SARS-CoV-2 binding to ACE2 triggers pericyte-mediated angiotensin-evoked cerebral capillary constriction

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Abstract

The SARS-CoV-2 receptor, ACE2, is found on pericytes, contractile cells enwrapping capillaries that regulate brain, heart and kidney blood flow. ACE2 converts vasoconstricting angiotensin II into vasodilating angiotensin-(1-7). In brain slices from hamster, which has an ACE2 sequence similar to human ACE2, angiotensin II alone evoked only a small capillary constriction, but evoked a large pericyte-mediated capillary constriction generated by AT1 receptors in the presence of the SARS-CoV-2 receptor binding domain (RBD). The effect of the RBD was mimicked by blocking ACE2. A mutated non-binding RBD did not potentiate constriction. A similar RBD-potentiated capillary constriction occurred in human cortical slices. This constriction reflects an RBD-induced decrease in the conversion of angiotensin II to angiotensin-(1-7). The clinically-used drug losartan inhibited the RBD-potentiated constriction. Thus AT1 receptor blockers could be protective in SARS-CoV-2 infection by reducing pericyte-mediated blood flow reductions in the brain, and perhaps the heart and kidney.

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  1. SciScore for 10.1101/2021.04.01.438122: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementConsent: Ethical approval was obtained (REC number 15/NW/0568, IRAS ID 180727 (v3.0), “Properties of human pericytes”, as approved on 9-10-2018 for extension and amendment) and all patients gave informed written consent.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableThe constriction evoked by angiotensin II in the presence of the RBD showed overlapping ranges of value for 2 female vessels and 9 male vessels (p=0.67).

    Table 2: Resources

    Antibodies
    SentencesResources
    Primary antibodies used were goat anti-ACE2 (R&D systems, AF933, 1:200)
    anti-ACE2
    suggested: None
    Secondary antibodies used were Alexa fluor 488 donkey anti-goat (Invitrogen, A11055, 1:500)
    anti-goat
    suggested: (Thermo Fisher Scientific Cat# A-11055, RRID:AB_2534102)
    A11055
    suggested: (Thermo Fisher Scientific Cat# A-11055, RRID:AB_2534102)
    Software and Algorithms
    SentencesResources
    Diameter was measured in ImageJ by drawing a line across the vessel between the inner walls of the endothelial cells.
    ImageJ
    suggested: (ImageJ, RRID:SCR_003070)

    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
    NCT04312009CompletedLosartan for Patients With COVID-19 Requiring Hospitalizatio…
    NCT04311177CompletedLosartan for Patients With COVID-19 Not Requiring Hospitaliz…


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


    Results from JetFighter: We did not find any issues relating to colormaps.


    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.