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Year : 2021  |  Volume : 12  |  Issue : 1  |  Page : 70

Renin angiotensin converting enzyme 2 and COVID-19: Prevention and treatment

1 Department of Physiology, Sazevar University of Medical Sciences, Sabzevar, Iran
2 Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Date of Submission27-Sep-2020
Date of Acceptance04-Feb-2021
Date of Web Publication25-Jun-2021

Correspondence Address:
Mehdi Nematbakhsh
Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijpvm.IJPVM_585_20

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How to cite this article:
Kafami M, Nematbakhsh M. Renin angiotensin converting enzyme 2 and COVID-19: Prevention and treatment. Int J Prev Med 2021;12:70

How to cite this URL:
Kafami M, Nematbakhsh M. Renin angiotensin converting enzyme 2 and COVID-19: Prevention and treatment. Int J Prev Med [serial online] 2021 [cited 2021 Nov 28];12:70. Available from: https://www.ijpvmjournal.net/text.asp?2021/12/1/70/319445

Dear Editor,

The 2019 novel corona virus (SARS-CoV-2) has already taken on pandemic proportions, having infected more than seven million people in 213 countries. The increased prevalence of the disease as well as involvement of the angiotensin-converting enzyme 2 (ACE2) have suggested to consider its role in corona virus infection diseases-2019 (COVID-19).

ACE2 is a type-I membrane-bound glycoprotein that cleavages angiotensin I (Ang I) into Ang 1-9 and Ang II into the Ang1-7. Organs such as the heart, liver, kidney, and especially the lungs play a greater role in COVID-19 mortality while a higher expression of ACE2 was detected in these organs. SARS-CoV-2 utilizes ACE2 as an entry receptor in ACE2-expressing cells, and actually inhibit the physiological activity of ACE2.[1] The ACE inhibitors and AngII type-I receptor blockers (ARBs) are the simple choice to increase ACE2 expression, and the binding of soluble ACE2 with SARS-CoV-2 spike may reduce the viral load,[2] and cellular blocking of ACE2 act as pro-inflammatory.[3] Diseases such as asthma, pneumonia, and influenza are dependent on ACE2 activity,[4] and ACE2 activators may prevent the lung against fibrosis.[5] The expression of ACE2 may promote by some vitamins such as vitamins C, D, and B3.[3] In addition, ARBs, metformin and the drugs containing diminazene aceturate also are suggested to be used as ACE2 activators.[3],[4] Collectively, the relationship between ACE2 and SARS-CoV-2 in the treatment of COVID-19 patients cannot be ignored.

However, the SARS-CoV-2 has spread in our lives and it has no time to go away. Special attention of course, should be paid to the treatment of COVID-19 patients, but prevention by diets and protection should not be forgotten. ACE2 is a good and a logical target, and proper nutrition to maintain the physiological level of ACE2 expression is needed. Proper use of compounds such vitamin C and prevention of vitamin E deficiency that increase ACE2 expression may be important for prevention of COVID-19. In addition, we must keep in mind that the activity of the enzyme depends on sex and age.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding. Lancet 2020;395:565-74.  Back to cited text no. 1
Monteil V, Kwon H, Prado P, Hagelkrüys A, Wimmer RA, Stahl M, et al. Inhibition of SARS-CoV-2 infections in engineered human tissues using clinical-grade soluble human ACE2. Cell 2020;181:905-13.e7.  Back to cited text no. 2
McLachlan CS. The angiotensin-converting enzyme 2 (ACE2) receptor in the prevention and treatment of COVID-19 are distinctly different paradigms. Clin Hypertens 2020;26:14.  Back to cited text no. 3
Rodríguez-Puertas R. ACE2 activators for the treatment of COVID 19 patients. J Med Virol 2020;92:1701-2.  Back to cited text no. 4
Prata LO, Rodrigues CR, Martins JM, Vasconcelos PC, Oliveira FM, Ferreira AJ, et al. Original Research: ACE2 activator associated with physical exercise potentiates the reduction of pulmonary fibrosis. Exp Biol Med (Maywood) 2017;242:8-21.  Back to cited text no. 5


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