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Tse LV, Meganck RM, Araba KC, Yount BL, Shaffer KM, Hou YJ, Munt JE, Adams LE, Wykoff JA, Morowitz JM, Dong S, Magness ST, Marzluff WF, Gonzalez LM, Ehre C, Baric RS. Genomewide CRISPR knockout screen identified PLAC8 as an essential factor for SADS-CoVs infection. Proc Natl Acad Sci U S A 2022; 119:e2118126119. [PMID: 35476513 PMCID: PMC9170153 DOI: 10.1073/pnas.2118126119] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/16/2022] [Indexed: 01/27/2023] Open
Abstract
Zoonotic transmission of coronaviruses poses an ongoing threat to human populations. Endemic outbreaks of swine acute diarrhea syndrome coronavirus (SADS-CoV) have caused severe economic losses in the pig industry and have the potential to cause human outbreaks. Currently, there are no vaccines or specific antivirals against SADS-CoV, and our limited understanding of SADS-CoV host entry factors could hinder prompt responses to a potential human outbreak. Using a genomewide CRISPR knockout screen, we identified placenta-associated 8 protein (PLAC8) as an essential host factor for SADS-CoV infection. Knockout of PLAC8 abolished SADS-CoV infection, which was restored by complementing PLAC8 from multiple species, including human, rhesus macaques, mouse, pig, pangolin, and bat, suggesting a conserved infection pathway and susceptibility of SADS-CoV among mammals. Mechanistically, PLAC8 knockout does not affect viral entry; rather, knockout cells displayed a delay and reduction in viral subgenomic RNA expression. In a swine primary intestinal epithelial culture (IEC) infection model, differentiated cultures have high levels of PLAC8 expression and support SADS-CoV replication. In contrast, expanding IECs have low levels of PLAC8 expression and are resistant to SADS-CoV infection. PLAC8 expression patterns translate in vivo; the immunohistochemistry of swine ileal tissue revealed high levels of PLAC8 protein in neonatal compared to adult tissue, mirroring the known SADS-CoV pathogenesis in neonatal piglets. Overall, PLAC8 is an essential factor for SADS-CoV infection and may serve as a promising target for antiviral development for potential pandemic SADS-CoV.
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Affiliation(s)
- Longping V. Tse
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
| | - Rita M. Meganck
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
| | - Kenza C. Araba
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
| | - Boyd L. Yount
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
| | - Kendall M. Shaffer
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
| | - Yixuan J. Hou
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
| | - Jennifer E. Munt
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
| | - Lily E. Adams
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
| | - Jason A. Wykoff
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
| | - Jeremy M. Morowitz
- Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
| | - Stephanie Dong
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
| | - Scott T. Magness
- Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill/North Carolina State University, Chapel Hill, NC 27514
| | - William F. Marzluff
- Integrated Program for Biological and Genome Sciences, Department of Biochemistry & Biophysics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
| | - Liara M. Gonzalez
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606
| | - Camille Ehre
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
| | - Ralph S. Baric
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514
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Wykoff JA, Shaffer KM, Araba KC, Markovetz MR, Patarin J, Robert de Saint Vincent M, Donaldson SH, Ehre C. Rapid Viscoelastic Characterization of Airway Mucus Using a Benchtop Rheometer. J Vis Exp 2022. [PMID: 35532240 DOI: 10.3791/63876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In muco-obstructive lung diseases (e.g., asthma, chronic obstructive pulmonary disease, cystic fibrosis) and other respiratory conditions (e.g., viral/bacterial infections), mucus biophysical properties are altered by goblet cell hypersecretion, airway dehydration, oxidative stress, and the presence of extracellular DNA. Previous studies showed that sputum viscoelasticity correlated with pulmonary function and that treatments affecting sputum rheology (e.g., mucolytics) can result in remarkable clinical benefits. In general, rheological measurements of non-Newtonian fluids employ elaborate, time-consuming approaches (e.g., parallel/cone-plate rheometers and/or microbead particle tracking) that require extensive training to perform the assay and interpret the data. This study tested the reliability, reproducibility, and sensitivity of Rheomuco, a user-friendly benchtop device that is designed to perform rapid measurements using dynamic oscillation with a shear-strain sweep to provide linear viscoelastic moduli (G', G", G*, and tan δ) and gel point characteristics (γc and σc) for clinical samples within 5 min. Device performance was validated using different concentrations of a mucus simulant, 8 MDa polyethylene oxide (PEO), and against traditional bulk rheology measurements. A clinical isolate harvested from an intubated patient with status asthmaticus (SA) was then assessed in triplicate measurements and the coefficient of variation between measurements is <10%. Ex vivo use of a potent mucus reducing agent, TCEP, on SA mucus resulted in a five-fold decrease in elastic modulus and a change toward a more "liquid-like" behavior overall (e.g., higher tan δ). Together, these results demonstrate that the tested benchtop rheometer can make reliable measures of mucus viscoelasticity in clinical and research settings. In summary, the described protocol could be used to explore the effects of mucoactive drugs (e.g., rhDNase, N-acetyl cysteine) onsite to adapt treatment on a case-by-case basis, or in preclinical studies of novel compounds.
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Affiliation(s)
- Jason A Wykoff
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - Kendall M Shaffer
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - Kenza C Araba
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - Matthew R Markovetz
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | | | | | - Scott H Donaldson
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill; Department of Pulmonary and Critical Care Medicine, The University of North Carolina at Chapel Hill
| | - Camille Ehre
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill; Department of Pediatric, Pediatric Pulmonology Division, The University of North Carolina at Chapel Hill;
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3
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Morrison CB, Edwards CE, Shaffer KM, Araba KC, Wykoff JA, Williams DR, Asakura T, Dang H, Morton LC, Gilmore RC, O’Neal WK, Boucher RC, Baric RS, Ehre C. SARS-CoV-2 infection of airway cells causes intense viral and cell shedding, two spreading mechanisms affected by IL-13. Proc Natl Acad Sci U S A 2022; 119:e2119680119. [PMID: 35353667 PMCID: PMC9169748 DOI: 10.1073/pnas.2119680119] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [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] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/14/2022] [Indexed: 12/15/2022] Open
Abstract
Muco-obstructive lung diseases are typically associated with high risks of COVID-19 severity; however, allergic asthma showed reduced susceptibility. To investigate viral spread, primary human airway epithelial (HAE) cell cultures were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and host–virus interactions were examined via electron microscopy, immunohistochemistry, RNA in situ hybridization, and gene expression analyses. In HAE cell cultures, angiotensin-converting enzyme 2 (ACE2) expression governed cell tropism and viral load and was up-regulated by infection. Electron microscopy identified intense viral egress from infected ciliated cells and severe cytopathogenesis, culminating in the shedding of ciliated cells packed with virions, providing a large viral reservoir for spread and transmission. Intracellular stores of MUC5AC, a major airway mucin involved in asthma, were rapidly depleted, likely to trap viruses. To mimic asthmatic airways, HAE cells were treated with interleukin-13 (IL-13), which reduced viral titers, viral messenger RNA, and cell shedding, and significantly diminished the number of infected cells. Although mucus hyperproduction played a shielding role, IL-13–treated cells maintained a degree of protection despite the removal of mucus. Using Gene Expression Omnibus databases, bulk RNA-sequencing analyses revealed that IL-13 up-regulated genes controlling glycoprotein synthesis, ion transport, and antiviral processes (albeit not the typical interferon-induced genes) and down-regulated genes involved in cilial function and ribosomal processing. More precisely, we showed that IL-13 reduced ACE2 expression, intracellular viral load, and cell-to-cell transmission while increasing the cilial keratan sulfate coating. In conclusion, intense viral and cell shedding caused by SARS-CoV-2 infection was attenuated by IL-13, which affected viral entry, replication, and spread.
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Affiliation(s)
- Cameron B. Morrison
- Marsico Lung Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Caitlin E. Edwards
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Kendall M. Shaffer
- Marsico Lung Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Kenza C. Araba
- Marsico Lung Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Jason A. Wykoff
- Marsico Lung Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Danielle R. Williams
- Department of Microbiology and Immunology, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Takanori Asakura
- Marsico Lung Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Hong Dang
- Marsico Lung Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Lisa C. Morton
- Marsico Lung Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Rodney C. Gilmore
- Marsico Lung Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Wanda K. O’Neal
- Marsico Lung Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Richard C. Boucher
- Marsico Lung Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Ralph S. Baric
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
- Department of Microbiology and Immunology, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Camille Ehre
- Marsico Lung Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
- Department of Pediatrics/Pediatric Pulmonology, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
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Morrison CB, Shaffer KM, Araba KC, Markovetz MR, Wykoff JA, Quinney NL, Hao S, Delion MF, Flen AL, Morton LC, Liao J, Hill DB, Drumm ML, O’Neal WK, Kesimer M, Gentzsch M, Ehre C. Treatment of cystic fibrosis airway cells with CFTR modulators reverses aberrant mucus properties via hydration. Eur Respir J 2022; 59:13993003.00185-2021. [PMID: 34172469 PMCID: PMC8859811 DOI: 10.1183/13993003.00185-2021] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/11/2021] [Indexed: 02/05/2023]
Abstract
QUESTION Cystic fibrosis (CF) is characterised by the accumulation of viscous adherent mucus in the lungs. While several hypotheses invoke a direct relationship with cystic fibrosis transmembrane conductance regulator (CFTR) dysfunction (i.e. acidic airway surface liquid (ASL) pH, low bicarbonate (HCO3 -) concentration, airway dehydration), the dominant biochemical alteration of CF mucus remains unknown. MATERIALS/METHODS We characterised a novel cell line (CFTR-KO Calu3 cells) and the responses of human bronchial epithelial (HBE) cells from subjects with G551D or F508del mutations to ivacaftor and elexacaftor-tezacaftor-ivacaftor. A spectrum of assays such as short-circuit currents, quantitative PCR, ASL pH, Western blotting, light scattering/refractometry (size-exclusion chromatography with inline multi-angle light scattering), scanning electron microscopy, percentage solids and particle tracking were performed to determine the impact of CFTR function on mucus properties. RESULTS Loss of CFTR function in Calu3 cells resulted in ASL pH acidification and mucus hyperconcentration (dehydration). Modulation of CFTR in CF HBE cells did not affect ASL pH or mucin mRNA expression, but decreased mucus concentration, relaxed mucus network ultrastructure and improved mucus transport. In contrast with modulator-treated cells, a large fraction of airway mucins remained attached to naïve CF cells following short apical washes, as revealed by the use of reducing agents to remove residual mucus from the cell surfaces. Extended hydration, but not buffers alkalised with sodium hydroxide or HCO3 -, normalised mucus recovery to modulator-treated cell levels. CONCLUSION These results indicate that airway dehydration, not acidic pH and/or low [HCO3 -], is responsible for abnormal mucus properties in CF airways and CFTR modulation predominantly restores normal mucin entanglement.
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Affiliation(s)
- Cameron B. Morrison
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - Kendall M. Shaffer
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - Kenza C. Araba
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - Matthew R. Markovetz
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - Jason A. Wykoff
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - Nancy L. Quinney
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - Shuyu Hao
- Department of Cell Biology and Physiology, The University of North Carolina at Chapel Hill
| | - Martial F. Delion
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - Alexis L. Flen
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - Lisa C. Morton
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - Jimmy Liao
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - David B. Hill
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill,Department of Physics and Astronomy, The University of North Carolina at Chapel Hill
| | - Mitchell L. Drumm
- Department of Genetics and Genome Sciences, Case Western Reserve University School of Medicine
| | - Wanda K. O’Neal
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - Mehmet Kesimer
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill
| | - Martina Gentzsch
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill,Division of Pediatric Pulmonology, The University of North Carolina at Chapel Hill,Department of Cell Biology and Physiology, The University of North Carolina at Chapel Hill
| | - Camille Ehre
- Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill,Division of Pediatric Pulmonology, The University of North Carolina at Chapel Hill,To whom correspondence should be addressed:
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5
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Toyonaga T, Araba KC, Kennedy MM, Keith BP, Wolber EA, Beasley C, Steinbach EC, Schaner MR, Jain A, Long MD, Barnes EL, Herfarth HH, Isaacs KL, Hansen JJ, Kapadia MR, Guillem JG, Gulati AS, Sethupathy P, Furey TS, Ehre C, Sheikh SZ. Increased colonic expression of ACE2 associates with poor prognosis in Crohn's disease. Sci Rep 2021; 11:13533. [PMID: 34188154 PMCID: PMC8241995 DOI: 10.1038/s41598-021-92979-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/18/2021] [Indexed: 12/13/2022] Open
Abstract
The host receptor for SARS-CoV-2, angiotensin-converting enzyme 2 (ACE2), is highly expressed in small intestine. Our aim was to study colonic ACE2 expression in Crohn's disease (CD) and non-inflammatory bowel disease (non-IBD) controls. We hypothesized that the colonic expression levels of ACE2 impacts CD course. We examined the expression of colonic ACE2 in 67 adult CD and 14 NIBD control patients using RNA-seq and quantitative (q) RT-PCR. We validated ACE2 protein expression and localization in formalin-fixed, paraffin-embedded matched colon and ileal tissues using immunohistochemistry. The impact of increased ACE2 expression in CD for the risk of surgery was evaluated by a multivariate regression analysis and a Kaplan–Meier estimator. To provide critical support for the generality of our findings, we analyzed previously published RNA-seq data from two large independent cohorts of CD patients. Colonic ACE2 expression was significantly higher in a subset of adult CD patients which was defined as the ACE2-high CD subset. IHC in a sampling of ACE2-high CD patients confirmed high ACE2 protein expression in the colon and ileum compared to ACE2-low CD and NIBD patients. Notably, we found that ACE2-high CD patients are significantly more likely to undergo surgery within 5 years of CD diagnosis, and a Cox regression analysis found that high ACE2 levels is an independent risk factor for surgery (OR 2.17; 95% CI, 1.10–4.26; p = 0.025). Increased intestinal expression of ACE2 is associated with deteriorated clinical outcomes in CD patients. These data point to the need for molecular stratification that can impact CD disease-related outcomes.
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Affiliation(s)
- Takahiko Toyonaga
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA.,Department of Gastroenterology and Hepatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenza C Araba
- Department of Genetics, Curriculum in Bioinformatics and Computational Biology, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA.,Marsico Lung Institute, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Meaghan M Kennedy
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA.,Department of Genetics, Curriculum in Bioinformatics and Computational Biology, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Benjamin P Keith
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA.,Department of Genetics, Curriculum in Bioinformatics and Computational Biology, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Elisabeth A Wolber
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Caroline Beasley
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Erin C Steinbach
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA.,Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Matthew R Schaner
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Animesh Jain
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Millie D Long
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Edward L Barnes
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Hans H Herfarth
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Kim L Isaacs
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Jonathan J Hansen
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Muneera R Kapadia
- Department of Surgery, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - José Gaston Guillem
- Department of Surgery, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Ajay S Gulati
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA.,Division of Gastroenterology, Department of Pediatrics, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Praveen Sethupathy
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Terrence S Furey
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA.,Department of Genetics, Curriculum in Bioinformatics and Computational Biology, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA.,Department of Biology, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Camille Ehre
- Marsico Lung Institute, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Shehzad Z Sheikh
- Center for Gastrointestinal Biology and Disease, University of North Carolina At Chapel Hill, 111 Mason Farm Road, 7312B MBRB, UNC Chapel Hill, Chapel Hill, NC, 27599, USA. .,Department of Genetics, Curriculum in Bioinformatics and Computational Biology, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA.
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6
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Toyonaga T, Araba KC, Kennedy MM, Keith BP, Wolber EA, Beasley C, Steinbach EC, Schaner MR, Jain A, Long MD, Barnes EL, Herfarth HH, Isaacs KL, Hansen JJ, Kapadia M, Gaston Guillem J, Koruda MJ, Rahbar R, Sadiq T, Gulati AS, Sethupathy P, Furey TS, Ehre C, Sheikh SZ. Increased Colonic Expression of ACE2 Associates with Poor Prognosis in Crohn's disease. bioRxiv 2020. [PMID: 33269348 DOI: 10.1101/2020.11.24.396382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background and Aims The host receptor for SARS-CoV-2, angiotensin-converting enzyme 2 (ACE2), is highly expressed in small intestine. Our aim was to study colonic ACE2 expression in Crohn's disease (CD) and non-inflammatory bowel disease (non-IBD) controls. We hypothesized that the colonic expression levels of ACE2 impacts CD course. Methods We examined the expression of colon ACE2 using RNA-seq and quantitative (q) RT-PCR from 69 adult CD and 14 NIBD control patients. In a subset of this cohort we validated ACE2 protein expression and localization in formalin-fixed, paraffin-embedded matched colon and ileal tissues using immunohistochemistry. The impact of increased ACE2 expression in CD for the risk of surgery was evaluated by a multivariate regression analysis and a Kaplan-Meier estimator. To provide critical support for the generality of our findings, we analyzed previously published RNA-seq data from two large independent cohorts of CD patients. Results Colonic ACE2 expression was significantly higher in a subset of adult CD patients (ACE2-high CD). IHC in a sampling of ACE2-high CD patients confirmed high ACE2 protein expression in the colon and ileum compared to ACE2-low CD and NIBD patients. Notably, we found that ACE2-high CD patients are significantly more likely to undergo surgery within 5 years of diagnosis, with a Cox regression analysis finding that high ACE2 levels is an independent risk factor (OR 2.18; 95%CI, 1.05-4.55; p=0.037). Conclusion Increased intestinal expression of ACE2 is associated with deteriorated clinical outcomes in CD patients. These data point to the need for molecular stratification that may impact CD disease-related outcomes.
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