Elsevier

Drug Discovery Today

Volume 26, Issue 4, April 2021, Pages 870-874
Drug Discovery Today

Feature
Drugs acting on the renin–angiotensin system and SARS-CoV-2

https://doi.org/10.1016/j.drudis.2021.01.010Get rights and content

Highlights

  • The angiotensin-converting enzyme 2 (ACE-2) facilitates access of SARS-CoV-2 in cells.

  • Therapeutic modulation of ACE-2 could be of clinical benefit.

  • Drugs acting on RAS should not be discontinued.

  • An increase of ACE-2 can play a protective role for the respiratory system.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the ongoing global Coronavirus 2019 (COVID-19) pandemic, resulting in thousands of deaths worldwide and representing a health challenge with few precedents in human history. Angiotensin-converting enzyme 2 (ACE-2) facilitates the access of SARS-CoV-2 to cells. Therapeutic agents acting on the renin–angiotensin system (RAS) might be able to modulate the concentration of ACE-2 and the various components of the system. Here, we discuss current pharmacological, molecular, and clinical evidence to investigate whether drugs acting on RAS with modulation of the ACE-2 concentration have added value in combating SARS-CoV-2 infection. We also highlight the possible deleterious action of the ACE/Ang-II/AT-1r axis and possible beneficial role of the ACE-2/Ang 1-7/MasR axis in acute respiratory distress syndrome (ARDS) caused by SARS-CoV-2, discussing the possibility of addressing the various RAS components with drug treatments to improve clinical outcomes.

Cited by (0)

View Abstract