing ACE2-mediated conversion of Ang II to Ang peptides that counteract pathophysiological effects of ACE1-generated ANG II. This hypothesis suggests several approaches to treat COVID-19 by restoring ACE1/ACE2 balance: (a) AT receptor antagonists; (b) ACE1 inhibitors (ACEIs); (iii) agonists of receptors activated by ACE2-derived peptides (e.g. Ang (1-7), which activates MAS1); (d) recombinant human ACE2 or ACE2 peptides as decoys for the virus. Reducing ACE1/ACE2 imbalance is predicted to blunt COVID-19-associated morbidity and mortality, especially in vulnerable patients. Importantly, approved AT antagonists and ACEIs can be rapidly repurposed to test their efficacy in treating COVID-19. LINKED ARTICLES: This article is part of a themed issue on The Pharmacology of COVID-19. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.21/issuetoc.
  • |Angiotensin II Type 1 Receptor Blockers/pharmacology[MESH]
  • |Angiotensin-Converting Enzyme 2[MESH]
  • |Angiotensin-Converting Enzyme Inhibitors/pharmacology[MESH]
  • |Animals[MESH]
  • |Betacoronavirus/enzymology/*isolation & purification[MESH]
  • |COVID-19[MESH]
  • |COVID-19 Drug Treatment[MESH]
  • |Coronavirus Infections/*drug therapy/enzymology/virology[MESH]
  • |Drug Repositioning[MESH]
  • |Humans[MESH]
  • |Pandemics[MESH]
  • |Peptidyl-Dipeptidase A/metabolism[MESH]
  • |Pneumonia, Viral/*drug therapy/enzymology/virology[MESH]
  • |Proto-Oncogene Mas[MESH]


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