The SARS-CoV2 - ACE2 link: A physiopathological analysis

Abstract

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.