The Renin-Angiotensin System: A Key Role in SARS-CoV-2-Induced COVID-19
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), was first identified in Eastern Asia (Wuhan, China) in December 2019. The virus then spread to Europe and across all continents where it has led to higher mortality and...
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2021
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oai:doaj.org-article:736d597a080d4006935345b422e3a0832021-11-25T18:28:36ZThe Renin-Angiotensin System: A Key Role in SARS-CoV-2-Induced COVID-1910.3390/molecules262269451420-3049https://doaj.org/article/736d597a080d4006935345b422e3a0832021-11-01T00:00:00Zhttps://www.mdpi.com/1420-3049/26/22/6945https://doaj.org/toc/1420-3049The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), was first identified in Eastern Asia (Wuhan, China) in December 2019. The virus then spread to Europe and across all continents where it has led to higher mortality and morbidity, and was declared as a pandemic by the World Health Organization (WHO) in March 2020. Recently, different vaccines have been produced and seem to be more or less effective in protecting from COVID-19. The renin–angiotensin system (RAS), an essential enzymatic cascade involved in maintaining blood pressure and electrolyte balance, is involved in the pathogenicity of COVID-19, since the angiotensin-converting enzyme II (ACE2) acts as the cellular receptor for SARS-CoV-2 in many human tissues and organs. In fact, the viral entrance promotes a downregulation of ACE2 followed by RAS balance dysregulation and an overactivation of the angiotensin II (Ang II)–angiotensin II type I receptor (AT1R) axis, which is characterized by a strong vasoconstriction and the induction of the profibrotic, proapoptotic and proinflammatory signalizations in the lungs and other organs. This mechanism features a massive cytokine storm, hypercoagulation, an acute respiratory distress syndrome (ARDS) and subsequent multiple organ damage. While all individuals are vulnerable to SARS-CoV-2, the disease outcome and severity differ among people and countries and depend on a dual interaction between the virus and the affected host. Many studies have already pointed out the importance of host genetic polymorphisms (especially in the RAS) as well as other related factors such age, gender, lifestyle and habits and underlying pathologies or comorbidities (diabetes and cardiovascular diseases) that could render individuals at higher risk of infection and pathogenicity. In this review, we explore the correlation between all these risk factors as well as how and why they could account for severe post-COVID-19 complications.George El-ArifAntonella FarhatShaymaa KhazaalCédric AnnweilerHervé KovacicYingliang WuZhijian CaoZiad FajlounZiad Abi KhattarJean Marc SabatierMDPI AGarticleSARS-CoV-2COVID-19ACE-2Ang II/AT1R axisRAS imbalancecytokine stormOrganic chemistryQD241-441ENMolecules, Vol 26, Iss 6945, p 6945 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
SARS-CoV-2 COVID-19 ACE-2 Ang II/AT1R axis RAS imbalance cytokine storm Organic chemistry QD241-441 |
| spellingShingle |
SARS-CoV-2 COVID-19 ACE-2 Ang II/AT1R axis RAS imbalance cytokine storm Organic chemistry QD241-441 George El-Arif Antonella Farhat Shaymaa Khazaal Cédric Annweiler Hervé Kovacic Yingliang Wu Zhijian Cao Ziad Fajloun Ziad Abi Khattar Jean Marc Sabatier The Renin-Angiotensin System: A Key Role in SARS-CoV-2-Induced COVID-19 |
| description |
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), was first identified in Eastern Asia (Wuhan, China) in December 2019. The virus then spread to Europe and across all continents where it has led to higher mortality and morbidity, and was declared as a pandemic by the World Health Organization (WHO) in March 2020. Recently, different vaccines have been produced and seem to be more or less effective in protecting from COVID-19. The renin–angiotensin system (RAS), an essential enzymatic cascade involved in maintaining blood pressure and electrolyte balance, is involved in the pathogenicity of COVID-19, since the angiotensin-converting enzyme II (ACE2) acts as the cellular receptor for SARS-CoV-2 in many human tissues and organs. In fact, the viral entrance promotes a downregulation of ACE2 followed by RAS balance dysregulation and an overactivation of the angiotensin II (Ang II)–angiotensin II type I receptor (AT1R) axis, which is characterized by a strong vasoconstriction and the induction of the profibrotic, proapoptotic and proinflammatory signalizations in the lungs and other organs. This mechanism features a massive cytokine storm, hypercoagulation, an acute respiratory distress syndrome (ARDS) and subsequent multiple organ damage. While all individuals are vulnerable to SARS-CoV-2, the disease outcome and severity differ among people and countries and depend on a dual interaction between the virus and the affected host. Many studies have already pointed out the importance of host genetic polymorphisms (especially in the RAS) as well as other related factors such age, gender, lifestyle and habits and underlying pathologies or comorbidities (diabetes and cardiovascular diseases) that could render individuals at higher risk of infection and pathogenicity. In this review, we explore the correlation between all these risk factors as well as how and why they could account for severe post-COVID-19 complications. |
| format |
article |
| author |
George El-Arif Antonella Farhat Shaymaa Khazaal Cédric Annweiler Hervé Kovacic Yingliang Wu Zhijian Cao Ziad Fajloun Ziad Abi Khattar Jean Marc Sabatier |
| author_facet |
George El-Arif Antonella Farhat Shaymaa Khazaal Cédric Annweiler Hervé Kovacic Yingliang Wu Zhijian Cao Ziad Fajloun Ziad Abi Khattar Jean Marc Sabatier |
| author_sort |
George El-Arif |
| title |
The Renin-Angiotensin System: A Key Role in SARS-CoV-2-Induced COVID-19 |
| title_short |
The Renin-Angiotensin System: A Key Role in SARS-CoV-2-Induced COVID-19 |
| title_full |
The Renin-Angiotensin System: A Key Role in SARS-CoV-2-Induced COVID-19 |
| title_fullStr |
The Renin-Angiotensin System: A Key Role in SARS-CoV-2-Induced COVID-19 |
| title_full_unstemmed |
The Renin-Angiotensin System: A Key Role in SARS-CoV-2-Induced COVID-19 |
| title_sort |
renin-angiotensin system: a key role in sars-cov-2-induced covid-19 |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/736d597a080d4006935345b422e3a083 |
| work_keys_str_mv |
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