Ace receptor
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Summary
10 papers analyzed
These studies suggest that ACE and ACE2 receptors play crucial roles in cardiovascular regulation, COVID-19 infection, and lung protection, with potential implications for drug development and treatment strategies.
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ACE Receptor: Insights and Implications
ACE Receptor and Its Role in the Renin-Angiotensin System
The angiotensin-converting enzyme (ACE) plays a crucial role in the renin-angiotensin system (RAS), which regulates blood pressure and fluid balance. ACE converts angiotensin I to the potent vasoconstrictor angiotensin II, which then acts on the AT1 and AT2 receptors to mediate vasoconstriction and vasodilation, respectively. ACE2, a homolog of ACE, counterbalances these effects by degrading angiotensin II to angiotensin-(1-7), which has vasodilatory and anti-inflammatory properties.
ACE2 as a Receptor for SARS-CoV-2
ACE2 has gained significant attention as the receptor for the SARS-CoV-2 virus, responsible for the COVID-19 pandemic. The virus's spike protein binds to ACE2, facilitating viral entry into host cells . This interaction is not limited to the lungs but extends to various tissues, including the heart, kidneys, and intestines, explaining the multi-organ impact of COVID-19 .
Epigenetic and Transcriptional Regulation of ACE2
The expression of ACE2 is regulated both transcriptionally and post-transcriptionally, with two promoters controlling its expression in different tissues. ACE2 is highly expressed in the small intestine, kidneys, and heart, and its regulation involves various chemical and mechanical signal transduction pathways. This regulation is crucial for understanding tissue-specific responses to SARS-CoV-2 infection.
Impact of ACE2 Downregulation in COVID-19
The binding of SARS-CoV-2 to ACE2 leads to the downregulation of ACE2 receptors, exacerbating the effects of angiotensin II. This downregulation results in increased pulmonary inflammation and coagulation, contributing to the severe respiratory symptoms observed in COVID-19 patients. The loss of ACE2's protective effects further amplifies the detrimental impact of the RAS, making ACE2 a critical target for therapeutic interventions.
ACE2 and Cardiovascular Therapies
The role of ACE2 in cardiovascular health extends beyond its function as a viral receptor. ACE inhibitors (ACE-Is) and angiotensin II receptor blockers (ARBs) are commonly used to treat hypertension and other cardiovascular diseases. However, their impact on ACE2 expression and COVID-19 outcomes is complex. While some studies suggest that these drugs may increase ACE2 expression, potentially facilitating viral entry, others indicate a downregulation of ACE2 at the mRNA and protein levels in treated patients. This paradox highlights the need for randomized clinical trials to determine the safety and efficacy of these drugs in COVID-19 patients.
ACE/ACE2 and Kinin B2 Receptor Interaction
Recent research has revealed that the interaction between ACE and the kinin B2 receptor modulates ACE activity. Coexpression of the kinin B2 receptor with ACE leads to increased ACE activity, which can be blocked by the B2 receptor antagonist icatibant. This interaction is significant in endothelial cells, where both proteins are naturally expressed, and suggests new avenues for understanding the regulation of ACE activity.
Conclusion
The ACE receptor, particularly ACE2, plays a multifaceted role in both cardiovascular regulation and as a critical entry point for SARS-CoV-2. Understanding the regulation and interaction of ACE and ACE2 with other receptors and pathways is essential for developing effective treatments for COVID-19 and related cardiovascular conditions. Further research and clinical trials are necessary to unravel the complexities of ACE2 modulation and its implications for therapy.
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