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Soluble Angiotensin Converting Enzyme 2 (ACE2) Is Upregulated and Soluble Endothelial Nitric Oxide Synthase (eNOS) Is Downregulated in COVID-19-induced Acute Respiratory Distress Syndrome (ARDS)

1
First Department of Critical Care Medicine & Pulmonary Services, School of Medicine, National and Kapodistrian University of Athens, Evangelismos Hospital, 106 76 Athens, Greece
2
Biochemical Department, Evangelismos Hospital, 106 76 Athens, Greece
3
Computational Biomedicine Laboratory, Department of Digital Systems, University of Piraeus, 185 34 Piraeus, Greece
*
Author to whom correspondence should be addressed.
Academic Editor: Nektarios Barabutis
Pharmaceuticals 2021, 14(7), 695; https://0-doi-org.brum.beds.ac.uk/10.3390/ph14070695
Received: 29 June 2021 / Revised: 15 July 2021 / Accepted: 16 July 2021 / Published: 19 July 2021
(This article belongs to the Special Issue Lung Injury and Repair)
A damaged endothelium is an underlying condition of the many complications of COVID-19 patients. The increased mortality risk associated with diseases that have underlying endothelial dysfunction, such as acute respiratory distress syndrome (ARDS), suggests that endothelial (e) nitric oxide synthase (NOS)-derived nitric oxide could be an important defense mechanism. Additionally, intravenous recombinant angiotensin converting enzyme 2 (ACE2) was recently reported as an effective therapy in severe COVID-19, by blocking viral entry, and thus reducing lung injury. Very few studies exist on the prognostic value of endothelium-related protective molecules in severe COVID-19 disease. To this end, serum levels of eNOS, inducible (i) NOS, adrenomedullin (ADM), soluble (s) ACE2 levels, and serum (s) ACE activity were measured on hospital admission in 89 COVID-19 patients, hospitalized either in a ward or ICU, of whom 68 had ARDS, while 21 did not. In our cohort, the COVID-19-ARDS patients had considerably lower eNOS levels compared to the COVID-19 non-ARDS patients. On the other hand, sACE2 was significantly higher in the ARDS patients. iNOS, ADM and sACE activity did not differ. Our results might support the notion of two distinct defense mechanisms in COVID-19-derived ARDS; eNOS-derived nitric oxide could be one of them, while the dramatic rise in sACE2 may also represent an endogenous mechanism involved in severe COVID-19 complications, such as ARDS. These results could provide insight to therapeutical applications in COVID-19. View Full-Text
Keywords: eNOS; sACE2; COVID-19; adrenomedullin; NO; treatment eNOS; sACE2; COVID-19; adrenomedullin; NO; treatment
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MDPI and ACS Style

Vassiliou, A.G.; Zacharis, A.; Keskinidou, C.; Jahaj, E.; Pratikaki, M.; Gallos, P.; Dimopoulou, I.; Kotanidou, A.; Orfanos, S.E. Soluble Angiotensin Converting Enzyme 2 (ACE2) Is Upregulated and Soluble Endothelial Nitric Oxide Synthase (eNOS) Is Downregulated in COVID-19-induced Acute Respiratory Distress Syndrome (ARDS). Pharmaceuticals 2021, 14, 695. https://0-doi-org.brum.beds.ac.uk/10.3390/ph14070695

AMA Style

Vassiliou AG, Zacharis A, Keskinidou C, Jahaj E, Pratikaki M, Gallos P, Dimopoulou I, Kotanidou A, Orfanos SE. Soluble Angiotensin Converting Enzyme 2 (ACE2) Is Upregulated and Soluble Endothelial Nitric Oxide Synthase (eNOS) Is Downregulated in COVID-19-induced Acute Respiratory Distress Syndrome (ARDS). Pharmaceuticals. 2021; 14(7):695. https://0-doi-org.brum.beds.ac.uk/10.3390/ph14070695

Chicago/Turabian Style

Vassiliou, Alice G., Alexandros Zacharis, Chrysi Keskinidou, Edison Jahaj, Maria Pratikaki, Parisis Gallos, Ioanna Dimopoulou, Anastasia Kotanidou, and Stylianos E. Orfanos 2021. "Soluble Angiotensin Converting Enzyme 2 (ACE2) Is Upregulated and Soluble Endothelial Nitric Oxide Synthase (eNOS) Is Downregulated in COVID-19-induced Acute Respiratory Distress Syndrome (ARDS)" Pharmaceuticals 14, no. 7: 695. https://0-doi-org.brum.beds.ac.uk/10.3390/ph14070695

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