Up-regulation of ACE2, the SARS-CoV-2 receptor, in asthmatics on maintenance inhaled corticosteroids.
| Publication Type | Academic Article |
| Authors | O'Beirne S, Salit J, Kaner R, Crystal R, Strulovici-Barel Y |
| Journal | Respir Res |
| Volume | 22 |
| Issue | 1 |
| Pagination | 200 |
| Date Published | 07/07/2021 |
| ISSN | 1465-993X |
| Keywords | Adrenal Cortex Hormones, Angiotensin-Converting Enzyme 2, Asthma, Receptors, Virus, Respiratory Mucosa |
| Abstract | BACKGROUND: The 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. METHODS: Large 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. RESULTS: As 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+. CONCLUSION: Airway 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. |
| DOI | 10.1186/s12931-021-01782-0 |
| PubMed ID | 34233672 |
| PubMed Central ID | PMC8261394 |