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Subcutaneous Angiotensin II Infusion using Osmotic Pumps Induces Aortic Aneurysms in Mice
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Angiotensin-converting enzyme 2, coronavirus disease 2019, and abdominal aortic aneurysms
Baohui Xu1, Gang Li1, Jia Guo1
1Department of Surgery, Stanford University School of Medicine, Stanford, Calif.
Journal of Vascular Surgery
|February 18, 2021
Summary
The COVID-19 pandemic may influence abdominal aortic aneurysm (AAA) disease through various SARS-CoV-2 mechanisms involving ACE2. Further research is needed to determine the pandemic's impact on AAA prevalence, progression, and lethality.
Area of Science:
- Cardiovascular Research
- Infectious Diseases
- Molecular Biology
Background:
- Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes COVID-19, utilizing Angiotensin-converting enzyme 2 (ACE2) as a host entry receptor.
- ACE2 plays a critical role in cellular inoculation and target organ injury, and its expression is modulated by various factors.
- The ACE2-angiotensin 1-7-Mas receptor axis is implicated in abdominal aortic aneurysm (AAA) pathogenesis.
Purpose of the Study:
- To review ACE2 expression and the role of the ACE2-angiotensin 1-7-Mas receptor axis in AAA pathogenesis.
- To identify potential influences of COVID-19 on AAA disease pathogenesis.
Main Methods:
- Comprehensive literature search on PubMed using keywords: COVID-19, SARS-CoV-2, AAA, ACE2, ACE inhibitors, angiotensin 1-7, Mas receptor, and related conditions.
- Review of key publications on the epidemiology and pathogenesis of COVID-19 and AAAs.
Main Results:
- ACE2 is expressed in vascular structural cells; its expression is promoted by conditions like diabetes, smoking, and viral infections, with variations by sex and age.
- ACE2 inhibition or deficiency augments experimental AAAs, while ACE2 activation or angiotensin 1-7 treatment attenuates progression.
- Potential SARS-CoV-2 influences on AAA include altered ACE-angiotensin II-AT1 receptor activity, increased proaneurysmal mediators, enhanced cellular cross-talk, hypoxemia, and systemic inflammation.
Conclusions:
- COVID-19 may theoretically influence AAA disease through multiple SARS-CoV-2-induced mechanisms.
- Further investigation and clinical follow-up are essential to ascertain the pandemic's impact on AAA prevalence, progression, and lethality.
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