Drugs acting on the renin–angiotensin system and SARS-CoV-2. Issue 4 (April 2021)

• Record Type: Journal Article
• Authors: Vitiello, Antonio; Pelliccia, Chiara; Ferrara, Francesco
• Is Part Of: Drug discovery today. Volume 26:Issue 4(2021)
• Page Start: 870
• Page End: 874
• Publication Date: 2021-04
• Subjects: Drugs -- Design -- Periodicals; Drugs -- Research -- Periodicals; 615.1
• DOI: 10.1016/j.drudis.2021.01.010
• Languages: English
• ISSNs: 1359-6446

Abstract

Highlights: The angiotensin-converting enzyme 2 (ACE-2) facilitates access of SARS-CoV-2 in cells. Therapeutic modulation of ACE-2 could be of clinical benefit. Drugs acting on RAS should not be discontinued. An increase of ACE-2 can play a protective role for the respiratory system. Abstract : Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the ongoing global Coronavirus 2019 (COVID-19) pandemic, resulting in thousands of deaths worldwide and representing a health challenge with few precedents in human history. Angiotensin-converting enzyme 2 (ACE-2) facilitates the access of SARS-CoV-2 to cells. Therapeutic agents acting on the renin–angiotensin system (RAS) might be able to modulate the concentration of ACE-2 and the various components of the system. Here, we discuss current pharmacological, molecular, and clinical evidence to investigate whether drugs acting on RAS with modulation of the ACE-2 concentration have added value in combating SARS-CoV-2 infection. We also highlight the possible deleterious action of the ACE/Ang-II/AT-1r axis and possible beneficial role of the ACE-2/Ang 1-7/MasR axis in acute respiratory distress syndrome (ARDS) caused by SARS-CoV-2, discussing the possibility of addressing the various RAS components with drug treatments to improve clinical outcomes.