Role of Renin-Angiotensin System in Acute Lung Injury Caused by Viral Infection

• Published in: Infection and drug resistance Vol. 13; p. 3715
• Main Authors: Gao, Yan-Lei, Du, Yue, Zhang, Chao, Cheng, Cheng, Yang, Hai-Yan, Jin, Yue-Fei, Duan, Guang-Cai, Chen, Shuai-Yin
• Format: Journal Article
• Language: English
• Published: Dove Medical Press Limited 31.10.2020
• Subjects: Adult respiratory distress syndrome; Angiotensin II; Avian influenza; Avian influenza viruses; COVID-19; Enzyme inhibitors; Enzymes; Health aspects; Infection; Prognosis; Renin-angiotensin system; Respiratory system agents; United Kingdom; China
• ISSN: 1178-6973; 1178-6973
• DOI: 10.2147/IDRS265718

The renin-angiotensin system (RAS) is the most important regulatory system of electrolyte homeostasis and blood pressure and acts through angiotensin-converting enzyme (ACE)/angiotensin II (Ang II)/Ang II type 1 (AT1) receptor axis and angiotensin-converting enzyme 2 (ACE2)/angiotensin (1-7)/MAS receptor axis. RAS dysfunction is related to the occurrence and development of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) and causes a serious prognosis and even death. ALI/ARDS can be induced by various ways, one of which is viral infections, such as SARS-CoV, SARS-CoV-2, H5N1, H7N9, and EV71. This article reviews the specific mechanism on how RAS dysfunction affects ALI/ARDs caused by viral infections. SARS-CoV and SARS-CoV-2 enter the host cells by binding with ACE2. H5N1 and H7N9 avian influenza viruses reduce the ACE2 level in the body, and EV71 increases Ang II concentration. Treatment with angiotensin-converting enzyme inhibitor and angiotensin AT1 receptor blocker can alleviate ALI/ARDS symptoms. This review provides suggestions for the treatment of lung injury caused by viral infections. Keywords: renin angiotensin system, acute lung injury and acute respiratory distress syndrome, viral infection