Angiotensin-converting enzyme 2 (ACE2) is a key enzyme
in the renin-angiotensin
system (RAS), also serving as an amino acid transporter and a receptor
for certain coronaviruses. Its primary role is to protect the cardiovascular
system via the ACE2/Ang (1–7)/MasR cascade.
Given the critical roles of ACE2 in regulating numerous physiological
functions, molecules that can upregulate or activate ACE2 show vast
therapeutic value. There are only a few ACE2 activators that have
been reported, a wide range of molecules, including food-derived compounds,
have been reported as ACE2 up-regulators. Effective doses of bioactive
peptides range from 10 to 50 mg/kg body weight (BW)/day when orally
administered for 1 to 7 weeks. Protein hydrolysates require higher
doses at 1000 mg/kg BW/day for 20 days. Phytochemicals and vitamins
are effective at doses typically ranging from 10 to 200 mg/kg BW/day
for 3 days to 6 months, while Traditional Chinese Medicine requires
doses of 1.25 to 12.96 g/kg BW/day for 4 to 8 weeks. ACE2 activation
is linked to its hinge-bending region, while upregulation involves
various signaling pathways, transcription factors, and epigenetic
modulators. Future studies are expected to explore novel roles of
ACE2 activators or up-regulators in disease treatments and translate
the discovery to bedside applications.