PMC:7243768 / 5636-7377 JSONTXT

{"target":"http://pubannotation.org/docs/sourcedb/PMC/sourceid/7243768","sourcedb":"PMC","sourceid":"7243768","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7243768","text":"The ACE-2 enzyme is found bound to the cell membranes of the cells in the regions of the heart, lungs, kidney, intestines, and arteries [12]. This enzyme's function is to degrade the angiotensin II peptide, which acts as a vasoconstrictor [13]. Therefore, the ACE2 enzyme is considered to be a potential vasodilator. The SARS-CoV-2 virus binds with the ACE-2 receptor, which mediates the virus's entry into the host cells [14] via the plasma membrane or endocytosis through the release of proteases [2]. The activated immune cells secrete chemokines and inflammatory cytokines into the endothelial cells of pulmonary arteries [15]. The angiotensin-converting enzyme (ACE) is required to convert angiotensin I to angiotensin II [16]. The angiotensin II produced results in vasoconstriction upon the activation of angiotensin II receptors due to which there is an increase in blood pressure [17,18]. Therefore, ACEi and ARBs are used as anti-hypertensive treatment options [18] (Fig. 1 ).\nFig. 1 The abnormal activation of the Renin-Angiotensin-Aldosterone system (RAAS) pathway via the ACE-AngII-AT1R axis results in vasoconstriction (hypertension) which is treated by the usage of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs). Since ACE2 is also the binding receptor for SARS-CoV-2 and enhances the viral entry, replication decreases the level of the ACE2, leading to reduced anti-atrophy and anti-fibrosis anti-inflammation, anti-oxidant, and vasodilation further leads to decreased tissue protection. On the other hand, there is a pro-atrophy, pro-fibrosis, pro-inflammation, vasoconstriction, pro-oxidant, and acute lung injury via angiotensin II type 1 receptor which leads to tissue 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