基于RAS双轴探讨中药对新型冠状病毒肺炎的干预机制

Intervention Mechanism of Traditional Chinese Medicine on Corona Virus Disease 2019(COVID-19)Based on RAS Axes

探讨新型冠状病毒肺炎(Corona Virus Disease 2019,COVID-19)肺损伤及多脏器损害与肾素-血管紧张素系统(RAS)双轴ACE/AngⅡ/AT1R、ACE2/Ang(1-7)/Mas的关联,提示血管紧张素转化酶2(ACE2)在介导SARS-CoV-2感染的易感性和免疫性中可能起双重作用。鉴于ACE2靶向治疗进退两难的境地,提出血管紧张素2型受体(AT2R)及Ang(1-7)/Mas受体或可作为中药干预的靶点。基于RAS双轴下游的信号通路,探讨中药治疗COVID-19可能的干预机制。人体内肺、胃肠、肾和血管上皮细胞高表达ACE2,印证了中医对病位主要在肺,可累及脾胃、肾和血脉的认识。根据病位,清肺、健脾、泄浊、化瘀或为主要治则。

It is to explore the lung injury of corona virus disease 2019(COVID-19)and the relationship between multiple organs damage and renin-angiotensin system(RAS)axes ACE/AngⅡ/AT1 R and ACE2/Ang(1-7)/Mas.It is suggested that angiotensin converting enzyme 2(ACE2)may play a dual role in mediating susceptibility and immunity of SARS-CoV-2 infection.In view of the dilemma of ACE2 targeted therapy,angiotensin type 2 receptor(AT2 R)and Ang(1-7)/Mas receptor may be proposed as targets for traditional Chinese medicine(TCM)intervention.Based on the RAS axes downstream signaling pathway,the possible intervention mechanism of TCM for COVID-19 was explored.It is proved that the location is mainly the lung,involving spleen,stomach kidney and vessels because the high expression of ACE2 in the lungs,stomach and intestines,kidneys and vascular epithelium cells.The main treatment principles are clearing lung,strengthening spleen,purging the turbid and resolving blood stasis.