The Significance of Angiotensin-Converting Enzyme-2 (ACE2) in SARS-Cov-2 Infection and COVID-19

ABSTRACT

The new coronavirus was first reported in 2019 (China) and officially announced by the World Health Organization as a pandemic in March 2020. Severe acute respiratory syndrome coro-navirus 2 (SARS-CoV-2) is the causative agent of the pneumonia-associated illnesses and shares structural homology with the related Severe acute respiratory syndrome coronavirus-1 (SARS-CoV--1). One of the mechanisms for SARS-Cov-1 and-2 infection is mediated by the angiotensin-con-verting enzyme-2 (ACE2) cell receptor, enabling the virus to enter the host cells. ACE2 is an iso-form of the angiotensin-converting enzyme 1 (ACE). The actions of ACE2 counterbalance the clas-sic renin-angiotensin system (RAS) axis through the production of Ang 1-7, which promotes car-diovascular, renal, and lung-protective effects. The ACE2 is not the only route for SARS-CoV-2 to enter the host cells. However, due to its roles in the RAS and its participation in the SARS-CoV-2 virulence, ACE2 has gained attention regarding viral mechanisms of pathogenesis, effects of drugs that interfere with the RAS, and as a potential target for therapeutic strategies for the damages caused by SARS-CoV-2 infection. Among other tissues, ACE2 gene expression seems to be in-creased in the lungs upon SARS-CoV-2 infection;however, amid other variables, expression and/or activity of ACE2 is shown as a disease, sex, and age-dependent. The present review covers critical aspects for a comprehensive understanding of ACE2 and its current involvement in SARS-CoV-2 infection and the development of COVID-19.Copyright © 2021 Bentham Science Publishers.