Kalra Rajkumar Singh, Tomar Dhanendra, Meena Avtar Singh, Kandimalla Ramesh
AIST-INDIA DAILAB, DBT-AIST International Center for Translational & Environmental Research (DAICENTER), National Institute of Advanced Industrial Science & Technology (AIST), Higashi 1-1-1, Tsukuba 305 8565, Japan.
Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA.
Pathogens. 2020 Jul 7;9(7):546. doi: 10.3390/pathogens9070546.
The rapidly evolving coronavirus disease 2019 (COVID-19, caused by severe acute respiratory syndrome coronavirus 2- SARS-CoV-2), has greatly burdened the global healthcare system and led it into crisis in several countries. Lack of targeted therapeutics led to the idea of repurposing broad-spectrum drugs for viral intervention. In vitro analyses of hydroxychloroquine (HCQ)'s anecdotal benefits prompted its widespread clinical repurposing globally. Reports of emerging cardiovascular complications due to its clinical prescription are revealing the crucial role of angiotensin-converting enzyme 2 (ACE2), which serves as a target receptor for SARS-CoV-2. In the present settings, a clear understanding of these targets, their functional aspects and physiological impact on cardiovascular function are critical. In an up-to-date format, we shed light on HCQ's anecdotal function in stalling SARS-CoV-2 replication and immunomodulatory activities. While starting with the crucial role of ACE2, we here discuss the impact of HCQ on systemic cardiovascular function, its associated risks, and the scope of HCQ-based regimes in current clinical settings. Citing the extent of HCQ efficacy, the key considerations and recommendations for the use of HCQ in clinics are further discussed. Taken together, this review provides crucial insights into the role of ACE2 in SARS-CoV-2-led cardiovascular activity, and concurrently assesses the efficacy of HCQ in contemporary clinical settings.
迅速演变的2019冠状病毒病（COVID-19，由严重急性呼吸综合征冠状病毒2即SARS-CoV-2引起）给全球医疗系统带来了沉重负担，并在多个国家导致其陷入危机。由于缺乏针对性的治疗方法，人们提出了将广谱药物重新用于病毒干预的想法。对羟氯喹（HCQ）传闻中的益处进行的体外分析促使其在全球范围内被广泛用于临床。因其临床处方而出现的心血管并发症报告揭示了血管紧张素转换酶2（ACE2）的关键作用，ACE2是SARS-CoV-2的靶受体。在当前情况下，清楚了解这些靶点、它们的功能方面以及对心血管功能的生理影响至关重要。我们以最新的形式阐明了HCQ在阻止SARS-CoV-2复制和免疫调节活动方面的传闻中的作用。从ACE2的关键作用开始，我们在此讨论HCQ对全身心血管功能的影响、其相关风险以及基于HCQ的治疗方案在当前临床环境中的适用范围。引用HCQ疗效的程度，进一步讨论了在临床中使用HCQ的关键考虑因素和建议。综上所述，本综述提供了对ACE2在SARS-CoV-2引发的心血管活动中的作用的关键见解，同时评估了HCQ在当代临床环境中的疗效。
