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Interactions of renin-angiotensin system and COVID-19: the importance of daily rhythms in ACE2, ADAM17 and TMPRSS2 expression
J. Zlacká, K. Stebelová, M. Zeman, I. Herichová
Language English Country Czech Republic
Document type Journal Article, Review
NLK
Directory of Open Access Journals
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Free Medical Journals
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PubMed Central
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ProQuest Central
from 2005-01-01
Medline Complete (EBSCOhost)
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- MeSH
- Angiotensin-Converting Enzyme 2 metabolism MeSH
- Time Factors MeSH
- Circadian Rhythm * MeSH
- COVID-19 metabolism physiopathology therapy virology MeSH
- Hypertension metabolism physiopathology MeSH
- Host-Pathogen Interactions MeSH
- Humans MeSH
- Periodicity MeSH
- Prognosis MeSH
- ADAM17 Protein metabolism MeSH
- Renin-Angiotensin System * MeSH
- SARS-CoV-2 metabolism pathogenicity MeSH
- Serine Endopeptidases metabolism MeSH
- Signal Transduction MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Angiotensin-converting enzyme 2 (ACE2) was identified as a molecule that mediates the cellular entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several membrane molecules of the host cell must cooperate in this process. While ACE2 serves in a membrane receptor-mediating interaction with the surface spike (S) glycoprotein of SARS-CoV-2 located on the virus envelope, enzyme A disintegrin and metalloproteinase 17 (ADAM17) regulates ACE2 availability on the membrane and transmembrane protease serine 2 (TMPRSS2) facilitates virus-cell membrane fusion. Interestingly, ACE2, ADAM17 and TMPRSS2 show a daily rhythm of expression in at least some mammalian tissue. The circadian system can also modulate COVID-19 progression via circadian control of the immune system (direct, as well as melatonin-mediated) and blood coagulation. Virus/ACE2 interaction causes ACE2 internalization into the cell, which is associated with suppressed activity of ACE2. As a major role of ACE2 is to form vasodilatory angiotensin 1-7 from angiotensin II (Ang II), suppressed ACE2 levels in the lung can contribute to secondary COVID-19 complications caused by up-regulated, pro-inflammatory vasoconstrictor Ang II. This is supported by the positive association of hypertension and negative COVID-19 prognosis although this relationship is dependent on numerous comorbidities. Hypertension treatment with inhibitors of renin-angiotensin system does not negatively influence prognosis of COVID-19 patients. It seems that tissue susceptibility to SARS-CoV-2 shows negative correlation to ACE2 expression. However, in lungs of infected patient, a high ACE2 expression is associated with better outcome, compared to low ACE2 expression. Manipulation of soluble ACE2 levels is a promising COVID-19 therapeutic strategy.
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Literatura
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