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After ACE2 cell surface cleavage by ADAM10 or TMPRSS2, the -secretase enzyme forms an ACE2 intracellular domain, which like NICD1, may serve as a cell signaling molecule ( In humans and experimental animals, ACE2 is expressed in renal tubular cells, podocytes, mesangial cells, and endothelial cells

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It has been found that a HFD disrupts the structure of intestinal flora and increases the abundance of LPS-producing bacteria, such as Desulfovibrio , which further enhances intestinal permeability and contributes to large amounts of LPS to enter the circulation from the intestine, triggering metabolic endotoxemia (Manco et al., 2010)

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