Molecular and Human Genetics Laboratory, Department of Zoology, University of Lucknow, Lucknow, Uttar Pradesh, India.
High Blood Press Cardiovasc Prev. 2021 Mar;28(2):129-139. doi: 10.1007/s40292-021-00439-9. Epub 2021 Feb 26.
Ever since its outbreak, Corona Virus Disease 2019(COVID-19) caused by SARS-CoV-2 has affected more than 26 million individuals in more than 200 countries. Although the mortality rate of COVID-19 is low, but several clinical studies showed, patients with diabetes mellitus (DM) or other major complication at high risk of COVID-19 and reported more severe disease and increased fatality. The angiotensin-converting-enzyme 2 (ACE2), a component of renin-angiotensin-system (RAS); acts on ACE/Ang-II/AT1recptor axis, and regulates pathological processes like hypertension, cardiac dysfunction, Acute Respiratory Distress Syndrome (ARDS) etc. The progression of T2DM and hypertension show decreased expression and activity of ACE2. There are several treatment strategies for controlling diabetes, hypertension, etc; like ACE2 gene therapies, endogenous ACE2 activators, human recombinant ACE2 (hrACE2), Angiotensin-II receptor blockers (ARBs) and ACE inhibitors (ACEi) medications. ACE2, the receptors for SARS-CoV2, facilitates virus entry inside host cell. Clinicians are using two classes of medications for the treatment of COVID-19; one targets the SARS-CoV-2-ACE2 interaction, while other targets human immune system. The aim of this review is to discuss the role of ACE2 in diabetes and in COVID-19 and to provide an analysis of data proposing harm and benefit of RAS inhibitor treatment in COVID-19 infection as well as showing no association whatsoever. This review also highlights some candidate vaccines which are undergoing clinical trials.
自 SARS-CoV-2 引发的 2019 年冠状病毒病（COVID-19）爆发以来，已经在 200 多个国家影响了超过 2600 万人。尽管 COVID-19 的死亡率较低，但几项临床研究表明，糖尿病（DM）或其他主要并发症患者患 COVID-19 的风险较高，报告的疾病更严重，死亡率更高。血管紧张素转换酶 2（ACE2）是肾素-血管紧张素系统（RAS）的一个组成部分；作用于 ACE/Ang-II/AT1 受体轴，调节高血压、心脏功能障碍、急性呼吸窘迫综合征（ARDS）等病理过程。T2DM 和高血压的进展表现出 ACE2 的表达和活性降低。有几种控制糖尿病、高血压等的治疗策略；如 ACE2 基因治疗、内源性 ACE2 激活剂、人重组 ACE2（hrACE2）、血管紧张素-II 受体阻滞剂（ARBs）和血管紧张素转换酶抑制剂（ACEi）药物。ACE2 是 SARS-CoV2 的受体，促进病毒进入宿主细胞。临床医生正在使用两类药物治疗 COVID-19；一种针对 SARS-CoV-2-ACE2 相互作用，另一种针对人体免疫系统。本综述的目的是讨论 ACE2 在糖尿病和 COVID-19 中的作用，并对提出 RAS 抑制剂治疗 COVID-19 感染的危害和益处的数据分析进行分析，以及显示与 COVID-19 感染毫无关联。该综述还强调了一些正在进行临床试验的候选疫苗。
