Circulating ACE2 in Cardiovascular and Kidney Diseases

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Biochemistry

Background:

• Angiotensin converting enzyme (ACE) 2 (ACE2) counterbalances Angiotensin II effects, offering protective cardiovascular and renal actions.
• ACE2 is increasingly recognized as a potential biomarker in kidney disease (KD) and cardiovascular (CV) conditions.
• Elevated circulating ACE2 activity is observed in patients with cardiovascular disease, hypertension, and diabetes.

Purpose of the Study:

• To review the measurement of circulating ACE2.
• To elucidate the role of ACE2 in kidney disease.
• To assess the potential of ACE2 as a renal and cardiovascular biomarker.

Main Methods:

• Review of human and experimental studies on circulating ACE2.
• Analysis of ACE2 enzymatic activity measurement techniques.
• Examination of associations between ACE2 and KD, cardiovascular risk factors, and outcomes.

Main Results:

• Circulating ACE2 is increased in patients with cardiovascular disease, hypertension, diabetes, and chronic kidney disease (CKD).
• ACE2 shows a negative association with estimated glomerular filtration rate in type 1 diabetes patients.
• In CKD patients, ACE2 is linked to cardiovascular risk factors, atherosclerosis, and adverse CV outcomes.
• Experimental studies in diabetic nephropathy indicate increased ACE2 activity and urinary albumin excretion.

Conclusions:

• Circulating ACE2 levels are altered in various kidney and cardiovascular diseases.
• ACE2 may serve as a valuable biomarker for renal and cardiovascular risk assessment in KD patients.
• Further research is warranted to fully understand ACE2's role and clinical utility.