ACE2–Molecular speculations on abdominal symptoms after COVID-19
infection
Xianqiang Yu 1 PhD
1 Southeast University
Corresponding Author:Xianqiang Yu (PhD, Southeast University)
Address: 87 Dingjiaqiao, Gulou District, Nanjing, China
Email:yuxianqiang302@126.com
Telephone number: +86 18553263899
Abstracts: There is growing evidence that the clinical manifestations of
COVID-19 are not just respiratory, but also gastrointestinal symptoms.
The difference of organ infection should be considered. In addition, as
a key molecule mediating viral infection of cells,
angiotensin-converting enzyme 2 (ACE2) provides an important
intervention means for the exploration of antivirus. This is
particularly important as the pandemic intensifies.
Keywords: COVID-19; angiotensin-converting enzyme 2; gastrointestinal
symptoms
Dear editor, we read with great interest an article in your journal
about molecular mechanism of COVID-19 [1]. In particular, it is
necessary for us to identify the role of ACE in COVID-19 infection.
There is increasing evidence that abdominal symptoms are an important
clinical manifestation of COVID-19 infection [2]. From this
perspective, the clinical manifestation of any disease should not be
excluded from the connection with novel coronavirus in the special
pandemic period. However, we should explore the specific etiology of
organ infection, especially as a clinician, it is necessary for us to
focus on the molecular factors involved in the high incidence of
abdominal organs after novel coronavirus infection.
To the best of our knowledge, angiotensin-converting enzyme 2 (ACE2) is
the key factor that novel coronavirus can infect cells and further cause
disease of related organs [3]. In other words, any organ expressing
ACE2 is a potential target organ infected by novel coronavirus.
Therefore, it is necessary to know the distribution of ACE2 in the
abdominal organs. At present, it is relatively clear that ACE2 plays its
role mainly by mediating the successful entry of virus into infected
cells. Individual digestive organs, including the pancreas and gall
bladder, are rich in ACE2. This may be an important reason that ACE2
rich organs are susceptible to infection by novel coronavirus. In
addition, viral infection is one of the causes of inflammation in
digestive organs such as acute pancreatitis, hepatitis and acute
appendicitis. At the same time, more evidence and studies are needed to
confirm the risk of COVID-19 infections in other digestive organs.
From this perspective, the key role of ACE2 in the novel coronavirus
infection process also provides us with a clear molecular target for
precise intervention or treatment. We can assume that antagonists or
blockers of ACE2 may be effective drugs to intervene in cells infected
with COVID-19. However, according to what we know, ACE2 plays an
important role in maintaining homeostasis in the human body and thus
preventing organ damage. Therefore, we need to evaluate adequately the
role of ACE2 in both injury resistance and virus infection mediation. We
urgently need to do so, especially in the midst of COVID-19 pandemic.
Obviously, the diagnosis and treatment of digestive diseases during the
pandemic is fraught with unprecedented difficulties and challenges.
Fortunately, from the autopsy pathology, we can more clearly identify
which gastrointestinal organs have novel coronavirus infection and the
pathological manifestations after infection [4]. Next, we may
explore antiviral means or organ-specific targeted drugs according to
the distribution characteristics of organ ACE2. As the pandemic
continues to spread and intensify, we do not want the diagnosis and
treatment of digestive diseases to be missed or misdiagnosed.
Ultimately, figuring out the pathological and molecular characteristics
of novel coronavirus will better serve doctors in clinical practice and
provide scientific basis for diagnosis, treatment and prevention and
control of epidemic diseases.