scholarly journals Potential harmful effects of discontinuing ACE-inhibitors and ARBs in COVID-19 patients

eLife ◽  
2020 ◽  
Vol 9 ◽  
Author(s):  
Gian Paolo Rossi ◽  
Viola Sanga ◽  
Matthias Barton
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Angiotensin Converting Enzyme ◽  
Distress Syndrome ◽  
Converting Enzyme ◽  
Angiotensin Converting Enzyme 2 ◽  
Mas Receptor ◽  
Pulmonary Protection ◽  
Therapeutic Considerations ◽  
Harmful Effects

The discovery of angiotensin converting enzyme-2 (ACE-2) as the receptor for SARS- CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) has implicated the renin-angiotensin-aldosterone system in acute respiratory distress syndrome (ARDS) and respiratory failure in patients with coronavirus disease-19 (COVID-19). The angiotensin converting enzyme-1–angiotensin II–angiotensin AT1 receptor pathway contributes to the pathophysiology of ARDS, whereas activation of the ACE-2–angiotensin(1-7)-angiotensin AT2 receptor and the ACE-2–angiotensin(1-7)–Mas receptor pathways have been shown to be protective. Here we propose and discuss therapeutic considerations how to increase soluble ACE-2 in plasma in order for ACE-2 to capture and thereby inactivate SARS-CoV-2. This could be achieved by administering recombinant soluble ACE-2. We also discuss why and how ACEIs and ARBs provide cardiovascular, renal and also pulmonary protection in SARS-CoV-2- associated ARDS. Discontinuing these medications in COVID-19 patients may therefore potentially be harmful.

scholarly journals Hyperglycemia and Angiotensin-Converting Enzyme 2 in Pulmonary Function in the Context of SARS-CoV-2 Infection

2022 ◽  
Vol 8 ◽  
Author(s):  
Jose R. Vargas-Rodriguez ◽  
Idalia Garza-Veloz ◽  
Virginia Flores-Morales ◽  
Jose I. Badillo-Almaraz ◽  
Maria R. Rocha-Pizaña ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Acute Respiratory Distress Syndrome ◽  
Severe Acute Respiratory Syndrome ◽  
Angiotensin Converting Enzyme ◽  
Distress Syndrome ◽  
Current Evidence ◽  
Pathophysiological Mechanism ◽  
Converting Enzyme ◽  
Angiotensin Converting Enzyme 2 ◽  
Worse Prognosis

Since the appearance of the severe acute respiratory syndrome coronavirus (SARS-CoV) in 2003 in China, diabetes mellitus (DM) and hyperglycemia in patients infected with SARS-CoV, represent independent predictors of mortality. Therefore, metabolic control has played a major role in the prognosis of these patients. In the current pandemic of coronavirus disease 19 (COVID-19), multiple studies have shown that DM is one of the main comorbidities associated with COVID-19 and higher risk of complications and death. The incidence and prevalence of COVID-19 complications and death related with hyperglycemia in patients with or without DM are high. There are many hypotheses related with worse prognosis and death related to COVID-19 and/or hyperglycemia. However, the information about the interplay between hyperglycemia and angiotensin-converting enzyme 2 (ACE2), the critical receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in the context of SARS-CoV-2 infection, is almost null, but there is enough information to consider the possible participation of hyperglycemia in the glycation of this protein, unleashing a pool of reactions leading to acute respiratory distress syndrome and death in patients with COVID-19. In this document we investigated the current evidence related with ACE2 as a key element within the pathophysiological mechanism related with hyperglycemia extrapolating it to context of SARS-CoV-2 infection and its relationship with worse prognosis and death for COVID-19.

The angiotensin converting enzyme 2/angiotensin-(1-7)/Mas Receptor axis as a key player in alveolar bone remodeling

Bone ◽  
2019 ◽  
Vol 128 ◽  
pp. 115041 ◽  
Author(s):  
Celso Martins Queiroz-Junior ◽  
Anna Clara Paiva Menezes Santos ◽  
Izabela Galvão ◽  
Giovanna Ribeiro Souto ◽  
Ricardo Alves Mesquita ◽  
...  
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Bone Remodeling ◽  
Alveolar Bone ◽  
Converting Enzyme ◽  
Angiotensin Converting Enzyme 2 ◽  
Mas Receptor ◽  
Alveolar Bone Remodeling

Targeting angiotensin-converting enzyme 2 as a new therapeutic target for cardiovascular diseases

2014 ◽  
Vol 92 (7) ◽  
pp. 558-565 ◽  
Author(s):  
Nirmal Parajuli ◽  
Tharmarajan Ramprasath ◽  
Vaibhav B. Patel ◽  
Wang Wang ◽  
Brendan Putko ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Angiotensin Converting Enzyme ◽  
Therapeutic Target ◽  
Ang Ii ◽  
Converting Enzyme ◽  
Angiotensin Converting Enzyme 2 ◽  
Heart Failure Patients ◽  
Positive Effects ◽  
Mas Receptor

Angiotensin-converting enzyme 2 (ACE2) is a monocarboxypeptidase that metabolizes several vasoactive peptides, including angiotensin II (Ang-II; a vasoconstrictive/proliferative peptide), which it converts to Ang-(1–7). Ang-(1–7) acts through the Mas receptor to mediate vasodilatory/antiproliferative actions. The renin–angiotensin system involving the ACE–Ang-II–Ang-II type-1 receptor (AT1R) axis is antagonized by the ACE2–Ang-(1–7)–Mas receptor axis. Loss of ACE2 enhances adverse remodeling and susceptibility to pressure and volume overload. Human recombinant ACE2 may act to suppress myocardial hypertrophy, fibrosis, inflammation, and diastolic dysfunction in heart failure patients. The ACE2–Ang-(1–7)–Mas axis may present a new therapeutic target for the treatment of heart failure patients. This review is mainly focused on the analysis of ACE2, including its influence and potentially positive effects, as well as the potential use of human recombinant ACE2 as a novel therapy for the treatment cardiovascular diseases, such as hypertension and heart failure.

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