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The Protective Potential Role of ACE2 against COVID-19

Fereshteh Golab1, Gelareh Vahabzadeh2, Leila SadeghRoudbari1

  • 1Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.

Advances in Virology
|June 5, 2023
PubMed

Insights

This review explores how angiotensin-converting enzyme 2 (ACE2) acts as a crucial receptor for SARS-CoV-2 infection. Understanding ACE2's role in COVID-19 pathogenesis may lead to new therapeutic strategies.

Area of Science:

  • Virology
  • Cardiovascular Research
  • Infectious Diseases

Background:

  • The coronavirus disease 2019 (COVID-19) pandemic necessitates urgent therapeutic development.
  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) utilizes angiotensin-converting enzyme 2 (ACE2) as a key receptor for cell entry and infection.
  • ACE2 downregulation by the SARS-CoV-2 spike protein triggers detrimental angiotensin II (Ang II)/angiotensin type 1 receptor axis overactivation.

Purpose of the Study:

  • To review the critical role of ACE2 in SARS-CoV-2 infection.
  • To explore the potential protective mechanisms of ACE2 against viral infection.
  • To provide insights for developing novel COVID-19 prevention and control strategies.

Main Methods:

  • Literature review of existing research on ACE2, SARS-CoV-2, and COVID-19 pathogenesis.
  • Analysis of the molecular interactions between SARS-CoV-2 spike protein and ACE2.
  • Examination of the physiological consequences of ACE2 downregulation in COVID-19.

Main Results:

  • ACE2 is essential for SARS-CoV-2-mediated cell fusion and infection.
  • Downregulation of ACE2 leads to harmful Ang II/AT1R axis overactivation, contributing to organ dysfunction in COVID-19 patients.
  • The widespread distribution of ACE2 contributes to the diverse symptoms and complications observed in COVID-19.

Conclusions:

  • ACE2 plays a dual role as a viral receptor and a critical regulator of the renin-angiotensin system.
  • Targeting ACE2 or its related pathways may offer a protective strategy against SARS-CoV-2 infection.
  • Further research into ACE2's function is vital for developing effective COVID-19 therapeutics and control measures.

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