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Editorial
. 2021 Apr 20;34(4):304-306.
doi: 10.1093/ajh/hpaa217.

A Cytokine/Bradykinin Storm Comparison: What Is the Relationship Between Hypertension and COVID-19?

Stephanie A Wilczynski  1 , Camilla F Wenceslau  2 , Cameron G McCarthy  2 , R Clinton Webb  1
Affiliations
Editorial

A Cytokine/Bradykinin Storm Comparison: What Is the Relationship Between Hypertension and COVID-19?

Stephanie A Wilczynski et al. Am J Hypertens. .
No abstract available

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Graphical abstract
Figure 1.
Figure 1.
ACE2 is present in the alveolar epithelium and is the receptor for SARS–CoV-2 via the spike protein. Following binding, there is decreased availability of ACE2 and therefore decreased activity. This downregulation of ACE2 by COVID-19 results in increases in the substrates of ACE2, AngII and BK. COVID-19 infection also shows evidence of an increase in HA synthase 2 expression which will upregulate the production of HA and can lead to fluid retention and decreased gas permeability and acute respiratory distress syndrome often seen in COVID-19 patients., In response to the infection, the pro-inflammatory cytokine, IL-6, is upregulated. This overexpression of IL-6 indirectly causes an increase in B1Rs on the cell surface and also indirectly causes the downregulation of SERPINA12, a suppressor for bradykinin, subsequently increasing the cell’s affinity for the uninhibited bradykinin. Abbreviations: ACE2, angiotensin-converting enzyme 2; Ang II, angiotensin II; AT1R, angiotensin II receptor type 1; AT2R, angiotensin II receptor type 2; BK, bradykinin; B1R, bradykinin-1 receptor; B2R, bradykinin-2 receptor; COVID-19, coronavirus disease 2019; HA, hyaluronic acid; HMW, high molecular weight; IL-6, interleukin-6; SARS–CoV-2, severe acute respiratory syndrome of coronavirus 2; SERPINA12, serpin family A member 12.,
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