High expression of angiotensin-converting enzyme-2 (ACE2) on tissue macrophages that may be targeted by virus SARS-CoV-2 in COVID-19 patients

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Abstract

Angiotensin-converting enzyme-2 (ACE2) has been recognized as the binding receptor for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that infects host cells, causing the development of the new coronavirus infectious disease (COVID-19). To better understand the pathogenesis of COVID-19 and build up the host anti-viral immunity, we examined the levels of ACE2 expression on different types of immune cells including tissue macrophages. Flow cytometry demonstrated that there was little to no expression of ACE2 on most of the human peripheral blood-derived immune cells including CD4 + T, CD8 + T, activated CD4 + T, activated CD8 + T, CD4 + CD25 + CD127 low/− regulatory T cells (Tregs), Th17 cells, NKT cells, B cells, NK cells, monocytes, dendritic cells (DCs), and granulocytes. Additionally, there was no ACE2 expression (< 1%) found on platelets. Compared with interleukin-4-treated type 2 macrophages (M2), the ACE2 expression was markedly increased on the activated type 1 macrophages (M1) after the stimulation with lipopolysaccharide (LPS). Immunohistochemistry demonstrated that high expressions of ACE2 were colocalized with tissue macrophages, such as alveolar macrophages found within the lungs and Kupffer cells within livers of mice. Flow cytometry confirmed the very low level of ACE2 expression on human primary pulmonary alveolar epithelial cells. These data indicate that alveolar macrophages, as the frontline immune cells, may be directly targeted by the SARS-CoV-2 infection and therefore need to be considered for the prevention and treatment of COVID-19.

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  1. SciScore for 10.1101/2020.07.18.210120: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIACUC: The final data were analyzed using the Kaluza Flow Cytometry Analysis Software (Beckman Coulter, Brea, CA, USA). 2.6. Immunohistochemistry: Female NOD/LtJ mice (aged 3 weeks) and NOD-scid mice (aged 5–6 weeks) were purchased from Jackson Laboratories (Bar Harbor, ME, USA) and maintained under pathogen-free conditions, according to a protocol approved by the institutional Animal Care Committee (ACC).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablePBMC isolation: To determine the expression of ACE2 on different types of immune cells, human buffy coat blood units (N = 6; mean age of 42 ± 13.89; age range from 27 to 58 years old; 3 males and 3 females) were purchased from the New York Blood Center (New York, NY, USA).

    Table 2: Resources

    Antibodies
    SentencesResources
    The purified CD4+ T cells were seeded at 1 × 105 cells/well in the anti-CD3 monoclonal antibody (mAb) (10 μg/mL, BD Pharmingen, Franklin Lakes, NJ, USA) precoated 96-well tissue culture-treated plate, in the presence of soluble anti-CD28 mAb (1 μg/mL, BD Pharmingen, Franklin Lakes, NJ, USA), interleukin (IL)-6 (10 ng/mL, Biolegend, San Diego, CA, USA), IL-1β (10 ng/mL, Biolegend, San Diego, CA, USA), transforming growth factor (TGF)-β1 (1 ng/mL, Biolegend, San Diego, CA, USA), IL-23 (10 ng/mL, Biolegend, San Diego, CA, USA), penicillin-streptomycin (10 μg/mL, Sigma, Saint Louis, MO, USA), the neutralizing antibodies anti-IL-4 mAb (10 μg/mL, BD Pharmingen, Franklin Lakes, NJ, USA) and anti-IFN-γ mAb (10 μg/mL, BD Pharmingen, Franklin Lakes, NJ, USA), in X-VIVO 15 serum-free medium (200 μl per well), at 37 °C, 5% CO2 conditions.
    anti-CD3
    suggested: None
    anti-CD28
    suggested: (Bio X Cell Cat# BE0015-1, RRID:AB_1107624)
    TGF)-β1 (1 ng/mL
    suggested: None
    IL-23
    suggested: None
    anti-IL-4
    suggested: None
    anti-IFN-γ
    suggested: None
    The antibodies FITC-conjugated anti-human Hsp60, PB-conjugated anti-human CD3, and APC-conjugated anti-IL17A mAbs were purchased from Biolegend (San Diego, CA, USA).
    anti-human
    suggested: None
    anti-human Hsp60
    suggested: None
    anti-human CD3
    suggested: None
    anti-IL17A
    suggested: None
    The antibodies PE-Cy7-conjugated anti-human CD11c mAb, PE-Cy7-conjugated anti-human CD56 mAb, BV-421-conjugated anti-human CD127 mAb, PE-conjugated anti-RORγT, and BV 421-conjugated anti-RORγT mAbs were purchased from BD (Franklin Lakes, NJ, USA).
    anti-RORγT
    suggested: None
    Tissue sections were initially immunostained with ACE2 rabbit polyclonal antibody (Abcam, Cambridge, MA, USA) at 1:100 dilution for 2 hours at room temperature.
    ACE2
    suggested: None
    Experimental Models: Organisms/Strains
    SentencesResources
    The final data were analyzed using the Kaluza Flow Cytometry Analysis Software (Beckman Coulter, Brea, CA, USA). 2.6. Immunohistochemistry: Female NOD/LtJ mice (aged 3 weeks) and NOD-scid mice (aged 5–6 weeks) were purchased from Jackson Laboratories (Bar Harbor, ME, USA) and maintained under pathogen-free conditions, according to a protocol approved by the institutional Animal Care Committee (ACC).
    NOD-scid
    suggested: None
    Tissue sections from NOD/LtJ mice (3 weeks old) were utilized for immunohistochemistry including lung tissue sections (n = 4), small intestine tissue sections (n = 4), liver tissue sections (n = 4), and kidney tissue sections (n = 4).
    NOD/LtJ
    suggested: None
    Software and Algorithms
    SentencesResources
    Finally, the slides were covered by using mounting medium with DAPI (Vector Laboratories, Burlingame, CA, USA) and photographed with a Nikon A1R confocal microscope on a Nikon Eclipse Ti2 inverted base, using NIS Elements Version 4.60 software. 2.7. Statistics: Statistical analyses were performed with GraphPad Prism 8 (version 8.0.1) software.
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04299152Not yet recruitingStem Cell Educator Therapy Treat the Viral Inflammation in C…


    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).


    Results from JetFighter: Please consider improving the rainbow (“jet”) colormap(s) used on page 32. At least one figure is not accessible to readers with colorblindness and/or is not true to the data, i.e. not perceptually uniform.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • No funding statement was detected.
    • No protocol registration statement was detected.

    About SciScore

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