Determination of soluble angiotensin-converting enzyme 2 in saliva samples and its association with nicotine

Abstract

Introduction: The Angiotensin-Converting Enzyme 2 (ACE2) is the main receptor of the SARS-CoV-2. There is contradictory evidence on how the exposure to nicotine may module the concentration of soluble ACE2 (sACE2). The aim of this study was to assess the association between nicotine and sACE2 concentrations in saliva samples.

Methods: Pooled analysis performed with data retrieved from two studies (n = 634 and n = 302). Geometric mean (GM) concentrations of sACE2, both total and relative to the total amount of protein in the sample, were compared according to sociodemographic variables and variables associated to nicotine. Multivariable linear regression models were fitted to explore the associations of sACE2 with nicotine adjusting for sex, age and body mass index. Spearman's rank-correlation coefficients were estimated between the concentrations of nicotine and cotinine, and pack-years, the concentration of relative sACE2 and the isoforms of sACE2.

Results: We observed a significant increase of 0.108‰ and 0.087 ng/μl in the relative and absolute salivary sACE2 GM concentrations, respectively, between the lowest and highest nicotine levels. Similar results were observed for cotinine. These associations did not change in the multivariable linear models. There was a low correlation of nicotine and cotinine concentration with the concentration of relative salivary sACE2 (r_s = 0.153 and r_s = 0.132, respectively), pack-years (r_s = 0.222 and r_s = 0.235, respectively) and with the concentration of isoform 40 KDa (r_s = 0.193 and r_s = 0.140, respectively).

Conclusion: Salivary nicotine concentration seems to be limitedly associated with the concentration of sACE2.

Keywords: Angiotensin-converting enzyme 2; COVID-19; Cotinine; Nicotine.