On 11 March 2020, the World Health Organization (WHO) declared the corona virus disease 2019 (COVID-19) outbreak as a ‘pandemic’.1 No valid therapy for COVID-19 is actually available. Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is empirically treated with antivirals, antimalarics,tocilizumab, etc.2 Production of a vaccine for COVID-19 has been attempted, although approval needs time. We describe a possible, alternative approach for treating COVID-19. Lymphocyte count hasbeen associated with increased disease severityrisk.3 Patients who died from COVID-19 showed a significantly lower lymphocyte count than survivors, therefore this should be closelymonitored.3 Repletion of lymphocytes couldprobably have beneficial effects on recovery. A recent hypothesis suggests that the inhibition of the angiotensin 1 receptor (AT1R) may provide benefits to COVID-19 patients.4 Thishypothesis is based on the observation that the SARS-CoV-2 virus uses angiotensin-converting enzyme 2 (ACE2) as a receptor to bind thevirus to the bronchial cell membrane. Theenzymes ACE and ACE2 belong to the samepeptidase family but have two very different physiological functions. ACE cleaves angiotensin I to generate angiotensin II (Ang II), whichbinds to and activates AT1R, and thus promoting vasoconstriction. ACE2 cleaves Ang II and generates angiotensin 1-7, a powerful vasodilator acting through Mas receptors. AT1R antagonists are widely used in hypertensive patientsbut they increase the ACE2 cardiac expressionin rats5 and the urinary concentration of ACE2.6 It has been demonstrated that the binding ofvirus to ACE2 leads to ACE2 down-regulation.
Neprilysin inhibitor-angiotensin II receptor blocker combination (sacubitril/valsartan): rationale for adoption in SARS-CoV-2 patients
Ciccone M. M.;Scicchitano Pietro
;
2020-01-01
Abstract
On 11 March 2020, the World Health Organization (WHO) declared the corona virus disease 2019 (COVID-19) outbreak as a ‘pandemic’.1 No valid therapy for COVID-19 is actually available. Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is empirically treated with antivirals, antimalarics,tocilizumab, etc.2 Production of a vaccine for COVID-19 has been attempted, although approval needs time. We describe a possible, alternative approach for treating COVID-19. Lymphocyte count hasbeen associated with increased disease severityrisk.3 Patients who died from COVID-19 showed a significantly lower lymphocyte count than survivors, therefore this should be closelymonitored.3 Repletion of lymphocytes couldprobably have beneficial effects on recovery. A recent hypothesis suggests that the inhibition of the angiotensin 1 receptor (AT1R) may provide benefits to COVID-19 patients.4 Thishypothesis is based on the observation that the SARS-CoV-2 virus uses angiotensin-converting enzyme 2 (ACE2) as a receptor to bind thevirus to the bronchial cell membrane. Theenzymes ACE and ACE2 belong to the samepeptidase family but have two very different physiological functions. ACE cleaves angiotensin I to generate angiotensin II (Ang II), whichbinds to and activates AT1R, and thus promoting vasoconstriction. ACE2 cleaves Ang II and generates angiotensin 1-7, a powerful vasodilator acting through Mas receptors. AT1R antagonists are widely used in hypertensive patientsbut they increase the ACE2 cardiac expressionin rats5 and the urinary concentration of ACE2.6 It has been demonstrated that the binding ofvirus to ACE2 leads to ACE2 down-regulation.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
