Bradykinin as a Probable Aspect in SARS-Cov-2 Scenarios: Is Bradykinin Sneaking out of Our Sight?

Iran J Allergy Asthma Immunol. 2020 May 17;19(S1):13-17. doi: 10.18502/ijaai.v19i(s1.r1).2850.


The new virus SARS-CoV-2 is savagely spreading out over the world. The biologic studies show that the target receptor for the virus might be angiotensin-converting enzyme 2 (ACE2). This peptide is responsible for converting angiotensin II (Ang II), which is a profoundly active peptide, into Ang 1-7 with quite a balancing barbell function. It is emphasized that the direct target of the virus is ACE2 underlining the obvious difference with ACE. Nevertheless, we hypothesized that a back load build up effect on Ang II may usurp the ACE capacity and subsequently leave the bradykinin system unabated. We think there are clinical clues for dry cough and the presumed aggravating role of ACE inhibitors like captopril on the disease process. Thereby, we speculated that inhibition of bradykinin synthesis and/or blockade of bradykinin B2 receptor using Aprotinin/ecallantide and Icatibant, respectively, may hold therapeutic promise in severe cases and these molecules can be advanced to clinical trials.

Keywords: Angiotensin-converting enzyme 2; Aprotinin; Bradykinin; Icatibant; SARS-CoV-2.

MeSH terms

  • Angiotensin-Converting Enzyme 2
  • Betacoronavirus / drug effects
  • Betacoronavirus / metabolism*
  • Bradykinin / metabolism*
  • Bradykinin B2 Receptor Antagonists / pharmacology*
  • COVID-19
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / metabolism*
  • Humans
  • Pandemics
  • Peptidyl-Dipeptidase A / metabolism
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / metabolism*
  • Receptors, Bradykinin / drug effects
  • Receptors, Bradykinin / metabolism
  • SARS-CoV-2
  • Signal Transduction / drug effects
  • Signal Transduction / physiology


  • Bradykinin B2 Receptor Antagonists
  • Receptors, Bradykinin
  • Peptidyl-Dipeptidase A
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2
  • Bradykinin