Open Access

REVIEW

Extracellular vesicles and angiotensin-converting enzyme 2 in COVID-19 disease

YU LIU^*, ROBERT J. KASPER, NATALIE J. S. CHOI^*

Department of Family and Community Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois

* Corresponding Authors: YU LIU. Email: ; NATALIE J. S. CHOI. Email:

BIOCELL 2024, 48(1), 1-8. https://doi.org/10.32604/biocell.2023.031158

Received 18 May 2023; Accepted 06 November 2023; Issue published 30 January 2024

Abstract

Extracellular vesicles (EVs) are membranous vesicular structures released from almost all eukaryotic cell types under different physiological or pathological conditions. Growing evidence demonstrates that EVs can serve as mediators of intercellular communication between donor and recipient cells or microorganism-infected and noninfected cells. Coronavirus disease 2019 (COVID-19) disease is caused by infection of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) of host cells in the respiratory system and various extra-pulmonary tissue/organs, resulting in complications of multiple organ systems. As the cell surface receptor, angiotensin-converting enzyme 2 (ACE2) mediates cellular entry of SARS-CoV-2 into the host cells in patients with COVID-19. Recent studies have found that ACE2 can be released with EVs, which have been shown to interfere with the entry of the virus into host cells and thus may be involved in COVID-19 pathophysiology. In addition, ACE2, neprilysin (NEP), and thimet oligopeptidase (TOP) are the key enzymes that regulate angiotensin metabolism by converting angiotensin II or angiotensin I to angiotensin 1-7, the latter of which has protective effects in counterbalancing the harmful effects of angiotensin II in COVID-19 disease. This review summarizes the recent research progress regarding EV-associated ACE2, NEP, and TOP and the perspectives of their potential involvement in the pathophysiology of COVID-19 disease.

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