Obesity Research Center, College of Medicine, King Saud University, P.O. Box 2925, Riyadh, 11461, Saudi Arabia.
Department of Biochemistry & National Creative Research Laboratory for Ca(2+) Signaling, Chonbuk National University Medical School, Jeonju, 54907, Republic of Korea.
Eur J Pharmacol. 2021 Jan 5;890:173656. doi: 10.1016/j.ejphar.2020.173656. Epub 2020 Oct 18.
Angiotensin-converting enzyme 2 (ACE2) has been recognized as a potential entry receptor for SARS-CoV-2 infection. Binding of SARS-CoV-2 to ACE2 allows engagement with pulmonary epithelial cells and pulmonary infection with the virus. ACE2 is an essential component of renin-angiotensin system (RAS), and involved in promoting protective effects to counter-regulate angiotensin (Ang) II-induced pathogenesis. The use of angiotensin receptor blockers (ARBs) and ACE inhibitors (ACEIs) was implicitly negated during the early phase of COVID-19 pandemic, considering the role of these antihypertensive agents in enhancing ACE2 expression thereby promoting the susceptibility to SARS-CoV-2. However, no clinical data has supported this assumption, but indeed evidence demonstrates that ACEIs and ARBs, besides their cardioprotective effects in COVID-19 patients with cardiovascular diseases, might also be beneficial in acute lung injuries by preserving the ACE2 function and switching the balance from deleterious ACE/Ang II/AT receptor axis towards a protective ACE2/Ang (1-7)/Mas receptor axis.
血管紧张素转化酶 2（ACE2）已被认为是 SARS-CoV-2 感染的潜在进入受体。SARS-CoV-2 与 ACE2 的结合允许与肺上皮细胞结合并导致肺部感染该病毒。ACE2 是肾素-血管紧张素系统（RAS）的重要组成部分，参与促进保护性作用以对抗血管紧张素（Ang）II 诱导的发病机制。在 COVID-19 大流行的早期阶段，考虑到这些降压药增强 ACE2 表达从而增加对 SARS-CoV-2 易感性的作用，血管紧张素受体阻滞剂（ARBs）和血管紧张素转化酶抑制剂（ACEIs）的使用被隐含否定。然而，没有临床数据支持这一假设，但事实上有证据表明，ACEIs 和 ARBs 除了在患有心血管疾病的 COVID-19 患者中具有心脏保护作用外，通过保护 ACE2 功能并将平衡从有害的 ACE/Ang II/AT 受体轴转向保护性 ACE2/Ang（1-7）/Mas 受体轴，也可能有益于急性肺损伤。
