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Kallikrein-kinin blockade in patients with COVID-19 to prevent acute respiratory distress syndrome
COVID-19 patients can present with pulmonary edema early in disease. We propose that this is due to a local vascular problem because of activation of bradykinin 1 receptor (B1R) and B2R on endothelial cells in the lungs. SARS-CoV-2 enters the cell via ACE2 that next to its role in RAAS is needed to...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
eLife Sciences Publications, Ltd
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213974/ https://www.ncbi.nlm.nih.gov/pubmed/32338605 http://dx.doi.org/10.7554/eLife.57555 |
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author | van de Veerdonk, Frank L Netea, Mihai G van Deuren, Marcel van der Meer, Jos WM de Mast, Quirijn Brüggemann, Roger J van der Hoeven, Hans |
author_facet | van de Veerdonk, Frank L Netea, Mihai G van Deuren, Marcel van der Meer, Jos WM de Mast, Quirijn Brüggemann, Roger J van der Hoeven, Hans |
author_sort | van de Veerdonk, Frank L |
collection | PubMed |
description | COVID-19 patients can present with pulmonary edema early in disease. We propose that this is due to a local vascular problem because of activation of bradykinin 1 receptor (B1R) and B2R on endothelial cells in the lungs. SARS-CoV-2 enters the cell via ACE2 that next to its role in RAAS is needed to inactivate des-Arg9 bradykinin, the potent ligand of the B1R. Without ACE2 acting as a guardian to inactivate the ligands of B1R, the lung environment is prone for local vascular leakage leading to angioedema. Here, we hypothesize that a kinin-dependent local lung angioedema via B1R and eventually B2R is an important feature of COVID-19. We propose that blocking the B2R and inhibiting plasma kallikrein activity might have an ameliorating effect on early disease caused by COVID-19 and might prevent acute respiratory distress syndrome (ARDS). In addition, this pathway might indirectly be responsive to anti-inflammatory agents. |
format | Online Article Text |
id | pubmed-7213974 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | eLife Sciences Publications, Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-72139742020-05-13 Kallikrein-kinin blockade in patients with COVID-19 to prevent acute respiratory distress syndrome van de Veerdonk, Frank L Netea, Mihai G van Deuren, Marcel van der Meer, Jos WM de Mast, Quirijn Brüggemann, Roger J van der Hoeven, Hans eLife Human Biology and Medicine COVID-19 patients can present with pulmonary edema early in disease. We propose that this is due to a local vascular problem because of activation of bradykinin 1 receptor (B1R) and B2R on endothelial cells in the lungs. SARS-CoV-2 enters the cell via ACE2 that next to its role in RAAS is needed to inactivate des-Arg9 bradykinin, the potent ligand of the B1R. Without ACE2 acting as a guardian to inactivate the ligands of B1R, the lung environment is prone for local vascular leakage leading to angioedema. Here, we hypothesize that a kinin-dependent local lung angioedema via B1R and eventually B2R is an important feature of COVID-19. We propose that blocking the B2R and inhibiting plasma kallikrein activity might have an ameliorating effect on early disease caused by COVID-19 and might prevent acute respiratory distress syndrome (ARDS). In addition, this pathway might indirectly be responsive to anti-inflammatory agents. eLife Sciences Publications, Ltd 2020-04-27 /pmc/articles/PMC7213974/ /pubmed/32338605 http://dx.doi.org/10.7554/eLife.57555 Text en © 2020, van de Veerdonk et al http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use and redistribution provided that the original author and source are credited. |
spellingShingle | Human Biology and Medicine van de Veerdonk, Frank L Netea, Mihai G van Deuren, Marcel van der Meer, Jos WM de Mast, Quirijn Brüggemann, Roger J van der Hoeven, Hans Kallikrein-kinin blockade in patients with COVID-19 to prevent acute respiratory distress syndrome |
title | Kallikrein-kinin blockade in patients with COVID-19 to prevent acute respiratory distress syndrome |
title_full | Kallikrein-kinin blockade in patients with COVID-19 to prevent acute respiratory distress syndrome |
title_fullStr | Kallikrein-kinin blockade in patients with COVID-19 to prevent acute respiratory distress syndrome |
title_full_unstemmed | Kallikrein-kinin blockade in patients with COVID-19 to prevent acute respiratory distress syndrome |
title_short | Kallikrein-kinin blockade in patients with COVID-19 to prevent acute respiratory distress syndrome |
title_sort | kallikrein-kinin blockade in patients with covid-19 to prevent acute respiratory distress syndrome |
topic | Human Biology and Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213974/ https://www.ncbi.nlm.nih.gov/pubmed/32338605 http://dx.doi.org/10.7554/eLife.57555 |
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