The protective Angiotensin-Converting Enzyme 2 (ACE2) – essential part of the Renin-Angiotensin-Aldosterone System (RAAS) – is the target receptor for its physiological ligands Angiotensin I and II (Ang I/II) as well as for SARS-CoViruses and – spikes. It mediates Ang II degradation and is the precondition for SARS-CoVirus cell entry, spike-induced adverse reactions, and cytotoxic cell fusion. In spike-induced ACE2 downregulation, Ang II degradation is reduced with the consequence of increasing Ang II concentrations; the counter-regulatory protective Ang 1-7/AT2R/MAS axis is impaired.
The presented analysis provides a substantial body of evidence for the causal involvement of Ang II/activated RAAS in eliciting adverse reactions after application of spike-based vaccine. As an example, some serious organ disturbances or adverse reactions, in which the connection with an activated RAAS is obvious (cardiovascular and blood coagulation disorders, disorders of the nervous and muscular system, inflammatory reactions, auto-immunological, vascular and renal disorders), are presented and discussed.
Only a consistent refraining from any unfavorable influence on the highly complex RAAS enables harm avoidance. To limit or repair harm that has already occurred, RAAS inhibitors or recombinant ACE2 or ACE2 activators are suitable for spike-related symptoms. Based on individual assessment, the preference is currently for ARBs. An individualized approach depending on symptoms, individual conditions and differentiated diagnostics is essential.