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Soluble ACE2 variants are engineered forms of the angiotensin-converting enzyme 2 (ACE2) protein with the transmembrane domain removed. These proteins act as decoy receptors for SARS-CoV-2 by binding to its spike (S) protein and preventing viral entry into host cells. Some variants are further bioengineered for enhanced properties; for example, fusing a truncated human ACE2 (amino acids 1–618) with an albumin-binding domain (ABD) extends duration of action in vivo. Dimerization motifs such as dodecapeptide (DDC) can be added to increase binding affinity to the viral spike protein[1][5][7]. Soluble ACE2 not only neutralizes SARS-CoV-2 but also retains enzymatic activity that converts angiotensin II to angiotensin-(1–7), potentially reducing inflammation and protecting organs such as lungs and kidneys[4][6]. Preclinical studies have shown efficacy in blocking infection in organoid models and animal studies; early clinical trials suggest safety in humans[6][8].
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