A consortium of researchers from the Arab world discovered certain medications that can protect kidney cells from SARS-CoV-2 by modulating their expression of ACE2 and other receptors to which the virus attaches itself. The discovery could lead to a reevaluation of these medications as a tool for preventing kidney damage following SARS-CoV-2 infection.
COVID-19 is largely known as a disease that affects the respiratory system. However, it has been shown that other organs are also affected by the SARS-CoV-2 virus infection. So far patients have suffered from health issues in the gastrointestinal tract, the liver, and the kidneys. But how does the viral infection affect those organs?
The cause of kidney injury may be due to several different factors. Those factors include the cytokine storm which the virus catalyzes in the body, acute inflammation, or even the toxicity induced by the drugs meant to alleviate the symptoms of the viral infection. It is vital to determine the correlation between kidney damage and the severity of the viral infection, as it has been established that kidney damage is correlated with poor outcomes in treating patients with COVID-19.
We know that the virus mainly binds to the Angiotensin-Converting Enzyme 2 (ACE2), which is a receptor on the surface of various cells. Cells that exhibit ACE2 include those in the throat – but they can also be found in the testicles and kidneys.
Certain commonly used medications inhibit the creation of ACE2 and two other proteins in kidney tissues. A consortium of scientists from several nations sought to determine just how well can those medications – 59 in number – regulate the creation of SARS-CoV-2 receptors in the kidneys, hoping to gain a better understanding about their potential for holding back infection.
The researchers conducted bioinformatic analyses to evaluate the effect of dozens of medications on the cells’ ability to synthesize three receptors to which the virus can bind: ACE2, TMPRSS2, and CD147. Rats were treated with different medications, and the effects on kidney cells were measured and quantified.
The results clearly indicated that many medications affect the synthesis of the receptors that SARS-CoV-2 binds to. Out of the 59 medications that were tested, 56% affected ACE2, 27% affected CD147, and 24% affected TMPRSS2.
The fact that 41% of medications decreased the synthesis rate of ACE2 makes sense, but is also a cause for concern. The ACE2 protein has a crucial role in the body: it protects internal organs from injury. Consequently, inhibiting ACE2 synthesis may have negative health consequences. Nonetheless, at least in the meantime, some of those medications could help in alleviating the susceptibility of the kidneys to the viral infection.
While further research is required to validate these results and make sure that they apply for human bodies as well, this discovery could have significant implications in the war against COVID-19. The medications that affect ACE2 synthesis in the kidneys may be used primarily to protect some internal organs in which ACE2 is abundant, like the kidneys and lungs. Eventually, this research may serve to save many lives worldwide.
The scientists involved in this research were Narjes Saheb Sharif‐Askari, Fatemeh Saheb Sharif‐Askari, Mashael Alabed, Rifat Hamoudi, Qutayba Hamid, and Rabih Halwani from Sharjah University in the United Arab Emirates; Ahmad Abou Tayoun, Tom Loney, Mohammed Uddin, Abiola Senok, Saba Al Heialy, and Alawi Alsheikh‐Ali from Mohammed Bin Rashid University of Medicine and Health Sciences in the United Arab Emirates; and Tarek Kashour from King Saud University in Saudi Arabia.
Original content by Nawartna