The renin-angiotensin-aldosterone system: Role in pathogenesis and potential therapeutic target in COVID-19

Cássia L Braga; Rodrigo P Silva-Aguiar; Denise Battaglini; Diogo B Peruchetti; Chiara Robba; Paolo Pelosi; Patricia R M Rocco; Celso Caruso-Neves; Pedro L Silva

doi:10.1002/prp2.623

The renin-angiotensin-aldosterone system: Role in pathogenesis and potential therapeutic target in COVID-19

Pharmacol Res Perspect. 2020 Aug;8(4):e00623. doi: 10.1002/prp2.623.

Authors

Cássia L Braga¹, Rodrigo P Silva-Aguiar², Denise Battaglini³, Diogo B Peruchetti², Chiara Robba³, Paolo Pelosi^{3

4}, Patricia R M Rocco^{1

5

6

7}, Celso Caruso-Neves^{2

5

6

7}, Pedro L Silva^{1

5

6

7}

Affiliations

¹ Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
² Laboratory of Biochemistry and Cell Signalling, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
³ Anesthesia and Intensive Care, Ospedale Policlinico San Martino, IRCCS for Oncology and Neuroscience, Genoa, Italy.
⁴ Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy.
⁵ National Institute of Science and Technology for Regenerative Medicine, Rio de Janeiro, Brazil.
⁶ Rio de Janeiro Innovation Network in Nanosystems for Health-NanoSAÚDE/FAPERJ, Rio de Janeiro, Brazil.
⁷ COVID-19 Virus Network, Ministry of Science and Technology, Innovation and Communication, Rio de Janeiro, Brazil.

Abstract

Coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 novel coronavirus, has spread worldwide causing high fatality rates. Neither a vaccine nor specific therapeutic approaches are available, hindering the fight against this disease and making better understanding of its pathogenesis essential. Despite similarities between SARS-CoV-2 and SARS-CoV, the former has unique characteristics which represent a great challenge to physicians. The mechanism of COVID-19 infection and pathogenesis is still poorly understood. In the present review, we highlight possible pathways involved in the pathogenesis of COVID-19 and potential therapeutic targets, focusing on the role of the renin-angiotensin-aldosterone system.

Keywords: COVID-19; SARS-CoV-2; angiotensin-converting enzyme; inflammation; therapy.

Publication types

Review

MeSH terms

Angiotensin Receptor Antagonists / therapeutic use
Angiotensin-Converting Enzyme 2
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Animals
Antiviral Agents / therapeutic use
Betacoronavirus / drug effects
Betacoronavirus / pathogenicity*
COVID-19
COVID-19 Drug Treatment
Coronavirus Infections / diagnosis
Coronavirus Infections / drug therapy
Coronavirus Infections / virology*
Evidence-Based Medicine
Host-Pathogen Interactions
Humans
Pandemics
Peptidyl-Dipeptidase A / metabolism*
Peptidyl-Dipeptidase A / therapeutic use
Pneumonia, Viral / diagnosis
Pneumonia, Viral / drug therapy
Pneumonia, Viral / virology*
Renin-Angiotensin System* / drug effects
SARS-CoV-2

Substances

Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Antiviral Agents
Peptidyl-Dipeptidase A
ACE2 protein, human
Angiotensin-Converting Enzyme 2