The alternative renin-angiotensin-system (RAS) signalling pathway in prostate cancer and its link to the current COVID-19 pandemic

Background: The renin-angiotensin system is known to maintain blood pressure and body fluids. However, it hasbeen found to consist of at least two major constituents, the classic and thealternative pathway, balancing and supporting each other’s signalling in a very intricate way. Current research has shown that the renin-angiotensin system is involved in a broad range of biological processes and diseases, such as cancer and infectious diseases. 

Methods and results: We conducted aliterature review on the interaction of the renin-angiotensin system andprostate cancer and explored the research on the possible impact of theSARS-CoV-2 virus in this context. This review provides an update on contemporaryknowledge into the alternative renin-angiotensin system, its role in cancer,specifically prostate cancer, and the implications of the current COVID-19 pandemic on cancer and cancer care. 

Conclusion: In this work, we aimto demonstrate how shifting the RAS signalling pathway from the classic to thealternative axis seems to be a viable option in supporting treatment of specific cancers and at the same time demonstrating beneficial properties in supportive care. It however seems to be the case that the infection with SARS-CoV-2 and subsequent impairment of the renin-angiotensin-system could exhibit serious deleterious long-term effects even in oncology.