ACE 2 acts a receptor for Spike S1 protein of SARS CoV 2. It has a protective role in acute lung injury and ARDS. Being a rate limiting factor in the pathogenesis of COVID 19 it can offers multiple avenues for therapeutic measures. The soluble form of ACE 2 if we can give in an inhaler or nebulised form can act as a competitive agent for viral binding in the lungs thus somewhat sparing the trans membrane ACE 2 from viral attack. An antibody directed against the ACE 2 receptor can have the same effect. As the human corona virus NL63 also binds to ACE 2 receptor in the same region as SARS CoV. Therefore co-infection with NL63 can be a disease modifier as NL63 causes mild disease in most of the cases. Also a potent selective inhibitor of ACE 2 can also be tested as a therapeutic option.
Corresponding Author: Oliyath Ali