December 2019 saw the emergence of the coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which has spread across the globe. The high infectivity and ongoing mortality of SARS-CoV-2 emphasize the demand of drug discovery. Angiotensin-converting enzyme II (ACE2) is the functional receptor for SARS-CoV-2 entry into host cells. ACE2 exists as a membrane-bound protein on major viral target pulmonary epithelial cells, and its peptidase domain (PD) interacts SARS-CoV-2 spike protein with higher affinity. Therefore, targeting ACE2 is an important pharmacological intervention for a SARS-CoV-2 infection. In this review, we described the two-way switch role of ACE2 in the treatment of novel coronavirus pneumonia and underlying comorbidities, and discussed the potential effect of the ACE inhibitor and angiotensin receptor blocker on a hypertension patient with the SARS-CoV-2 infection. In addition, we analyzed the S-protein-binding site on ACE2 and suggested that blocking hot spot-31 and hot spot-353 on ACE2 could be a therapeutic strategy for preventing the spread of SARS-CoV-2. Besides, the recombinant ACE2 protein could be another potential treatment option for SARS-CoV-2 induced acute severe lung failure. This review could provide beneficial information for the development of anti-SARS-CoV-2 agents via targeting ACE2 and the clinical usage of renin-angiotensin system (RAS) drugs for novel coronavirus pneumonia treatment.
【저자키워드】 Lung injury, hypertension, Severe acute respiratory syndrome (SARS), angiotensin-converting enzyme II (ACE2), renin-angiotensin system (RAS), 【초록키워드】 COVID-19, Treatment, coronavirus disease, SARS-CoV-2, Coronavirus disease 2019, ACE2, Drug discovery, Mortality, Coronavirus pneumonia, Pneumonia, SARS-COV-2 infection, Infection, Comorbidities, Intervention, drug, severe acute respiratory syndrome Coronavirus, novel coronavirus pneumonia, hypertension, anti-SARS-CoV-2, RAS, Spike protein, Novel coronavirus, renin-angiotensin system, Spread, Severe acute respiratory syndrome, Protein, Viral, SARS-CoV-2 spike protein, Patient, hot spot, epithelial cells, receptor, respiratory, inhibitor, information, therapeutic strategy, Coronavirus-2, angiotensin receptor blocker, angiotensin, ACE, host cells, receptor blocker, pulmonary epithelial cells, acute respiratory syndrome, Renin, acute respiratory syndrome coronavirus, potential treatment option, SARS-CoV-2 entry, domain, acute respiratory syndrome coronavirus-2, recombinant ACE2, higher affinity, lung failure, pharmacological, membrane-bound, described, analyzed, caused, globe, addition, functional, suggested, interact, enzyme II, the SARS-CoV-2, 【제목키워드】 ACE2, Pneumonia, Novel coronavirus, switch, role,