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Alunacedase alfa is a recombinant, soluble glycosylated form of human angiotensin-converting enzyme 2 (ACE2). It acts as a decoy receptor for the SARS-CoV-2 spike protein, preventing viral entry into host cells. Additionally, it enzymatically converts angiotensin II (Ang1–8), which promotes inflammation and vasoconstriction, into angiotensin 1–7 (Ang1–7), which has vasodilatory and anti-inflammatory effects. This dual mechanism underlies its investigation for acute respiratory distress syndrome (ARDS) and COVID-19-related lung injury. The drug is being developed primarily by Apeiron Biologics and was previously investigated by GlaxoSmithKline under the code name GSK2586881[1][3][4][5][7].
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