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Intestinal Inflammation Modulates the Expression of ACE2 and TMPRSS2 and Potentially Overlaps With the Pathogenesis

Mayte Suárez-Fariñas1, Minami Tokuyama2, Gabrielle Wei3

  • 1Center for Biostatistics, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York; Icahn Institute for Data Science and Genomic Technology, New York City, New York.

Gastroenterology
|September 27, 2020
PubMed
Abstract

Insights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) actively replicates in the intestines, with implications for inflammatory bowel disease (IBD) patients. Shared molecular pathways between COVID-19 and IBD warrant further investigation into IBD drug efficacy for COVID-19 treatment.

Area of Science:

  • Gastroenterology
  • Virology
  • Immunology

Background:

  • Gastrointestinal symptoms and high SARS-CoV-2 RNA levels in stool suggest active viral replication in enterocytes.
  • ACE2 receptor expression on small bowel enterocytes supports SARS-CoV-2 intestinal infectivity.

Purpose of the Study:

  • To investigate the interplay between COVID-19, intestinal inflammation, and IBD treatments in large patient cohorts.
  • To explore shared molecular mechanisms between COVID-19 and IBD.

Main Methods:

  • Analysis of large patient cohorts with inflammatory bowel disease (IBD).
  • Assessment of ACE2 and TMPRSS2 receptor expression in relation to IBD medications.
  • Identification of molecular responses to COVID-19 infection in IBD patients.

Main Results:

  • Common IBD medications do not significantly alter ACE2/TMPRSS2 expression in uninflamed intestines.
  • COVID-19 infection elicits molecular responses also found in IBD, indicating shared pathways.
  • Evidence supports SARS-CoV-2 replication within intestinal enterocytes.

Conclusions:

  • Findings highlight the convergence of COVID-19 and IBD inflammation.
  • Mechanistic insights suggest potential for repurposing IBD drugs in COVID-19 treatment.
  • Further research is warranted to explore IBD drug efficacy for COVID-19.
Keywords:
COVID-19GI TractIBD MedicationsNetwork Analyses

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