Does activation of the protective Renin-Angiotensin System have therapeutic potential in COVID-19?

Mol Med. 2020 Aug 17;26(1):80. doi: 10.1186/s10020-020-00211-0.

Abstract

Infection of lung cells by the corona virus results in a loss of the balance between, on the one hand, angiotensin II-mediated stimulation of the angiotensin II type 1 receptor and, on the other hand, stimulation of the angiotensin II type 2 receptor and/or the Mas receptor. The unbalanced enhanced stimulation of the angiotensin II type 1 receptor causes inflammation, edema and contributes to the pathogenesis of severe acute respiratory distress syndrome. Here we hypothesize that stable, receptor-specific agonists of the angiotensin II type 2 receptor and of the Mas receptor are molecular medicines to treat COVID-19 patients. These agonists have therapeutic potential in the acute disease but in addition may reduce COVID-19-associated long-term pulmonary dysfunction and overall end-organ damage of this disease.

Keywords: ACE2; ARDS; AT1R; AT2R; Angiotensin; COVID-19; MasR.

MeSH terms

  • Angiotensin-Converting Enzyme 2
  • Animals
  • COVID-19
  • COVID-19 Drug Treatment
  • Clinical Trials as Topic
  • Coronavirus Infections / drug therapy
  • Humans
  • Imidazoles / pharmacology
  • Pandemics
  • Peptidyl-Dipeptidase A / metabolism*
  • Pneumonia, Viral / drug therapy
  • Proto-Oncogene Mas
  • Receptor, Angiotensin, Type 2 / agonists*
  • Receptor, Angiotensin, Type 2 / metabolism
  • Renin-Angiotensin System / drug effects*
  • Renin-Angiotensin System / physiology

Substances

  • AVE 0991
  • Imidazoles
  • MAS1 protein, human
  • Proto-Oncogene Mas
  • Receptor, Angiotensin, Type 2
  • Peptidyl-Dipeptidase A
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2