Circulating ACE2-expressing Exosomes Block SARS-CoV-2 Infection as an Innate Antiviral Mechanism
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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.
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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 Statement IRB: 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 …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 Statement IRB: 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.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Cell Line Authentication Contamination: Cells were tested for mycoplasma contamination before culturing. Table 2: Resources
Antibodies Sentences Resources 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 ACE2suggested: NoneThe 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) ACE2suggested: (R and D Systems Cat# AF933, RRID:AB_355722)CD81suggested: NoneCTX101766suggested: NoneCD63suggested: (Proteintech Cat# 25682-1-AP, RRID:AB_2783831)GRP94suggested: (Proteintech Cat# 60012-1-Ig, RRID:AB_2119056)TSG101suggested: (Proteintech Cat# 14497-1-AP, RRID:AB_2208090)14497-1-APsuggested: (Proteintech Cat# 14497-1-AP, RRID:AB_2208090)β-actinsuggested: (Sigma-Aldrich Cat# A5441, RRID:AB_476744)Results were normalized to the CR3022 antibody with known affinity to RBD of SARS-CoV-2 42. CR3022suggested: NoneExperimental Models: Cell Lines Sentences Resources 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-293suggested: CLS Cat# 300192/p777_HEK293, RRID:CVCL_0045)HeLasuggested: CLS Cat# 300194/p772_HeLa, RRID:CVCL_0030)HeLa-ACE2suggested: NoneRBD 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: NoneSoftware and Algorithms Sentences Resources After motion correction of the movies 38, exosomes were identified manually using ImageJ 39. ImageJsuggested: (ImageJ, RRID:SCR_003070)Plasma was run in quadruplicate and reported as the average. Plasmasuggested: NoneBiotin 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 Sceintificsuggested: NoneStatistical Analysis: GraphPad Prism 6.0 Software was used to perform statistical analyses and calculate the IC50. GraphPadsuggested: (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.
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