The SARS-CoV2 - ACE2 link: a physiopathological analysis

The Covid-19 pandemic represents an unsolved problem which has caused numerous fatalities At the present time, there is no vaccination available or curative therapy However, recent reports suggest that SARS-CoV2 acts upon its functional receptor ACE2 inducing a variety of deleterious effects such as inflammation, endothelial dysfunction, microangiopathy, myocarditis, thrombosis and myocardial infarction The details of the SARS-CoV2-ACE2 interaction are poorly understood and most of the hypothesis related to this are based on the extrapolation of previous research focusing on ACE2 as a receptor for SARS-CoV Considering the similarities between SARS-CoV2 and SARS-CoV we have conducted a physiopathological analysis focusing on the key pathogenic role of ACE2 as a functional receptor for SARS-CoV2 In this context, we have identified several potential therapeutic targets which should be further evaluated in patients with Covid-19 It is likely that an efficient therapy for Covid-19 will be revealed by research investigating the binding of viral spike S protein to ACE2, and the immunological response determined by SARS-CoV2-ACE2 interaction, including the anti-viral role of plasmacytoid dendritic cells and anti-inflammatory reprogramming of macrophages © Eugen B Petcu, Christopher Andry, Eric J Burks, Stephen Hamlet, Emiel AM Janssen, Kjell H Kjellevold, Antonio de Las Morenas, Nancy S Miller, Rodica I Miroiu, Iulian Nusem, Aurel Popa-Wagner