Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb 26;41(2):BSR20202014.
doi: 10.1042/BSR20202014.

ACE/ACE2 balance might be instrumental to explain the certain comorbidities leading to severe COVID-19 cases

Sarbashri Bank  1   2 , Subrata Kumar De  3 , Biswabandhu Bankura  4 , Smarajit Maiti  5 , Madhusudan Das  4 , Gausal A Khan  6
Affiliations

ACE/ACE2 balance might be instrumental to explain the certain comorbidities leading to severe COVID-19 cases

Sarbashri Bank et al. Biosci Rep. .

Abstract

The outbreak of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a global catastrophe. The elderly and people with comorbidity are facing a serious complication of the disease. The entry and infection strategy of SARS-CoV-2 in a host cell is raised by an amazing way of angiotensin-converting enzyme (ACE) 2 (ACE2) receptor recognition and imbalance of ACE/ACE2 in various organs, especially in the lungs. Here it has been discussed the role of interferon and protease during the receptor recognition (begining of infection) and followed by the impact of cytokine and hypoxia in the context of the balance of ACE/ACE2. It has also very concisely delineated the biochemistry and mechanism of ACE/ACE2 balance in different stages of infection and its role in comorbidity.

Keywords: ACE/ACE2; Comorbidity; Hypoxia; SARS-CoV-2.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there are no competing interests associated with the manuscript.

Figures

Figure 1
Figure 1. Balance of ACE and ACE2 activity in normal individuals and hypertensive/hyperglycemic persons and in case of infection by SARS-CoV-2
ACE converts Ang I into Ang II (arrow 1 and 2; where thick reddish arrow-(2) indicates the higher activity of ACE in hypertensive/hyperglycemic/CKD, i.e. comorbid patients) and ACE2 converts Ang II into Ang (1-7) (arrow 3 and 4) (thick green arrow demonstrates higher ACE2 activity in normal) and dotted red arrows [3” and 4”] indicate ACE2 activity (impaired activity Ɵ) after SARS-CoV-2 binding. In normal, ACE activity is counterbalanced by ACE2, (arrow 6) i.e. ACE≈ACE2; but in diseased state, imbalance of ACE and ACE2 (indicates arrow 7) and further more while SARS-CoV-2 binds to ACE2, there is high imbalance of ACE and ACE2 activity, i.e. ACE >> ACE2 because of impairement of ACE2 (arrow 8). When normals are infected by SARS-CoV-2, the balance of ACE and ACE2 shows in arrow 5. Boxes A–D represent the effect of imbalace of ACE and ACE2 activity. And this regulatory mechanism (balance/imbalance) of ACE and ACE2 is global in certain cell types. Turqoise bcakets ([ ]) represent related references in the figure.
See this image and copyright information in PMC

References

    1. Li W., Moore M.J., Vasilieva N., Sui J., Wong S.K., Berne M.A.et al. (2003) Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus. Nature 426, 450–454 10.1038/nature02145 - DOI - PMC - PubMed
    1. Qian Z., Travanty E.A., Oko L., Edeen K., Berglund A., Wang J.et al. (2013) Innate immune response of human alveolar type II cells infected with severe acute respiratory syndrome-coronavirus. Am. J. Respir. Cell Mol. Biol. 48, 742–748 10.1165/rcmb.2012-0339OC - DOI - PMC - PubMed
    1. Deeks S.G., Odorizzi P.M. and Sekaly R.P. (2017) The interferon paradox: can inhibiting an antiviral mechanism advance an HIV cure? J. Clin. Invest. 127, 103–105 10.1172/JCI91916 - DOI - PMC - PubMed
    1. Bailey C.C., Zhong G., Huang I.C. and Farzan M. (2014) IFITM-family proteins: the cell’s first line of antiviral defense. Annu. Rev. Virol. 1, 261–283 10.1146/annurev-virology-031413-085537 - DOI - PMC - PubMed
    1. Broggi A., Granucci F. and Zanoni I. (2020) Type III interferons: balancing tissue tolerance and resistance to pathogen invasion. J. Exp. Med. 217, e20190295 10.1084/jem.20190295 - DOI - PMC - PubMed

Publication types

MeSH terms