{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T19:15:45Z","timestamp":1781291745302,"version":"3.54.1"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"05","funder":[{"name":"Ministry of Health, Clinician Scientist Award","award":["MOH-CSAINV17nov-0006"],"award-info":[{"award-number":["MOH-CSAINV17nov-0006"]}]},{"name":"National Medical Research Council Centre Grant","award":["NMRC\/CG\/017\/2013"],"award-info":[{"award-number":["NMRC\/CG\/017\/2013"]}]},{"name":"Ong Tiong Tat Professorship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>COVID-19 is a rapidly spreading outbreak globally. Emerging evidence demonstrates\n                    that older individuals and people with underlying metabolic conditions of\n                    diabetes mellitus, hypertension, and hyperlipidemia are at higher risk of\n                    morbidity and mortality. The SARS-CoV-2 infects humans through the angiotensin\n                    converting enzyme (ACE-2) receptor. The ACE-2 receptor is a part of the dual\n                    system renin-angiotensin-system (RAS) consisting of ACE-Ang-II-AT1R\n                    axis and ACE-2-Ang-(1\u20137)-Mas axis. In metabolic disorders and with\n                    increased age, it is known that there is an upregulation of\n                        ACE-Ang-II-AT1R axis with a downregulation of\n                    ACE-2-Ang-(1\u20137)-Mas axis. The activated ACE-Ang-II-AT1R axis leads to\n                    pro-inflammatory and pro-fibrotic effects in respiratory system, vascular\n                    dysfunction, myocardial fibrosis, nephropathy, and insulin secretory defects\n                    with increased insulin resistance. On the other hand, the\n                    ACE-2-Ang-(1\u20137)-Mas axis has anti-inflammatory and antifibrotic effects\n                    on the respiratory system and anti-inflammatory, antioxidative stress, and\n                    protective effects on vascular function, protects against myocardial fibrosis,\n                    nephropathy, pancreatitis, and insulin resistance. In effect, the balance\n                    between these two axes may determine the prognosis. The already strained\n                    ACE-2-Ang-(1\u20137)-Mas in metabolic disorders is further stressed due to\n                    the use of the ACE-2 by the virus for entry, which affects the prognosis in\n                    terms of respiratory compromise. Further evidence needs to be gathered on\n                    whether modulation of the renin angiotensin system would be advantageous due to\n                    upregulation of Mas activation or harmful due to the concomitant ACE-2 receptor\n                    upregulation in the acute management of COVID-19.<\/jats:p>","DOI":"10.1055\/a-1155-0501","type":"journal-article","created":{"date-parts":[[2020,4,27]],"date-time":"2020-04-27T22:59:20Z","timestamp":1588028360000},"page":"257-263","source":"Crossref","is-referenced-by-count":132,"title":["The ACE-2 in COVID-19: Foe or Friend?"],"prefix":"10.1055","volume":"52","author":[{"given":"Rinkoo","family":"Dalan","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital, Singapore"},{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University\n                    Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan R.","family":"Bornstein","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University\n                    Singapore, Singapore"},{"name":"Department of Medicine III, University Hospital Carl Gustav Carus,\n                    Dresden, Germany"},{"name":"Division of Diabetes & Nutritional Sciences, Faculty of Life\n                    Sciences & Medicine, King's College London, London,\n                    UK"},{"name":"Klinik f\u00fcr Endokrinologie, Diabetologie und Klinische\n                    Ern\u00e4hrung, University Hospital, Z\u00fcrich,\n                    Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"El-Armouche","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, Medical Faculty Carl Gustav\n                    Carus, Technische Universit\u00e4t Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman N","family":"Rodionov","sequence":"additional","affiliation":[{"name":"Division of Angiology, Department of Internal Medicine III, University\n                    Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden, Dresden,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Markov","sequence":"additional","affiliation":[{"name":"Department of General Physiology, Saint-Petersburg State University,\n                    Saint-Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Wielockx","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry, University Hospital Carl Gustav Carus,\n                    Technische Universit\u00e4t Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Beuschlein","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Endokrinologie, Diabetologie und Klinische\n                    Ern\u00e4hrung, University Hospital, Z\u00fcrich,\n                    Switzerland"},{"name":"Medizinische Klinik und Poliklinik IV, Klinikum der Universit\u00e4t\n                    M\u00fcnchen, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard O.","family":"Boehm","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital, Singapore"},{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University\n                    Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,4,27]]},"container-title":["Hormone and Metabolic Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1155-0501.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,5,13]],"date-time":"2020-05-13T22:33:16Z","timestamp":1589409196000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1155-0501"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,27]]},"references-count":0,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2020,5,13]]},"published-print":{"date-parts":[[2020,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1155-0501","relation":{},"ISSN":["0018-5043","1439-4286"],"issn-type":[{"value":"0018-5043","type":"print"},{"value":"1439-4286","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,27]]}}}