"COVID-19 and confusion: the story of a nasty but nice viral receptor"

Hunter Branch Meeting 2020-2 of the Royal Society of NSW
"COVID-19 and confusion: the story of a nasty but nice viral receptor"
Emeritus Professor Eugenie Lumbers AM DistFRSN FAA
https://royalsoc.org.au/blog/hunter-branch-meeting-2020-2

Timing Marks
00:00 Introduction: Mr Paul Jeans FRSN, Chair Hunter Branch, RSNSW, and Chancellor, University of Newcastle
04:33 Presentation: Emeritus Professor Eugenie Lumbers AM DistFRSN FAA, University of Newcastle and Hunter Medical Research Institute
37:03 Q&A Session: Professor Natalie Thamwattana, University of Newcastle
53:15 Vote of Thanks: Mr Paul Jeans FRSN

Summary
COVID-19 is an infection caused by a corona virus (SARS-CoV-2). To get into the body it binds to a protein on the surface of the cells of the body’s organs by a viral protein spike. These spikes stick out from the surface of the virus giving it a crown-like appearance, hence the name corona virus. The spike protein binds to an enzyme, ACE2. It is thought that the more ACE2 there is on cell membranes the greater the load of infectious particles there will be to enter cells, i.e., the greater the level of infection.
When the spike protein binds to ACE2 it ‘destroys’ it. ACE2 protects lung, heart and kidneys from the actions of angiotensin II which activates inflammatory pathways, by removing angiotensin II and converting it to an anti-inflammatory peptide. SARS-CoV-2 by binding to ACE2, therefore removes its protective effects.
Recombinant ACE2 can be easily introduced into the body. The question is could ACE2 be used safely to treat COVID-19? Do drugs that lower blood pressure by blocking angiotensin II and also by causing upregulation of ACE2 enhance the severity of COVID-19? Or do these drugs protect against severe tissue damage by suppressing angiotensin II’s inflammatory actions? These conflicting actions of ACE2 are causing confusion in the race to manage patients with COVID-19 and to prevent infection.

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