Angiotensin Converting Enzyme 2 (ACE2) and COVID-19: An overview of its structure, physiologic role and its involvement in SARS-COV2 infection and therapy


  • Nourdin HARICH Equipe des Sciences Anthropogénétiques et biotechnologies, Faculté des Sciences d'El Jadida Université Chouaib Doukkali, El Jadida
  • Abdellah EL HABAZI Laboratoire de Biotechnologie, Biochimie et Nutrition, Faculté des Sciences d'El Jadida, Université Chouaib Doukkali, El Jadida.
  • Omar ABIDI Institut Supérieur des Professions Infirmières et Techniques de Santé (ISPITS) de Casablanca, Ministère de la Santé



COVID-19 outbreak, SARS-CoV-2, Angiotensin Converting Enzyme 2, Renin-angiotensin system, Treatment options.


Coronavirus disease of 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is of a great global and national public health concern. Structural studies suggested that the SARS-CoV2 binds through its spike-protein to target cells by interacting with the angiotensin-converting enzyme 2 (ACE2) receptor which is widely expressed in the heart, kidneys, lungs, gut and testes cells. This article reviews the structural and physiologic roles of the human ACE2 and its correlation with the SARS-CoV2 infection and therapy. Evidence has been provided that the amino acids 318-510 of the viral spike protein represent the receptor-binding domain (RBD) which binds to ACE2, especially by means of the critical amino acids at positions 479 and 487, then allowing virus tropism and propagation. ACE2 play a crucial role in the down regulation of the renin-angiotensin-aldosterone system (RAAS). The RAAS ACE-Angiotensin II-AT1R regulatory axis promotes detrimental effects on the host, such as vasoconstriction, generation of reactive oxygen species, inflammation and matrix remodeling. However, the ACE2-Ang 1-7-MasR axis counterbalances the activation of the classical RAS system which inhibits cell growth, inflammation and fibrosis. The ACE2 has a protective effect against organ damage, lung injury and underlying chronic diseases such as hypertension, diabetes, and cardiovascular diseases wich are linked with poor prognosis of healing in patients with COVID-19. On account of the protective effects of ACE2, the design and development of drugs enhancing its activity may become one of the most promising strategies for the therapy of COVID-19 in the future.


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