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Related Experiment Video

Updated: Nov 27, 2025

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SARS-CoV-2, ACE2 expression, and systemic organ invasion.

Usman M Ashraf1, Ahmed A Abokor1, Jonnelle M Edwards1

  • 1Department of Physiology and Pharmacology, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio.

Physiological Genomics
|December 4, 2020
PubMed
Summary

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) disrupts angiotensin-converting enzyme 2 (ACE2), a key regulator of the renin-angiotensin-aldosterone system (RAAS). This disruption impacts multiple organ systems, explaining diverse COVID-19 clinical outcomes.

Keywords:
ACE2COVID-19RAASSARS-CoV-2complex disease

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Area of Science:

  • * Virology and Molecular Biology
  • * Cardiovascular and Respiratory Medicine
  • * Endocrinology and Metabolism

Background:

  • * The COVID-19 pandemic, caused by SARS-CoV-2, presents a significant global health challenge.
  • * SARS-CoV-2 utilizes the angiotensin-converting enzyme 2 (ACE2) receptor on host cells for entry.
  • * ACE2 plays a vital role in regulating the renin-angiotensin-aldosterone system (RAAS) and maintaining tissue homeostasis.

Purpose of the Study:

  • * To review the current literature on the impact of SARS-CoV-2-induced ACE2 disruption on various organ systems.
  • * To elucidate the mechanisms by which ACE2 dysregulation contributes to the multifaceted clinical manifestations of COVID-19.
  • * To highlight the critical role of ACE2 distribution and expression in understanding COVID-19's systemic effects.

Main Methods:

  • * Perspective review of existing scientific literature.
  • * Analysis of current research on SARS-CoV-2-ACE2 interactions.
  • * Synthesis of findings regarding RAAS modulation and organ-specific effects.

Main Results:

  • * SARS-CoV-2 binding to ACE2 leads to its internalization and downregulation.
  • * Disruption of ACE2 impairs RAAS regulation, affecting lung, heart, kidney, and vascular function.
  • * Widespread ACE2 expression explains the multi-organ involvement observed in COVID-19 patients.

Conclusions:

  • * SARS-CoV-2 infection significantly impacts ACE2 function, leading to systemic consequences.
  • * ACE2 dysregulation is a critical factor in the pathogenesis of severe COVID-19 and its varied clinical presentations.
  • * Understanding ACE2's role is crucial for developing targeted therapies and managing COVID-19 complications.