Unveiling the Interplay—Vitamin D and ACE-2 Molecular Interactions in Mitigating Complications and Deaths from SARS-CoV-2
Sunil J Wimalawansa
Biology, doi:10.3390/biology13100831
Simple Summary: The SARS-CoV-2 virus that caused COVID-19 devastated families, social structures, and economies worldwide. This pandemic has overwhelmed healthcare systems, increased deaths and disabilities, and triggered a global socio-economic crisis. Although the COVID-19 vaccines were developed rapidly, their effectiveness significantly decreased by the end of 2021 due to mutated viruses evading the immune system. As a result, despite high vaccination rates in industrialized countries, significant outbreaks occurred due to immune evasion associated with viral mutations. Over 300 clinical studies have shown that vitamin D (and ivermectin) are widely available and economical agents that promote immune system function. Proper doses of vitamin D effectively prevent and treat SARS-CoV-2, reducing complications, hospitalizations, and deaths by approximately 50%. Those with vitamin D deficiency fare the worse. SARS-CoV-2 activates the renin-angiotensin system by increasing renin expression, leading to elevated levels of the inflammatogenic and vasoconstrictor peptide angiotensin-II. SARS-CoV-2 viruses cause widespread inflammation, blood clots, and lung damage through multiple mechanisms, leading to impaired tissue oxygenation and death. In addition to enhancing the immune system, vitamin D increases ACE-2 enzyme levels, which breaks down angiotensin-II and reduces SARS-CoV-2-induced inflammation. It also lowers blood pressure and mitigates abnormal clotting. While the virus enters human cells through ACE-2 receptors, excess ACE-2 spills into the bloodstream and neutralizes viruses. This manuscript discusses how vitamin D mitigates the harmful effects of COVID-19.
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'abstract': '<jats:p>The interaction of the SARS-CoV-2 spike protein with membrane-bound '
'angiotensin-converting enzyme-2 (ACE-2) receptors in epithelial cells facilitates viral entry '
'into human cells. Despite this, ACE-2 exerts significant protective effects against '
'coronaviruses by neutralizing viruses in circulation and mitigating inflammation. While '
'SARS-CoV-2 reduces ACE-2 expression, vitamin D increases it, counteracting the virus’s '
'harmful effects. Vitamin D’s beneficial actions are mediated through complex molecular '
'mechanisms involving innate and adaptive immune systems. Meanwhile, vitamin D status [25(OH)D '
'concentration] is inversely correlated with severity, complications, and mortality rates from '
'COVID-19. This study explores mechanisms through which vitamin D inhibits SARS-CoV-2 '
'replication, including the suppression of transcription enzymes, reduced inflammation and '
'oxidative stress, and increased expression of neutralizing antibodies and antimicrobial '
'peptides. Both hypovitaminosis D and SARS-CoV-2 elevate renin levels, the rate-limiting step '
'in the renin-angiotensin-aldosterone system (RAS); it increases ACE-1 but reduces ACE-2 '
'expression. This imbalance leads to elevated levels of the pro-inflammatory, pro-coagulatory, '
'and vasoconstricting peptide angiotensin-II (Ang-II), leading to widespread inflammation. It '
'also causes increased membrane permeability, allowing fluid and viruses to infiltrate soft '
'tissues, lungs, and the vascular system. In contrast, sufficient vitamin D levels suppress '
'renin expression, reducing RAS activity, lowering ACE-1, and increasing ACE-2 levels. ACE-2 '
'cleaves Ang-II to generate Ang(1–7), a vasodilatory, anti-inflammatory, and anti-thrombotic '
'peptide that mitigates oxidative stress and counteracts the harmful effects of SARS-CoV-2. '
'Excess ACE-2 molecules spill into the bloodstream as soluble receptors, neutralizing and '
'facilitating the destruction of the virus. These combined mechanisms reduce viral '
'replication, load, and spread. Hence, vitamin D facilitates rapid recovery and minimizes '
'transmission to others. Overall, vitamin D enhances the immune response and counteracts the '
'pathological effects of SARS-CoV-2. Additionally, data suggests that widely used '
'anti-hypertensive agents—angiotensin receptor blockers and ACE inhibitors—may lessen the '
'adverse impacts of SARS-CoV-2, although they are less potent than vitamin D.</jats:p>',
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'title': 'Unveiling the Interplay—Vitamin D and ACE-2 Molecular Interactions in Mitigating Complications '
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