Myocyte Specific Upregulation of ACE2 in Cardiovascular Disease: Implications for SARS-CoV-2 mediated myocarditis

Nathan R Tucker; Mark Chaffin; Kenneth C Bedi; Irinna Papangeli; Amer-Denis Akkad; Alessandro Arduini; Sikander Hayat; Gökcen Eraslan; Christoph Muus; Roby Bhattacharyya; Christian M Stegmann; Kenneth B Margulies; Patrick T Ellinor

Since patients with DCM were on an ACEi and nonfailing controls were not on an ACEi, our ability to examine effects of ACEi use on ACE2 expression was limited to the the patients with HCM. Among these patients, there was a trend towards increased ACE2 expression with ACEi treatment in all cell types ( Fig. 1d and Supplementary Table 5 ), but these results were not statistically significant. Future studies with larger patient cohorts to examine cell type specific ACE2 expression in additional disease states and in nonfailing donors receiving an ACEi or ARB are urgently needed. Further, it is important to note that transcriptional assessments do not reflect the effects of RNA half-life, translation efficiency, or protein turnover. As such, it will be important that surface localized ACE2 protein is also evaluated in future studies.