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Angiotensin-(1-7)—A Potential Remedy for AKI: Insights Derived from the COVID-19 Pandemic

1
Department of Medicine, Hadassah Hebrew University Hospital, Mt. Scopus, Jerusalem 91240, Israel
2
Department of Pharmacology and Therapeutics, School of Medicine and School of Pharmacy, University College Cork, T12 YN60 Cork, Ireland
3
Institute of Medical Biochemistry and Molecular Biology, University Medicine Greifswald, 17489 Greifswald, Germany
4
Department of Physiology and Biophysics, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel
5
Department of Laboratory Medicine, Rambam Health Campus, Haifa 3109601, Israel
*
Author to whom correspondence should be addressed.
Academic Editor: Clive N. May
J. Clin. Med. 2021, 10(6), 1200; https://doi.org/10.3390/jcm10061200
Received: 9 February 2021 / Revised: 2 March 2021 / Accepted: 8 March 2021 / Published: 13 March 2021
(This article belongs to the Special Issue The New Therapeutic Targets in Acute Kidney Injury)
Membrane-bound angiotensin converting enzyme (ACE) 2 serves as a receptor for the Sars-CoV-2 spike protein, permitting viral attachment to target host cells. The COVID-19 pandemic brought into light ACE2, its principal product angiotensin (Ang) 1-7, and the G protein-coupled receptor for the heptapeptide (MasR), which together form a still under-recognized arm of the renin–angiotensin system (RAS). This axis counteracts vasoconstriction, inflammation and fibrosis, generated by the more familiar deleterious arm of RAS, including ACE, Ang II and the ang II type 1 receptor (AT1R). The COVID-19 disease is characterized by the depletion of ACE2 and Ang-(1-7), conceivably playing a central role in the devastating cytokine storm that characterizes this disorder. ACE2 repletion and the administration of Ang-(1-7) constitute the therapeutic options currently tested in the management of severe COVID-19 disease cases. Based on their beneficial effects, both ACE2 and Ang-(1-7) have also been suggested to slow the progression of experimental diabetic and hypertensive chronic kidney disease (CKD). Herein, we report a further step undertaken recently, utilizing this type of intervention in the management of evolving acute kidney injury (AKI), with the expectation of renal vasodilation and the attenuation of oxidative stress, inflammation, renal parenchymal damage and subsequent fibrosis. Most outcomes indicate that triggering the ACE2/Ang-(1-7)/MasR axis may be renoprotective in the setup of AKI. Yet, there is contradicting evidence that under certain conditions it may accelerate renal damage in CKD and AKI. The nature of these conflicting outcomes requires further elucidation. View Full-Text
Keywords: COVID-19; acute kidney injury; angiotensin 1-7; Mas receptor; ACE2; RAAS COVID-19; acute kidney injury; angiotensin 1-7; Mas receptor; ACE2; RAAS
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MDPI and ACS Style

Heyman, S.N.; Walther, T.; Abassi, Z. Angiotensin-(1-7)—A Potential Remedy for AKI: Insights Derived from the COVID-19 Pandemic. J. Clin. Med. 2021, 10, 1200. https://doi.org/10.3390/jcm10061200

AMA Style

Heyman SN, Walther T, Abassi Z. Angiotensin-(1-7)—A Potential Remedy for AKI: Insights Derived from the COVID-19 Pandemic. Journal of Clinical Medicine. 2021; 10(6):1200. https://doi.org/10.3390/jcm10061200

Chicago/Turabian Style

Heyman, Samuel N., Thomas Walther, and Zaid Abassi. 2021. "Angiotensin-(1-7)—A Potential Remedy for AKI: Insights Derived from the COVID-19 Pandemic" Journal of Clinical Medicine 10, no. 6: 1200. https://doi.org/10.3390/jcm10061200

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