ReviewReviews in endocrine & metabolic disorders2022
Functional ACE2 deficiency leading to angiotensin imbalance in the pathophysiology of COVID-19.
Review in Reviews in endocrine & metabolic disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 31 citations in OpenAlex.
- Isolation and characterization of LH5, a novel rodent Embecovirus from Rattus tanezumi with respiratory tropism in a mouse model.BMC biology · 2026Article
- Natural Fatty Acids as Dual ACE2-Inflammatory Modulators: Integrated Computational Framework for Pandemic Preparedness.International journal of molecular sciences · 2025Article
- Diabetes Mellitus, Energy Metabolism, and COVID-19.Endocrine reviews · 2024Review
- The severity of COVID-19 in hypertensive patients is associated with mirSNPs in the 3' UTR ofJournal of Taibah University Medical Sciences · 2023Article
- Diabetic Ketoacidosis and Long-term Insulin Requirements in Youths with Newly Diagnosed Type 2 Diabetes During the SARS-CoV-2 Pandemic.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2023Article
- Angiotensin converting enzyme 2 gene expression and markers of oxidative stress are correlated with disease severity in patients with COVID-19.Molecular biology reports · 2023Article
- Sex and age affect acute and persisting COVID-19 illness.Scientific reports · 2023Observational
- Angiotensin-Converting Enzyme 2 Expression and Severity of SARS-CoV-2 Infection.Microorganisms · 2023Review
- Comprehensive molecular expression profiling of SARS-CoV-associated factors in the endometrium across the menstrual cycle and elevated susceptibility in women with recurrent pregnancy loss.Frontiers in genetics · 2023Article
- Article
- Decrease in Angiotensin-Converting Enzyme activity but not concentration in plasma/lungs in COVID-19 patients offers clues for diagnosis/treatment.Molecular therapy. Methods & clinical development · 2022Article
- Adipose tissue in COVID-19: detection of SARS-CoV-2 in adipocytes and activation of the interferon-alpha response.Journal of endocrinological investigation · 2022Article
- SNPs of ACE1 (rs4343) and ACE2 (rs2285666) genes are linked to SARS-CoV-2 infection but not with the severity of disease.Virology journal · 2022Article
- Selection and Validation of siRNAs Preventing Uptake and Replication of SARS-CoV-2.Frontiers in bioengineering and biotechnology · 2022Article
- Molecular pathways involved in COVID-19 and potential pathway-based therapeutic targets.Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2022Review
- Mechanisms of SARS-CoV-2 Infection-Induced Kidney Injury: A Literature Review.Frontiers in cellular and infection microbiology · 2022Review
- Role of the Renin-Angiotensin-Aldosterone and Kinin-Kallikrein Systems in the Cardiovascular Complications of COVID-19 and Long COVID.International journal of molecular sciences · 2021Review
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
SARS-CoV-2, the virus responsible for COVID-19, uses angiotensin converting enzyme 2 (ACE2) as its primary cell-surface receptor. ACE2 is a key enzyme in the counter-regulatory pathway of the broader renin-angiotensin system (RAS) that has been implicated in a broad array of human pathology. The RAS is composed of two competing pathways that work in opposition to each other: the "conventional" arm involving angiotensin converting enzyme (ACE) generating angiotensin-2 and the more recently identified ACE2 pathway that generates angiotensin (1-7). Following the original SARS pandemic, additional studies suggested that coronaviral binding to ACE2 resulted in downregulation of the membrane-bound enzyme. Given the similarities between the two viruses, many have posited a similar process with SARS-CoV-2. Proponents of this ACE2 deficiency model argue that downregulation of ACE2 limits its enzymatic function, thereby skewing the delicate balance between the two competing arms of the RAS. In this review we critically examine this model. The available data remain incomplete but are consistent with the possibility that the broad multisystem dysfunction of COVID-19 is due in large part to functional ACE2 deficiency leading to angiotensin imbalance with consequent immune dysregulation and endothelial cell dysfunction.
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Registered trials
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