Table 1

Characteristics and key findings of included studies

Drug classSample size, median (range)Exposure to treatment, mean (SD)Effect on ACE2 expression, levels or activity (number of studies)*Model tested (number of studies)*Site of ACE2 receptor measurement (number of studies)*Condition of subjects (number of studies)*
ACE inhibitors27–3632 (7–375)4 weeks (3)Increase (n=17)
Decrease (n=1)
No effect (n=4)
Rats, in vivo (n=16)
Humans, in vivo (n=2)
Other (n=4)
Cardiac (n=14)
Hepatic (n=2)
Renal (n=2)
Not stated (n=2)
Other (n=3)
Heart disease/heart failure (n=7)
Hypertension (n=3)
Diabetes (n=3)
Healthy (n=2)
Other (n=1)
Not stated (n=6)
Aldosterone antagonists37–3963 (28–75)4 weeks (4)Increase (n=3)
Decrease (n=0)
No effect (n=0)
Rats, in vivo (n=3)Renal (n=3)Diabetes (n=1)
Renal disease (n=1)
Hepatic dysfunction (n=1)
Angiotensin receptor blockers28 30 35 36 40–8936 (6–180)6 weeks (6)Increase (n=43)
Decrease (n=7)
No effect (n=3)
Unclear/mixed findings (n=2)
Rats, in vivo (n=34)
Mice, in vivo (n=11)
Humans, in vivo (n=4)
Other (n=6)
Cardiac (n=27)
Hepatic (n=2)
Renal (n=12)
Lung (n=2)
Not stated (n=1)
Other (n=7)
Hypertension (n=13)
Heart disease/heart failure (n=10)
Diabetes (n=5)
Healthy (n=6)
Not stated (n=13)
Other (n=5)
Beta blockers63 9052 (44–62)4 weeks (2)Increase (n=0)
Decrease (n=0)
No effect (n=2)
Rats, in vivo (n=1)
Rats, in vitro (n=1)
Cardiac (n=2)Hypertension (n=2)
Calcium channel blockers51 91 92117 (N/A)3 weeks (1)Increase (n=2)
Decrease (n=1)
No effect (n=0)
Rats, in vivo (n=2)
Human, in vitro (n=1
Hepatic (n=1)
Cardiac (n=1)
Cerebral (n=1)
Healthy (n=2)
Hypertension (n=1)
Centrally acting vasodilators866 (N/A)8 weeks (N/A)Increase (n=0)
Decrease (n=0)
No effect (n=1)
Mice, in vitro (n=1)Cardiac (n=1)Other (n=1)
DPP4 inhibitor9324 (N/A)4 weeks (N/A)Increase (n=1)
Decrease (n=0)
No effect (n=0)
Rats, in vivo (n=1)Cardiac (n=1)Healthy (n=1)
GABA analogues948 (N/A)3 weeks (N/A)Increase (n=0)
Decrease (n=1)
No effect (n=0)
Rats, in vivo (n=1)Cerebral (n=1)Heathy (n=1)
GLP-1 agonists93 9538 (24–54)3 weeks (1)Increase (n=2)
Decrease (n=0)
No effect (n=0)
Rats, in vivo (n=2)Cardiac (n=1)
Lung (n=1)
Diabetic (n=1)
Healthy (n=1)
Insulin96–10357 (8–84)6 weeks (6)Increase (n=6)
Decrease (n=1)
No effect (n=1)
Mice, in vivo (n=4)
Mice, in vitro (n=1)
Rats, in vivo (n=2)
Rats, in vitro (n=1)
Renal (n=5)
Cardiac (n=2)
Diabetes (n=7)
Healthy (n=1)
Ivabradine10424 (N/A)12 weeks (N/A)Increase (n=1)
Decrease (n=0)
No effect (n=0)
Canine, in vivo (n=1)Cardiac (n=1)Heart failure (n=1)
NSAIDs105 10618 (N/A)8 weeks (0)Increase (n=2)
Decrease (n=0)
No effect (n=0)
Rats, in vivo (n=2)Cardiac (n=2)Diabetic (n=2)
Oestrogens45 107–11127 (17–75)3 weeks (3)Increase (n=3)
Decrease (n=1)
No effect (n=1)
Human, in vitro (n=2)
Human, in vivo (n=1)
Rats, in vivo (n=2)
Mice, in vivo (n=1)
Cardiac (n=2)
Ovarian (n=1)
Cerebral (n=1)
Not stated (n=2)
Heart disease (n=1)
Hypertension (n=1)
Hypertension+ovariectomy (n=1)
Healthy (n=1)
Not stated (n=1)
Alzheimers (n=1)
PDE-5 inhibitors1123230 min (N/A)Increase (n=0)
Decrease (n=0)
No effect (n=1)
Rats, in vitro (n=1)Cardiac (n=1)Healthy (n=1)
SGLT2 inhibitors113Not stated15 weeks (N/A)Increase (n=0)
Decrease (n=0)
No effect (n=1)
Mice, in vitro (n=1)Renal (n=1)Diabetic (n=1)
Statins92 103 114–11662 (36–87)5 weeks (3)Increase (n=3)
Decrease (n=1)
No effect (n=1)
Rats, in vivo (n=4)
Rats, in vitro (n=1)
Cardiac (n=4)
Renal (n=1)
Diabetes (n=2)
Hypertension (n=1)
Unclear (n=1)
Unclear (n=1)
Thiazide and thiazide-like diuretics11748 (N/A)1 week (N/A)Increase (n=1)
Decrease (n=1)
No effect (n=0)
Rats, in vivo (n=1)Cardiac (n=1)Hypertension (n=1)
Healthy (n=1)
Thiazolidinedione105 118–12321 (8–60)6 weeks (8)Increase (n=5)
Decrease (n=1)
No effect (n=1)
Rats, in vivo (n=4)
Rats, in vitro (n=1)
Human, in vitro (n=1)
Mice, in vivo (n=1)
Renal (n=3)
Cardiac (n=2)
Hepatic (n=1)
Cerebral (n=1)
Hypertension (n=1)
Heart disease/heart failure (n=1)
Diabetes (n=1)
Healthy (n=1)
Renal disease (n=1)
Not stated (n=2)
Vitamin D123–12547 (33–60)6 weeks (6)Increase (n=2)
Decrease (n=0)
No effect (n=1)
Rats, in vivo (n=3)Cardiac (n=1)
Renal (n=1)
Not stated (n=0)
Hypertension (n=1)
Renal disease (n=1)
Not stated (n=1)
Vitamin D analogues126 12728 (25–30)8 weeks (11)Increase (n=1)
Decrease (n=0)
No effect (n=1)
Rats, in vivo (n=1)
Rats, in vitro (n=1)
Renal (n=1)
Lung (n=1)
Diabetes (n=5)
Lung injury (n=1)
Zinc(128)Not statedNot statedIncrease (n=0)
Decrease (n=1)
No effect (n=0)
Rats, in vitro (n=1)Renal (n=1)
Lung (n=1)
Not stated (n=1)
  • *Studies reporting on multiple sites or in multiple models have been listed separately and appear more than once in the table.

  • GABA, gamma-Aminobutyric acid; GLP-1, glucagon-like peptide 1; PDE-5 inhibitor, phosphodiesterase type 5 inhibitor.