The molecular mechanism behind the pathogenic action of the SARS-CoV-2 virus, the role of the ACE2 receptors in the creation of surfactant and in the protection of large functional surfaces

ABSTRACT

COVID-19 is caused by the SARS-CoV-2 virus. SARS-CoV-2 is different from other corona viruses due to the fact that it can intensely bind to the ACE2 receptor. Expression of ACE2 receptors is especially characteristic for the following cells alveolar type 2 cells, endothelial cells of both small and large arteries, and the smooth muscle cells of the arteries, enterocytes of the small intestine, Leydig and Sertoli cells, proximal cells of the renal tubules and intestine cells. A common characteristic of these organs, tissues and cells, which have a high ACE2 expression, is that they have a "large functional surface". ACE2 receptor is critical in maintaining the integrity and stability of these so called "large functional surfaces". Production of surfactant in order for the ACE2 receptor to realize its protective function. Surfactants role in the stabilization and immunoprotection of large functional surfaces. People with a lower number of ACE2 receptors (the obese, elderly, people with comorbidities, males) are more susceptible to the virus occupying all avalaible ACE2 receptors and blocking the production of surfactant to such a degree that the antigens of ''large functional surfaces" become visible to the immune system and cause a massive inflammatory response in the COVID-19 cases. The molecular mechanism of the pathological action of the SARS-CoV-2 virus as explained from the aspect of ACE2 binding and the subsequent inhibition of surfactant production.