Role of endothelial dysfunction in the severity of COVID‑19 infection (Review)

Kadiyska,Tanya; Tourtourikov,Ivan; Dabchev,Kristiyan; Cherneva,Radostina; Stoynev,Nikolay; Hadjiolova,Radka; Mitev,Vanyo; Spandidos,Demetrios A.; Adamaki,Maria; Zoumpourlis,Vassilis

doi:10.3892/mmr.2022.12867

Role of endothelial dysfunction in the severity of COVID‑19 infection (Review)

Authors:
- Tanya Kadiyska
- Ivan Tourtourikov
- Kristiyan Dabchev
- Radostina Cherneva
- Nikolay Stoynev
- Radka Hadjiolova
- Vanyo Mitev
- Demetrios A. Spandidos
- Maria Adamaki
- Vassilis Zoumpourlis
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Affiliations: Department of Physiology and Pathophysiology, Medical University, 1413 Sofia, Bulgaria, Genetic Medico‑Diagnostic Laboratory Genica, 1612 Sofia, Bulgaria, University Hospital for Respiratory Diseases St. Sophia, 1413 Sofia, Bulgaria, Laboratory of Clinical Virology, Medical School, University of Crete, Heraklion 71003, Greece, Biomedical Applications Unit, Institute Of Chemical Biology, National Hellenic Research Foundation, 11635 Athens, Greece
Published online on: October 3, 2022 https://doi.org/10.3892/mmr.2022.12867
Article Number: 351
Copyright: © Kadiyska et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

COVID‑19 patients with severe infection have been observed to have elevated auto‑antibodies (AAs) against angiotensin II receptor type 1 (AT1R) and endothelin (ET) 1 receptor type A (ETAR), compared with healthy controls and patients with favorable (mild) infection. AT1R and ETAR are G protein‑coupled receptors, located on vascular smooth muscle cells, fibroblasts, immune and endothelial cells, and are activated by angiotensin II (Ang II) and ET1 respectively. AAs that are specific for these receptors have a functional role similar to the natural ligands, but with a more prolonged vasoconstrictive effect. They also induce the production of fibroblast collagen, the release of reactive oxygen species and the secretion of proinflammatory cytokines (including IL‑6, IL‑8 and TNF‑α) by immune cells. Despite the presence of AAs in severe COVID‑19 infected patients, their contribution and implication in the severity of the disease is still not well understood and further studies are warranted. The present review described the major vascular homeostasis systems [ET and renin‑angiotensin‑aldosterone system (RAAS)], the vital regulative role of nitric oxide, the AAs, and finally the administration of angiotensin II receptor blockers (ARBs), so as to provide more insight into the interplay that exists among these components and their contribution to the severity, prognosis and possible treatment of COVID‑19.

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