<p>Role of Renin-Angiotensin System in Acute Lung Injury Caused by Viral Infection</p>

Abstract

The renin-angiotensin system (RAS) is the most important regulatory system of electrolyte homeostasis and blood pressure and acts through angiotensin-converting enzyme (ACE)/angiotensin II (Ang II)/Ang II type 1 (AT1) receptor axis and angiotensin-converting enzyme 2 (ACE2)/angiotensin (1-7)/MAS receptor axis. RAS dysfunction is related to the occurrence and development of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) and causes a serious prognosis and even death. ALI/ARDS can be induced by various ways, one of which is viral infections, such as SARS-CoV, SARS-CoV-2, H5N1, H7N9, and EV71. This article reviews the specific mechanism on how RAS dysfunction affects ALI/ARDs caused by viral infections. SARS-CoV and SARS-CoV-2 enter the host cells by binding with ACE2. H5N1 and H7N9 avian influenza viruses reduce the ACE2 level in the body, and EV71 increases Ang II concentration. Treatment with angiotensin-converting enzyme inhibitor and angiotensin AT1 receptor blocker can alleviate ALI/ARDS symptoms. This review provides suggestions for the treatment of lung injury caused by viral infections.

A multipronged deep omics-based investigation of COVID-19 plasma samples identifies key molecular networks of disease severity progression

“…Angiotensinogen (AGT) is a component of the renin-angiotensin system (RAS), a substrate of renin that regulates blood pressure and uid balance. The dysregulation of AGT and RAS might lead to acute lung injury and acute respiratory distress leading to serious prognosis 41 . Apolipoprotein B-100 (APOB) is involved in lipid transport and low-density lipoprotein (LDL) catabolism.…”

COVID-19 plasma deep proteome reveals distinct signatures in severe patients

“…The dysregulation of AGT and RAS might lead to acute lung injury and acute respiratory distress leading to a severe prognosis. 39 Apolipoprotein B-100 (APOB) is involved in lipid transport and low-density lipoprotein (LDL) catabolism. The high levels of APOB in the plasma might be an indicator of signi cant cardiovascular manifestation seen in COVID-19 infected severe patients.…”

Multifunctional angiotensin converting enzyme 2, the SARS-CoV-2 entry receptor, and critical appraisal of its role in acute lung injury

“…ARDS is the clinical presentation of acute lung injury; it is defined by the presence of bilateral opacities in chest imaging, non-cardiogenic pulmonary edema, acute hypoxemia, reduced lung compliance, compromised arterial oxygenation, and pulmonary hypertension [ 258 ]. The RAS, along with the KKS regulates several pathophysiological events in the body, including vascular and pulmonary pressure, inflammation, fibrosis, and coagulation [ 258 , 259 ]. In the lungs, Ang-II is able to induce bronchoconstriction, vasoconstriction, fibroproliferation, cytokine expression, and cell apoptosis, thus promoting tissue injury.…”