Modeling SARS-CoV-2 infection in vitro with a human intestine-on-chip device

This article has been Reviewed by the following groups

Read the full article

Abstract

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) has given rise to a global pandemic. The gastrointestinal symptoms of some COVID-19 patients are underestimated. There is an urgent need to develop physiologically relevant model that can accurately reflect human response to viral infection. Here, we report the creation of a biomimetic human intestine infection model on a chip system that allows to recapitulate the intestinal injury and immune response induced by SARS-CoV-2, for the first time. The microengineered intestine-on-chip device contains human intestinal epithelium (co-cultured human intestinal epithelial Caco-2 cells and mucin secreting HT-29 cells) lined in upper channel and vascular endothelium (human umbilical vein endothelial cells, HUVECs) in a parallel lower channel under fluidic flow condition, sandwiched by a porous PDMS membrane coated with extracellular matrix (ECM). At day 3 post-infection of SARS-CoV-2, the intestine epithelium showed high susceptibility to viral infection and obvious morphological changes with destruction of intestinal villus, dispersed distribution of mucus secreting cells and reduced expression of tight junction (E-cadherin), indicating the destruction of mucous layer and the integrity of intestinal barrier caused by virus. Moreover, the endothelium exhibited abnormal cell morphology with disrupted expression of adherent junction protein (VE-cadherin). Transcriptional analysis revealed the abnormal RNA and protein metabolism, as well as activated immune responses in both epithelial and endothelial cells after viral infection (e.g., up-regulated cytokine genes, TNF signaling and NF-kappa B signaling-related genes). This bioengineered in vitro model system can mirror the human relevant pathophysiology and response to viral infection at the organ level, which is not possible in existing in vitro culture systems. It may provide a promising tool to accelerate our understanding of COVID-19 and devising novel therapies.

Article activity feed

  1. SciScore for 10.1101/2020.09.01.277780: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    RandomizationThe kit eliminates duplication bias in PCR and sequencing steps, by using unique molecular identifier (UMI) of 8 random bases to label the pre-amplified cDNA molecules.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.
    Cell Line Authenticationnot detected.

    Table 2: Resources

    Experimental Models: Cell Lines
    SentencesResources
    Human umbilical vein endothelial cells (HUVEC) were isolated from human umbilical cord and cultured in Endothelial Cell Medium purchased from ScienCell Research Laboratories, inc
    HUVEC
    suggested: KCB Cat# KCB 200648YJ, RRID:CVCL_2959)
    Then, Caco-2 cells (∼ 1×105 cells) and HT29 cells (∼ 1×104 cells) were mixed and seeded into the upper channel under static cultures.
    HT29
    suggested: None
    Virus: A clinical isolate SARS-COV-2 strain 107 was obtained from Guangdong Provincial Center for Disease Control and Prevention, China, and propagated in Vero E6 cells.
    Vero E6
    suggested: RRID:CVCL_XD71)
    The virus titers were (infectious titers of virus) were determined by a TCID50 assay on Vero cells.
    Vero
    suggested: CLS Cat# 605372/p622_VERO, RRID:CVCL_0059)
    At day 3 post-infection, the epithelial cells and endothelial cells cultured on chip were fixed for immunofluorescence analysis or lysed for RNA-sequencing analysis, respectively. Immunostaining: Caco-2 cells cultured on well plate were washed with PBS and fixed with 4% PFA at 4°C overnight.
    Caco-2
    suggested: None
    Software and Algorithms
    SentencesResources
    Image processing was done using ImageJ (NIH).
    ImageJ
    suggested: (ImageJ, RRID:SCR_003070)
    RNA-sequencing analysis: Raw sequencing data was first filtered by Trimmomatic (version 0.36), low-quality reads were discarded and the reads contaminated with adaptor sequences were trimmed.
    Trimmomatic
    suggested: (Trimmomatic, RRID:SCR_011848)
    They were mapped to the reference genome of Homo sapiens from Ensembl database (ftp://ftp.ensembl.org/pub/release-87/fasta/homo_sapiens/dna/) using STAR software (version 2.5.3a) with default parameters.
    Ensembl
    suggested: (Ensembl, RRID:SCR_002344)
    STAR
    suggested: (STAR, RRID:SCR_015899)
    Reads mapped to the exon regions of each gene were counted by featureCounts (Subread-1.5.1; Bioconductor) and then RPKMs were calculated.
    featureCounts
    suggested: (featureCounts, RRID:SCR_012919)
    Bioconductor
    suggested: (Bioconductor, RRID:SCR_006442)
    Genes differentially expressed between groups were identified using the edgeR package (version 3.12.1).
    edgeR
    suggested: (edgeR, RRID:SCR_012802)
    Gene ontology (GO) analysis and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis for differentially expressed genes were both implemented by KOBAS software (version: 2.1.1) with a corrected P-value cutoff of 0.05 to judge statistically significant enrichment.
    KEGG
    suggested: (KEGG, RRID:SCR_012773)
    KOBAS
    suggested: (KOBAS, RRID:SCR_006350)
    Statistical analyses: Data were collected in Excel (Microsoft).
    Excel
    suggested: None

    Results from OddPub: Thank you for sharing your data.


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    One potential limitation of this work is the use of immortalized intestinal epithelial cell lines (e.g., Caco-2) originally isolated from human colon tumors. However, Caco-2 cells have been widely used to recapitulate many physiological and pathological functions of human intestine in vivo (38, 39). The intestinal epithelium differentiated from primary intestinal stem cells may be selected for further studies in later time. Overall, in this work, we provide the proof-of-concept to build an intestine-on-chip infection model at organ-level that permits to closely mirror the intestinal pathophysiology and human response to SARS-CoV-2 infection, which is impossible to achieve by existing in vitro culture models. It can not only supply a unique, rapid and low-cost in vitro platform for viral infection, but also provide a complement to animal models to study disease progress, virus transmission and host-virus interactions in a more realistic manner, thereby accelerating the COVID-19 research and development of novel therapeutics.

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    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 pages 17 and 19. 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.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.