Angiotenzin konvertáló enzim endogén szabályozása poszttranszlációs módosításokkal
és ennek szere...(FK 128809) Támogató: NKFIH
National Research, Development and Innovation Office (NKFIH) of Hungary(K134939)
Új perspektívák a renin-angiotenzin-aldoszteron rendszerben(K 116940) Támogató: NKFIH
Kezelés-specifikus diagnosztikus módszerek fejlesztése a személyre szabott kardiovaszkuláris
terá...(K 132623)
Nemzeti szívprogram(NVKP_16-1–2016-0017) Támogató: NKFIH
Thematic Excellence Program (Semmelweis University)(2020-4.1.1.-TKP2020) Támogató:
Innovációs és Technológiai Minisztérium
(TKP2020-NKA-04)
(TKP2020-IKA-04)
Szakterületek:
Klinikai orvostan
Orvos- és egészségtudomány
Angiotensin-converting enzyme 2 (ACE2) is essential for SARS-CoV-2 cellular entry.
Here we studied the effects of common comorbidities in severe COVID-19 on ACE2 expression.
ACE2 levels (by enzyme activity and ELISA measurements) were determined in human serum,
heart and lung samples from patients with hypertension (n = 540), heart transplantation
(289) and thoracic surgery (n = 49). Healthy individuals (n = 46) represented the
controls. Serum ACE2 activity was increased in hypertensive subjects (132%) and substantially
elevated in end-stage heart failure patients (689%) and showed a strong negative correlation
with the left ventricular ejection fraction. Serum ACE2 activity was higher in male
(147%), overweight (122%), obese (126%) and elderly (115%) hypertensive patients.
Primary lung cancer resulted in higher circulating ACE2 activity, without affecting
ACE2 levels in the surrounding lung tissue. Male sex resulted in elevated serum ACE2
activities in patients with heart transplantation or thoracic surgery (146% and 150%,
respectively). Left ventricular (tissular) ACE2 activity was unaffected by sex and
was lower in overweight (67%), obese (62%) and older (73%) patients with end-stage
heart failure. There was no correlation between serum and tissular (left ventricular
or lung) ACE2 activities. Neither serum nor tissue (left ventricle or lung) ACE2 levels
were affected by RAS inhibitory medications. Abandoning of ACEi treatment (non-compliance)
resulted in elevated blood pressure without effects on circulating ACE2 activities.
ACE2 levels associate with the severity of cardiovascular diseases, suggestive for
a role of ACE2 in the pathomechanisms of cardiovascular diseases and providing a potential
explanation for the higher mortality of COVID-19 among cardiovascular patients. Abandoning
RAS inhibitory medication worsens the cardiovascular status without affecting circulating
or tissue ACE2 levels.
