Enzyme targeted by coronavirus also influences gut inflammation, study finds

An enzyme that helps the novel coronavirus (COVID-19) infect the body also plays a role in inflammation and patient outcomes in inflammatory bowel disease (IBD), according to a new study led by Cedars-Sinai Medical Center and published in the journal Gastroenterology.

The study focused on angiotensin-converting enzyme 2 (ACE2), which normally plays a role by activating a hormone that helps regulate blood pressure. In COVID-19 infections, the SARS-CoV-2 virus, the virus that causes COVID-19, binds to ACE2 and uses it to invade and infect cells, "hijacking" them to spread the virus, the researchers said.

To learn more about how ACE2 affects the body, the researchers examined its role in Crohn's disease and ulcerative colitis, two types of IBD that can cause inflammation and scarring or fibrosis in the digestive tract along with diarrhea, cramping, and loss of appetite.

By examining records of nearly 1,000 patients at multiple health centers across North America, the researchers found that levels of ACE2 in the small bowel were lower in Crohn's patients and higher in the colons of ulcerative colitis patients than they were in patients without IBD. The differing ACE2 levels were associated with poorer outcomes and more severe disease in the IBD patients.

The findings raise the possibility that anti-inflammatory therapies for IBD may aid recovery from coronavirus, the researchers said.

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