bioRxiv · 10.1101/2020.05.21.109124
Intestinal inflammation modulates the expression of ACE2 and TMPRSS2 and potentially overlaps with the pathogenesis of SARS-CoV-2 related disease
Abstract
The presence of gastrointestinal symptoms and high levels of viral RNA in the stool suggest active Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) replication within enterocytes. Here, in multiple, large cohorts of patients with inflammatory bowel disease (IBD), we have studied the intersections between Coronavirus Disease 2019 (COVID-19), intestinal inflammation and IBD treatment. A striking expression of ACE2 on the small bowel enterocyte brush border supports intestinal infectivity by SARS-CoV-2. Commonly used IBD medications, both biologic and non-biologic, do not significantly impact ACE2 and TMPRSS2 receptor expression in the uninflamed intestines. Additionally, we have defined molecular responses to COVID-19 infection that are also enriched in IBD, pointing to shared molecular networks between COVID-19 and IBD. These data generate a novel appreciation of the confluence of COVID-19- and IBD-associated inflammation and provide mechanistic insights supporting further investigation of specific IBD drugs in the treatment of COVID-19.
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Suarez-Farinas, M., Tokuyama, M., Wei, G., Huang, R., Livanos, A., Jha, D., Levescot, A., Kosoy, R., Irizar, H., Cording, S., Wang, W., Ungaro, R., Di Narzo, A., Martinez, G., Suprun, M., Corley, M. J., Stojmirovic, A., Houten, S., Curran, M., Brodmerkel, C., Perrigoue, J., Friedman, J. R., Hao, K., Schadt, E. E., Zhu, J., Ko, H. M., Cho, J., Dubinsky, M. C., Sands, B. E., Ndhlovu, L., Cerf-Bensusan, N., Kasarskis, A., Colombel, J.-F., Harpaz, N., Argmann, C., Mehandru, S.. 2020-05-23. Intestinal inflammation modulates the expression of ACE2 and TMPRSS2 and potentially overlaps with the pathogenesis of SARS-CoV-2 related disease. https://doi.org/10.1101/2020.05.21.109124
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