The Possible Dual Role of the ACE2 Receptor in Asthma and Coronavirus (SARS-CoV2) Infection

Branco, Anna Cláudia Calvielli Castelo; Sato, Maria Notomi; Alberca, Ricardo Wesley

doi:10.3389/fcimb.2020.550571

Cited by 30 publications

(33 citation statements)

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“…This phenomenon in smokers and COPD patients could be partially explained by the local inflammatory and oxidative response ( Tian et al, 2017 ) and the up-regulation of ACE2 receptor, SARS-CoV-2 entry receptor, in the lungs ( Jacobs et al, 2020 ). In comparison, allergic asthma downregulates ACE2 receptor expression in the lungs ( Castelo Branco et al, 2020 ), possibly being a protective factor in COVID-19 ( Alberca et al, 2020e ). This still needs to be further explored since the elderly, an established risk group for severe COVID-19, also presents a downregulation in the ACE2 receptor expression in the lungs ( Tavares et al, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

“…The infection caused by SARS-CoV-2 can lead to the development of a severe pulmonary and systemic disease named COVID-19 ( Alberca et al, 2020c ). Previous reports have identified that COVID-19 is often more severe in the elderly and individuals with comorbidities such as obesity, hypertension, diabetes Mellitus, other co-infections ( Alberca, 2020 ; Alberca et al, 2020a , d , f ; Castelo Branco et al, 2020 ; Shaw et al, 2020 ). Those patients generally present an increase in COVID-19-associated inflammatory markers, such as d-dimer, leukocytes count, neutrophil count, neutrophil-to-lymphocyte (NTL) ratio, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and c-reactive protein (CRP) ( Wolff et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

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COVID-19 Disease Course in Former Smokers, Smokers and COPD Patients

et al. 2021

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The severe respiratory and systemic disease named coronavirus disease-2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Currently, the COVID-19 pandemic presents a huge social and health challenge worldwide. Many different risk factors are associated with disease severity, such as systemic arterial hypertension, diabetes mellitus, obesity, older age, and other co-infections. Other respiratory diseases such as chronic obstructive pulmonary disease (COPD) and smoking are common comorbidities worldwide. Previous investigations have identified among COVID-19 patients smokers and COPD patients, but recent investigations have questioned the higher risk among these populations. Nevertheless, previous reports failed to isolate smokers and COPD patients without other comorbidities. We performed a longitudinal evaluation of the disease course of smokers, former smokers, and COPD patients with COVID-19 without other comorbidities, from hospitalization to hospital discharge. Although no difference between groups was observed during hospital admission, smokers and COPD patients presented an increase in COVID-19-associated inflammatory markers during the disease course in comparison to non-smokers and former smokers. Our results demonstrated that smoking and COPD are risk factors for severe COVID-19 with possible implications for the ongoing pandemic.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

COVID-19 Disease Course in Former Smokers, Smokers and COPD Patients

et al. 2021

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“…Post-mortem analysis of lung samples from COVID-19 patients showed neutrophil infiltration in pulmonary capillaries and neutrophil extravasation into the alveolar space, and the inflammatory profile observed in lungs from COVID-19 patients is Th1, Th17 phenotype 21 , 24 . In experimental models of smoke-induced acute respiratory distress, a Th17/neutrophilic syndrome, ACE2 was upregulated 26 . A type 2-low endotype can be an aggravating factor to COVID-19 severity 27 .…”

Section: Resultsmentioning

confidence: 99%

Severe asthma in the era of COVID-19: A narrative review

et al. 2022

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Introduction and objectives: Severe asthma management during the coronavirus disease 2019 (COVID-19) pandemic is a challenge and will continue to be, at least in the next few months, as herd immunity is still a mirage. A lot has to be learned about how COVID-19 affects underlying diseases, and severe asthma is no exception. Methods: Narrative review of papers available until February 2021 in PubMed and Google Scholar, relating severe asthma and COVID-19. Four main research topics were reviewed: SARS-CoV-2 infection: immunology and respiratory pathology; interrelationship of severe asthma endotypes and COVID-19 disease mechanisms; severe asthma epidemiology and COVID-19; and biologics for severe asthma in the context of COVID-19. Results: COVID-19 disease mechanisms start with upper respiratory cell infection, and afterwards several immunological facets are activated, contributing to disease severity, namely cell-mediated immunity and antibody production. Although infrequent in the COVID-19 course some patients develop a cytokine storm that causes organ damage and may lead to acute respiratory distress syndrome or multiorgan failure. Regarding severe asthma endotypes, type2-high might have a protective role both in infection risk and disease course. There is conflicting data regarding the epidemiological relationship between COVID-19 among severe asthma patients, with some studies reporting increased risk of infection and disease course, whereas others the other way round. Biologics for severe asthma do not seem to increase the risk of infection and severe COVID-19, although further evidence is needed. Conclusions: Globally, in the era of COVID-19, major respiratory societies recommend continuing the biologic treatment, preferably in a self-home administration program.

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“…It is hypothesized that different endotypes of asthma may modify ACE2 expression differently, thereby affecting COVID-19. Some cytokines typical for particular asthma endotypes can lead to upregulation of expression of ACE2, such as IL-17, and some can cause downregulation of this receptor, for example, IL-4 and IL-13 [55].…”

Section: Differences In Ace2 and Tmprss2 Expression Among Copd And Asthmatic Patientsmentioning

confidence: 99%

Asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome and the risk of severe COVID-19

Waszczykowska¹,

Węgierska²,

Drygała³

et al. 2021

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Asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome (ACOS) significantly affect the patient's respiratory system, which requires individualised treatment and professional control. During the SARS-CoV-2 pandemic, all respiratory diseases were taken into consideration as risk factors for severe COVID-19. ACE2 and TMPRSS2 genes, which are crucial for SARS-CoV-2 to enter the host cell, have different expression in the occurrence of asthma or COPD. Also, comparing the severity and mortality of patients with coexistence of asthma or COPD and COVID-19, only COPD patients had worse outcomes of COVID-19, and their mortality was significantly higher. Although ACOS is also a potential risk factor for hospitalisation and mortality in COVID-19 patients, the condition still requires further studies. This overview presents the current state of knowledge on the relationship between the diseases mentioned above and COVID-19. Key wORDsbronchial asthma, chronic obstructive pulmonary disease (COPD), asthma-COPD overlap syndrome, COVID-19, SARS-CoV-2.stReszCzenie Astma, przewlekła obturacyjna choroba płuc (POChP) oraz zespół nakładania astmy i POChP (ACOS) znacząco wpływają na układ oddechowy pacjentów, co wymaga indywidualnego leczenia oraz specjalistycznej kontroli. W czasie pandemii SARS-CoV-2 wszelkie choroby związane z układem oddechowym zostały wzięte pod uwagę jako czynniki ryzyka ciężkiego przebiegu COVID-19. Potwierdzono, że geny ACE2 i TMPRSS2, kluczowe dla infekcji SARS-CoV-2, wykazują różną ekspresję w przypadku astmy i POChP. Ponadto, porównując ciężkość przebiegu COVID-19 oraz śmiertelność pacjentów cierpiących jednocześnie na COVID-19 i astmę lub POChP, tylko u chorych na POChP stwierdzono istotnie zwiększoną śmiertelność. Również ACOS jest potencjalnym czynnikiem ryzyka hospitalizacji i śmiertelności pacjentów z COVID-19, jednak nadal wymaga on dalszych badań. W niniejszej pracy przedstawiono aktualny stan wiedzy na temat związku między wspomnianymi chorobami a COVID-19.

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The Possible Dual Role of the ACE2 Receptor in Asthma and Coronavirus (SARS-CoV2) Infection

Cited by 30 publications

References 88 publications

COVID-19 Disease Course in Former Smokers, Smokers and COPD Patients

COVID-19 Disease Course in Former Smokers, Smokers and COPD Patients

Severe asthma in the era of COVID-19: A narrative review

Asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome and the risk of severe COVID-19

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