Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi

Eroglu, Imdat; Uyaroğlu, Oğuz Abdullah; SAINGUVEN, GULAY

doi:10.20515 / otd. 756606

Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi

İmdat Eroğlu, (Hacettepe Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı Ankara, Türkiye)

Oğuz Abdullah Uyaroğlu, (Hacettepe Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı Ankara, Türkiye)

Gülay Sain Güven (Hacettepe Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı Ankara, Türkiye)

Osmangazi Tıp Dergisi

4 1

Yıl: 2021 Cilt: 43 Sayı: 1 Sayfa Aralığı: 86 - 93 Metin Dili: Türkçe DOI: 10.20515 / otd. 756606 İndeks Tarihi: 06-05-2021

Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi

Öz:

Aralık 2019’da Çin’de etiyolojisi bilinmeyen pnömoni vakaları bildirilmiş olup daha önce insanlarda tespit edilmemiş yeni bircoronavirusun hastalığa neden olduğu tespit edilmiştir. 2002 yılında salgın yapan SARS-CoV virusuna olan benzerliğinden dolayıSARS-CoV-2 olarak adlandırılmış, virusun yol açtığı klinik hastalığa da “coronavirus hastalığı-2019 (coronavirus disease – 2019,COVID-19)” adı verilmiştir. Hastalığın patofizyolojisi üzerine yapılan ilk çalışmalarda SARS-CoV-2’nin hücreye giriş reseptörü olarakAnjiyotensin Dönüştürücü Enzim2 (ACE2)’yi kullandığı saptanmıştır. Hastalığın Renin Anjiyotensin Aldosteron Sistemi (RAAS)blokerlerinin sıklıkla kullanıldığı hasta gruplarında (hipertansiyon, kardiyovasküler hastalıklar) daha sık saptandığı ve daha ağır seyrettiğinin görülmesi RAAS blokeri olarak kullanılan Anjiyotensin Dönüştürücü Enzim İnhibitörleri(ACEI) ve Anjiyotensin ReseptörBlokörlerinin (ARB) kullanımı ile ilgili endişelere yol açmıştır. COVID-19 pandemisinin başından itibaren bilim dünyasında bu konuile ilgili birçok farklı görüş bildirilmiş, çalışmalar yapılmış ve yapılmaya devam etmektedir. Bu yazıda, COVID-19 ve RAAS arasındakiilişki ve COVID-19 hastalarında ACEI/ARB kullanımının potansiyel etkileri güncel literatür eşliğinde gözden geçirilmiştir.

Anahtar Kelime:

The Relation Between COVID-19 and Renin Angiotensin Aldosterone System in the Light of Current Literature

Öz:

In December 2019, pneumonia cases of unknown etiology reported in China. A new coronavirus not previously detected in humans has been found to cause disease. The virus was named SARS-CoV-2 because of the similarity to the epidemic SARS-CoV virus in 2002. The clinical disease caused by the virus was called coronavirus disease-2019 (coronavirus disease - 2019, COVID-19). In the first studies on the pathophysiology of the disease, it was found that SARS-CoV-2 used Angiotensin-Converting Enzyme 2 (ACE2) as the cell entry receptor. The disease has been observed to be more frequent and severe in patient groups (hypertension, cardiovascular diseases) whom Renin Angiotensin Aldosterone System (RAAS) blockers are frequently used. This situation has led to concerns about the use of Angiotensin-Converting Enzyme Inhibitors (ACEI) and Angiotensin Receptor Blockers (ARB). Since the beginning of the COVID-19 pandemic, many different opinions about this issue have been reported. Studies have been done and continue to be carried out. In this article, the relationship between COVID-19 and RAAS and the potential effects of ACEI / ARB use in COVID-19 patients are reviewed in the light of current literature.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

1. Türkiye Cumhuriyeti Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Erişim tarihi: 14 Nisan 2020. Available from: https://hsgm.saglik.gov.tr/tr/covid19
2. Leung, Char. “Clinical features of deaths in the novel coronavirus epidemic in China.” Reviews in Medical Virology 2020: e2103.
3. Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor Recognition by the Novel Coronavirus from Wuhan: an Analysis Based on Decade-Long Structural Studies of SARS Coronavirus. J Virol. 2020;94:e00127-20.
4. Hasöksüz, Mustafa, Selçuk Kiliç, and Fahriye Saraç. Coronaviruses and SARS-CoV-2. Turkish Journal of Medical Sciences 50.SI-1 2020:549-56.
5. World Healt Organization. WHO. Novel Coronavirus (2019-nCoV) situation report – 10. Data as reported by 30 January 2020. Avaible from: https://www. who.int/docs/default-source/coronaviruse/situation-reports/20200130-sitrep-10-ncov.pdf?sfvrsn=d0b2e480_2.
6. Donoghue M, Hsieh F, Baronas E, et al. A novel angiotensin-converting enzyme-related carboxypeptidase (ACE2) converts angiotensin I to angiotensin 1-9. Circ Res. 2000;87:E1-E9.
7. Patel, Sheila K., et al. From gene to protein—experimental and clinical studies of ACE2 in blood pressure control and arterial hypertension. Frontiers in physiology, 2014,5: 227.
8. Tipnis SR, Hooper NM, Hyde R, Karran E, Christie G, Turner AJ. A human homolog of angiotensin-converting enzyme. Cloning and functional expression as a captopril-insensitive carboxypeptidase. J Biol Chem. 2000;275:33238-43.
9. Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203:631-7.
10. Crackower MA, Sarao R, Oudit GY, et al. Angiotensin-converting enzyme 2 is an essential regulator of heart function. Nature. 2002;417:822-8.
11. Zisman LS, Keller RS, Weaver B, et al. Increased angiotensin-(1-7)-forming activity in failing human heart ventricles: evidence for upregulation of the angiotensin-converting enzyme Homologue ACE2. Circulation. 2003 Oct;108:1707-12 KAYNAKLAR
12. Burrell LM, Risvanis J, Kubota E, et al. Myocardial infarction increases ACE2 expression in rat and humans. Eur Heart J. 2005;26:369-324.
13. Der Sarkissian S, Grobe JL, Yuan L, et al. Cardiac overexpression of angiotensin converting enzyme 2 protects the heart from ischemia-induced pathophysiology. Hypertension. 2008;51:712-8.
14. Kuba K, Imai Y, Rao S, et al. A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury. Nat Med. 2005;11:875-9.
15. Imai Y, Kuba K, Rao S, et al. Angiotensin-converting enzyme 2 protects from severe acute lung failure. Nature. 2005;436:112-6.
16. Xie X, Chen J, Wang X, Zhang F, Liu Y. Age- and gender-related difference of ACE2 expression in rat lung [published correction appears in Life Sci. 2006 Nov 25;79:2499.
17. Jia HP, Look DC, Shi L, et al. ACE2 receptor expression and severe acute respiratory syndrome coronavirus infection depend on differentiation of human airway epithelia. J Virol. 2005;79:14614-21.
18. Kai H, Kai M. Interactions of coronaviruses with ACE2, angiotensin II, and RAS inhibitors-lessons from available evidence and insights into COVID-19. Hypertens Res. 2020;43:648-54. 19. Backhaus A. Coronavirus: why it’s so deadly in Italy.
Demographics and why they are a warning to other countries. Medium, 13 March 2020. Available from: https:// medium.com/@andreasbackhausab/coronavirus-why-itsso-deadly-in-italy-c4200a15a7bf
20. AlGhatrif M, Cingolani O, Lakatta EG. The Dilemma of Coronavirus Disease 2019, Aging, and Cardiovascular Disease: Insights From Cardiovascular Aging Science [published online ahead of print, 2020 Apr 3]. JAMA Cardiol. 2020;10.1001/jamacardio.2020.1329.
21. Metzger R, Franke FE, Bohle RM, Alhenc-Gelas F, Danilov SM. Heterogeneous distribution of angiotensin I-converting enzyme (CD143) in the human and rat vascular systems: vessel, organ and species specificity. Microvasc Res. 2011;81:206–15
22. Zhang H, Baker A. Recombinant human ACE2: acing out angiotensin II in ARDS therapy. Crit Care. 2017;21:305
23. Varga Z, Flammer AJ, Steiger P, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395:1417-8.
24. Watanabe T, Barker TA, Berk BC. Angiotensin II and the endothelium: diverse signals and effects. Hypertension. 2005;45:163-9.
25. Zhang T, Sun LX, Feng RE. [Comparison of clinical and pathological features between severe acute respiratory syndrome and coronavirus disease 2019]. Zhonghua jie he he hu xi za zhi = Zhonghua Jiehe he Huxi Zazhi = Chinese Journal of Tuberculosis and Respiratory Diseases. 2020;43:496-502
26. Senchenkova EY, Russell J, Almeida-Paula LD, Harding JW, Granger DN, Angiotensin II-mediated microvascular thrombosis. Hypertension. 2010; 56:1089-95.
27. Brambilla M, Gelosa P, Rossetti L, et al. Impact of angiotensin-converting enzyme inhibition on platelet tissue factor expression in stroke-prone rats. J Hypertens. 2018;36:1360-71.
28. Vaduganathan, Muthiah, et al. Renin–angiotensin– aldosterone system inhibitors in patients with Covid-19. New England Journal of Medicine, 2020, 382.17: 1653-9.
29. Ferrario, Carlos M., et al. Effect of angiotensin-converting enzyme inhibition and angiotensin II receptor blockers on cardiac angiotensin-converting enzyme 2. Circulation, 2005, 111.20: 2605-10.
30. Wang, Xingxu, et al. The effects of different angiotensin II type 1 receptor blockers on the regulation of the ACE-AngII-AT1 and ACE2-Ang (1–7)-Mas axes in pressure overload-induced cardiac remodeling in male mice. Journal of molecular and cellular cardiology, 2016, 97:180-90.
31. Serfozo, Peter, et al. Ang II (angiotensin II) conversion to angiotensin-(1-7) in the circulation is POP (prolyloligopeptidase)-dependent and ACE2 (angiotensin-converting enzyme 2)-independent. Hypertension, 2020, 75.1: 173-82.
32. Danser AHJ, Epstein M, Batlle D. Renin-Angiotensin System Blockers and the COVID-19 Pandemic: At Present There Is No Evidence to Abandon Renin-Angiotensin System Blockers. Hypertension 2020;75:1382-5.
33. Xu, Jiaxi, et al. Clinical relevance and role of neuronal AT1 receptors in ADAM17-mediated ACE2 shedding in neurogenic hypertension. Circulation research, 2017, 121.1: 43-55.
34. Esler, Murray; Esler, Danielle. Can angiotensin receptor-blocking drugs perhaps be harmful in the COVID-19 pandemic?. Journal of hypertension, 2020, 38.5: 781-2
35. Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? [published correction appears in Lancet Respir Med. 2020 Jun;8(6):e54]. Lancet Respir Med. 2020;8:e21
36. WHO, COVID-19 and the use of angiotensin-converting enzyme inhibitors and receptor blockers, Scintific Brief, 07 MAY 2020, Avaliable from: https://www.who. int/news-room/commentaries/detail/covid-19-and-theuse-of-angiotensin-converting-enzyme-inhibitors-andreceptor-blockers)
37. Kuster GM, Pfister O, Burkard T, et al. SARSCoV2: should inhibitors of the renin-angiotensin system be withdrawn in patients with COVID-19?. Eur Heart J. 2020;41:1801-3.
38. Zhang P, Zhu L, Cai J, et al. Association of Inpatient Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Mortality Among Patients With Hypertension Hospitalized With COVID-19. Circ Res. 2020;126:1671-81.
39. Meng J, Xiao G, Zhang J, et al. Renin-angiotensin system inhibitors improve the clinical outcomes of COVID-19 patients with hypertension. Emerg Microbes Infect. 2020;9:757‐60.
40. De Abajo FJ, Rodríguez-Martín S, Lerma V, et al. Use of renin-angiotensin-aldosterone system inhibitors and risk of COVID-19 requiring admission to hospital: a case-population study. Lancet. 2020;395:1705-14.

APA	Eroglu I, Uyaroğlu O, SAINGUVEN G (2021). Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi. , 86 - 93. 10.20515 / otd. 756606
Chicago	Eroglu Imdat,Uyaroğlu Oğuz Abdullah,SAINGUVEN GULAY Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi. (2021): 86 - 93. 10.20515 / otd. 756606
MLA	Eroglu Imdat,Uyaroğlu Oğuz Abdullah,SAINGUVEN GULAY Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi. , 2021, ss.86 - 93. 10.20515 / otd. 756606
AMA	Eroglu I,Uyaroğlu O,SAINGUVEN G Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi. . 2021; 86 - 93. 10.20515 / otd. 756606
Vancouver	Eroglu I,Uyaroğlu O,SAINGUVEN G Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi. . 2021; 86 - 93. 10.20515 / otd. 756606
IEEE	Eroglu I,Uyaroğlu O,SAINGUVEN G "Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi." , ss.86 - 93, 2021. 10.20515 / otd. 756606
ISNAD	Eroglu, Imdat vd. "Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi". (2021), 86-93. https://doi.org/10.20515 / otd. 756606

APA	Eroglu I, Uyaroğlu O, SAINGUVEN G (2021). Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi. Osmangazi Tıp Dergisi, 43(1), 86 - 93. 10.20515 / otd. 756606
Chicago	Eroglu Imdat,Uyaroğlu Oğuz Abdullah,SAINGUVEN GULAY Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi. Osmangazi Tıp Dergisi 43, no.1 (2021): 86 - 93. 10.20515 / otd. 756606
MLA	Eroglu Imdat,Uyaroğlu Oğuz Abdullah,SAINGUVEN GULAY Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi. Osmangazi Tıp Dergisi, vol.43, no.1, 2021, ss.86 - 93. 10.20515 / otd. 756606
AMA	Eroglu I,Uyaroğlu O,SAINGUVEN G Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi. Osmangazi Tıp Dergisi. 2021; 43(1): 86 - 93. 10.20515 / otd. 756606
Vancouver	Eroglu I,Uyaroğlu O,SAINGUVEN G Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi. Osmangazi Tıp Dergisi. 2021; 43(1): 86 - 93. 10.20515 / otd. 756606
IEEE	Eroglu I,Uyaroğlu O,SAINGUVEN G "Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi." Osmangazi Tıp Dergisi, 43, ss.86 - 93, 2021. 10.20515 / otd. 756606
ISNAD	Eroglu, Imdat vd. "Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi". Osmangazi Tıp Dergisi 43/1 (2021), 86-93. https://doi.org/10.20515 / otd. 756606