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World J Diabetes. Jun 15, 2021; 12(6): 839-854
Published online Jun 15, 2021. doi: 10.4239/wjd.v12.i6.839
New perspectives on angiotensin-converting enzyme 2 and its related diseases
Li-Ping Liu, Xiao-Li Zhang, Jian Li
Li-Ping Liu, Jian Li, Key Laboratory of Model Animals and Stem Cell Biology in Hunan Province, School of Medicine, Hunan Normal University, Changsha 410013, Hunan Province, China
Xiao-Li Zhang, TheFifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Heidelberg 68135, Baden-Württemberg, Germany
Author contributions: Liu LP and Zhang XL wrote the manuscript; Li J designed and revised the review.
Supported by National Natural Science Foundation of China, No. 81873861; and Key Grant of Research and Development in Hunan Province, No. 2020DK2002.
Conflict-of-interest statement: The authors declare no conflicts of interest related to this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Li, PhD, Associate Professor, Key Laboratory of Model Animals and Stem Cell Biology in Hunan Province, School of Medicine, Hunan Normal University, No. 371 Tongzhipo Road, Changsha 410013, Hunan Province, China. lijianyxy@hunnu.edu.cn
Received: February 18, 2021
Peer-review started: February 18, 2021
First decision: March 16, 2021
Revised: March 30, 2021
Accepted: April 20, 2021
Article in press: April 20, 2021
Published online: June 15, 2021
Abstract

Since the worldwide outbreak of coronavirus disease 2019, angiotensin-converting enzyme 2 (ACE2) has received widespread attention as the cell receptor of the severe acute respiratory syndrome coronavirus 2 virus. At the same time, as a key enzyme in the renin-angiotensin-system, ACE2 is considered to be an endogenous negative regulator of vasoconstriction, proliferation, fibrosis, and proinflammation caused by the ACE-angiotensin II-angiotensin type 1 receptor axis. ACE2 is now implicated as being closely connected to diabetes, cardiovascular, kidney, and lung diseases, and so on. This review covers the available information on the host factors regulating ACE2 and discusses its role in a variety of pathophysiological conditions in animal models and humans.

Keywords: Angiotensin-converting enzyme 2, COVID-19, Salt, Renin-angiotensin-system inhibitors, Diabetes and cardiovascular disease, Renal and lung disease

Core Tip: Angiotensin-converting enzyme 2 (ACE2) as the key cell receptor for the severe acute respiratory syndrome coronavirus 2 virus has received widespread attention. This paper will review the new perspectives on ACE2, covers available information on the host regulative factors of ACE2, and discusses its role in a variety of pathophysiological conditions. This review will help us with a better understanding of the biological function and role of ACE2 in coronavirus disease 2019 and its treatment.