ANGIOTENSIN-CONVERTING ENZYME 2 AND TMPRSS2 EXPRESSIONS IN COVID-19
Keywords:COVID-19, Angiotensin-converting enzyme 2, Transmembrane serine protease 2, Obesity, Smoking, Alcohol, Antioxidant, Comorbidity, Climate, Pollution
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters into host cells through the angiotensin-converting enzyme 2 (ACE2) receptor and transmembrane serine protease 2 (TMPRSS2) helps in propagation. Expression of ACE2 gene was found to be higher in kidney, testis, heart, thyroid, and adipose tissue whereas expression of TMPRSS2 was found to be highest in the kidney, small intestine, and prostate. ACE2 and TMPRSS2 expression increases as age increases. Estrogen has a protective role against SARS-CoV-2. Thus mortality rate of SARS-CoV-2 is more in men compared to women. ACE2 is also expressed in adipose tissue therefore as body mass index increases the disease severity increases. Smoking upregulates the lung airway expression of ACE2 and TMPRSS2. Alcoholics have more chances to get a COVID-19 as it elevates the expression of the angiotensin II type 1 receptor. Administer an antioxidant-rich diet to fight against COVID-19. Patients with hypertension, diabetes, cardiovascular disease, chronic lung disease, chronic kidney disease, and cancer cause more severity to COVID-19. ACE2 expression increased while administering drugs such as ACE inhibitors, angiotensin II type I receptor blocker, thiazolidinediones, and NSAIDs thus elevates the severity of COVID-19 infection. Anti-histo-blood natural antibodies act as a protective role in blood group O. Blacks and Histapanic community have a higher risk of infection and mortality compared white people. Temperature and humidity are negatively correlated with COVID-19. ACE2 expression is elevated in the alveolar cells of the population exposed to air pollution thus elevates the exposure to the SARS-CoV infection. In this article, we will compare the modifiable and non-modifiable risk factors of COVID-19 that affect both first and second waves.
Wang L, Wang, Y, Ye D, Liu Q. Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence. Int J Antimicrob Agents 2020;55:105948.
Kumar D, Malviya R, Sharma PK. Corona virus: A review of COVID-19. EJMO 2020;4:8-25.
Kai H, Kai M. Interactions of coronaviruses with ACE2, angiotensin II, and RAS inhibitors lessons from available evidence and insights into COVID-19. Hypertens Res 2020;43:648-54.
Meyer D, Sielaff F, Hammami M, Böttcher-Friebertshäuser E, Garten W, Steinmetzer T. Identification of the first synthetic inhibitors of the Type II transmembrane serine protease TMPRSS2 suitable for inhibition of influenza virus activation. Biochem J 2013;452:331-43.
Sharif-Askari NS, Sharif-Askari FS, Alabed M, Temsah MH, Al Heialy S, Hamid Q, et al. Airways expression of SARS-CoV-2 receptor, ACE2, and TMPRSS2 is lower in children than adults and increases with smoking and COPD. Mol Ther Methods Clin Dev 2020;18:1-6.
Zhang BN, Wang Q, Liu T, Dou SQ, Qi X, Jiang H, et al. Expression analysis of 2019-nCoV related ACE2 and TMPRSS2 in eye tissues. Zhonghua Yan Ke Za Zhi 2020;56:438-46.
Lange C, Wolf J, Auw‐Haedrich C, Schlecht A, Boneva S, Lapp T, et al. Expression of the COVID‐19 receptor ACE2 in the human conjunctiva. J Med Virol 2020;92:2081-6.
Uranaka T, Kashio A, Ueha R, Sato T, Bing H, Ying G, et al. Expression of ACE2, TMPRSS2, and furin in mouse ear tissue, and the implications for SARS‐CoV‐2 infection. Laryngoscope 2021;131:E2013-7.
Li M.Y, Li L, Zhang Y, Wang XS. Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues. Infect Dis Poverty 2020;9:1-7.
Vaarala MH, Porvari KS, Kellokumpu S, Kyllönen AP, Vihko PT. Expression of transmembrane serine protease TMPRSS2 in mouse and human tissues. J Pathol 2001;193:134-40.
Naqvi SS, Phulpoto AH, Memon AQ, Channo MA, Mangi MR, Maher A. Association of mortality and raised inflammatory markers such as serum LDH, serum ferritin and CRP in hospitalized patient with Covid-19 infection. Age (years) 2021;42:17-84.
Bunyavanich S, Do A, Vicencio A. Nasal gene expression of angiotensin-converting enzyme 2 in children and adults. JAMA 2020;323:2427-9.
Yoon HE, Kim EN, Kim M, Lim JH, Jang I, Ban TH, et al. Age-associated changes in the vascular renin-angiotensin system in mice. Oxid Med Cell Longev 2016;2016:6731093.
Li H, Xu XL, Dai DW, Huang ZY, Ma Z, Guan YJ. Air pollution and temperature are associated with increased COVID-19 incidence: A time series study. Int J Infect Dis 2020;97:278-82.
Iftimie S, López-Azcona AF, Vallverdú I, Hernández-Flix S, De Febrer G, Parra S, et al. First and second waves of coronavirus disease-19: A comparative study in hospitalized patients in Reus, Spain. PLoS One 2021;16:e0248029.
Cianfarani S. Pediatric endocrinology in the time of the COVID-19 pandemic. In: Hormone Research in Paediatrics. Basel, Switzerland: Karger Publishers; 2020. p. 1.
Ramalingam L, Menikdiwela K, LeMieux M, Dufour JM, Kaur G, Kalupahana N, et al. The renin angiotensin system, oxidative stress and mitochondrial function in obesity and insulin resistance. Biochim Biophys Acta 2017;1863:1106-4.
Kassir R. Risk of COVID‐19 for patients with obesity. Obes Rev 2020;21:e13034.
Iannelli A, Favre G, Frey S, Esnault V, Gugenheim J, Bouam S, et al. Obesity and COVID-19: ACE 2, the missing tile. Obes Surg 2020;30:4615-7.
Krams IA, Jõers P, Luoto S, Trakimas G, Lietuvietis V, Krams R, et al. The obesity paradox predicts the second wave of COVID-19 to be severe in Western countries. Int J Environ Res Public Health 2021;18:1029.
Engin AB, Engin ED, Engin A. Two important controversial risk factors in SARS-CoV-2 infection: obesity and smoking. Environ Toxicol Pharmacol 2020;78:103411.
Chagué F, Boulin M, Eicher J, Bichat F, Saint-Jalmes M, Cransac A, et al. Alarming increased rate of smoking and associated lifestyle behaviours in patients with chronic cardiac diseases during COVID-19 pandemic related lockdown. Arch Cardiovasc Dis Suppl 2021;13:127.
Testino G. Are patients with alcohol use disorders at increased risk for Covid-19 infection? Alcohol Alcohol 2020;55:344-6.
Alpers SE, Skogen JC, Mæland S, Pallesen S, Rabben ÅK, Lunde LH, et al. Alcohol consumption during a pandemic lockdown period and change in alcohol consumption related to worries and pandemic measures. Int J Environ Res Public Health 2021;18:1220.
Kalantar-Zadeh K, Moore LW. Impact of nutrition and diet on COVID-19 infection and implications for kidney health and kidney disease management. J Renal Nutr 2020;30:179-81.
Gao H, Tanchico DT, Yallampalli U, Yallampalli C. A low-protein diet enhances angiotensin II production in the lung of pregnant rats but not nonpregnant rats. J Pregnancy 2016;2016:4293431.
Li X, Hu C, Su F, Dai J. Hypokalemia and clinical implications in patients with coronavirus disease 2019 (COVID-19). MedRxiv 2020;2020:20028530.
Ali I, Alharbi OM. COVID-19: Disease, management, treatment, and social impact. Sci Total Environ 2020;728:138861.
Bennett G, Young E, Butler I, Coe S. The impact of lockdown during the COVID-19 outbreak on dietary habits in various population groups: A scoping review. Front Nutr 2021;8:53.
Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, et al. Comorbidity and its impact on patients with COVID-19. SN Compr Clin Med 2020;2:1069-76.
Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China:A nationwide analysis. Eur Respir J 2020;55:2000547.
Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med 2020;8:e21.
Giavina-Bianchi P, Aun MV, Agondi RC, Kalil J. Debate on drugs that may aggravate COVID-19. J Allergy Clin Immunol 2020;8:2452-3.
Apicella M, Campopiano MC, Mantuano M, Mazoni L, Coppelli A, Del Prato S. COVID-19 in people with diabetes: Understanding the reasons for worse outcomes. Lancet Diabetes Endocrinol 2020;8:782-92.
Latz CA, DeCarlo C, Boitano L, Png CY, Patell R, Conrad MF, et al. Blood type and outcomes in patients with COVID-19. Ann Hematol 2020;99:2113-8.
Guillon P, Clément M, Sébille V, Rivain JG, Chou CF, Ruvoën-Clouet N, Le Pendu J. Inhibition of the interaction between the SARS-CoV spike protein and its cellular receptor by anti-histo-blood group antibodies. Glycobiology 2008;18:1085-93.
Terao C, Bayoumi N, McKenzie CA, Zelenika D, Muro S, Mishima M, et al. Quantitative variation in plasma angiotensin‐I converting enzyme activity shows allelic heterogeneity in the ABO blood group locus. Ann Hum Genet 2013;77:465-71.
Gómez J, Albaiceta GM, García-Clemente M, García-Gala JM, Coto E. DNA genotyping of the ABO gene showed a significant association of the A-group (A1/A2 variants) with severe COVID-19. Eur J Intern Med 2021;88:129-32.
Golestaneh L, Neugarten J, Fisher M, Billett HH, Gil MR, Johns T. The association of race and COVID-19 mortality. EclinicalMedicine 2020;25:100455.
Hawkins D. Differential occupational risk for COVID‐19 and other infection exposure according to race and ethnicity. Am J Ind Med 2020;63:817-20.
Doumas M, Patoulias D, Katsimardou A, Stavropoulos K, Imprialos K, Karagiannis A. COVID19 and increased mortality in African Americans: Socioeconomic differences or does the renin angiotensin system also contribute? J Hum Hypertens 2020;34:764-7.
Huang Z, Huang J, Gu Q, Du P, Liang H, Dong Q. Optimal temperature zone for the dispersal of COVID-19. Sci Total Environ 2020;736:139487.
Yuan S, Jiang SC, Li ZL. Do humidity and temperature impact the spread of the novel coronavirus? Front Public Health 2020;8:240.
Domingo JL, Marquès M, Rovira J. Influence of airborne transmission of SARS-CoV-2 on COVID-19 pandemic. A review. Environ Res 2020;188:109861.
Comunian S, Dongo D, Milani C, Palestini P. Air pollution and COVID-19: The role of particulate matter in the spread and increase of COVID-19’s morbidity and mortality. Int J Environ Res Public Health 2020;17:4487.
Contini D, Costabile F. Does air pollution influence COVID-19 outbreaks? Atmosphere 2020;11:377.
How to Cite
Copyright (c) 2022 Aleeta Maria Jolly, Jaya Thomas
This work is licensed under a Creative Commons Attribution 4.0 International License.