Plasma Angiotensin Peptide Profiling and ACE (Angiotensin-Converting Enzyme)-2 Activity in COVID-19 Patients Treated With Pharmacological Blockers of the Renin-Angiotensin System
“…Similarly, another recent study reported that plasma ACE2 activity remained unaltered in patients treated with ACE-Inhs. and ARBs ( Kintscher et al, 2020 ). However, this study reported that plasma ACE2 activity was significantly increased in a small cohort of COVID-19 patients using ACE-Inhs.…”
The recent emergence of coronavirus disease-2019 (COVID-19) as a global pandemic has prompted scientists to address an urgent need for defining mechanisms of disease pathology and treatment. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent for COVID-19, employs angiotensin converting enzyme 2 (ACE2) as its primary target for cell surface attachment and likely entry into the host cell. Thus, understanding factors that may regulate the expression and function of ACE2 in the healthy and diseased body is critical for clinical intervention. Over 66% of all adults in the United States are currently using a prescription drug and while earlier findings have focused on possible upregulation of ACE2 expression through the use of renin angiotensin system (RAS) inhibitors, mounting evidence suggests that various other widely administered drugs used in the treatment of hypertension, heart failure, diabetes mellitus, hyperlipidemias, coagulation disorders, and pulmonary disease may also present a varied risk for COVID-19. Specifically, we summarize mechanisms on how heparin, statins, steroids and phytochemicals, besides their established therapeutic effects, may also interfere with SARS-CoV-2 viral entry into cells. We also describe evidence on the effect of several vitamins, phytochemicals, and naturally occurring compounds on ACE2 expression and activity in various tissues and disease models. This comprehensive review aims to provide a timely compendium on the potential impact of commonly prescribed drugs and pharmacologically active compounds on COVID-19 pathology and risk through regulation of ACE2 and RAS signaling.
“…Similarly, another recent study reported that plasma ACE2 activity remained unaltered in patients treated with ACE-Inhs. and ARBs ( Kintscher et al, 2020 ). However, this study reported that plasma ACE2 activity was significantly increased in a small cohort of COVID-19 patients using ACE-Inhs.…”
The recent emergence of coronavirus disease-2019 (COVID-19) as a global pandemic has prompted scientists to address an urgent need for defining mechanisms of disease pathology and treatment. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent for COVID-19, employs angiotensin converting enzyme 2 (ACE2) as its primary target for cell surface attachment and likely entry into the host cell. Thus, understanding factors that may regulate the expression and function of ACE2 in the healthy and diseased body is critical for clinical intervention. Over 66% of all adults in the United States are currently using a prescription drug and while earlier findings have focused on possible upregulation of ACE2 expression through the use of renin angiotensin system (RAS) inhibitors, mounting evidence suggests that various other widely administered drugs used in the treatment of hypertension, heart failure, diabetes mellitus, hyperlipidemias, coagulation disorders, and pulmonary disease may also present a varied risk for COVID-19. Specifically, we summarize mechanisms on how heparin, statins, steroids and phytochemicals, besides their established therapeutic effects, may also interfere with SARS-CoV-2 viral entry into cells. We also describe evidence on the effect of several vitamins, phytochemicals, and naturally occurring compounds on ACE2 expression and activity in various tissues and disease models. This comprehensive review aims to provide a timely compendium on the potential impact of commonly prescribed drugs and pharmacologically active compounds on COVID-19 pathology and risk through regulation of ACE2 and RAS signaling.
“…In other recent studies, neither down- nor upregulation of ACE2 was observed in human cell lines infected with SARS-CoV-2 [ 228 , 229 , 280 ]. In COVID-19 patients, plasma levels and enzymatic activity of ACE2 were found increased [ 281 , 282 ] or not altered [ 278 , 283 , 284 ]. On the other hand, plasma levels of DPP4, the entry receptor for MERS-CoV, were reported to be decreased in COVID-19 patients [ 285 ] and in patients infected with MERS-CoV [ 286 ].…”
Section: The Roles Of Ace2 and Angiotensin II In Coronavirus-induced mentioning
“…Eines der wichtigsten RAS-modulierenden Enzyme, ACE2, hat während der SARS-CoV-2-Pandemie zunehmend an Aufmerksamkeit gewonnen, da es nicht nur Angiotensin(ANG) II in den alternativen RAS-Metaboliten ANG 1–7 umwandelt, sondern auch als zellulärer Eintrittsrezeptor für SARS-CoV‑2 fungiert (Abb. 1 ; [ 16 , 34 ]). ACE-Hemmer und ARBs können zu einer Hochregulierung der ACE2-Expression/Aktivität führen und wurden daher zu Beginn der SARS-CoV-2-Pandemie mit einem verschlechterten Outcome bei COVID-19-Patienten in Verbindung gebracht (Abb.…”
Section: Arterielle Hypertonie Und Covid-19unclassified
“…ACE-Hemmer und ARBs können zu einer Hochregulierung der ACE2-Expression/Aktivität führen und wurden daher zu Beginn der SARS-CoV-2-Pandemie mit einem verschlechterten Outcome bei COVID-19-Patienten in Verbindung gebracht (Abb. 1 ; [ 16 , 34 ]). …”
Section: Arterielle Hypertonie Und Covid-19unclassified
Die arterielle Hypertonie bleibt weltweit der prävalenteste Risikofaktor für kardiovaskuläre Erkrankungen und damit einhergehende Behinderungen. Auch im Bereich der arteriellen Hypertonie bestimmte die COVID-19-Pandemie einen Teil der wissenschaftlichen Debatte. Die arterielle Hypertonie ist mit einem schwereren Krankheitsverlauf von COVID-19 assoziiert, wohingegen das SARS-CoV-2-Infektionsrisiko bei Hypertonikern nicht erhöht zu sein scheint. Nach aktueller Datenlage ist die Therapie mit ACE(Angiotensin-Converting-Enzym)-Hemmer und Angiotensin-Typ-1-Rezeptorblocker weder mit einem erhöhten SARS-CoV-2-Infektionsrisiko noch mit einem schwereren Krankheitsverlauf von COVID-19 verbunden. Eine Studie zur antihypertensiven Chronotherapie bestimmte den wissenschaftlichen Diskurs zur medikamentösen Therapie der Hypertonie. Die HYGIA-Studie kam zu der Schlussfolgerung, dass eine abendliche Medikamenteneinnahme das kardiovaskuläre Risiko von Patienten*innen mit arterieller Hypertonie reduziert. Aufgrund einiger Limitationen ist die Datenlage aktuell unzureichend, um eine routinemäßige nächtliche Gabe von antihypertensiven Medikamenten zu empfehlen. Wir werden einige der Aspekte diskutieren. Ein weiterer wissenschaftlicher Schwerpunkt lag auf den neuen Studien zur renalen Denervation. Hier kann man zusammenfassen, dass nach neuer Studienlage die katheterbasierte renale Denervation ein effektives und sicheres Verfahren zur Behandlung der arteriellen Hypertonie darstellt, das sich als alternatives Verfahren zur medikamentösen Blutdrucksenkung weiter etablieren könnte.
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