Common gut inflammation linked to COVID-19, study finds

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In a new study, researchers found An enzyme that helps COVID-19 (coronavirus) infect the body also plays a role in inflammation and patient outcomes in inflammatory bowel disease (IBD).

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

The research was conducted by a team at Cedars-Sinai and elsewhere.

In the study, the team focused on angiotensin-converting enzyme 2 (ACE2), which normally plays a crucial health role by activating a hormone that helps regulate blood pressure.

But in COVID-19 infections, the SARS-CoV-2 virus binds to ACE2 and uses it to invade and infect cells, “hijacking” them to spread the virus.

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 (fibrosis) in the digestive tract along with diarrhea, cramping and loss of appetite.

They checked records of nearly 1,000 patients at Cedars-Sinai, Washington University in St. Louis, Missouri, and multiple other centers across North America.

They 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 IBD patients.

In both types of IBD, treatment with infliximab, an anti-inflammatory drug, normalized the levels of ACE2 and was linked to improved disease outcomes in patients.

This finding suggests these drugs, commonly used in autoimmune diseases, also might improve outcomes in COVID-19.

Overall, the study supports the potential paradoxical function of ACE2 in inflammation and COVID-19.

But judging from the discoveries of how ACE2 works in IBD, this enzyme likely has anti-inflammatory and anti-fibrotic functions that also could help certain COVID-19 patients recover from the virus.

One author of the study is Dermot P. McGovern, MD, Ph.D.

The study is published in the journal Gastroenterology.

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