Role of Renin-Angiotensin System in Acute Lung Injury Caused by Viral Infection

Abstract

Yan-Lei Gao,* Yue Du,* Chao Zhang, Cheng Cheng, Hai-Yan Yang, Yue-Fei Jin, Guang-Cai Duan, Shuai-Yin Chen Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guang-Cai Duan; Shuai-Yin Chen Email [email protected]: The renin-angiotensin system (RAS) is the most important regulatory system of electrolyte homeostasis and blood pressure and acts through angiotensin-converting enzyme (ACE)/angiotensin II (Ang II)/Ang II type 1 (AT1) receptor axis and angiotensin-converting enzyme 2 (ACE2)/angiotensin (1-7)/MAS receptor axis. RAS dysfunction is related to the occurrence and development of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) and causes a serious prognosis and even death. ALI/ARDS can be induced by various ways, one of which is viral infections, such as SARS-CoV, SARS-CoV-2, H5N1, H7N9, and EV71. This article reviews the specific mechanism on how RAS dysfunction affects ALI/ARDs caused by viral infections. SARS-CoV and SARS-CoV-2 enter the host cells by binding with ACE2. H5N1 and H7N9 avian influenza viruses reduce the ACE2 level in the body, and EV71 increases Ang II concentration. Treatment with angiotensin-converting enzyme inhibitor and angiotensin AT1 receptor blocker can alleviate ALI/ARDS symptoms. This review provides suggestions for the treatment of lung injury caused by viral infections.Keywords: renin angiotensin system, acute lung injury and acute respiratory distress syndrome, viral infection

Keywords

• renin-angiotensin system
• acute lung injury and acute respiratory distress syndrome
• virus infection