Title:The Ineluctable Role of ACE-2 Receptors in SARS COV-2 Infection and Drug Repurposing as a Plausible SARS COV-2 Therapy: A Concise Treatise
Volume: 21
Issue: 10
Author(s): Sherin Joseph, Bhagyalakshmi Nair and Lekshmi R. Nath*
Affiliation:
- Department of Pharmacognosy, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Ponekkara P.O., Kochi, Kerala 682041,India
Keywords:
SARS-CoV-2, ACE-2 receptors, severe acute respiratory syndrome (SARS), antiviral therapy, RAAS,
COVID-19.
Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the
etiological agent for the COVID-19 infectious disease that spreads via the respiratory
route and has reached a drastic level of a global pandemic. Symptoms of COVID-19
may vary from mild (fever, dry cough, shortness of breath) to severe pneumonia-like
respiratory symptoms as exacerbation of disease occurs. Unlike SARS-CoV, the SARSCoV-
2 has a higher binding affinity to ACE-2 receptors, which signifies its higher
transmission rate from person to person. Even though ACE-2 is significant in the reninangiotensin-
aldosterone system (RAAS) regulation that exhibits protection to various
organs, it plays a significant role in COVID-19 disease pathogenesis. Viral interferences
with the ACE-2 peptidase activity are found in SARS-CoV-2 infected patients leading to
pro-inflammatory responses, hypertension and multi-organ damage. Angiotensinconverting
enzyme-2 is constrained to a variety of organ systems, but surface ACE-2
receptors on lung epithelia are largely affected, which lead to pathological alterations in
lung histology which may progress to respiratory failure. The viral tropism mainly occurs
by the attachment to the angiotensin-converting enzymes-2 receptors in the host cell;
thus drugs targeting ACE-2 expressions may arise as the future therapeutic strategy to
combat COVID-19 infections. The innovative approach of repurposing drugs has shown
temporary effectiveness to curb the rising pandemic. This article mainly focuses on the
prominence of ACE-2 receptors which are expressed during the COVID infections and
the repurposing strategy of available drug therapies.
