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Critical Care
Published in: Critical Care 1/2020

Open Access 01-12-2020 | Spironolactone | Letter

Blocking mineralocorticoid receptor with spironolactone may have a wide range of therapeutic actions in severe COVID-19 disease

Authors: Lucas Liaudet, Csaba Szabo

Published in: Critical Care | Issue 1/2020

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Excerpt

The pulmonary renin angiotensin (Ang) system (RAS) comprises two pathways whose balance is important for lung homeostasis. Endothelial ACE generates Ang II, acting on AT1 receptors to promote vasoconstriction and pro-inflammatory effects, whereas epithelial ACE2 cleaves Ang II into Ang1–7, acting on the Mas receptor to exert vasodilatory and anti-inflammatory effects. A shift towards predominant ACE-dependent Ang II formation has been postulated as an important pathophysiological mechanism in various forms of ARDS [1]. …
Literature
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South AM, Tomlinson L, Edmonston D, Hiremath S, Sparks MA. Controversies of renin-angiotensin system inhibition during the COVID-19 pandemic. Nat Rev Nephrol. 2020;16:305–7.CrossRef
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Biwer LA, Wallingford MC, Jaffe IZ. Vascular mineralocorticoid receptor: evolutionary mediator of wound healing turned harmful by our modern lifestyle. Am J Hypertens. 2019;32:123–34.CrossRef
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Belden Z, Deiuliis JA, Dobre M, Rajagopalan S. The role of the mineralocorticoid receptor in inflammation: focus on kidney and vasculature. Am J Nephrol. 2017;46:298–314.CrossRef
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Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, Liu S, Zhao P, Liu H, Zhu L, Tai Y, Bai C, Gao T, Song J, Xia P, Dong J, Zhao J, Wang FS. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8:420–2.CrossRef
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Metadata
Title
Blocking mineralocorticoid receptor with spironolactone may have a wide range of therapeutic actions in severe COVID-19 disease
Authors
Lucas Liaudet
Csaba Szabo
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2020
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-020-03055-6

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