A model of persistent post SARS-CoV-2 induced lung disease for target identification and testing of therapeutic strategies

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Abstract

COVID-19 survivors develop post-acute sequelae of SARS-CoV-2 (PASC), but the mechanistic basis of PASC-associated lung abnormalities suffers from a lack of longitudinal samples. Mouse-adapted SARS-CoV-2 MA10 produces an acute respiratory distress syndrome (ARDS) in mice similar to humans. To investigate PASC pathogenesis, studies of MA10-infected mice were extended from acute disease through clinical recovery. At 15-120 days post-virus clearance, histologic evaluation identified subpleural lesions containing collagen, proliferative fibroblasts, and chronic inflammation with tertiary lymphoid structures. Longitudinal spatial transcriptional profiling identified global reparative and fibrotic pathways dysregulated in diseased regions, similar to human COVID-19. Populations of alveolar intermediate cells, coupled with focal upregulation of pro-fibrotic markers, were identified in persistently diseased regions. Early intervention with antiviral EIDD-2801 reduced chronic disease, and early anti-fibrotic agent (nintedanib) intervention modified early disease severity. This murine model provides opportunities to identify pathways associated with persistent SARS-CoV-2 pulmonary disease and test countermeasures to ameliorate PASC.

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  1. SciScore for 10.1101/2022.02.15.480515: (What is this?)

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

    Table 1: Rigor

    EthicsIRB: Ethics and biosafety: The generation of SARS-CoV-2 MA10 was approved for use under BSL3 conditions by the University of North Carolina at Chapel Hill Institutional Review Board (UNC-CH IBC) and by a Potential Pandemic Pathogen Care and Oversight committee at the National Institute of Allergy and Infectious Diseases (NIAID).
    IACUC: All animal work was approved by Institutional Animal Care and Use Committee at University of North Carolina at Chapel Hill according to guidelines outlined by the Association for the Assessment and Accreditation of Laboratory Animal Care and the U.S. Department of Agriculture.
    Sex as a biological variablenot detected.
    RandomizationAt indicated harvest time points, randomly assigned animals were euthanized by an overdose of isoflurane and samples for analyses of titer (caudal right lung lobe) and histopathology (left lung lobe) were collected.
    BlindingDisease incidence scoring: Profibrotic disease incidence was scored by a blinded veterinary pathologist using serial H&E and Picrosirius Red stained slides.
    Power Analysisnot detected.
    Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    After pretreatment, slides were incubated with primary antibodies (see Key Resources Table) for 1h followed with Novolink Polymer (RE7260-K) secondary.
    RE7260-K
    suggested: None
    Experimental Models: Cell Lines
    SentencesResources
    A large working stock of SARS-CoV-2 MA10 was generated by passaging the plaque purified clonal isolate sequentially on Vero E6 cells at 37°C (passage 3, SARS-CoV-2 P3).
    Vero E6
    suggested: None
    Experimental Models: Organisms/Strains
    SentencesResources
    In vivo infection: All BALB/c mice used in this study were purchased from Envigo (BALB/cAnNHsd; strain 047) and housed at the University of North Carolina at Chapel Hill until the start of the experiment.
    BALB/c
    suggested: None
    Software and Algorithms
    SentencesResources
    Images were viewed with ImageJ.
    ImageJ
    suggested: (ImageJ, RRID:SCR_003070)
    Pre-ranked gene set enrichment analysis (GSEA) was performed using the Bioconductor R package, fgsea (84), with gene set collections obtained from Gene Ontology Biological Process (85), and Reactome pathways (86).
    Bioconductor
    suggested: (Bioconductor, RRID:SCR_006442)
    Reactome
    suggested: (Reactome, RRID:SCR_003485)
    Plots and hierarchical clustering heatmaps were generated using the R package, ggplot2 (87), and ComplexHeatmap (88).
    ComplexHeatmap
    suggested: (ComplexHeatmap, RRID:SCR_017270)
    Preliminary analysis of the log2 transformed and scaled Q3 normalized data identified a putative batch effect between two runs as identified using the PCA in the R package FactoMineR.
    FactoMineR
    suggested: (FactoMineR, RRID:SCR_014602)
    Sets of differentially expressed genes were tested for overrepresentation of the genes in the databases (GO: Biological Process, GO: Molecular Function, GO: Cellular Components, KEGG, and Reactome) using R package enrichR (93).
    GO: Biological
    suggested: None
    KEGG
    suggested: (KEGG, RRID:SCR_012773)
    enrichR
    suggested: (Enrichr, RRID:SCR_001575)
    Various plots and heatmaps were generated using the R packages ggplot2 and heatmap3 (94).
    ggplot2
    suggested: (ggplot2, RRID:SCR_014601)
    Stained areas of Sirius Red and SMA detected by IHC in the alveolar regions were quantitated using Fiji software.
    Fiji
    suggested: (Fiji, RRID:SCR_002285)
    Statistical significance was evaluated with the R lmerTest package(92), using the Satterthwarte’s degrees of freedom method.
    lmerTest
    suggested: (R package: lmerTest, RRID:SCR_015656)
    Supplemental Table 1: Cytokine and chemokine protein levels in SARS-CoV-2 MA10 infected young and old mice Supplemental Table 2: Gene lists in heat maps Supplemental Table 3: Mouse whole transcriptome GeoMx data Supplemental Table 4: Mouse GeoMx differential gene expression analysis Supplemental Table 5: Mouse GeoMx pathway enrichment analysis Supplemental Table 6: Human donor demographics Supplemental Table 7: Human whole transcriptome GeoMx data Supplemental Table 8: Reagent and Resource descriptions References and Notes:
    Notes
    suggested: None

    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: 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.

    Results from scite Reference Check: We found no unreliable references.


    About SciScore

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