Can a Combination of AT1R Antagonist and Vitamin D Treat the Lung Complication of COVID-19?

Am J Med Sci. 2020 Oct;360(4):338-341. doi: 10.1016/j.amjms.2020.07.018. Epub 2020 Jul 15.

Abstract

Severe Acute Respiratory Distress Syndrome caused by a novel human coronavirus SARS-CoV-2 named COVID-19 and declared as a pandemic. This paper reviews the possibility of repurposing angiotensin type 1 receptor (AT1R) antagonists and vitamin D to treat COVID-19. ACE2 protein found on the cell membranes is the target of SARS-CoV-2 for entering into the host cells. Viral spike protein-binding with ACE2 down-regulates it. As ACE2 is known to protect the lung from injuries, SARS-CoV-2-induced ACE2 deficiency may expose patients to lung damage. AT1R antagonists and vitamin D increase the expression of ACE2 independently. Besides, vitamin D suppresses the compensatory increase in renin levels following the inhibition of the renin-angiotensin system by AT1R antagonists. Therefore, a combination of AT1R antagonists and vitamin D may offer protection against COVID-19 induced lung injury.

Keywords: COVID-19; Coronavirus; SARS; SARS-CoV-2.

Publication types

  • Review

MeSH terms

  • Angiotensin II Type 1 Receptor Blockers / pharmacology
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use*
  • Angiotensin-Converting Enzyme 2
  • Animals
  • Betacoronavirus
  • COVID-19
  • COVID-19 Drug Treatment
  • Coronavirus Infections / blood
  • Coronavirus Infections / complications
  • Coronavirus Infections / drug therapy*
  • Host-Pathogen Interactions
  • Humans
  • Pandemics
  • Peptidyl-Dipeptidase A / blood
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / drug therapy*
  • Renin-Angiotensin System / drug effects
  • SARS-CoV-2
  • Severe Acute Respiratory Syndrome / drug therapy*
  • Severe Acute Respiratory Syndrome / virology
  • Virus Internalization
  • Vitamin D / pharmacology
  • Vitamin D / therapeutic use*
  • Vitamins / pharmacology
  • Vitamins / therapeutic use*

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Vitamins
  • Vitamin D
  • Peptidyl-Dipeptidase A
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2