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Angiotensin-Converting Enzyme 2 (ACE2) as a Potential Diagnostic and Prognostic Biomarker for Chronic Inflammatory
Dejan Marčetić1,2, Miroslav Samaržija2, Andrea Vukić Dugac2
1Department of Internal and Pulmonary Diseases, General Hospital Virovitica, Ljudevita Gaja 21, 33000 Virovitica, Croatia.
Abstract:
Chronic inflammatory lung diseases are characterized by uncontrolled immune response in the airways as their main pathophysiological manifestation. The lack of specific diagnostic and therapeutic biomarkers for many pulmonary diseases represents a major challenge for pulmonologists. The majority of the currently approved therapeutic approaches are focused on achieving disease remission, although there is no guarantee of complete recovery. It is known that angiotensin-converting enzyme 2 (ACE2), an important counter-regulatory component of the renin-angiotensin-aldosterone system (RAAS), is expressed in the airways. It has been shown that ACE2 plays a role in systemic regulation of the cardiovascular and renal systems, lungs and liver by acting on blood pressure, electrolyte balance control mechanisms and inflammation. Its protective role in the lungs has also been presented, but the exact pathophysiological mechanism of action is still elusive. The aim of this study is to review and discuss recent findings about ACE2, including its potential role in the pathophysiology of chronic inflammatory lung diseases:, i.e., chronic obstructive pulmonary disease, asthma, and pulmonary hypertension. Additionally, in the light of the coronavirus 2019 disease (COVID-19), we will discuss the role of ACE2 in the pathophysiology of this disease, mainly represented by different grades of pulmonary problems. We believe that these insights will open up new perspectives for the future use of ACE2 as a potential biomarker for early diagnosis and monitoring of chronic inflammatory lung diseases.
Insights
Angiotensin-converting enzyme 2 (ACE2) plays a role in chronic inflammatory lung diseases like COPD and asthma. Understanding ACE2 could lead to new biomarkers for early diagnosis and monitoring of these conditions.
Area of Science:
- Pulmonary Medicine
- Biomarker Discovery
- Immunology
Background:
- Chronic inflammatory lung diseases lack specific diagnostic and therapeutic biomarkers.
- Current treatments focus on remission, not complete recovery.
- Angiotensin-converting enzyme 2 (ACE2) is expressed in airways and influences cardiovascular, renal, and lung systems.
Purpose of the Study:
- To review and discuss recent findings on ACE2.
- To explore ACE2's role in the pathophysiology of chronic inflammatory lung diseases (COPD, asthma, pulmonary hypertension).
- To examine ACE2's role in COVID-19's pulmonary manifestations.
Main Methods:
- Literature review of recent findings on ACE2.
- Discussion of ACE2's pathophysiological mechanisms in lung diseases.
- Analysis of ACE2's involvement in COVID-19.
Main Results:
- ACE2 has a known role in systemic regulation and a presented protective role in the lungs, though mechanisms are unclear.
- ACE2 is implicated in the pathophysiology of COPD, asthma, and pulmonary hypertension.
- ACE2 is crucial in COVID-19's pulmonary pathology.
Conclusions:
- ACE2's role in chronic inflammatory lung diseases warrants further investigation.
- ACE2 may serve as a potential biomarker for early diagnosis and monitoring.
- Targeting ACE2 pathways could offer new therapeutic strategies.
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