Modulation of the renin-angiotensin system against COVID-19: A path forward?
Soon after the pandemic outbreak in 2020, it was proposed that binding of SARS-CoV-2 to the angiotensin converting enzyme-2 may explain most of COVID-19’s manifestations. Therefore, manipulation of the renin-angiotensin system (RAS) by using well known and commercialized blockers of its classical ar...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-05-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971225000906 |
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| author | Serge Camelo Waly Dioh J. Pedro Teixeira Laurence W. Busse Girish Nair Gaëtan Plantefeve Capucine Morelot-Panzini Suzana Margareth Lobo Wesley H. Self Sean P. Collins Rob Van Maanen Stanislas Veillet |
| author_facet | Serge Camelo Waly Dioh J. Pedro Teixeira Laurence W. Busse Girish Nair Gaëtan Plantefeve Capucine Morelot-Panzini Suzana Margareth Lobo Wesley H. Self Sean P. Collins Rob Van Maanen Stanislas Veillet |
| author_sort | Serge Camelo |
| collection | DOAJ |
| description | Soon after the pandemic outbreak in 2020, it was proposed that binding of SARS-CoV-2 to the angiotensin converting enzyme-2 may explain most of COVID-19’s manifestations. Therefore, manipulation of the renin-angiotensin system (RAS) by using well known and commercialized blockers of its classical arm or by repurposing new stimulators of the alternative RAS pathway in clinical development was seen as a potentially effective strategy for the treatment of COVID-19. Moreover, this therapeutic approach had previously shown significant promise in the treatment of other respiratory viral respiratory infections and forms of acute respiratory distress syndrome. Consequently, several randomized clinical trials (RCTs) were launched to test the efficacy of rebalancing the RAS to reduce the severity of COVID-19. While most of these trials produced neutral results, certain studies reached their primary endpoints. In the present collaborative review, sponsors and main investigators of some of these trials attempt to reach a consensus regarding their clinical significance and which factors influenced their differing outcomes. The knowledge gained through the careful analysis of these RCTs of RAS modulators in patients with severe COVID-19 may prove useful for other forms of acute lung injury. |
| format | Article |
| id | doaj-art-e01dfddef45b453d9c73bf0578aa453d |
| institution | OA Journals |
| issn | 1201-9712 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj-art-e01dfddef45b453d9c73bf0578aa453d2025-08-20T02:09:29ZengElsevierInternational Journal of Infectious Diseases1201-97122025-05-0115410786710.1016/j.ijid.2025.107867Modulation of the renin-angiotensin system against COVID-19: A path forward?Serge Camelo0Waly Dioh1J. Pedro Teixeira2Laurence W. Busse3Girish Nair4Gaëtan Plantefeve5Capucine Morelot-Panzini6Suzana Margareth Lobo7Wesley H. Self8Sean P. Collins9Rob Van Maanen10Stanislas Veillet11Biophytis, Sorbonne Université, Paris, France; Corresponding authorBiophytis, Sorbonne Université, Paris, FranceDivisions of Nephrology and Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of New Mexico School of Medicine MSC10-5550, 1 University of New Mexico, Albuquerque, New Mexico, USADivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University School of Medicine, Atlanta, Georgia, USAOUWB School of Medicine, William Beaumont Hospital, Royal Oak, Michigan, USARéanimation Polyvalente, CH DUPOUY, Argenteuil, FranceSorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, hôpital Pitié-Salpêtrière, Service de Pneumologie (Département R3S), Paris, FranceIntensive Care Division, Hospital de Base, Faculdade de Medicina de São José do Rio Preto - São José do Rio Preto (Sao Paulo), BrazilDepartment of Emergency Medicine and Vanderbilt University Medical Center Veterans Affairs Tennessee Valley Healthcare System, Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee, USADepartment of Emergency Medicine and Vanderbilt University Medical Center Veterans Affairs Tennessee Valley Healthcare System, Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee, USABiophytis, Sorbonne Université, Paris, FranceBiophytis, Sorbonne Université, Paris, FranceSoon after the pandemic outbreak in 2020, it was proposed that binding of SARS-CoV-2 to the angiotensin converting enzyme-2 may explain most of COVID-19’s manifestations. Therefore, manipulation of the renin-angiotensin system (RAS) by using well known and commercialized blockers of its classical arm or by repurposing new stimulators of the alternative RAS pathway in clinical development was seen as a potentially effective strategy for the treatment of COVID-19. Moreover, this therapeutic approach had previously shown significant promise in the treatment of other respiratory viral respiratory infections and forms of acute respiratory distress syndrome. Consequently, several randomized clinical trials (RCTs) were launched to test the efficacy of rebalancing the RAS to reduce the severity of COVID-19. While most of these trials produced neutral results, certain studies reached their primary endpoints. In the present collaborative review, sponsors and main investigators of some of these trials attempt to reach a consensus regarding their clinical significance and which factors influenced their differing outcomes. The knowledge gained through the careful analysis of these RCTs of RAS modulators in patients with severe COVID-19 may prove useful for other forms of acute lung injury.http://www.sciencedirect.com/science/article/pii/S1201971225000906COVID-19Renin-angiotensin systemAngiotensin type 1 receptorAngiotensin-IIAngiotensin-(1-7)Mas receptor |
| spellingShingle | Serge Camelo Waly Dioh J. Pedro Teixeira Laurence W. Busse Girish Nair Gaëtan Plantefeve Capucine Morelot-Panzini Suzana Margareth Lobo Wesley H. Self Sean P. Collins Rob Van Maanen Stanislas Veillet Modulation of the renin-angiotensin system against COVID-19: A path forward? International Journal of Infectious Diseases COVID-19 Renin-angiotensin system Angiotensin type 1 receptor Angiotensin-II Angiotensin-(1-7) Mas receptor |
| title | Modulation of the renin-angiotensin system against COVID-19: A path forward? |
| title_full | Modulation of the renin-angiotensin system against COVID-19: A path forward? |
| title_fullStr | Modulation of the renin-angiotensin system against COVID-19: A path forward? |
| title_full_unstemmed | Modulation of the renin-angiotensin system against COVID-19: A path forward? |
| title_short | Modulation of the renin-angiotensin system against COVID-19: A path forward? |
| title_sort | modulation of the renin angiotensin system against covid 19 a path forward |
| topic | COVID-19 Renin-angiotensin system Angiotensin type 1 receptor Angiotensin-II Angiotensin-(1-7) Mas receptor |
| url | http://www.sciencedirect.com/science/article/pii/S1201971225000906 |
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