But a possible second receptor, CD209L (L-SIGN) has also been identified from in vitro studies 15. Recently, ACE2 was identified as a functional SARS coronavirus receptor in cell lines 14.
These results provide a molecular explanation why SARS-CoV infections cause severe and often lethal lung failure and suggest a rational therapy for SARS and possibly other respiratory disease viruses. Notably, injection of SARS-CoV Spike into mice worsens acute lung failure in vivo that can be attenuated by blocking the renin-angiotensin pathway. SARS-CoV infections and the Spike protein of the SARS-CoV reduce ACE2 expression. Here we provide the first genetic proof that ACE2 is a crucial SARS-CoV receptor in vivo. The high lethality of SARS-CoV infections, its enormous economic and social impact, fears of renewed outbreaks as well as the potential misuse of such viruses as biologic weapons make it paramount to understand the pathogenesis of SARS-CoV. In cell lines, angiotensin-converting enzyme 2 (ACE2) has been identified as a potential SARS-CoV receptor 14. Moreover, among infected individuals influenza such as the Spanish flu 9, 10 and the emergence of new respiratory disease viruses 11, 12 have caused high lethality resulting from acute lung failure 13. A new coronavirus (SARS-CoV) was identified as the SARS pathogen 4, 5, 6, 7, which triggered severe pneumonia and acute, often lethal, lung failure 8. During several months of 2003, a newly identified illness termed severe acute respiratory syndrome (SARS) spread rapidly through the world 1, 2, 3.
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