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Covid-19: the renin-angiotensin system imbalance hypothesis.
Clin Sci (Lond). 2020 Jun 12; 134(11):1259-1264.CS

Abstract

The emergency of SARS-CoV-2 in China started a novel challenge to the scientific community. As the virus turns pandemic, scientists try to map the cellular mechanisms and pathways of SARS-CoV-2 related to the pathogenesis of Coronavirus Disease 2019 (Covid-19). After transmembrane angiotensin-converting enzyme 2 (ACE2) has been found to be SARS-CoV-2 receptor, we hypothesized an immune-hematological mechanism for Covid-19 based on renin-angiotensin system (RAS) imbalance to explain clinical, laboratory and imaging findings on disease course. We believe that exaggerated activation of ACE/Angiotensin II (Ang II)/Angiotensin Type 1 (AT1) receptor RAS axis in line with reduction of ACE2/Angiotensin-(1-7)/Mas receptor may exert a pivotal role in the pathogenesis of Covid-19. In this perspective, we discuss potential mechanisms and evidence on this hypothesis.

Links

Authors+Show Affiliations

Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

Simões E Silva AC

Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

MeSH

Angiotensin-Converting Enzyme 2Angiotensin-Converting Enzyme InhibitorsAnimalsBetacoronavirusCOVID-19Coronavirus InfectionsHumansPandemicsPeptidyl-Dipeptidase APneumonia, ViralRenin-Angiotensin SystemSARS-CoV-2

Pub Type(s)

Journal Article

Review

Language

eng

PubMed ID

32507883

Clinical Trial Links

The Clinical Manifestations of the Severe Acute Respiratory Syndrome, Coronavirus 2( SARS-Cov-2 ); Not Only Pulmonary

Citation

Lanza, Katharina, et al. "Covid-19: the Renin-angiotensin System Imbalance Hypothesis." Clinical Science (London, England : 1979), vol. 134, no. 11, 2020, pp. 1259-1264.

Lanza K, Perez LG, Costa LB, et al. Covid-19: the renin-angiotensin system imbalance hypothesis. Clin Sci (Lond). 2020;134(11):1259-1264.

Lanza, K., Perez, L. G., Costa, L. B., Cordeiro, T. M., Palmeira, V. A., Ribeiro, V. T., & Simões E Silva, A. C. (2020). Covid-19: the renin-angiotensin system imbalance hypothesis. Clinical Science (London, England : 1979), 134(11), 1259-1264. https://doi.org/10.1042/CS20200492

Lanza K, et al. Covid-19: the Renin-angiotensin System Imbalance Hypothesis. Clin Sci (Lond). 2020 Jun 12;134(11):1259-1264. PubMed PMID: 32507883.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Covid-19: the renin-angiotensin system imbalance hypothesis. AU - Lanza,Katharina, AU - Perez,Lucas G, AU - Costa,Larissa B, AU - Cordeiro,Thiago M, AU - Palmeira,Vitria A, AU - Ribeiro,Victor T, AU - Simões E Silva,Ana Cristina, PY - 2020/4/24/received PY - 2020/5/19/revised PY - 2020/5/26/accepted PY - 2020/6/9/entrez PY - 2020/6/9/pubmed PY - 2020/6/17/medline KW - Angiotensin-Converting Enzyme 2 KW - Covid-19 KW - Renin-Angiotensin System KW - SARS-CoV-2 SP - 1259 EP - 1264 JF - Clinical science (London, England : 1979) JO - Clin Sci (Lond) VL - 134 IS - 11 N2 - The emergency of SARS-CoV-2 in China started a novel challenge to the scientific community. As the virus turns pandemic, scientists try to map the cellular mechanisms and pathways of SARS-CoV-2 related to the pathogenesis of Coronavirus Disease 2019 (Covid-19). After transmembrane angiotensin-converting enzyme 2 (ACE2) has been found to be SARS-CoV-2 receptor, we hypothesized an immune-hematological mechanism for Covid-19 based on renin-angiotensin system (RAS) imbalance to explain clinical, laboratory and imaging findings on disease course. We believe that exaggerated activation of ACE/Angiotensin II (Ang II)/Angiotensin Type 1 (AT1) receptor RAS axis in line with reduction of ACE2/Angiotensin-(1-7)/Mas receptor may exert a pivotal role in the pathogenesis of Covid-19. In this perspective, we discuss potential mechanisms and evidence on this hypothesis. SN - 1470-8736 UR - https://www.unboundmedicine.com/medline/citation/32507883/Covid_19:_the_renin_angiotensin_system_imbalance_hypothesis_ DB - PRIME DP - Unbound Medicine ER -