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The Two Faces of ACE2: The Role of ACE2 Receptor and Its Polymorphisms in Hypertension and COVID-19.
Molecular Therapy - Methods & Clinical Development ( IF 4.7 ) Pub Date : 2020-06-25 , DOI: 10.1016/j.omtm.2020.06.017
Mira Bosso 1 , Thangavel Alphonse Thanaraj 1 , Mohamed Abu-Farha 2 , Muath Alanbaei 3 , Jehad Abubaker 2 , Fahd Al-Mulla 1
Affiliation  

The mechanism for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection requires the binding of the virus to the angiotensin-converting enzyme 2 (ACE2) receptor, well-known for its role in counteracting ACE. ACE2 is involved in modulating blood pressure and establishing blood pressure homeostasis. Recently, a critical debatable question has arisen whether using antihypertensive medications will have a favorable impact on people infected with SARS-CoV-2 or a deleterious one, mainly because angiotensin-converting enzyme inhibitor (ACEI) and angiotensin-receptor blocker (ARB) therapy can modulate the expression of ACE2 protein. The concern is that the use of ACEIs and ARBs will increase the expression of ACE2 and increase patient susceptibility to viral host cell entry and propagation. On the other hand, several genetic association studies have examined the relationship between ACE2 genetic variants and the risk of developing hypertension in different ethnic populations. In this review, we discuss the ongoing arguments in the literature about ACE2’s role in mortality rate among coronavirus disease 2019 (COVID-19) patients comorbid with hypertension and critically evaluate the current debate about the usage or discontinuation of ACEI/ARB antihypertensive drugs. Moreover, we explore the two opposing roles that ACE2 genetic variants might be playing in COVID-19 by reducing ACE2 receptor effectiveness and mitigating SARS-CoV-2 infectivity.



中文翻译:

ACE2的两张面孔:ACE2受体及其多态性在高血压和COVID-19中的作用。

严重急性呼吸系统综合症冠状病毒2(SARS-CoV-2)感染的机制要求该病毒与血管紧张素转化酶2(ACE2)受体结合,该受体以对抗ACE的作用而闻名。ACE2参与调节血压和建立血压稳态。最近,出现了一个值得商critical的关键问题,即使用降压药是否会对感染SARS-CoV-2或有害药物的人产生有利影响,主要是因为血管紧张素转化酶抑制剂(ACEI)和血管紧张素受体阻滞剂(ARB)治疗可以调节ACE2蛋白的表达。令人担心的是,使用ACEI和ARB将增加ACE2的表达,并增加患者对病毒宿主细胞进入和繁殖的敏感性。另一方面,几项遗传协会研究已经检查了ACE2基因变异与不同种族人群患高血压风险之间的关系。在这篇综述中,我们讨论了文献中有关ACE2在冠心病2019年合并高血压的冠状病毒病(COVID-19)患者死亡率中的作用的争论,并严格评估了关于使用或停用ACEI / ARB降压药的当前争论。此外,我们通过降低ACE2受体的有效性并减轻SARS-CoV-2的感染性,探讨了ACE2遗传变异可能在COVID-19中发挥的两个相反的作用。我们讨论了文献中有关ACE2在2019年合并高血压的冠状病毒病(COVID-19)患者死亡率中的作用的争论,并严格评估了关于使用或停用ACEI / ARB降压药的当前争论。此外,我们通过降低ACE2受体的有效性并减轻SARS-CoV-2的感染性,探讨了ACE2遗传变异可能在COVID-19中发挥的两个相反的作用。我们将讨论文献中有关ACE2在2019年冠状病毒病合并高血压的冠心病患者死亡率中的作用的争论,并严格评估有关ACEI / ARB降压药使用或停用的当前争论。此外,我们通过降低ACE2受体的有效性并减轻SARS-CoV-2的感染性,探讨了ACE2遗传变异可能在COVID-19中发挥的两个相反的作用。

更新日期:2020-07-03
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