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Wagner JUG, Bojkova D, Shumliakivska M, Luxán G, Nicin L, Aslan GS, Milting H, Kandler JD, Dendorfer A, Heumueller AW, Fleming I, Bibli SI, Jakobi T, Dieterich C, Zeiher AM, Ciesek S, Cinatl J, Dimmeler S. Increased susceptibility of human endothelial cells to infections by SARS-CoV-2 variants. Basic Res Cardiol 2021; 116:42. [PMID: 34224022 PMCID: PMC8256413 DOI: 10.1007/s00395-021-00882-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/01/2021] [Indexed: 12/14/2022]
Abstract
Coronavirus disease 2019 (COVID-19) spawned a global health crisis in late 2019 and is caused by the novel coronavirus SARS-CoV-2. SARS-CoV-2 infection can lead to elevated markers of endothelial dysfunction associated with higher risk of mortality. It is unclear whether endothelial dysfunction is caused by direct infection of endothelial cells or is mainly secondary to inflammation. Here, we investigate whether different types of endothelial cells are susceptible to SARS-CoV-2. Human endothelial cells from different vascular beds including umbilical vein endothelial cells, coronary artery endothelial cells (HCAEC), cardiac and lung microvascular endothelial cells, or pulmonary arterial cells were inoculated in vitro with SARS-CoV-2. Viral spike protein was only detected in HCAECs after SARS-CoV-2 infection but not in the other endothelial cells tested. Consistently, only HCAEC expressed the SARS-CoV-2 receptor angiotensin-converting enzyme 2 (ACE2), required for virus infection. Infection with the SARS-CoV-2 variants B.1.1.7, B.1.351, and P.2 resulted in significantly higher levels of viral spike protein. Despite this, no intracellular double-stranded viral RNA was detected and the supernatant did not contain infectious virus. Analysis of the cellular distribution of the spike protein revealed that it co-localized with endosomal calnexin. SARS-CoV-2 infection did induce the ER stress gene EDEM1, which is responsible for clearance of misfolded proteins from the ER. Whereas the wild type of SARS-CoV-2 did not induce cytotoxic or pro-inflammatory effects, the variant B.1.1.7 reduced the HCAEC cell number. Of the different tested endothelial cells, HCAECs showed highest viral uptake but did not promote virus replication. Effects on cell number were only observed after infection with the variant B.1.1.7, suggesting that endothelial protection may be particularly important in patients infected with this variant.
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Affiliation(s)
- Julian U G Wagner
- Institute for Cardiovascular Regeneration, Centre of Molecular Medicine, Goethe University Frankfurt, Theodor Stern Kai 7, 60590, Frankfurt, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Frankfurt, Germany
- Cardiopulmonary Institute (CPI), Frankfurt, Germany
| | - Denisa Bojkova
- Institute of Medical Virology, University Frankfurt, Frankfurt, Germany
| | - Mariana Shumliakivska
- Institute for Cardiovascular Regeneration, Centre of Molecular Medicine, Goethe University Frankfurt, Theodor Stern Kai 7, 60590, Frankfurt, Germany
| | - Guillermo Luxán
- Institute for Cardiovascular Regeneration, Centre of Molecular Medicine, Goethe University Frankfurt, Theodor Stern Kai 7, 60590, Frankfurt, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Frankfurt, Germany
- Cardiopulmonary Institute (CPI), Frankfurt, Germany
| | - Luka Nicin
- Institute for Cardiovascular Regeneration, Centre of Molecular Medicine, Goethe University Frankfurt, Theodor Stern Kai 7, 60590, Frankfurt, Germany
| | - Galip S Aslan
- Institute for Cardiovascular Regeneration, Centre of Molecular Medicine, Goethe University Frankfurt, Theodor Stern Kai 7, 60590, Frankfurt, Germany
| | - Hendrik Milting
- Clinic for Thoracic and Cardiovascular Surgery, Bad Oeyenhausen, Germany
| | - Joshua D Kandler
- Institute of Medical Virology, University Frankfurt, Frankfurt, Germany
| | - Andreas Dendorfer
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Frankfurt, Germany
- Walter-Brendel-Centre, Hospital of the Ludwig-Maximilians-University München, Munich, Germany
| | - Andreas W Heumueller
- Institute for Cardiovascular Regeneration, Centre of Molecular Medicine, Goethe University Frankfurt, Theodor Stern Kai 7, 60590, Frankfurt, Germany
- Cardiopulmonary Institute (CPI), Frankfurt, Germany
| | - Ingrid Fleming
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Frankfurt, Germany
- Cardiopulmonary Institute (CPI), Frankfurt, Germany
- Institute for Vascular Signalling, Centre for Molecular Medicine, Goethe University, Frankfurt am Main, Germany
| | - Sofia-Iris Bibli
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Frankfurt, Germany
- Cardiopulmonary Institute (CPI), Frankfurt, Germany
- Institute for Vascular Signalling, Centre for Molecular Medicine, Goethe University, Frankfurt am Main, Germany
| | - Tobias Jakobi
- Department of Internal Medicine and the Center for Translational Cardiovascular Research, University of Arizona, 475 N. 5th Street, Phoenix, AZ, 85004, USA
| | - Christoph Dieterich
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Frankfurt, Germany
- Klaus Tschira Institute for Integrative Computational Cardiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas M Zeiher
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Frankfurt, Germany
- Cardiopulmonary Institute (CPI), Frankfurt, Germany
- Department of Cardiology, University Frankfurt, Frankfurt, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, University Frankfurt, Frankfurt, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine und Pharmacology, Frankfurt, Germany
- German Centre for Infection Research (DZIF), External Partner Site Frankfurt, Frankfurt, Germany
| | - Jindrich Cinatl
- Institute of Medical Virology, University Frankfurt, Frankfurt, Germany
| | - Stefanie Dimmeler
- Institute for Cardiovascular Regeneration, Centre of Molecular Medicine, Goethe University Frankfurt, Theodor Stern Kai 7, 60590, Frankfurt, Germany.
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Frankfurt, Germany.
- Cardiopulmonary Institute (CPI), Frankfurt, Germany.
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