FRecent warnings in the media have caused considerable uncertainty that common remedies for high blood pressure could promote infection with the new coronavirus Sars-CoV-19 and favor severe pneumonia among those infected. We are talking about ACE inhibitors and angiotensin antagonists, drugs that lower blood pressure and relieve the heart by switching off the vasoconstricting hormone angiotensin in different ways.
The media shock waves were triggered by theoretical considerations, not by the results of scientific studies. Scientists led by Michael Roth from the University Hospital Basel in the journal “Lancet” had given reason to think that the said blood pressure lowerers led to an increase in the protein that Sars-CoV-19 uses to infect its host. The viral “robber ladder” is an enzyme called ACE2, which is found on the surface of many cells and has the task of incapacitating angiotensin. As an opponent of the angiotensin-producing enzyme ACE, ACE2 thus supports the therapeutic effects of ACE inhibitors and angiotensin antagonists.
So far, it has not been possible to prove whether the aforementioned blood pressure lowerers actually help the new type of corona virus. The Lancet authors nevertheless believe that this is possible. As an indication of such a danger, they argue that patients with severe Covid 19 course often have high blood pressure and other disorders that are often treated with ACE inhibitors and angiotensin antagonists.
Do corona patients benefit from ACE inhibitors?
Franz Messerli from the Department of Cardiology at the University Hospital in Bern does not accept this argument. As the high-pressure expert says on request, the virus is known to particularly affect old and sick people. With age, however, the risk of high blood pressure and many other ailments also increases. It is therefore not surprising that patients with a severe Covid 19 course are more often affected by such conditions.
Nevertheless, the Swiss cardiologist described it as important to get to the bottom of the questions about the safety of such high-pressure drugs in Covid-19 patients. According to the European Society for Hypertension and the German Hypertension League, there is currently no reason to avoid ACE inhibitors and angiotensin antagonists. They also strongly advise against selling the funds concerned without consulting your doctor.
On the other hand, there are also indications that Covid-19 patients could benefit from the use of such drugs. Several surveys show that people treated with ACE inhibitors and angiotensin antagonists are less likely to develop pneumonia – due to bacteria or viruses – than patients who do not take such agents. The threatening illness in the former is also said to result in fatal lung failure comparatively less often.
Interceptor for corona viruses
Whether this also applies to infections with Sars-CoV-19 cannot yet be answered. Studies in mice nevertheless suggest such a conclusion. Scientists led by the Viennese geneticist Josef Penninger were able to show years ago that the causative agent of the lung disease Sars – a close relative of the new coronavirus, which like this enters the victims via the enzyme ACE2 – damages the lungs through an increased release of angiotensin. If they suppressed the hormone with relevant inhibitors, the Sars pathogen caused much less damage in the lungs.
Josef Penninger, who has headed the Life Sciences Institute at the University of British Columbia in Vancouver for two years, is currently investigating with a research group whether the novel coronavirus can cope with an oversupply of free, i.e. not cell-bound, ACE2 proteins preventing them from causing infections and exacerbating their consequences.
The synthetic ACE2 molecule called APN01 is developed by the company “Apeiron Biologics”, a biotech company founded by Penninger and based in Vienna. It remains to be hoped that enough investors can be found to quickly initiate the patient studies planned in Europe and China.