Unlocking ACE2: The enzyme that links COVID-19, heart disease, and diabetes

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Unlocking ACE2: The enzyme that links COVID-19, heart disease, and diabetes
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A recent study in the Journal of Biomedical Science examines the critical role of ACE2, an enzyme involved in blood volume and electrolyte balance, in chronic diseases like cardiovascular conditions, diabetes, and COVID-19. The research suggests that ACE2 could serve as both a disease severity biomarker and a therapeutic target.

By Neha MathurAug 28 2023Reviewed by Benedette Cuffari, M.Sc. Within the renin-angiotensin system , which regulates blood volume, electrolyte balance, and systemic vascular resistance within the body, the angiotensin-converting enzyme 2 cleaves angiotensin II to Ang-, which subsequently leads to vasodilation. Under normal physiological conditions, ACE2 expression can be found within the thymus, lungs, kidneys, pancreas, and heart.

The role of ACE2 in chronic diseases Within endothelial cells, RAS regulates vasodilation, antifibrosis, and antihypertrophy, all of which prevent the development of pulmonary hypertension, with ACE2 levels inversely correlated with pulmonary arterial pressure levels. Likewise, lungs and artery endothelial cells from pulmonary arterial hypertension patients often exhibit reduced ACE2 levels.

Regulating ACE2 expression in COVID-19 To gain entry into cells for infection, the SARS-CoV-2 spike protein attaches to ACE2 receptors present on the surface of host cells. SARS-CoV-2 has been shown to upregulate the expression of ACE2, with severe COVID-19 patients often exhibiting high plasma levels of ACE2.

Vitamin C supplementation has also been shown to reduce the effects of COVID-19. This antiviral activity is likely due to the inhibition of ubiquitin-specific peptidase 50 , whose overexpression mediates the stabilizing deubiquitination of ACE2 proteins. Thus, vitamin C ultimately reduces the expression of ACE2 proteins, thereby limiting SARS-CoV-2 entry into cells.

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