PMC:7161517 / 9777-11799 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7161517","sourcedb":"PMC","sourceid":"7161517","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7161517","text":"Because of the importance of the RAS in cardiovascular disease, its regulation via ACE inhibitors, ARBs, and MRAs has played an essential role in the management of cardiovascular diseases (Central Illustration ).\nCentral Illustration The Renin-Angiotensin System Interaction With COVID-19\nNormally, angiotensin I (Ang I) is converted to Ang II via angiotensin-converting enzyme (ACE), which could be inhibited by ACE inhibitors. The pro-inflammatory effects of Ang II are mediated through AT1R in several ways: 1) in the zona glomerulosa of the adrenal medulla, it stimulates aldosterone secretion and binding to mineralocorticoid receptors to promote water reabsorption and to increase salt retention; it is inhibited by mineralocorticoid receptor antagonists (MRAs); 2) in the posterior pituitary, Ang II stimulates antidiuretic hormone secretion to promote water retention; and 3) in other tissues, it stimulates pathways responsible for hypertrophy, fibrosis, oxidative stress, and apoptosis. These effects are attenuated by angiotensin receptor blockers (ARBs), which block Ang II binding to AT1R. Ang II can also be converted to angiotensin 1-7 (Ang 1-7) via ACE2, which stimulates the Mas receptor promoting anti-inflammatory benefits. The ACE2/Ang1-7/Mas axis acts as a counter regulatory pathway to the traditional renin-angiotensin system (RAS). AT1R and ACE2 are coupled. Ang II binding to AT1R allows dissociation of ACE2 and subsequent degradation. ARB prevents dissociation of ACE2 and renders it availability for unused Ang II conversion to Ang 1-7. ACE2 has been identified as the targeted receptor for both the severe acute respiratory syndrome coronavirus (SARS-CoV) 2 and SARS-CoV. ACE2 mediates S protein binding that stimulates viral entry into the host cytosol that results in infection and viral replication. Diversion of Ang II towards ACE2 could competitively inhibit viral binding and also counter regulate the adverse effects caused by AT1R and improve outcomes by Mas R−based favorable 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