SARS-CoV-2 effects on the renin-angiotensin-aldosterone system, therapeutic implications

doi:10.1111/apha.13608

Editorial

. 2021 Apr;231(4):e13608.

doi: 10.1111/apha.13608. Epub 2021 Jan 7.

SARS-CoV-2 effects on the renin-angiotensin-aldosterone system, therapeutic implications

Qing Ye¹, En Yin Lai^{2

3}, Friedrich C Luft⁴, Pontus B Persson³, Jianhua Mao¹

Affiliations

¹ National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
² Department of Physiology, School of Basic Medical Sciences, Zhejiang University School of Medicine, Hangzhou, China.
³ Institute of Vegetative Physiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁴ Experimental and Clinical Research Center MDC/Charité, Berlin, Germany.

PMID: 33350096
PMCID: PMC7883221
DOI: 10.1111/apha.13608

Editorial

SARS-CoV-2 effects on the renin-angiotensin-aldosterone system, therapeutic implications

Qing Ye et al. Acta Physiol (Oxf). 2021 Apr.

. 2021 Apr;231(4):e13608.

doi: 10.1111/apha.13608. Epub 2021 Jan 7.

Authors

Qing Ye¹, En Yin Lai^{2

3}, Friedrich C Luft⁴, Pontus B Persson³, Jianhua Mao¹

Affiliations

¹ National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
² Department of Physiology, School of Basic Medical Sciences, Zhejiang University School of Medicine, Hangzhou, China.
³ Institute of Vegetative Physiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁴ Experimental and Clinical Research Center MDC/Charité, Berlin, Germany.

PMID: 33350096
PMCID: PMC7883221
DOI: 10.1111/apha.13608

No abstract available

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

**FIGURE 1**
Possible effects of COVID‐19 on kidney RAS and its treatment. A, SARS‐CoV‐2 gains entry into the cell by binding to angiotensin‐converting enzyme 2 (ACE‐2) and weakens the activity of ACE‐2, then elevates angiotensin II (ANGII), which drives kidney injury by activating the angiotensin II type 1 receptor (AT1R), causing inflammation and fibrosis (left panel). The addition of angiotensin‐converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) could increase ACE‐2 abundance and thus enhance viral entry, and diminish the production of ANGII. Enhanced angiotensin‐(1‐7) generation takes place by ACE‐2, which promotes the activation of Mas receptor (MasR), thus attenuating inflammation and fibrosis (right panel). B, SARS‐CoV‐2 gains entry into the cell by binding to angiotensin‐converting enzyme 2 (ACE‐2) (left panel). Human recombinant soluble ACE‐2 (hrsACE‐2) binds to Spike protein can reduce binding to ACE‐2 at the membrane, thus inhibiting SARS‐CoV‐2 internalization (right panel)

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References

1. Fournier D, Luft FC, Bader M, Ganten D, Andrade‐Navarro MA. Emergence and evolution of the renin‐angiotensin‐aldosterone system. J Mol Med (Berl). 2012;90(5):495‐508. - PMC - PubMed
1. Imai Y, Kuba K, Rao S, et al. Angiotensin‐converting enzyme 2 protects from severe acute lung failure. Nature. 2005;436(7047):112‐116. - PMC - PubMed
1. Wang N, Shi X, Jiang L, et al. Structure of MERS‐CoV spike receptor‐binding domain complexed with human receptor DPP4. Cell Res. 2013;23(8):986‐993. - PMC - PubMed
1. Sun J, Zhu A, Li H, et al. Isolation of infectious SARS‐CoV‐2 from urine of a COVID‐19 patient. Emerg Microbes Infect. 2020;9(1):991‐993. - PMC - PubMed
1. Ye Q, Wang B, Mao J. The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID‐19. J Infect. 2020;80(6):607‐613. - PMC - PubMed

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[1] Fournier D, Luft FC, Bader M, Ganten D, Andrade‐Navarro MA. Emergence and evolution of the renin‐angiotensin‐aldosterone system. J Mol Med (Berl). 2012;90(5):495‐508. - PMC - PubMed

[2] Fournier D, Luft FC, Bader M, Ganten D, Andrade‐Navarro MA. Emergence and evolution of the renin‐angiotensin‐aldosterone system. J Mol Med (Berl). 2012;90(5):495‐508. - PMC - PubMed

[3] Imai Y, Kuba K, Rao S, et al. Angiotensin‐converting enzyme 2 protects from severe acute lung failure. Nature. 2005;436(7047):112‐116. - PMC - PubMed

[4] Imai Y, Kuba K, Rao S, et al. Angiotensin‐converting enzyme 2 protects from severe acute lung failure. Nature. 2005;436(7047):112‐116. - PMC - PubMed

[5] Wang N, Shi X, Jiang L, et al. Structure of MERS‐CoV spike receptor‐binding domain complexed with human receptor DPP4. Cell Res. 2013;23(8):986‐993. - PMC - PubMed

[6] Wang N, Shi X, Jiang L, et al. Structure of MERS‐CoV spike receptor‐binding domain complexed with human receptor DPP4. Cell Res. 2013;23(8):986‐993. - PMC - PubMed

[7] Sun J, Zhu A, Li H, et al. Isolation of infectious SARS‐CoV‐2 from urine of a COVID‐19 patient. Emerg Microbes Infect. 2020;9(1):991‐993. - PMC - PubMed

[8] Sun J, Zhu A, Li H, et al. Isolation of infectious SARS‐CoV‐2 from urine of a COVID‐19 patient. Emerg Microbes Infect. 2020;9(1):991‐993. - PMC - PubMed

[9] Ye Q, Wang B, Mao J. The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID‐19. J Infect. 2020;80(6):607‐613. - PMC - PubMed

[10] Ye Q, Wang B, Mao J. The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID‐19. J Infect. 2020;80(6):607‐613. - PMC - PubMed

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SARS-CoV-2 effects on the renin-angiotensin-aldosterone system, therapeutic implications

Affiliations

SARS-CoV-2 effects on the renin-angiotensin-aldosterone system, therapeutic implications

Authors

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Conflict of interest statement

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