Up-regulation of ACE2, the SARS-CoV-2 receptor, in asthmatics on maintenance inhaled corticosteroids

Respiratory Research

Jacqueline Salit¹  Yael Strulovici-Barel¹  Ronald G. Crystal²  Sarah L. O’Beirne²  Robert J. Kaner² 

[1] Department of Genetic Medicine, Weill Cornell Medical College, Box 164, 1300 York Avenue, 10065, New York, NY, USA;Department of Genetic Medicine, Weill Cornell Medical College, Box 164, 1300 York Avenue, 10065, New York, NY, USA;Department of Medicine, Weill Cornell Medical College, New York, NY, USA;

关键词: Asthma;    Maintenance inhaled corticosteroids;    ACE2;    SARS-CoV-2;    Gene expression;    Large airway epithelium;   

DOI  :  10.1186/s12931-021-01782-0

来源: Springer

【 摘 要 】

BackgroundThe first step in SARS-CoV-2 infection is binding of the virus to angiotensin converting enzyme 2 (ACE2) on the airway epithelium. Asthma affects over 300 million people world-wide, many of whom may encounter SARS-CoV-2. Epidemiologic data suggests that asthmatics who get infected may be at increased risk of more severe disease. Our objective was to assess whether maintenance inhaled corticosteroids (ICS), a major treatment for asthma, is associated with airway ACE2 expression in asthmatics.MethodsLarge airway epithelium (LAE) of asthmatics treated with maintenance ICS (ICS+), asthmatics not treated with ICS (ICS−), and healthy controls (controls) was analyzed for expression of ACE2 and other coronavirus infection-related genes using microarrays.ResultsAs a group, there was no difference in LAE ACE2 expression in all asthmatics vs controls. In contrast, subgroup analysis demonstrated that LAE ACE2 expression was higher in asthmatics ICS+ compared to ICS‾ and ACE2 expression was higher in male ICS+ compared to female ICS+ and ICS‾ of either sex. ACE2 expression did not correlate with serum IgE, absolute eosinophil level, or change in FEV1 in response to bronchodilators in either ICS− or ICS+.ConclusionAirway ACE2 expression is increased in asthmatics on long-term treatment with ICS, an observation that should be taken into consideration when assessing the use of inhaled corticosteroids during the pandemic.

【 授权许可】

CC BY