关键词: Angiotensin-converting enzyme 2 COVID-19 Inflammatory response Ischemic stroke Renin-angiotensin system

Mesh : Angiotensin-Converting Enzyme 2 Angiotensin-Converting Enzyme Inhibitors / therapeutic use Betacoronavirus / pathogenicity physiology Blood-Brain Barrier Brain Ischemia / epidemiology etiology immunology physiopathology COVID-19 Chemotaxis, Leukocyte Comorbidity Coronavirus Infections / complications epidemiology physiopathology Cytokine Release Syndrome / etiology physiopathology Cytokines / physiology Encephalitis, Viral / complications physiopathology Hemodynamics Humans Inflammation Models, Immunological Models, Neurological Multiple Organ Failure / etiology physiopathology Nervous System Diseases / epidemiology etiology Pandemics Peptidyl-Dipeptidase A / physiology Pneumonia, Viral / complications epidemiology physiopathology Receptors, Virus / physiology Renin-Angiotensin System / physiology Risk SARS-CoV-2 Stroke / epidemiology etiology immunology physiopathology

来  源:   DOI:10.1007/s12035-020-02072-4   PDF(Sci-hub)   PDF(Pubmed)

Abstract:
The global pandemic of novel coronavirus disease 2019 (COVID-19) has taken the entire human race by surprise and led to an unprecedented number of mortalities worldwide so far. Current clinical studies have interpreted that angiotensin-converting enzyme 2 (ACE2) is the host receptor for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). In addition, ACE2 is the major component of the renin-angiotensin system. ACE2 deteriorates angiotensin II, a peptide that is responsible for the promotion of stroke. The downregulation of ACE2 further activates an immunological cascade. Thus, researchers need to explore and examine the possible links between COVID-19 and ischemic stroke (IS). Human ACE2 expression level and pattern in various tissues might be decisive for the vulnerability, symptoms, and treatment outcomes of the SARS-CoV-2 infection. The swift increase in the knowledge of SARS-CoV-2 has given creditable evidence that SARS-CoV-2 infected patients also encounter neurological deficits. As the SARS-CoV-2 binds to ACE2, it will hamper the activity of ACE2 in providing neuroprotection, especially in the case of stroke patients. Due to the downregulation of ACE2, the inflammatory response is activated in the ischemic penumbra. The COVID-19 pandemic has affected people with various pre-existing diseases, including IS, in such a way that these patients need special care and attention for their survival. Several clinical trials are currently ongoing worldwide as well as many other projects are in different stages of conceptualization and planning to facilitate the effective management of stroke patients with COVID-19 infection.
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