الفهرس 
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Abstract
Asthma is a chronic inflammatory condition affecting the airways characterised by the presence of many inflammatory cells as well as proinflammatory cytokines. During respiratory virus infection, asthmatic sufferers can modulate a wide range of substances expressed in the lungs, including ACE-2. ACE-2 expression has been reported to decrease the lung inflammation and damage that occur in response to viral infection.
ACE2 is a zinc-metallopeptidase that belongs to renin-angiotensin system (RAS) was discovered to be the SARS-Co V cell entrance receptor and widely investigated to be the receptor for SARS- CoV2. ACE-2 catalyzes the change of angiotensinII (Ang II) into angiotensin1-7
(Ang 1-7) and the ACE-2/Ang1-7/MAS axis ameliorate the deleterious effects of the renin angiotensin system. It is distributed widely in kidneys, testis, heart, intestine and lung. Although data emerged about the association between asthma and COVID-19 yet, this association is still less clear and the function of ACE2 in the lung is unclear.
Our goal was to determine the concentration of ACE2 receptors in the serum of patients with different asthma phenotypes. The present study was conducted on 90 participants; grouped into 20 non asthmatic non obese, non-smoker subjects and 70 asthmatic patients
(as defined by GINA guidelines).
The following investigations were carried out on all candidates:
1) Anthropometric measures (weight, height, waist circumference and BMI).
2) Assessment of airflow limitation by measurement of FEV1 (% pred.), PEF (% pred.) using of FEV1 metre and PEF meter.
3) Assessment of atopy in asthmatic patients by measurement of total IgE
4) Measurement of differential leukocytic count in blood.
5) Measurement of angiotensin converting enzyme 2 receptor (ACE2 R) level in serum by ELISA.
6) Data were calculated and analyzed using the statistical package of social science (SPSS version 20 Armonk, NY: IBM Corp).
Our results revealed that:
• ACE2 receptor exists in serum of all participants.
• There was a significant reduction in the serum level of ACE2 R in patients with asthma than in control subjects indicating the possible involvement of ACE2 R disturbance in the pathophysiology of asthma.
• The significantly lower ACE2 in asthmatics than in control explains the less prevalence of COVID 19 cases among asthmatics which is inverse to the expected early in the pandemic.
• Atopic asthmatic patients had significantly higher ACE 2 R than non-atopic asthmatic indicating the possible involvement of asthma phenotype on the expression of ACE2R and subsequently the susceptibility of the patient to catch COVID 19 infection.
• The positive significant correlation found between BMI and ACE2 R concentration in patients with asthma suggests that the increased level of ACE 2 receptor in obese asthmatics may be a drive to increased morbidity and mortality in this type of patient when affected with COVID 19.