The Angiotensin Converting Enzyme 2 (ACE2), Gut Microbiota, and Cardiovascular Health

Background: The renin-angiotensin system (RAS) is an important enzymatic system responsible for the regulation of biological functions, such as the arterial pressure, hydroelectrolytic control, vascular vasodilatation/vasoconstriction and more recently metabolic functions. Objectives: The aim of the present review is to discuss the associations between the gut microbiome and the renin-angiotensin system and the influence of their intimate relationship on the cardiovascular health. Methods: A literature review of the main studies published regarding the relationship among the renin-angiotensin system, gut microbiota and cardiovascular health was performed. Results: The association between the ACE2 and gut microbiota has been discussed. It is shown that the ACE2/Ang 1-7 axis modulates the immune response, influencing the microbiota composition, and thus being one of the causes for some diseases physiophatologies, such as diarrhea and intestinal inflammatory disease. Conclusion: The association between RAS and gut microbiota seems to have a strong influence on the genesis of cardiovascular diseases, through direct mechanisms, such as nerve stimulation, or indirectly on metabolic parameters, such as weight, adiposity and lipid profile.