Investigating the Relationship between COVID-19 Vaccination and ACE2 Gene Expression in Cardiovascular Disease

Nabaa Shihab Shihab 1, Havva Cobanogullari 2, Aya Badeea Ismail 3, Ozlem Balcioglu 4, Mahmut Cerkez Ergoren 3 *
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1 Department of Molecular Medicine, Near East University, Nicosia, Cyprus
2 Department of Biological Sciences, Eastern Mediterranean University, Famagusta, Cyprus
3 Department of Medical Genetics, Near East University, Nicosia, Cyprus
4 Department of Cardiovascular Surgery, Near East University, Nicosia, Cyprus
* Corresponding Author
J CLIN MED KAZ, Volume 23, Issue 3, pp. 52-57. https://doi.org/10.23950/jcmk/18567
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Author Contributions: Conceived and designed the analysis: O.B and M.C.E; collected the data: O.B.; contributed data or analysis tools: N.S.S.S., A.B.I., M.C.E; performed the analysis: N.S.S.S., A.B.I., M.C.E; medical contribution and diagnosis: O.B.; wrote the paper: H.C and M.C.E.; revised the paper: N.S.S.S., A.B.I., O.B., M.C.E; supervised the project: O.B and M.C.E. All authors have read and agreed to the published version of the manuscript.

Data availability statement: The corresponding author can provide the data supporting the study's conclusions upon request. 

Patient Informed Consent Statement: Informed consent was obtained from all individual participants included in the study.

Artificial Intelligence (AI) Disclosure Statement: The authors declare no AI Tools used for preparation of this work.

ABSTRACT

Background: Cardiovascular disease (CVD) is a major global health problem, and the angiotensin-converting enzyme 2 (ACE 2) gene plays a crucial role in SARS-CoV-2  cell entry and cardiovascular homeostasis. Although COVID-19 vaccines are widely used, their potential effects on ACE2 gene expression in individuals with pre-existing cardiac disease remain incompletely understood.

Objective: The aim of this study was to investigate whether ACE2 gene expression is altered by COVID-19 vaccination in cardiac patients compared with healthy controls.

Methods: A total of 90 participants were studied, including 47 healthy controls and 43 patients with confirmed heart disease. Veneous tissue samples were obtained, total RNA extracted and reverse-transcribed to cDNA and ACE2 expression levels were determined by quantitative real-time PCR (qPCR) with  ACTB as the reference gene. Fold-change calculations and correlation tests were performed for statistical analysis.

Results: ACE2 mRNA expression was detectable in venous tissue samples from both patient and control groups. No statistically significant difference in normalized ACE2 expression was observed between healthy controls and  patients with cardiovascular disease (p > 0.05). Correlation analyses showed no significant association between ACTB and ACE2 expression in either group. Although considerable inter-individual variability in ACE2 expression was observed, fold-change analysis did not reveal a consistent directional difference between groups.

Conclusion: These findings indicate that COVID-19 vaccination is not associated with significant alterations in ACE2 mRNA expression in venous tissue of healthy individuals or patients with cardiovascular disease. Further large-scale, multicentre and longitudinal studies are  required to clarify tissue-specific regulation of ACE2 and its potential clinical implications following vaccination.
Keywords: ACE2 gene, cardiovascular disease, COVID-19 vaccine, gene expression, qPCR

CITATION

Shihab Shihab N, Cobanogullari H, Ismail AB, Balcioglu O, Ergoren MC. Investigating the Relationship between COVID-19 Vaccination and ACE2 Gene Expression in Cardiovascular Disease. J CLIN MED KAZ. 2026;23(3):52-7. https://doi.org/10.23950/jcmk/18567

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