Characterization of ACE Inhibitors and AT₁R Antagonists with Regard to Their Effect on ACE2 Expression and Infection with SARS-CoV-2 Using a Caco-2 Cell Model

• Main Authors: Philipp Reus, Ann-Kathrin Schneider, Thomas Ulshöfer, Marina Henke, Denisa Bojkova, Jindrich Cinatl, Sandra Ciesek, Gerd Geisslinger, Volker Laux, Mira Grättinger, Philip Gribbon, Susanne Schiffmann
• Format: Article
• Language: English
• Published: MDPI AG 2021-08-01
• Series: Life
• Subjects: ACE inhibitor; AT1 receptor antagonist; SARS-CoV-2; cell barrier integrity
• Online Access: https://www.mdpi.com/2075-1729/11/8/810

Blood-pressure-lowering drugs are proposed to foster SARS-CoV-2 infection by pharmacological upregulation of angiotensin-converting enzyme 2 (ACE2), the binding partner of the virus spike (S) protein, located on the surface of the host cells. Conversely, it is postulated that angiotensin–renin system antagonists may prevent lung damage caused by SARS-CoV-2 infection, by reducing angiotensin II levels, which can induce permeability of lung endothelial barrier via its interaction with the AT₁ receptor (AT₁R). Methods: We have investigated the influence of the ACE inhibitors (lisinopril, captopril) and the AT₁ antagonists (telmisartan, olmesartan) on the level of ACE2 mRNA and protein expression as well as their influence on the cytopathic effect of SARS-CoV-2 and on the cell barrier integrity in a Caco-2 cell model. Results: The drugs revealed no effect on ACE2 mRNA and protein expression. ACE inhibitors and AT₁R antagonist olmesartan did not influence the infection rate of SARS-CoV-2 and were unable to prevent the SARS-CoV-2-induced cell barrier disturbance. A concentration of 25 µg/mL telmisartan significantly reduced the virus replication rate. Conclusion: ACE inhibitors and AT₁R antagonist showed neither beneficial nor detrimental effects on SARS-CoV-2-infection and cell barrier integrity in vitro at pharmacologically relevant concentrations.