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Angiotensin-converting enzyme 2 (ACE2) receptor–SARS-CoV-2 spike protein interaction (ACE2–SARS-CoV-2 S interaction)

Target
ACE2–SARS-CoV-2 S interaction
Molecular classification
Protein-protein interaction, Receptor-ligand complex, Viral entry mechanism
01

Overview

The interaction between the SARS-CoV-2 spike protein and the human angiotensin-converting enzyme 2 (ACE2) receptor is the primary mechanism for viral entry into host cells [PubMed: 32142651]. The spike protein, specifically its receptor-binding domain (RBD), recognizes and binds to the extracellular peptidase domain of ACE2 with high affinity [UniProt: Q9BYF1]. This binding event triggers a series of conformational changes and proteolytic processing by host enzymes like TMPRSS2, facilitating the fusion of the viral and host cell membranes [PubMed: 32225175]. Because this interaction is essential for the initiation of the COVID-19 infection cycle, it has become a central focus for therapeutic intervention [NIH: COVID-19 Treatment Guidelines]. Most neutralizing monoclonal antibodies and vaccines are designed to block this specific interface to prevent the virus from infecting respiratory and systemic tissues [PubMed: 32511530]. However, the rapid evolution of the spike protein leads to variants that can evade these treatments, presenting a significant challenge for long-term therapeutic efficacy [PubMed: 33585887].

Other names
ACE2-Spike interactionSARS-CoV-2 spike-ACE2 complexSpike-ACE2 binding interfaceSARS-CoV-2 entry receptor interaction
02

Mechanism of action

Neutralization of the viral spike protein receptor-binding domain (RBD) to competitively inhibit its binding to the host ACE2 receptor, thereby preventing viral attachment, membrane fusion, and subsequent cellular entry.

03

Biological functions

Viral entryMembrane fusionEndocytosisProteolysisRegulation of systemic blood pressureInactivation of angiotensin II
04

Disease associations

InfectionCOVID-19Acute respiratory distress syndrome (ARDS)Systemic inflammation
05

Safety considerations

Viral escape due to rapid mutation of the spike protein receptor-binding domain [PubMed: 33585887]Antibody-dependent enhancement (ADE) of infectionPotential interference with the physiological role of ACE2 in the renin-angiotensin system [PubMed: 32142651]Reduced efficacy of monoclonal antibodies against emerging variants of concern (e.g., Omicron)
06

Interacting drugs

Bamlanivimab

9 more in the full profile.

07

Biomarkers

SARS-CoV-2 viral loadSpike protein RBD mutationsSoluble ACE2 (sACE2) levelsAnti-spike protein antibody titersTMPRSS2 expression levels

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