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10.1016/j.ebiom.2020.102907

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suck abstract from ncbi


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pmid32771682      EBioMedicine 2020 ; 58 (ä): 102907
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  • SARS-CoV-2 and ACE2: The biology and clinical data settling the ARB and ACEI controversy #MMPMID32771682
  • Chung MK; Karnik S; Saef J; Bergmann C; Barnard J; Lederman MM; Tilton J; Cheng F; Harding CV; Young JB; Mehta N; Cameron SJ; McCrae KR; Schmaier AH; Smith JD; Kalra A; Gebreselassie SK; Thomas G; Hawkins ES; Svensson LG
  • EBioMedicine 2020[Aug]; 58 (ä): 102907 PMID32771682show ga
  • 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.
  • |Angiotensin Receptor Antagonists/pharmacology/*therapeutic use[MESH]
  • |Angiotensin-Converting Enzyme 2[MESH]
  • |Angiotensin-Converting Enzyme Inhibitors/pharmacology/*therapeutic use[MESH]
  • |Animals[MESH]
  • |Betacoronavirus/pathogenicity[MESH]
  • |COVID-19[MESH]
  • |Coronavirus Infections/*drug therapy/metabolism/pathology/virology[MESH]
  • |Humans[MESH]
  • |Kallikrein-Kinin System/drug effects[MESH]
  • |Pandemics[MESH]
  • |Peptidyl-Dipeptidase A/genetics/*metabolism[MESH]
  • |Pneumonia, Viral/*drug therapy/metabolism/pathology/virology[MESH]
  • |Renin-Angiotensin System/drug effects[MESH]


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