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2020 ; 62
(ä): 101123
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ACE2 imbalance as a key player for the poor outcomes in COVID-19 patients with
age-related comorbidities - Role of gut microbiota dysbiosis
#MMPMID32683039
Viana SD
; Nunes S
; Reis F
Ageing Res Rev
2020[Sep]; 62
(ä): 101123
PMID32683039
show ga
Coronavirus disease 19 (COVID-19) is a pandemic condition caused by the new
coronavirus SARS-CoV-2. The typical symptoms are fever, cough, shortness of
breath, evolving to a clinical picture of pneumonia and, ultimately, death.
Nausea and diarrhea are equally frequent, suggesting viral infection or
transmission via the gastrointestinal-enteric system. SARS-CoV-2 infects human
cells by using angiotensin converting enzyme 2 (ACE2) as a receptor, which is
cleaved by transmembrane proteases during host cells infection, thus reducing its
activities. ACE2 is a relevant player in the renin-angiotensin system (RAS),
counterbalancing the deleterious effects of angiotensin II. Furthermore,
intestinal ACE2 functions as a chaperone for the aminoacid transporter B(0)AT1.
It has been suggested that B(0)AT1/ACE2 complex in the intestinal epithelium
regulates gut microbiota (GM) composition and function, with important
repercussions on local and systemic immune responses against pathogenic agents,
namely virus. Notably, productive infection of SARS-CoV-2 in ACE2(+) mature human
enterocytes and patients' GM dysbiosis was recently demonstrated. This review
outlines the evidence linking abnormal ACE2 functions with the poor outcomes
(higher disease severity and mortality rate) in COVID-19 patients with
pre-existing age-related comorbidities and addresses a possible role for GM
dysbiosis. The article culminates with the therapeutics opportunities based on
these pathways.