ACE2, Metformin, and COVID-19

COVID-19 is becoming a leading cause of mortality throughout the world, and few effective therapies are currently available. Angiotensin converting enzyme 2 (ACE2) is essential to COVID-19 pathogenesis, as the binding of SARS-CoV-2 spike protein (S protein) is required for viral entry and developmen...

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Published iniScience Vol. 23; no. 9; p. 101425
Main Authors Malhotra, Atul, Hepokoski, Mark, McCowen, Karen C., Y-J Shyy, John
Format Journal Article Web Resource
LanguageEnglish
Published United States Elsevier Inc 25.09.2020
Elsevier BV
Elsevier
Subjects
Endocrinology
Review
Virology
Endocrinology
Virology
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Summary:COVID-19 is becoming a leading cause of mortality throughout the world, and few effective therapies are currently available. Angiotensin converting enzyme 2 (ACE2) is essential to COVID-19 pathogenesis, as the binding of SARS-CoV-2 spike protein (S protein) is required for viral entry and development of COVID-19. ACE2 regulates the protective arm of the renin-angiotensin-aldosterone system (RAAS) that endows anti-hypertensive and anti-inflammatory effects in the cardiovascular and pulmonary systems. Preclinical data suggest ACE2 might be downregulated after SARS-CoV-2 binding, and treatments that increase ACE2 may prevent cardiopulmonary injury. Development, testing, and mass production of novel ACE2 therapies may take years, whereas more effective treatments for COVID-19 are needed urgently. Metformin is a widely available anti-diabetic agent that has an excellent safety profile, and clinical and preclinical data suggest metformin may offer cardiopulmonary protection in COVID-19 via enhanced ACE2 expression. Virology; Endocrinology
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ISSN:2589-0042
2589-0042
DOI:10.1016/j.isci.2020.101425