Coronavirus in Hematologic Malignancies: Targeting Molecules Beyond the Angiotensin-Converting Enzyme 2 (ACE2) Wall in C
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LETTER TO THE EDITOR
Coronavirus in Hematologic Malignancies: Targeting Molecules Beyond the Angiotensin-Converting Enzyme 2 (ACE2) Wall in COVID-19 Evangelos Tsiambas 1,2 & Vasileios Papanikolaou 3 & Aristeidis Chrysovergis 3 & Nicholas Mastronikolis 4 & Vasileios Ragos 5 & Nikolaos Kavantzas 2 & Andreas C. Lazaris 2 & Efthymios Kyrodimos 3 Received: 16 March 2020 / Accepted: 26 March 2020 # Arányi Lajos Foundation 2020
Dear Editor, Among the viral-mediated pandemics that have been rapidly spread worldwide in the last twenty years, coronaviruses (CoVs) –dependent outbreaks seem to be the most severe implicated in lung pathology. CoVs represent a significant superfamily of viruses including four major sub-classifications: alpha-, beta-, gamma-, and delta-CoVs. In fact, CoVs belong in a broader viruses group – the Nidovirales order- that comprises Roniviridae, Arteriviridae, and Coronaviridae [1]. Severe Acute Respiratory Syndrome (SARS-CoV) in 2002/2003, Middle-East Respiratory Syndrome (MERSCoV) in 2012/2013, and the current 2019/2020 Severe Acute Respiratory Syndrome-2 (SARS-CoV-2) are causes of major public health disorganization testing also the national health systems’ endurance worldwide. Extensive molecular analyses have decoded all CoVs’ genomic sequences concluding that although there are small specific differences at the For PubMed citation: Tsiambas E, Papanikolaou V, Chrysovergis A, Mastronikolis N, Ragos V, Kavantzas N, Lazaris AC, Kyrodimos E * Evangelos Tsiambas [email protected] 1
Department of Cytology, 401 & 417 VA Hospital (NIMTS), Athens, Greece
2
Department of Pathology, Medical School, National and Kapodistrian University of Athens, 17 Patriarchou Grigoriou E Street, Ag. Paraskevi, 153 41 Athens, Greece
3
1st ENT Department, Hippocration Hospital, University of Athens, Athens, Greece
4
Department of Otorhinolaryngology, Head and Neck Surgery, Medical School, University of Patras, Patras, Greece
5
Department of Maxillofacial Surgery, School of Health Sciences, University of Ioannina, Ioannina, Greece
RNA level referring to five only nucleotide sites, the group of 380 amino acid substitutions in 2019 novel beta-CoV (2019-nCoV) -phylogenetic and RNA sequence similarity at 96% with BatCoV RaTG13-provides not only structural divergence, but also more aggressive functional and clinicpathogenic characteristics in infected communities [2]. Concerning its genetic substrate and protein morphology, its RNA molecule (a large positive-sense RNA genome of approximately 30 kb) is enclosed in a spherical-like glycoprotein envelope characterized by many spikes (S projections) on its surface that create a crown-like formation (corona). These modifications act as binding tools for the corresponding membrane receptors of the host epithelial cells. The main receptorbinding loci that CoVs selectively use for cell invasion are human angiotensin-converting enzyme 2 (hACE2), CD209L, and dipeptyl peptidase 4 (DPP4/CD26) [3, 4]. hACE gene is located on chromosome 17 (band 17q23.3) encoding for a specifi
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