Süregelen Bir Tartışma: Anjiotensin-Konverting Enzim İnhibitörü ve/veya Anjiotensin Reseptör Blokörü Kullanan Hastaların COVID-19’a Karşı Duyarlılığı Daha Fazla mıdır?

Yıl 2020, Sayı: Special Issue on COVID 19, 79 - 84, 20.03.2020

Sarper Yılmaz , Nazif Elaldı , Hakan Ertın

https://doi.org/10.21673/anadoluklin.716125

Öz

Halen içinde olduğumuz beklenmedik Covid-19 pandemisi ile ilgili bilimsel dergilerde konuya ilişkin çok sayıda makale yayımlandı. Bunlardan bir tanesi, halen tedavi görmekte olan hastaların tedavisinde önemli bir değişiklik önermesi nedeniyle özel olarak ele alınmayı hakketmektedir. Bu makalede, Anjiyotensin Konverting Enzim inhibitörleri ile Anjiotensin reseptör blokörü ilaçların hastanın durumunu kötüleştirme riski nedeniyle bırakılması önerilmekteydi. Makalenin Lancet Respiratory Medicine dergisinde yayımlanmasını takiben bilim çevrelerinde hararetli bir tartışma başladı. Burada bu olayı bir olgu şeklinde özetlemeye ve önemli noktaları ilgili bilimsel literatürün ışığında değerlendirmeye çalışacağız

Anahtar Kelimeler

Pandemi, Anjiotensin, ACE, ACE2, Coronavirus, Covid-19

An ongoing debate: Are the patients receiving angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers more susceptible to COVID-19 ?

Öz

As a result of the unprecedented current pandemic, abundant publications about the various aspects of this disease appear in the scientific journals. Among them, one publication deserves special attention because of recommending a substantial change in the management of patients in the current pandemic. This publication recommended the disuse of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers because of the risk of worsening the infection. Immediately following its publication in the Lancet Respiratory Medicine, a vivid discussion emerged in the scientific communities. Herein we will try to summarize this event as a case and mention the important points of the discussion under the light of the relevant literature.

Anahtar Kelimeler

Coronavirus, pandemic, angiotensin, ACE, ace2, covid-19

Kaynakça

• 1.Fang L, Karakiulakis G, Roth M. “Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?” Lancet Respir Med; published online March 11. https://doi.org/10.1016/S2213-2600(20)30116-8.
• 2.Sommerstein R, Grani C, “Re: Preventing a Covid Pandemic: ACE inhibitors as a potential risk factor for fatal Covid-19”, British Medical Journal, 368, 2020, March 3. https://www.bmj.com/content/368/bmj.m810/rr-2
• 3.Kuster GM, Pfister O, Burkard T, “SARS-CoV2: Should inhibitors of the renin-angiotensin system be withdrawn in patients with Covid-19?”, European Heart Journal, 2020, March 18. doi:10.1093/eurheartj/ehaa235.
• 4.Wan Y, Shang J, Graham R, et al. Receptor recognition by novel coronavirus from Wuan: An analysis based on Decade-Long Structural Studies of SARS. J Virol, 2020;94(7). pii: e00127-20. doi: 10.1128/JVI.00127-20.
• 5.Procko E, “The Sequence of Human ACE2 is Suboptimal for Binding the S Spike Protein of SARS coronavirus 2”, BioRxiv, March 17, 2020.
• 6. Cao Y, Li L, Feng Z et al., “Comparative genetic analysis of the novel coronavirus (2019-nCoV/SARS-CoV-2) receptor ACE2 in different populations”, Cell Discovery, 6:11, 2020.
• 7. Li XC, Zhang J, Zhuo JL, “The vasoprotective axes of the renin-angiotensin system: physiological relevance and therapeutic implications in cardiovascular, hypertensive and kidney diseases”, Pharmacological Research, 125(Pt A): 21-38, 2017.
• 8.Donoghue M, Hsieh F et al., “A Novel Angiotensin-Converting Enzyme–Related Carboxypeptidase (ACE2) Converts Angiotensin I to Angiotensin 1-9”, Circulation Research, 87:e1-e9, 2000.
• 9.Tipnis SR, Hooper NM et al., “A Human Homolog of Angiotensin-Converting Enzyme”, The Journal of Biological Chemistry, 275(43):33238-33243, 2000.
• 10.Ferrario MC, Jessup J, Chappell MC et al., “Effect of Angiotensin-Converting Enzyme Inhibiton and Angiotensin II Receptor blockers on Cardiac Angiotensin-Converting Enzyme-II ”, Circulation, 111:2605-2610, 2005.
• 11.Hristova M, Stanilova S, Miteva L, “Serum concentration of renin-angiotensin system components in association with ACE I/D polymorphism among hypertensive subjects in response to ACE inhibitor therapy”, Clinical and Experimental Hypertension, 41(7):662-669, 2019.
• 12.Cai, G. Bulk and Single-Cell Transcriptomics Identify Tobacco-Use Disparity in Lung Gene Expression of ACE2, the Receptor of 2019-nCov. Preprints 2020, 2020020051 (doi: 10.20944/preprints202002.0051.v2).
• 13.Qiao W, Wang C, Chen B, “Ibuprofen attenuates cardiac fibrosis in Streptozotocin-induced dibaetic rats”, Cardiology, 131(2):97-106, 2005.
• 14.https://www.sciencealert.com/who-recommends-to-avoid-taking-ibuprofen-for-covid-19-symptoms, reached on March 20, 2020.
• 15.Flores-Sotomoyor, Rivera-Mejias P, Vasquez-Trincado C et al. “Angiotensin-(1-9) prevents cardiomyocyte hypertrophy by controlling mitochondrial dynamics via miR-129-3p/PKIA pathway”, Cell Death & Differentiation, March 9, 2020, doi: 10.1038/s41418-020-0522-3.
• 16.Vickers C, Hales P, Kaushik V, “Hydrolysis of Biological Peptides by Human Angiotensin Converting Enyzme Related Carboxypeptidase (ACE2)”, J. Biol. Chem., 227(17):14838-43, 2002
• 17.https://www.escardio.org/Councils/Council-on-Hypertension-(CHT)/News/position statement-of-the-esc-council-on-hypertension-on-ace-inhibitors-and-ang, reached on March 29, 2020.
• 18.https://www.acc.org/latest-in-cardiology/articles/2020/03/17/08/59/hfsa-acc-aha-statement-addresses-concerns-re-using-raas-antagonists-in-covid-19, reached on March 29, 2020.
• 19.Sparks MA, Hiremath S et al. "The Coronavirus Conundrum: ACE2 and Hypertension Edition” NephJC, http://www.nephjc.com/news/covidace2, reached on March 29, 2020.
• 20.Braun JD, “Antihypertensive drugs and risk of Covid-19?”, Lancet Respiratory Medicine, March 26, 2020, https://doi.org/10.1016/ S2213-2600(20)30158-2, reached on March 30, 2020.
• 21.Tignanelli CJ, Ingraham NE, Sparks MA et al, “Antihypertensive Drugs and risk of Covid-19?”, Lancet Respiratory Medicine, March 26, 2020, https://doi.org/10.1016/ S2213-2600(20)30153-3, reached on March 30, 2020.
• 22.Lo KB, McCullough PA, Rangaswami J, “Antihypertensive Drugs and risk of Covid-19?”, Lancet Respiratory Medicine, March 26, 2020, https://doi.org/10.1016/S2213-2600(20)30156-9, reached on March 30, 2020.
• 23. Amatruda O., “ACE inhibitors and ARBs are not a risk factor for fatal for Covid-19 Re: Preventing a Covid-19 pandemic”, BMJ, 2020, 368:m810; https://www.bmj.com/content/368/bmj.m810/rr-16, reached on April 6, 2020.