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Shukla AK, Awasthi K, Usman K, Banerjee M. Role of renin-angiotensin system/angiotensin converting enzyme-2 mechanism and enhanced COVID-19 susceptibility in type 2 diabetes mellitus. World J Diabetes 2024; 15(4): 606-622 [PMID: 38680697 DOI: 10.4239/wjd.v15.i4.606]
Ashwin Kumar Shukla, Komal Awasthi, Monisha Banerjee, Molecular and Human Genetics Laboratory, Department of Zoology, University of Lucknow, Lucknow 226007, Uttar Pradesh, India
Kauser Usman, Department of Medicine, King Georges’ Medical University, Lucknow 226003, Uttar Pradesh, India
Monisha Banerjee, Institute of Advanced Molecular Genetics, and Infectious Diseases (IAMGID), University of Lucknow, Lucknow 226007, Uttar Pradesh, India
Co-first authors: Ashwin K Shukla and Komal Awasthi.
Author contributions: Shukla AK and Awasthi K contributed equally to the study; Shukla AK contributed to the conceptualizing and writing; Awasthi K contributed to the conceptual writing of the manuscript; Usman K provided expert clinical input and interpretation of the reviewed literature; Banerjee M contributed to critical reading and reviewing the article and making critical revisions related to the intellectual content of the manuscript.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
Corresponding author: Monisha Banerjee, PhD, Professor, Molecular and Human Genetics Laboratory, Department of Zoology, University of Lucknow, University Road, Lucknow 226007, Uttar Pradesh, India. monishabanerjee30@gmail.com
Received: December 31, 2023 Peer-review started: December 31, 2023 First decision: January 16, 2024 Revised: January 22, 2024 Accepted: February 27, 2024 Article in press: February 27, 2024 Published online: April 15, 2024 Processing time: 102 Days and 11.6 Hours
Core Tip
Core Tip: This manuscript explored the complex connection between type 2 diabetes mellitus and coronavirus disease 2019 (COVID-19), emphasizing the heightened susceptibility of diabetic individuals. It revealed the crucial involvement of the renin-angiotensin system and angiotensin converting enzyme (ACE)/ACE2 enzymes, clarifying how decreased ACE2 expression in diabetes amplifies renin-angiotensis system activity, contributing to inflammation and fibrosis. While ACE inhibitors exhibit therapeutic potential, concerns arise regarding their potential to facilitate viral entry. The review suggested that innovative approaches, including recombinant human ACE2 therapy and the detection of epigenetic signatures, present promising avenues for addressing COVID-19 and its complications in type 2 diabetes mellitus.
