Circulating ACE2-expressing Exosomes Block SARS-CoV-2 Infection as an Innate Antiviral Mechanism

This article has been Reviewed by the following groups

Read the full article See related articles

Discuss this preprint

Start a discussion What are Sciety discussions?

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the coronavirus disease 2019 (COVID-19) with innate and adaptive immune response triggered in such patients by viral antigens. Both convalescent plasma and engineered high affinity human monoclonal antibodies have shown therapeutic potential to treat COVID-19. Whether additional antiviral soluble factors exist in peripheral blood remain understudied. Herein, we detected circulating exosomes that express the SARS-CoV-2 viral entry receptor angiotensin-converting enzyme 2 (ACE2) in plasma of both healthy donors and convalescent COVID-19 patients. We demonstrated that exosomal ACE2 competes with cellular ACE2 for neutralization of SARS-CoV-2 infection. ACE2-expressing (ACE2 + ) exosomes blocked the binding of the viral spike (S) protein RBD to ACE2 + cells in a dose dependent manner, which was 400- to 700-fold more potent than that of vesicle-free recombinant human ACE2 extracellular domain protein (rhACE2). As a consequence, exosomal ACE2 prevented SARS-CoV-2 pseudotype virus tethering and infection of human host cells at a 50-150 fold higher efficacy than rhACE2. A similar antiviral activity of exosomal ACE2 was further demonstrated to block wild-type live SARS-CoV-2 infection. Of note, depletion of ACE2 + exosomes from COVID-19 patient plasma impaired the ability to block SARS-CoV-2 RBD binding to host cells. Our data demonstrate that ACE2 + exosomes can serve as a decoy therapeutic and a possible innate antiviral mechanism to block SARS-CoV-2 infection.

Article activity feed

  1. SciScore for 10.1101/2020.12.03.407031: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: Human subject study and biosafety approvals: All research activities with human blood specimens of pre-COVID-19 and COVID-19 convalescent patients were implemented under NIH guidelines for human subject studies and the protocols approved by the Northwestern University Institutional Review Board (STU00205299 and #STU00212371) as well as the Institutional Biosafety Committee.
    IACUC: Human subject study and biosafety approvals: All research activities with human blood specimens of pre-COVID-19 and COVID-19 convalescent patients were implemented under NIH guidelines for human subject studies and the protocols approved by the Northwestern University Institutional Review Board (STU00205299 and #STU00212371) as well as the Institutional Biosafety Committee.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.
    Cell Line AuthenticationContamination: Cells were tested for mycoplasma contamination before culturing.

    Table 2: Resources

    Antibodies
    SentencesResources
    Flow cytometry: Cells were blocked with mouse serum IgG (Sigma, 15381) for 10 min at room temperature and then incubated with specific antibodies; AF-647 mouse anti-human ACE2 (R&D systems, FAB9332R),
    anti-human ACE2
    suggested: None
    The antibodies, ACE2 (R&D systems, AF933), CD81 (GeneTex, CTX101766), CD63 (Proteintech, 25682-1-AP), GRP94 (Proteintech, 1H10B7), TSG101 (Proteintech, 14497-1-AP) and β-actin (Sigma, A5441) were used as primary antibodies and horseradish peroxidase (HRP)-conjugated secondary antibodies were from Promega (Rabbit W401B and Mouse W402B), and the substrate ECL was detected by Pierce ECL2 solution (Thermo Fisher Scientific, 1896433A)
    ACE2
    suggested: (R and D Systems Cat# AF933, RRID:AB_355722)
    CD81
    suggested: None
    CTX101766
    suggested: None
    CD63
    suggested: (Proteintech Cat# 25682-1-AP, RRID:AB_2783831)
    GRP94
    suggested: (Proteintech Cat# 60012-1-Ig, RRID:AB_2119056)
    TSG101
    suggested: (Proteintech Cat# 14497-1-AP, RRID:AB_2208090)
    14497-1-AP
    suggested: (Proteintech Cat# 14497-1-AP, RRID:AB_2208090)
    β-actin
    suggested: (Sigma-Aldrich Cat# A5441, RRID:AB_476744)
    Results were normalized to the CR3022 antibody with known affinity to RBD of SARS-CoV-2 42.
    CR3022
    suggested: None
    Experimental Models: Cell Lines
    SentencesResources
    Cell culture: The parent ACE2− human embryonic kidney HEK-293 cells (HEK) or human cervical cancer HeLa cells (HeLa) are transduced with lentiviral pDual-ACE2 expression vector for stable ACE2 expression and production of ACE2+ exosomes. Dr. Thomas Gallagher of Stritch Medical School, Loyola University kindly provided HeLa and HeLa-ACE2 cells via the Hope group.
    HEK-293
    suggested: CLS Cat# 300192/p777_HEK293, RRID:CVCL_0045)
    HeLa
    suggested: CLS Cat# 300194/p772_HeLa, RRID:CVCL_0030)
    HeLa-ACE2
    suggested: None
    RBD bait that was incubated with PBS, or with ACE2− exosomes, non-fluorescent RBD bait (mock control) and ACE2− cells were used as controls.
    ACE2−
    suggested: None
    Software and Algorithms
    SentencesResources
    After motion correction of the movies 38, exosomes were identified manually using ImageJ 39.
    ImageJ
    suggested: (ImageJ, RRID:SCR_003070)
    Plasma was run in quadruplicate and reported as the average.
    Plasma
    suggested: None
    Biotin conjugated RBD protein (ACROBiosystems, SPD-C82E9) were coupled with magnetic beads (CELLection Biotin Binder Kit, Thermo Fisher Sceintific, 11533D), and 5 μg of anti-ACE2 antibody (R&D systems, AF933) or isotope control IgG (R&D systems) were conjugated to dynabeads (Dynabeads Co-Immunoprecipitation Kit, Thermo Fisher Scientific, 14321D)
    Thermo Fisher Sceintific
    suggested: None
    Statistical Analysis: GraphPad Prism 6.0 Software was used to perform statistical analyses and calculate the IC50.
    GraphPad
    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: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: Please consider improving the rainbow (“jet”) colormap(s) used on pages 16 and 21. 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.