Faculty of Medicine, Institute of Translational Medicine, Semmelweis University, Budapest, Hungary.
Biol Futur. 2021 Sep;72(3):291-297. doi: 10.1007/s42977-021-00092-2. Epub 2021 Jun 8.
COVID-19 is a disease-causing current pandemic. It prevails in patients with pre-existing conditions such as diabetes and hypertension. Renin-angiotensin system was identified as a center of COVID-19 pathophysiology. There is a current controversy concerning the usage of ACE inhibitors and AR blockers in patients with COVID-19. Multiple clinical trials are on the way to determine the effect of RAS blockers in patients with COVID-19. ACE2 receptor is thought to be the point of entry utilized by a coronavirus. However, other factors have been identified which potentially facilitate SARS-CoV-2 entry into the cell. ADAM17 could facilitate viral entry in hyperglycemic and diabetic patients. Insulin is an ADAM17 inhibitor. Heme oxygenase (HO)-1 level is reduced in diabetic patients, contributing to the worst outcome for patients with poor glycemic control. The combined therapy of glycemic control and antioxidant response to oxidative stress could be explored in patients with COVID-19.
新型冠状病毒肺炎是一种致病的大流行疾病。它在患有糖尿病和高血压等既往疾病的患者中流行。肾素-血管紧张素系统被确定为新型冠状病毒肺炎病理生理学的中心。目前,关于在新型冠状病毒肺炎患者中使用血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂存在争议。正在进行多项临床试验,以确定 RAS 阻滞剂在新型冠状病毒肺炎患者中的作用。ACE2 受体被认为是冠状病毒进入的关键点。然而,已经确定了其他潜在因素,这些因素可能有助于 SARS-CoV-2 进入细胞。ADAM17 可促进高血糖和糖尿病患者的病毒进入。胰岛素是 ADAM17 的抑制剂。糖尿病患者的血红素加氧酶(HO)-1 水平降低,导致血糖控制不佳的患者预后最差。可以在新型冠状病毒肺炎患者中探索血糖控制和抗氧化应激反应的联合治疗。