Muslim Shahnawaz, Nasrin Nasrin, Alotaibi Faisal Obaid, Prasad Geeta, Singh Shambhu Kumar, Alam Izhar, Mustafa Gulam
Dept. of Surgery, Madhubani Medical College and Hospital, Madhubani, Bihar India.
Dept. of Tuberculosis and Chest, Katihar Medical College and Hospital, Karim Bagh, Katihar, Bihar India.
SN Compr Clin Med. 2020;2(10):1761-1766. doi: 10.1007/s42399-020-00407-9. Epub 2020 Aug 22.
Corona virus disease (COVID-19), caused by SARS-CoV-2, is rapidly spreading all around the world and is posing a threat to mankind. Since SARS-CoV-2 is a novel virus, little is known about it and no effective drug is available for its treatment. While many drugs are being evaluated, an effective therapeutic measure is still lacking. SARS-CoV-2 like SARS-CoV binds with angiotensin-converting enzyme 2 (ACE2) present on human cells. SARS-CoV has been found to downregulate ACE2 and SARS- CoV-2 infection has been found to be associated with increased level of Angiotensin II. Based on these facts, we presume that SARS-CoV-2 like SARS-CoV downregulates ACE2, and in absence/reduced activity of ACE2, level of angiotensin (1-7) and angiotensin (1-9) is decreased while that of angiotensin II is increased and increased level of angiotensin II has been found to correlate with lung injury and viral load. We presume that restoration of normal functioning of renin-angiotensin system with recombinant human angiotensin-converting enzyme 2 (rhACE2), angiotensin (1-7) and angiotensin (1-9) may be an effective therapeutic measure but studies will be required to test this hypothesis and explore its possible role in treatment of COVID-19.
由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的冠状病毒病(COVID-19)正在全球迅速传播,对人类构成威胁。由于SARS-CoV-2是一种新型病毒,人们对其了解甚少,且尚无有效的治疗药物。虽然许多药物正在评估中,但仍缺乏有效的治疗措施。与严重急性呼吸综合征冠状病毒(SARS-CoV)一样,SARS-CoV-2与人类细胞上存在的血管紧张素转换酶2(ACE2)结合。已发现SARS-CoV会下调ACE2,并且已发现SARS-CoV-2感染与血管紧张素II水平升高有关。基于这些事实,我们推测SARS-CoV-2与SARS-CoV一样会下调ACE2,并且在ACE2缺乏/活性降低的情况下,血管紧张素(1-7)和血管紧张素(1-9)的水平会降低,而血管紧张素II的水平会升高,并且已发现血管紧张素II水平升高与肺损伤和病毒载量相关。我们推测用重组人血管紧张素转换酶2(rhACE2)、血管紧张素(1-7)和血管紧张素(1-9)恢复肾素-血管紧张素系统的正常功能可能是一种有效的治疗措施,但需要进行研究来验证这一假设并探索其在治疗COVID-19中的可能作用。