People with chronic obstructive pulmonary disease (COPD) and people who currently smoke may have higher levels of molecules, called angiotensin converting enzyme II (ACE-2), in their lungs, according to a study published in European Respiratory Journal today.
Previous research has shown that ACE-2, which sits on the surface of lung cells, is an ‘entry point’ that allows coronaviruses to enter the lung cells and cause infection.
This new study also shows that ACE-2 levels in former smokers are lower than current smokers.
The research was led by Dr. Janice Leung at the University of British Columbia and St. Paul’s Hospital, Vancouver, Canada. He said: “Data emerging from China shows that patients with COPD are at a higher risk of having worse outcomes than COVID-19. We hypothesize that this could be because ACE-2 levels in their airways might increase compared to people without COPD, which might make it easier for viruses to infect the airway. “
The team studied samples taken from the lungs of 21 COPD patients and 21 people who did not have COPD. They tested samples to measure ACE-2 levels and compared them with other factors, such as whether they were people who had never smoked, were active smokers or ex-smokers. Not only did they find higher levels of ACE-2 in COPD patients, they also found higher levels in smokers.
The researchers then examined their new findings on two existing study groups, which together contained data on 249 further people – some non-smokers, some current smokers and some former smokers. Once again, they found that ACE-2 levels were higher in current smokers but lower in non-smokers and in those who were former smokers.
Leung said: “We found that patients with COPD and people who still smoke have higher ACE-2 levels in their airways, which might put them on increased risk develop severe COVID-19 infection. Patients with COPD should be advised to adhere strictly to social distance and proper hand hygiene to prevent infection.
“We also found the traces smoker have ACE-2 levels similar to people who have never smoked. This shows that there has never been a better time to stop smoking to protect yourself from COVID-19. “
Professor Tobias Welte is an infection expert from the European Respiratory Society and is the coordinator for the German COVID-19 national task force and was not involved in this study. He said: “This study provides some interesting insights about why some people are at risk for COVID-19 symptoms that are more severe than others. What doesn’t tell us is whether it is possible to manipulate ACE-2 levels to improve survival in infected patients. with COVID-19 or whether this will make a difference in COPD patients who have contracted the infection. ”
Janice M. Leung et al, ACE-2 Expression in the Airway Epithelium of Small Smokers and COPD Patients: Implications for COVID-19, European Respiratory Journal (2020). DOI: 10.1183 / 13993003.00688-2020
European Lung Foundation
Higher levels of the coronavirus entry point enzyme in the lungs of COPD smokers and patients (2020, 9 April)
taken April 9 2020
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