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Updated: Dec 1, 2025

Live Imaging and Quantification of Viral Infection in K18 hACE2 Transgenic Mice Using Reporter-Expressing Recombinant SARS-CoV-2
Published on: November 5, 2021
ACE2: The Major Cell Entry Receptor for SARS-CoV-2
Filippo Scialo1,2, Aurora Daniele3,2, Felice Amato4,2
1Dipartimento di Scienze Mediche Traslazionali, University of Campania "L. Vanvitelli", Naples, Italy.
Abstract:
Despite the unprecedented effort of the scientific community, the novel SARS-CoV-2 virus has infected more than 46 million people worldwide, killing over one million two hundred thousand. Understanding the mechanisms by which some individuals are more susceptible to SARS-CoV-2 infection and why a subgroup of them are prone to experience severe pneumonia, and death should lead to a better approach and more effective treatments for COVID-19. Here, we focus our attention on ACE2, a primary receptor of SARS-CoV-2. We will discuss its biology, tissue expression, and post-translational regulation that determine its potential to be employed by SARS-CoV-2 for cell entry. Particular attention will be given to how the ACE2 soluble form can have a great impact on disease progression and thus be used in a potential therapeutic strategy. Furthermore, we will discuss repercussions that SARS-CoV-2/ACE2 binding has on the renin-angiotensin system and beyond. Indeed, although mostly neglected, ACE2 can also act on [des-Arg 937]-bradykinin of the kinin-kallikrein system regulating coagulation and inflammation. Thorough comprehension of the role that ACE2 plays in different pathways will be the key to assess the impact that SARS-CoV-2/ACE2 binding has on organismal physiology and will help us to find better therapies and diagnostic tools.
Insights
The angiotensin-converting enzyme 2 (ACE2) receptor is crucial for SARS-CoV-2 entry into cells. Understanding ACE2
Area of Science:
- Virology and Molecular Biology
- Immunology and Inflammation
- Cardiovascular Physiology
Background:
- The COVID-19 pandemic, caused by SARS-CoV-2, has led to millions of infections and deaths globally.
- Individual susceptibility to severe COVID-19 and mortality remains incompletely understood.
- The angiotensin-converting enzyme 2 (ACE2) is a key receptor for SARS-CoV-2 cell entry.
Purpose of the Study:
- To elucidate the biological functions of ACE2, including its expression and regulation.
- To investigate the role of soluble ACE2 in COVID-19 disease progression and its therapeutic potential.
- To explore the impact of SARS-CoV-2 binding to ACE2 on the renin-angiotensin and kinin-kallikrein systems.
Main Methods:
- Review of existing literature on ACE2 biology, SARS-CoV-2 infection mechanisms, and related physiological systems.
- Analysis of the interplay between SARS-CoV-2, ACE2, and the renin-angiotensin system.
- Discussion of ACE2's involvement in regulating bradykinin and its implications for coagulation and inflammation.
Main Results:
- ACE2's expression and post-translational modifications influence SARS-CoV-2 cell entry.
- Soluble ACE2 levels may correlate with COVID-19 severity and represent a therapeutic target.
- SARS-CoV-2/ACE2 interaction disrupts the renin-angiotensin system and affects kinin-kallikrein pathways, impacting inflammation and coagulation.
Conclusions:
- A comprehensive understanding of ACE2's multifaceted roles is essential for developing effective COVID-19 therapies and diagnostics.
- Targeting ACE2 or its related pathways offers potential therapeutic strategies for managing COVID-19.
- Further research into ACE2's regulation of coagulation and inflammation is critical for assessing SARS-CoV-2's systemic impact.
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