COVID-19, ACE2 and the Cardiovascular Consequences.

COVID-19, ACE2 and the Cardiovascular Consequences. Am J Physiol Heart Circ Physiol. 2020 Mar 31;: Authors: South AM, Diz D, Chappell MC Abstract The novel SARS coronavirus SARS-CoV-2 pandemic may be particularly deleterious to patients with underlying cardiovascular disease (CVD). The mechanism for SARS-CoV-2 infection is the requisite binding of the virus to the membrane-bound form of angiotensin-converting enzyme 2 (ACE2) and internalization of the complex by the host cell. Recognition that ACE2 is the co-receptor for the coronavirus has prompted new therapeutic approaches to block the enzyme or reduce its expression to prevent the cellular entry and SARS-CoV-2 infection in tissues that express ACE2 including lung, heart, kidney, brain, and gut. ACE2, however, is a key enzymatic component of the renin-angiotensin-aldosterone system (RAAS); ACE2 degrades Ang II, a peptide with multiple actions that promote CVD, and generates Ang-(1-7) which antagonizes the effects of Ang II. Moreover, experimental evidence suggests that RAAS blockade by ACE inhibitors, AT1 receptor antagonists and mineralocorticoid antagonists, as well as statins enhance ACE2 that, in part, contribute to the benefit of these regimens. In lieu of the fact that many older patients with hypertension or other CVDs are routinely treated with RAAS blockers and statins, new clinical concerns have developed regarding whether these patients are at greater risk for SARS-CoV-...
Source: American Journal of Physiology. Heart and Circulatory Physiology - Category: Physiology Authors: Tags: Am J Physiol Heart Circ Physiol Source Type: research