{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:00:01Z","timestamp":1791907201779,"version":"4.3.4"},"reference-count":68,"publisher":"Portland Press Ltd.","issue":"3","license":[{"start":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T00:00:00Z","timestamp":1611273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["portlandpress.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,2,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The key link between renin\u2013angiotensin system (RAS) and COVID-19 is ACE2 (angiotensin-converting enzyme 2), which acts as a double-edged sword, because ACE2 increases the tissue anti-inflammatory response but it is also the entry receptor for the virus. There is an important controversy on several drugs that regulate RAS activity and possibly ACE2, and are widely used, particularly by patients most vulnerable to severe COVID-19. In the lung of healthy rats, we observed that candesartan (an angiotensin type-1, AT1, receptor blocker; ARB) and captopril (an ACE inhibitor; ACEI) up-regulated expression of tissue ACE2 and RAS anti-inflammatory axis receptors (AT2 and Mas receptors). This effect was particularly pronounced in rats with metabolic syndrome (obesity, increased blood pressure and hyperglycemia) and aged rats. Treatment of cultures of human type-II pneumocytes with candesartan or captopril induced up-regulation of ACE2 expression in cells. Treatment with viral spike protein induced a decrease in full-length (i.e. transmembrane) ACE2, an increase in levels of a short intracellular ACE2 polypeptide and an increase in ADAM17 activity in cells, together with an increase in levels of soluble ACE2 and major proinflammatory cytokines in the culture medium. Spike protein-induced changes and levels of spike protein internalization in cells were inhibited by pretreatment with the above-mentioned drugs. The results suggest that these drugs increase ACE2 levels and promote the anti-inflammatory RAS axis in the lung. Furthermore, possible up-regulation of viral entry by the drug-induced increase in expression of transmembrane ACE2 is counteracted by additional mechanisms, particularly by drug-induced inhibition of ADAM17 activity.<\/jats:p>","DOI":"10.1042\/cs20201511","type":"journal-article","created":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T12:21:46Z","timestamp":1611404506000},"page":"465-481","update-policy":"https:\/\/doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Experimental data using candesartan and captopril indicate no double-edged sword effect in COVID-19"],"prefix":"10.1042","volume":"135","author":[{"given":"Maria\u00a0A.","family":"Pedrosa","sequence":"first","affiliation":[{"name":"Research Center for Molecular Medicine and Chronic Diseases (CIMUS), IDIS, University of Santiago de Compostela, Santiago de Compostela, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Valenzuela","sequence":"additional","affiliation":[{"name":"Research Center for Molecular Medicine and Chronic Diseases (CIMUS), IDIS, University of Santiago de Compostela, Santiago de Compostela, Spain"},{"name":"Networking Research Center on Neurodegenerative Diseases (CIBERNED), Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Garrido-Gil","sequence":"additional","affiliation":[{"name":"Research Center for Molecular Medicine and Chronic Diseases (CIMUS), IDIS, University of Santiago de Compostela, Santiago de Compostela, Spain"},{"name":"Networking Research Center on Neurodegenerative Diseases (CIBERNED), Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen\u00a0M.","family":"Labandeira","sequence":"additional","affiliation":[{"name":"Research Center for Molecular Medicine and Chronic Diseases (CIMUS), IDIS, University of Santiago de Compostela, Santiago de Compostela, Spain"},{"name":"Hospital Alvaro Cunqueiro, University Hospital Complex, Vigo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Navarro","sequence":"additional","affiliation":[{"name":"Networking Research Center on Neurodegenerative Diseases (CIBERNED), Spain"},{"name":"Department of Biochemistry and Physiology, Faculty of Pharmacy, University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Franco","sequence":"additional","affiliation":[{"name":"Networking Research Center on Neurodegenerative Diseases (CIBERNED), Spain"},{"name":"Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8243-9791","authenticated-orcid":false,"given":"Jose\u00a0L.","family":"Labandeira-Garcia","sequence":"additional","affiliation":[{"name":"Research Center for Molecular Medicine and Chronic Diseases (CIMUS), IDIS, University of Santiago de Compostela, Santiago de Compostela, Spain"},{"name":"Networking Research Center on Neurodegenerative Diseases (CIBERNED), Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana\u00a0I.","family":"Rodriguez-Perez","sequence":"additional","affiliation":[{"name":"Research Center for Molecular Medicine and Chronic Diseases (CIMUS), IDIS, University of Santiago de Compostela, Santiago de Compostela, Spain"},{"name":"Networking Research Center on Neurodegenerative Diseases (CIBERNED), Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"288","published-online":{"date-parts":[[2021,2,1]]},"reference":[{"key":"2021113011192348800_B1","doi-asserted-by":"publisher","first-page":"2277","DOI":"10.1002\/jcp.27205","article-title":"The potential therapeutic use of renin-angiotensin system inhibitors in the treatment of inflammatory diseases","volume":"234","author":"Ranjbar","year":"2019","journal-title":"J. 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