Why the study?
To review the mechanistic and target organ effects related to ACE2 activity and the importance of ACE2 in SARS-CoV-2 infection.
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Design
Review
This review highlights the dual role of ACE2 in counter-regulating the renin-angiotensin system and facilitating SARS-CoV-2 entry, emphasizing the need for research on how RAS-acting drugs affect COVID-19 outcomes.
PURPOSE OF THE REVIEW: Angiotensin-converting enzyme 2 (ACE2) is a key counter-regulatory component of the renin-angiotensin system. Here, we briefly review the mechanistic and target organ effects related to ACE2 activity, and the importance of ACE2 in SARS-CoV-2 infection. RECENT FINDINGS: ACE2 converts angiotensin (Ang) II to Ang-(1-7), which directly opposes the vasoconstrictive, proinflammatory, and prothrombotic effects of Ang II. ACE2 also facilitates SARS-CoV-2 viral entry into host cells. Drugs that interact with the renin-angiotensin system may impact ACE2 expression and COVID-19 pathogenesis; however, the magnitude and direction of these effects are unknown at this time. High quality research is needed to improve our understanding of how agents that act on the renin-angiotensin system impact ACE2 and COVID-19-related disease outcomes.
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Cohen et al. (2020) studied this question.
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