Angiotensin-(1-7)

Where it comes from

Made in

Made from angiotensin II by ACE2 and from angiotensin I by neprilysin, in heart, kidney, lung and brain

Sent out by

Rises on ACE inhibitors and angiotensin receptor blockers, which divert angiotensin toward it

Acts on

• Vessels (nitric oxide release)
• Heart
• Kidney
• Lung

What it does

• Relaxes vessels and lowers pressure ¹
• Opposes the scarring, growth and inflammation angiotensin II drives ¹
• Part of why ACE2 matters: the enzyme that makes it is also the door the COVID-19 virus uses ¹

In medicine

• No approved medicine. It is the protective arm of the renin-angiotensin system that ACE inhibitors and sartans strengthen indirectly, by diverting angiotensin towards it ¹
• It is not measured clinically: it is present in picomolar amounts and keeps degrading in the tube, so published levels depend heavily on how the blood was collected ¹

Beyond the body’s own use

• A randomised trial of infusions in 343 adults hospitalised with COVID-19 was stopped early for futility: oxygen-free days did not differ from placebo ²
• The same peptide was given before and after chemotherapy in a phase 1/2 study aimed at blood counts, which is the only other setting it has been tested in people ³
• An oral formulation, the peptide held inside a cyclodextrin, has been worked on in Brazil and is active in rodents; human data remain minimal ¹
• The COVID-19 idea came from ACE2 being both the enzyme that makes this peptide and the receptor the virus uses. The trial did not support it ²