Angiotensin-Converting Enzyme 2 Expression Is Detectable in Keratinocytes, Cutaneous Appendages, and Blood Vessels by
Clarisse Ganier1, Nasrat Harun, Imogen Peplow
1At the Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK, Clarisse Ganier, PhD, is Associate Researcher; Nasrat Harun, BSc, is Assistant Researcher; Imogen Peplow, BSc, is Assistant Researcher; Xinyi Du-Harpur, MBBChir, is PhD student; Callum Arthurs, BSc, is PhD student; Fiona M. Watt, PhD, is Director, Head of the Medical Research Council; and Magnus D. Lynch, MA, DPhil, MRCS, MRCP, is Consultant Dermatologist and Surgeon.
Objective:
The angiotensin-converting enzyme 2 (ACE2) receptor mediates uptake of SARS-CoV-2, the virus responsible for COVID-19. Previous work analyzing publicly available bulk RNA-sequencing data sets has shown the expression of ACE2 in human keratinocytes. This finding is potentially relevant for the etiology of COVID-19-associated rashes and might also suggest a possible entry mechanism for the SARS-CoV-2 virus. In this study, the authors examined the spatial localization of ACE2 mRNA in vivo.
Methods And Results:
The authors analyzed several publicly available single-cell RNA-sequencing data sets. They determined spatial localization of ACE2 mRNA using multiplex RNA in situ hybridization in human skin.
Conclusions:
Both analyses supported ACE2 expression in keratinocytes and skin vasculature, which could reflect a potential cutaneous entry point for SARS-CoV-2, particularly in damaged or broken skin. Moreover, ACE2 expression in vascular endothelial cells may support direct, virally mediated mechanisms in the etiology of the chilblain-like acral eruption that is seen in patients with COVID-19.
