Evidence map›Paper›PMID 40868984›Full record

ArticleInternational journal of molecular sciences2025

Angiotensin-Converting Enzyme Inhibition and/or Angiotensin Receptor Blockade Modulate Cytokine Profiles and Improve Clinical Outcomes in Experimental COVID-19 Infection.

Yasmin da Silva-Santos, Roberta Liberato Pagni, Thais Helena Martins Gamon, Marcela Santiago Pacheco de Azevedo, Maria Laura Goussain Darido, Danielle Bruna Leal de Oliveira, Edson Luiz Durigon, Maria Cecília Rui Luvizotto, Hans Christian Ackerman, Claudio Romero Farias Marinho and 2 more

Abstract read
In one paragraph

Article in International journal of molecular sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Yasmin da Silva-SantosLaboratory of Cellular and Molecular Immunopathology of Malaria, Department of Clinical and Toxicological Analysis, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo 05508-000, Brazil.
Roberta Liberato PagniImmunology Laboratory, Heart Institute, Faculty of Medicine, University of São Paulo, São Paulo 05403-000, Brazil.
Thais Helena Martins GamonLaboratory of Clinical and Molecular Virology, Institute of Biomedical Sciences, Department of Microbiology, University of São Paulo, São Paulo 05508-000, Brazil.
Marcela Santiago Pacheco de AzevedoLaboratory of Clinical and Molecular Virology, Institute of Biomedical Sciences, Department of Microbiology, University of São Paulo, São Paulo 05508-000, Brazil.ORCID 0000-0001-5694-4578
Maria Laura Goussain DaridoLaboratory of Clinical and Molecular Virology, Institute of Biomedical Sciences, Department of Microbiology, University of São Paulo, São Paulo 05508-000, Brazil.ORCID 0000-0002-2042-6776
Danielle Bruna Leal de OliveiraLaboratory of Clinical and Molecular Virology, Institute of Biomedical Sciences, Department of Microbiology, University of São Paulo, São Paulo 05508-000, Brazil.
Edson Luiz DurigonLaboratory of Clinical and Molecular Virology, Institute of Biomedical Sciences, Department of Microbiology, University of São Paulo, São Paulo 05508-000, Brazil.ORCID 0000-0003-4898-6553
Maria Cecília Rui LuvizottoSchool of Veterinary Medicine of Araçatuba, São Paulo State University, São Paulo 16050-680, Brazil.
Hans Christian AckermanPhysiology Unit, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, Rockville, MD 20852, USA.ORCID 0000-0003-4940-3305
Claudio Romero Farias MarinhoLaboratory of Experimental Immunoparasitology, Institute of Biomedical Sciences, Department of Parasitology, University of São Paulo, São Paulo 05508-000, Brazil.ORCID 0000-0002-1227-3845
Leonardo José de Moura CarvalhoLaboratory of Malaria Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil.ORCID 0000-0003-0133-6430
Sabrina EpiphanioLaboratory of Cellular and Molecular Immunopathology of Malaria, Department of Clinical and Toxicological Analysis, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo 05508-000, Brazil.ORCID 0000-0001-6094-9750

Funding

Coordenação de Aperfeicoamento de Pessoal de Nível Superior 88887.509097/2020-00 and 88887.929469/2023-00Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro E-26/200.314/2022 - 260923Fundação de Amparo à Pesquisa do Estado de São Paulo 2022/13150-0 and 2023/05478-8Fundação Oswaldo Cruz VPPCB-005-FIO-20-2-49National Council for Scientific and Technological Development 316462/2021-7; 307193/2023-3; 403464/2023-4 and 304033/2021-9NIAID/NIH AI001150 to HCA
6 · The paper itself

Abstract

The regulation of angiotensin-converting enzyme 2 (ACE2) expression by medications such as ACE inhibitors (ACEis) and angiotensin receptor blockers (ARBs) has raised critical questions regarding their potential benefits and risks during COVID-19. ACE2, a regulator of blood pressure through the renin-angiotensin system (RAS), is the primary receptor for SARS-CoV-2. ACEis and ARBs can modulate ACE2 expression, potentially exacerbating viral load. However, the risks of higher viral load could be mitigated by favorable anti-inflammatory responses associated with ACEi and ARB use, highlighting the complexity of their impact on viral replication and disease outcomes. This study investigates the effects of sustained Losartan monotherapy (ARB) and combination Losartan + Lisinopril (ARB + ACEi) on viral replication, inflammation, lung function, and clinical measures of disease severity in a murine model of severe COVID-19 involving humanized ACE2 transgenic mice infected with SARS-CoV-2 Wuhan strain. Both ARB and ARB + ACEi treatments led to increased ACE2 expression in the lungs and higher viral load post-infection. Despite this, the ARB + ACEi combination improved clinical scores, reduced weight loss and inflammatory cytokine levels, and preserved lung function, though it did not improve survival. Overall, the results of these controlled experiments provide insight into the complex dynamics of ACEi and ARB use in COVID-19; while these drugs induce expression of the ACE2 receptor and increase viral load, they provide compensatory modulation of the inflammatory response that appears to diminish severity of the infection.

Indexed as

Angiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsCOVID-19 Drug TreatmentCytokinesAngiotensin-Converting Enzyme 2AnimalsCOVID-19Disease Models, AnimalFemaleHumansLisinoprilLosartanLungMaleMiceMice, TransgenicACE2 protein, humanAngiotensin-Converting Enzyme 2Angiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsCytokinesLisinoprilLosartanCOVID-19K18-hACE2 micelisinoprilLosartanSARS-CoV-2

Identifiers

PMID40868984
PMCPMC12387000

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.