Vol 27, No 2 (2020)
Review Article
Published online: 2020-04-14

open access

Page views 22395
Article views/downloads 1915
Get Citation

Connect on Social Media

Connect on Social Media

Inhibitors of the renin–angiotensin system: The potential role in the pathogenesis of COVID-19

Ziyin Huang1, Yufeng Jiang1, Jingjing Chen1, Yafeng Zhou1
Pubmed: 32286678
Cardiol J 2020;27(2):171-174.

Abstract

Coronavirus disease 2019 (COVID-19), which initially began in China, has spread to other countries of Asia, Europe, America, Africa and Oceania, with the number of confirmed cases and suspected cases increasing each day. According to recently published research, it was found that the majority of the severe cases were elderly, and many of them had at least one chronic disease, especially cardiovascular diseases. Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) are the most widely used drugs for cardiovascular diseases. The clinical effect of ACEIs/ARBs on patients with COVID-19 is still uncertain. This paper describes their potential role in the pathogenesis of COVID-19, which may provide useful in the advice of cardiologists and physicians.

Article available in PDF format

View PDF Download PDF file

References

  1. Velavan TP, Meyer CG. The COVID-19 epidemic. Trop Med Int Health. 2020; 25(3): 278–280.
  2. Habibzadeh P, Stoneman EK. The novel coronavirus: a bird's eye view. Int J Occup Environ Med. 2020; 11(2): 65–71.
  3. Arabi YM, Murthy S, Webb S, et al. COVID-19: a novel coronavirus and a novel challenge for critical care. Intensive Care Med. 2020 [Epub ahead of print].
  4. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223): 497–506.
  5. Tan WS, Liao W, Zhou S, et al. Targeting the renin-angiotensin system as novel therapeutic strategy for pulmonary diseases. Curr Opin Pharmacol. 2018; 40: 9–17.
  6. Kurtz A. Control of renin synthesis and secretion. Am J Hypertens. 2012; 25(8): 839–847.
  7. Balakumar P, Jagadeesh G. A century old renin-angiotensin system still grows with endless possibilities: AT1 receptor signaling cascades in cardiovascular physiopathology. Cell Signal. 2014; 26(10): 2147–2160.
  8. Zhao Y, Zhao ZX, Wang YJ, et al. Single-cell RNA expression profiling of ACE2, the putative receptor of Wuhan 2019-nCov. BioRxiv. 2020.
  9. Fan C, Li K, Ding Y, et al. ACE2 expression in kidney and testis may cause kidney and testis damage after 2019-nCov infection. MedRxiv. 2020.
  10. Hamming I, Timens W, Bulthuis MLC, et al. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004; 203(2): 631–637.
  11. Kaparianos A, Argyropoulou E. Local renin-angiotensin II systems, angiotensin-converting enzyme and its homologue ACE2: their potential role in the pathogenesis of chronic obstructive pulmonary diseases, pulmonary hypertension and acute respiratory distress syndrome. Curr Med Chem. 2011; 18(23): 3506–3515.
  12. Imai Y, Kuba K, Penninger JM. The discovery of angiotensin-converting enzyme 2 and its role in acute lung injury in mice. Exp Physiol. 2008; 93(5): 543–548.
  13. Santos RA, Sampaio WO, Alzamora AC, et al. The ACE2/Angiotensin-(1-7)/MAS Axis of the Renin-Angiotensin System: Focus on Angiotensin-(1-7). Physiol Rev. 2018; 98(1): 505–553.
  14. Song W, Gui M, Wang X, et al. Cryo-EM structure of the SARS coronavirus spike glycoprotein in complex with its host cell receptor ACE2. PLoS Pathog. 2018; 14(8): e1007236.
  15. Liu Z, Xiao X, Wei X, et al. Composition and divergence of coronavirus spike proteins and host ACE2 receptors predict potential intermediate hosts of SARS-CoV-2. J Med Virol. 2020 [Epub ahead of print].
  16. Imai Y, Kuba K, Rao S, et al. Angiotensin-converting enzyme 2 protects from severe acute lung failure. Nature. 2005; 436(7047): 112–116.
  17. Imai Y, Kuba K, Penninger JM. [Lessons from SARS: a new potential therapy for acute respiratory distress syndrome (ARDS) with angiotensin converting enzyme 2 (ACE2)]. Masui. 2008; 57(3): 302–310.
  18. Khan A, Benthin C, Zeno B, et al. A pilot clinical trial of recombinant human angiotensin-converting enzyme 2 in acute respiratory distress syndrome. Crit Care. 2017; 21(1): 234.
  19. Kuba K, Imai Y, Rao S, et al. A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury. Nat Med. 2005; 11(8): 875–879.
  20. Crackower MA, Sarao R, Oudit GY, et al. Angiotensin-converting enzyme 2 is an essential regulator of heart function. Nature. 2002; 417(6891): 822–828.
  21. Xu X, Chen P, Wang J, et al. Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission. Sci China Life Sci. 2020; 63(3): 457–460.
  22. Wevers BA, van der Hoek L. Renin-angiotensin system in human coronavirus pathogenesis. Future Virol. 2010; 5(2): 145–161.
  23. Huentelman MJ, Zubcevic J, Hernández Prada JA, et al. Structure-based discovery of a novel angiotensin-converting enzyme 2 inhibitor. Hypertension. 2004; 44(6): 903–906.
  24. Gurwitz D. Angiotensin receptor blockers as tentative SARS-CoV-2 therapeutics. Drug Dev Res. 2020 [Epub ahead of print].