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A specific metallopeptidase called angiotensin-converting enzyme 2 (ACE2) has been identified as the modulating receptor on the surface of the endothelium and other human cells infected by the new coronavirus causing Severe Acute Respiratory Syndrome (SARS-CoV-2) and Human Coronavirus Disease 2019 (COVID -19). This modulation of the expression of ACE2 in human cells may be responsible for the production of pro-inflammatory response with the development of the state of the systemic response of the inflammatory system, hypercoagulability/stasis also an increased risk of both ischemic and hemorrhagic strokes. Therefore, like ACE2, despite being present in almost all human organs, its expression is variable and probably dependent on epigenetic polymorphism, then this is still to be better understood. However, this highlights the importance to understand its pathogenesis and open the doors for the development of future treatment strategies aimed at various diseases related to ACE2, mainly cerebral vascular diseases, and perhaps COVID-19 itself.

Emerging highlights from novel human coronavirus and angiotensin-converting enzyme 2: promising way to target brain vascular diseases