Angiotensin converting enzyme 2 and inflammatory cytokines: A potential link between chronic periodontitis and COVID-19
1 Dr S.N Medical College, Jodhpur, India.
2 Rajasthan Dental College Devi Nagar Jaipur, India.
Review Article
World Journal of Advanced Research and Reviews, 2021, 09(01), 062-068
Article DOI: 10.30574/wjarr.2021.9.1.0498
Publication history:
Received on 24 December 2020; revised on 03 January 2021; accepted on 05 January 2021
Abstract:
The global COVID-19 outbreak has caused a public health emergency crisis, as declared by the World Health Organization in January 2020. Periodontitis is associated with increased risk for respiratory condition; hence there is biological plausibility for a link between periodontitis, elevated pro-inflammatory cytokines levels and COVID-19-related pulmonary problems. The mechanism could be similar to what has been proposed and established for the progression of COPD in Periodontitis patients. Periodontal pockets have also been found to harbour viral species. The periodontal pockets could provide a favourable environment for SARS–CoV-2 virus replication and survival.
ACE2 is a primary receptor for SARS-CoV-2 infections. The oral cavity and lungs are primary targets for SARS-CoV-2 virus. The evidences suggest that the regulation of the inflammatory pattern by ACE2 might also be connected to the response in periodontal disease. ACE2 can regulate the pro-inflammatory and anti-inflammatory processes, balancing cytokine expression. Cytokine storm has been found to be a key feature of COVID-19, where the cytokine levels are very high, inducing an exaggerated general inflammation. The same cytokines are involved in periodontal disease, but they have a different initiation path related to biofilm and bacteria. During a SARS-CoV-2 co-infection, the periodontal disease might be exacerbated due to the down-regulation of ACE2 and an increase in ACE and Ang II, with the consequent involvement of several pro-inflammatory cytokines. Treating any existing periodontal disease and maintaining good periodontal health could prove vital in clinical management of COVID-positive patients.
ACE2 is a primary receptor for SARS-CoV-2 infections. The oral cavity and lungs are primary targets for SARS-CoV-2 virus. The evidences suggest that the regulation of the inflammatory pattern by ACE2 might also be connected to the response in periodontal disease. ACE2 can regulate the pro-inflammatory and anti-inflammatory processes, balancing cytokine expression. Cytokine storm has been found to be a key feature of COVID-19, where the cytokine levels are very high, inducing an exaggerated general inflammation. The same cytokines are involved in periodontal disease, but they have a different initiation path related to biofilm and bacteria. During a SARS-CoV-2 co-infection, the periodontal disease might be exacerbated due to the down-regulation of ACE2 and an increase in ACE and Ang II, with the consequent involvement of several pro-inflammatory cytokines. Treating any existing periodontal disease and maintaining good periodontal health could prove vital in clinical management of COVID-positive patients.
Keywords:
Angiotensin Converting Enzyme, Inflammatory Cytokines, Chronic Periodontitis, COVID-19
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