1. Endothelial cells and SARS-CoV-2: An intimate relationship.
- Author
-
Barbosa LC, Gonçalves TL, de Araujo LP, Rosario LVO, and Ferrer VP
- Subjects
- Angiotensin-Converting Enzyme 2 metabolism, Animals, Blood Coagulation, COVID-19 complications, COVID-19 therapy, Cardiovascular Diseases metabolism, Cardiovascular Diseases pathology, Cardiovascular Diseases therapy, Endothelium, Vascular metabolism, Endothelium, Vascular pathology, Host-Pathogen Interactions, Humans, Inflammation metabolism, Inflammation pathology, Inflammation therapy, Inflammation Mediators metabolism, Neoplasms metabolism, Neoplasms pathology, Pulmonary Edema metabolism, Pulmonary Edema pathology, Pulmonary Edema virology, Signal Transduction, COVID-19 virology, Cardiovascular Diseases virology, Endothelium, Vascular virology, Inflammation virology, SARS-CoV-2 pathogenicity
- Abstract
Angiotensin-converting enzyme 2 (ACE2) is an important player of the renin-angiotensin-aldosterone system (RAAS) in regulating the conversion of angiotensin II into angiotensin (1-7). While expressed on the surface of human cells, such as lung, heart, kidney, neurons, and endothelial cells (EC), ACE2 is the entry receptor for SARS-CoV-2. Here, we would like to highlight that ACE2 is predominant on the EC membrane. Many of coronavirus disease 2019 (COVID-19) symptoms have been associated with the large recruitment of immune cells, directly affecting EC. Additionally, cytokines, hypoxia, and complement activation can trigger the activation of EC leading to the coagulation cascade. The EC dysfunction plus the inflammation due to SARS-CoV-2 infection may lead to abnormal coagulation, actively participating in thrombo-inflammatory processes resulting in vasculopathy and indicating poor prognosis in patients with COVID-19. Considering the intrinsic relationship between EC and the pathophysiology of SARS-CoV-2, EC-associated therapies such as anticoagulants, fibrinolytic drugs, immunomodulators, and molecular therapies have been proposed. In this review, we will discuss the role of EC in the lung inflammation and edema, in the disseminate coagulation process, ACE2 positive cancer patients, and current and future EC-associated therapies to treat COVID-19., (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF