Receptor recognition is a crucial step in viral infection and is a critical factor for cell entry and tissue tropism. In several recent studies, angiotensin-converting enzyme 2 (ACE2) has been demonstrated to be the cellular receptor of SARS-CoV-2 as it was previously well known as the receptor of SARS-CoV. SARS-CoV-2 can bind with high affinity to human ACE2 and engages it as an entry receptor. It seems that the genetic, notably epigenetic variations of ACE2 are less known in different populations, indicating the need for its further investigation. These variations have the potential to affect its contribution to the pathogenicity of COVID-19. The contribution of epigenetics in the interindividual variability of ACE2 merits more attention because epigenetic processes can play important roles in ACE2 alterations in various tissues and different people and populations. Analyzing different DNA methylation patterns and microRNAs, contributing to the ACE2 modulation in the lungs will have a high priority. The epigenetic and genetic variations of ACE2 become even more important when considering that some people have mild clinical symptoms despite having COVID-19. The pathogenicity of SARS-CoV-2 infection is complex; therefore, a better understanding of the underlying pathobiology, especially binding the virus to its receptors, could help improve therapeutic and preventive approaches. This review aims to highlight the importance of evaluating both the epigenetic and genetic variations of ACE2 as a receptor for the deadly SARS-CoV-2.

受体识别是病毒感染的关键步骤，也是细胞进入和组织趋向性的关键因素。在最近的几项研究中，血管紧张素转换酶 2 (ACE2) 已被证明是 SARS-CoV-2 的细胞受体，因为它以前被称为 SARS-CoV 的受体。SARS-CoV-2 可以与人类 ACE2 以高亲和力结合，并将其作为进入受体。似乎 ACE2 的遗传变异，尤其是表观遗传变异在不同人群中鲜为人知，这表明需要对其进行进一步研究。这些变异有可能影响其对 COVID-19 致病性的贡献。表观遗传学对 ACE2 个体间变异的贡献值得更多关注，因为表观遗传过程可以在各种组织、不同人群和人群中的 ACE2 改变中发挥重要作用。分析不同的 DNA 甲基化模式和 microRNA，有助于肺部 ACE2 调节将具有高度优先级。考虑到有些人尽管患有 COVID-19 但临床症状较轻，ACE2 的表观遗传和遗传变异就变得更加重要。SARS-CoV-2 感染的致病性很复杂；因此，更好地了解潜在的病理生物学，尤其是病毒与其受体的结合，可能有助于改进治疗和预防方法。