Assessing ACE2 expression patterns in lung tissues in the pathogenesis of COVID-19

J Autoimmun. 2020 Aug;112:102463. doi: 10.1016/j.jaut.2020.102463. Epub 2020 Apr 13.


It has been reported that SARS-CoV-2 may use ACE2 as a receptor to gain entry into human cells, in a way similar to that of SARS-CoV. Analyzing the distribution and expression level of ACE2 may therefore help reveal underlying mechanisms of viral susceptibility and post-infection modulation. In this study, we utilized previously uploaded information on ACE2 expression in various conditions including SARS-CoA to evaluate the role of ACE2 in SARS-CoV and extrapolate that to COVID-19. We found that the expression of ACE2 in healthy populations and patients with underlying diseases was not significantly different. However, based on the elevated expression of ACE2 in cigarette smokers, we speculate that long-term smoking may be a risk factor for COVID-19. Analysis of ACE2 in SARS-CoV infected cells suggests that ACE2 is not only a receptor but is also involved in post-infection regulation, including immune response, cytokine secretion, and viral genome replication. Moreover, we constructed Protein-protein interaction (PPI) networks and identified hub genes in viral activity and cytokine secretion. Our findings may help clinicians and researchers gain more insight into the pathogenesis of SARS-CoV-2 and design therapeutic strategies for COVID-19.

Keywords: 2019-nCoV; ACE2; COVID-19; Immune response; Protein-protein interactions; SARS-CoV-2; Susceptibility.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin-Converting Enzyme 2
  • Betacoronavirus / metabolism*
  • COVID-19
  • Coronavirus Infections / enzymology*
  • Coronavirus Infections / pathology
  • Gene Expression Regulation, Enzymologic*
  • Humans
  • Lung / enzymology*
  • Pandemics
  • Peptidyl-Dipeptidase A / biosynthesis*
  • Pneumonia, Viral / enzymology*
  • Pneumonia, Viral / pathology
  • Protein Interaction Maps
  • SARS-CoV-2
  • Smoking / adverse effects*


  • Peptidyl-Dipeptidase A
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2