Enzyme Targeted by COVID-19 Virus Impacts Gut Inflammation, Study Says

(Photo: Darko Djurin)

ALSO READ: Oral Bacteria Linked to Severe Forms of Inflammatory Bowel Disease

COVID-19 has affected numerous systems in the body, causing troubles such as blood clotting and heart-related complications. Recently, a study related the disease to the gut causing it to be inflamed. A new study led by Cedars-Sinai suggests that an enzyme that aids COVID-19 infects the body also plays a role in the inflammation and patient outcomes in inflammatory bowel disease (IBD).

It is known that IBD is a term for two conditions, such as Chron's disease and ulcerative colitis, which is associated with chronic inflammation in the gastrointestinal tract.

Focusing on angiotensin-converting enzyme 2 (ACE2), the study led by Cedar-Sinai revealed that the enzyme normally plays a vital role by activating a hormone that helps in regulating blood pressure. Eureka Alert added that in COVID-19 infections, SARS-CoV-2 BIND ACE2 uses it to invade and infect cells taking over them to spread the virus.

Method of the study

To gather more information on how ACE2 affects the body, the researchers examined its role in Crohn's disease and ulcerative colitis that can cause inflammation and scarring in the digestive tract and diarrhea, cramping, and loss of appetite. Dermot P. McGovern, MD, Ph.D., senior author of the new study, said that the diseases were chosen even though they are known to attack the lungs and were seen causing gastrointestinal symptoms.

According to the Basic and Translational - Alimentary Act, Early reports in Wuhan China showed that 2% to 10% of patients with COVID-19 had gastrointestinal (GI) symptoms such as diarrhea. Still, a meta-analysis reported that up to 20% had GI symptoms. They added that the SARS-CoV-2 virus was seen in stool samples and anal swabs in almost 50% of the patients positive for COVID-19, which suggests that the digestive tract might be an extrapulmonary site for virus replication activity.

Dr. McGovern added that it is important for them to understand how COVID-19 might affect IBD patients medicated with anti-inflammatory medications. He further said that there is increasing evidence that the GI tract serves as an alternative route for the uptake of SARS-CoV-2 in general.

Results

Eureka Alert said that the researchers found levels of ACE2 in the small bowel were lower in Crohn's patients and higher in the colons of ulcerative colitis patients than they were in patients with no IBD. The researchers added that differing ACE2 levels are associated with poorer results and more severe IBD patients' disease. According to McGovern, the effect of the ACE2 depends on both its specific location in the GI tract and the specific disease involved.

The researchers added that infliximab, an anti-inflammatory drug used as medication in IBD patients, normalized the levels of ACE2, simultaneously improving disease outcomes in patients. The study suggests that the drug commonly used in auto-immune disease also might improve COVID-19 results. They also stressed that their study supports the potential paradoxical function of ACE2 in inflammation and COVID-19. McGovern furthered that judging from their discoveries on how ACE2 works in IBD, the enzyme has likely anti-inflammatory and anti-fibrotic functions that may also help recover certain COVID-19 patients from the virus.

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