Coronavirus disease 2019 (COVID-19) is a rapid-spread infectious disease caused by the SARS-CoV-2 virus, which can culminate in the renin-angiotensin-aldosterone (RAAS) and kallikrein-kinin (KKS) systems imbalance, and in serious consequences for infected patients. This scoping review of published research exploring the RAAS and KKS was undertaken in order to trace the history of the discovery of both systems and their multiple interactions, discuss some aspects of the viral-cell interaction, including inflammation and the system imbalance triggered by SARS-CoV-2 infection, and their consequent disorders. Furthermore, we correlate the effects of continued use of the RAAS blockers in chronic diseases therapies with the virulence and physiopathology of COVID-19. We also approach the RAAS and KKS-related proposed potential therapies for treatment of COVID-19. In this way, we reinforce the importance of exploring both systems and the application of their components or their blockers in the treatment of coronavirus disease.

ACE is responsible for generating the vasoconstrictor peptide angiotensin II of the Renin Angiotensin Aldosterone System, and blockage of this system with the use of ACE inhibitors and antagonists of angiotensin II receptors are strategies for treatment of hypertension. Studies demonstrated that the use of site‐directed mutagenesis and the construction of chimeric enzymes can assist in the identification of the amino acids responsible for the interaction of enzyme/substrate or enzyme‐inhibitor complexes. We investigated the role of amino acid residues targets located in the N‐domain of ACE, Ala361, Thr378 and Phe467, strong candidates for the interaction of the enzyme with its inhibitors. The enzyme mutants were expressed in CHO cells, purified and characterized by enzymatic activity using specific substrates, inhibition assays with captopril, lisinopril and enalapril. After plasmid expression of wild type ACE (WT) cDNA in mammalian cells, PCR was performed to insert mutations 1 to 9 (M1 to M9), followed by electrophoresis, bacterial transfection, amplification of plasmids and sequencing. Only mutations M4 (A361W), M7 (T378A) and M8 (F437A) showed satisfactory results. M4, M7, M8 and WT were purified by a Superdex 200 column coupled to the FPLC system. The purified enzymes were characterized biochemically through enzymatic assays using the specific substrates for ACE, Hippuryl‐His‐Leu (HHL) and Z‐Phe‐His‐Leu (z‐FHL). WT, M4 and M7 showed high specific activity values. Analyzing the catalytic efficiency (kcat/KM), we observed that mutant enzymes better hydrolyzed the substrate z‐FHL when compared to HHL. M7 showed higher specificity (0.39 mM) and catalytic velocity (1.02 s‐1) for the substrate z‐FHL. The one with the best specificity for the HHL substrate (1.35 mM) and catalytic velocity (0.54 s‐1) was M4, compared to the WT. All enzymes showed an optimum pH around 8.0 with both substrates. Captopril inhibited the enzymes most efficiently using HHL as substrate, while Lisinopril was the one that best inhibited the enzymes using z‐FHL. It suggests that there is a negative cooperation between the ACE catalytic sites by the substrate. For both inhibitors and substrates, the best inhibition occurred with M7, suggesting that this mutation may have altered the interaction of the enzyme active site. The results obtained in this work can lead to a better understanding of the importance of these amino acids residues for the activity/functionality of the enzyme, seeking the identification of new molecules that can inhibit ACE.

A introdução da automação laboratorial, nos últimos anos definiu um novo cenário para os laboratórios, que passaram a visar a eficiência e otimizar a qualificação e quantificação de falhas em todas as fases dos processos no laboratório clínico: pré-analítica, analítica e pós-analítica, bem como na implantação de medidas corretivas e preventivas. O objetivo deste estudo é apresentar uma revisão sobre a evolução da gestão da qualidade na área da saúde, em específico na área laboratorial e demonstrar como a tecnologia e automação laboratorial foram responsáveis pelo surgimento de indicadores e tendências em medicina laboratorial. Trata-se de uma revisão integrativa da literatura, onde se pesquisou nas bases de dados BIREME, LILACS e sciELO, com os descritores cadastrados no DeCS. Após cruzamento e exposição aos critérios de inclusão e exclusão, foram selecionados 11 trabalhos. Os resultados mostraram que a gestão da qualidade nos laboratórios ganhou destaque com a implantação da automação, pois surgiu tempo hábil para os colaboradores realizarem essa função, aumentando os níveis de segurança para os pacientes, minimizando-se os erros na fase analítica, promovendo maior velocidade na produção e aumento da produtividade no setor laboratorial. Todos os textos analisados nesse trabalho apontam para a eficácia e crescimento da gestão da qualidade no setor laboratorial. Foi possível constatar que o atendimento das expectativas dos clientes (pacientes e organização de saúde) é responsabilidade do setor de gestão em saúde, que necessitam realizar um bom planejamento dos projetos. Sendo assim, este setor tem extrema importância na implantação da automação laboratorial, pois é capaz de identificar e solucionar falhas no processo, a fim de trazer benefícios para a cadeia de saúde.Palavras-chave: patologia clínica, automação laboratorial, gestão da qualidade e técnicas de laboratório clínico.