Covid-19: the renin–angiotensin system imbalance hypothesis
Open Access
- 8 June 2020
- journal article
- research article
- Published by Portland Press Ltd. in Clinical Science
- Vol. 134 (11), 1259-1264
- https://doi.org/10.1042/cs20200492
Abstract
The emergency of SARS-CoV-2 in China started a novel challenge to the scientific community. As the virus turns pandemic, scientists try to map the cellular mechanisms and pathways of SARS-CoV-2 related to the pathogenesis of Coronavirus Disease 2019 (Covid-19). After transmembrane angiotensin-converting enzyme 2 (ACE2) has been found to be SARS-CoV-2 receptor, we hypothesized an immune-hematological mechanism for Covid-19 based on renin–angiotensin system (RAS) imbalance to explain clinical, laboratory and imaging findings on disease course. We believe that exaggerated activation of ACE/Angiotensin II (Ang II)/Angiotensin Type 1 (AT1) receptor RAS axis in line with reduction of ACE2/Angiotensin-(1-7)/Mas receptor may exert a pivotal role in the pathogenesis of Covid-19. In this perspective, we discuss potential mechanisms and evidence on this hypothesis.Keywords
This publication has 30 references indexed in Scilit:
- Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathologySeminars in Immunopathology, 2017
- Epochs in the depressor/pressor balance of the renin–angiotensin systemClinical Science, 2016
- The cytokine storm of severe influenza and development of immunomodulatory therapyCellular & Molecular Immunology, 2015
- Atlas of tissue renin-angiotensin-aldosterone system in human: A transcriptomic meta-analysisScientific Reports, 2015
- IL-6 in Inflammation, Immunity, and DiseaseCold Spring Harbor Perspectives in Biology, 2014
- ACE2, angiotensin‐(1‐7) and Mas receptor axis in inflammation and fibrosisBritish Journal of Pharmacology, 2013
- Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysisThe Lancet, 2010
- Age- and gender-related difference of ACE2 expression in rat lungLife Sciences, 2006
- A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus–induced lung injuryNature Medicine, 2005
- Angiotensin-converting enzyme 2 protects from severe acute lung failureNature, 2005