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The Yin and Yang of ACE/ACE2 Pathways: The Rationale for the Use of Renin-Angiotensin System Inhibitors in COVID-19 Patients.
Cells. 2020 07 16; 9(7)C

Abstract

The article describes the rationale for inhibition of the renin-angiotensin system (RAS) pathways as specific targets in patients infected by SARS-CoV-2 in order to prevent positive feedback-loop mechanisms. Based purely on experimental studies in which RAS pathway inhibitors were administered in vivo to humans/rodents, a reasonable hypothesis of using inhibitors that block both ACE and ACE2 zinc metalloproteases and their downstream pathways in COVID-19 patients will be proposed. In particular, metal (zinc) chelators and renin inhibitors may work alone or in combination to inhibit the positive feedback loops (initially triggered by SARS-CoV-2 and subsequently sustained by hypoxia independently on viral trigger) as both arms of renin-angiotensin system are upregulated, leading to critical, advanced and untreatable stages of the disease.

Authors+Show Affiliations

Department of Biomolecular Sciences, University of Urbino "Carlo Bo", 61032 Urbino, Italy. INFN-Gran Sasso National Laboratory, Assergi, 67100 L'Aquila, Italy.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32708755

Citation

Zamai, Loris. "The Yin and Yang of ACE/ACE2 Pathways: the Rationale for the Use of Renin-Angiotensin System Inhibitors in COVID-19 Patients." Cells, vol. 9, no. 7, 2020.
Zamai L. The Yin and Yang of ACE/ACE2 Pathways: The Rationale for the Use of Renin-Angiotensin System Inhibitors in COVID-19 Patients. Cells. 2020;9(7).
Zamai, L. (2020). The Yin and Yang of ACE/ACE2 Pathways: The Rationale for the Use of Renin-Angiotensin System Inhibitors in COVID-19 Patients. Cells, 9(7). https://doi.org/10.3390/cells9071704
Zamai L. The Yin and Yang of ACE/ACE2 Pathways: the Rationale for the Use of Renin-Angiotensin System Inhibitors in COVID-19 Patients. Cells. 2020 07 16;9(7) PubMed PMID: 32708755.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Yin and Yang of ACE/ACE2 Pathways: The Rationale for the Use of Renin-Angiotensin System Inhibitors in COVID-19 Patients. A1 - Zamai,Loris, Y1 - 2020/07/16/ PY - 2020/03/20/received PY - 2020/06/10/revised PY - 2020/06/25/accepted PY - 2020/7/26/entrez PY - 2020/7/28/pubmed PY - 2020/8/12/medline KW - IL-10 KW - Mas receptor KW - asthma KW - cardiac dysfunction KW - eosinophil KW - hypertension KW - hypoxia KW - lung fibrosis KW - renin-angiotensin system KW - severe acute respiratory syndrome coronavirus-2 JF - Cells JO - Cells VL - 9 IS - 7 N2 - The article describes the rationale for inhibition of the renin-angiotensin system (RAS) pathways as specific targets in patients infected by SARS-CoV-2 in order to prevent positive feedback-loop mechanisms. Based purely on experimental studies in which RAS pathway inhibitors were administered in vivo to humans/rodents, a reasonable hypothesis of using inhibitors that block both ACE and ACE2 zinc metalloproteases and their downstream pathways in COVID-19 patients will be proposed. In particular, metal (zinc) chelators and renin inhibitors may work alone or in combination to inhibit the positive feedback loops (initially triggered by SARS-CoV-2 and subsequently sustained by hypoxia independently on viral trigger) as both arms of renin-angiotensin system are upregulated, leading to critical, advanced and untreatable stages of the disease. SN - 2073-4409 UR - https://www.unboundmedicine.com/medline/citation/32708755/The_Yin_and_Yang_of_ACE/ACE2_Pathways:_The_Rationale_for_the_Use_of_Renin_Angiotensin_System_Inhibitors_in_COVID_19_Patients_ L2 - https://www.mdpi.com/resolver?pii=cells9071704 DB - PRIME DP - Unbound Medicine ER -