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Li X, Yin W, Li A, Li D, Gao X, Wang R, Cui B, Qiu S, Li R, Jia L, Zuo C, Zhang L, Li M. ACE2 PET to reveal the dynamic patterns of ACE2 recovery in an infection model with pseudocorona virus. J Med Virol 2023; 95:e28470. [PMID: 36606602 DOI: 10.1002/jmv.28470] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/27/2022] [Accepted: 12/25/2022] [Indexed: 01/07/2023]
Abstract
Due to the COVID-19 pandemic, a series of sequelae, such as fatigue, tachypnea, and ageusia, appeared in long COVID patients, but the pathological basis was still uncertain. The targeted radiopharmaceuticals were of potential to systemically and dynamically trace the pathological changes. For the key ACE2 protein in the virus-host interaction, 68 Ga-cyc-DX600 was developed on the basis of DX600 as a PET tracer of ACE2 fluctuation and maintained the ability in differentiating ACE and ACE2. In the temporary infection model inhaled with the radio-traceable pseudovirus in the upper respiratory tract of male humanized ACE2 (hACE2) mice, organ-specific ACE2 dysfunction in acute period and the following ACE2 recovery in a relatively long period was visualized and quantified by ACE2 PET, revealing a complex pattern of virus concentration-dependent degree and time period-dependent tendency of ACE2 recovery, mainly a sudden decrease of apparent ACE2 in the heart, liver, kidneys, lungs, and so on, but the liver was of a quick functional compensation on ACE2 expression after a temporary decrease. ACE2 expression of most organs has recovered to a normal level at 15 days post inhalation, with brain and genitals still of a decreased SUVACE2 ; meanwhile, kidneys were of an increased SUVACE2 . These findings on ACE2 PET were further verified by western blot. When compared with high-resolution computed tomography on structural changes and FDG PET on glycometabolism, ACE2 PET was superior in an earlier diagnostic window during infection and more comprehensive understanding of functional dysfunction post-infection. In the respective ACE2 PET/CT and ACE2 PET/MR scans of a volunteer, the repeatability of SUVACE2 and the ACE2 specificity were further confirmed. In conclusion, 68 Ga-cyc-DX600 was developed as an ACE2-specific tracer, and the corresponding ACE2 PET revealed the dynamic patterns of functional ACE2 recovery and provided a reference and approach to explore the ACE2-related pathological basis of sequelae in long COVID.
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Affiliation(s)
- Xiao Li
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai, China.,University of Chinese Academy of Sciences, Beijing, China.,Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, China
| | - Wei Yin
- Department of Radiology, Shanghai Changhai Hospital, Shanghai, China
| | - Ao Li
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, China
| | - Danni Li
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, China
| | - Xiaolong Gao
- Department of Radiology, Luodian Hospital, Baoshan District, Shanghai, China
| | - Ruizhi Wang
- Department of Radiology, Huadong Hospital, Fudan University, Shanghai, China
| | - Bin Cui
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, China
| | - Shuang Qiu
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, China
| | - Rou Li
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, China
| | - Lina Jia
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai, China
| | - Changjing Zuo
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, China
| | - Lan Zhang
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai, China
| | - Ming Li
- Department of Radiology, Huadong Hospital, Fudan University, Shanghai, China
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7
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Crunfli F, Carregari VC, Veras FP, Silva LS, Nogueira MH, Antunes ASLM, Vendramini PH, Valença AGF, Brandão-Teles C, Zuccoli GDS, Reis-de-Oliveira G, Silva-Costa LC, Saia-Cereda VM, Smith BJ, Codo AC, de Souza GF, Muraro SP, Parise PL, Toledo-Teixeira DA, Santos de Castro ÍM, Melo BM, Almeida GM, Firmino EMS, Paiva IM, Silva BMS, Guimarães RM, Mendes ND, Ludwig RL, Ruiz GP, Knittel TL, Davanzo GG, Gerhardt JA, Rodrigues PB, Forato J, Amorim MR, Brunetti NS, Martini MC, Benatti MN, Batah SS, Siyuan L, João RB, Aventurato ÍK, Rabelo de Brito M, Mendes MJ, da Costa BA, Alvim MKM, da Silva Júnior JR, Damião LL, de Sousa IMP, da Rocha ED, Gonçalves SM, Lopes da Silva LH, Bettini V, Campos BM, Ludwig G, Tavares LA, Pontelli MC, Viana RMM, Martins RB, Vieira AS, Alves-Filho JC, Arruda E, Podolsky-Gondim GG, Santos MV, Neder L, Damasio A, Rehen S, Vinolo MAR, Munhoz CD, Louzada-Junior P, Oliveira RD, Cunha FQ, Nakaya HI, Mauad T, Duarte-Neto AN, Ferraz da Silva LF, Dolhnikoff M, Saldiva PHN, Farias AS, Cendes F, Moraes-Vieira PMM, Fabro AT, Sebollela A, Proença-Modena JL, Yasuda CL, Mori MA, Cunha TM, Martins-de-Souza D. Morphological, cellular, and molecular basis of brain infection in COVID-19 patients. Proc Natl Acad Sci U S A 2022. [DOI: 10.1073/pnas.2200960119 1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
Although increasing evidence confirms neuropsychiatric manifestations associated mainly with severe COVID-19 infection, long-term neuropsychiatric dysfunction (recently characterized as part of “long COVID-19” syndrome) has been frequently observed after mild infection. We show the spectrum of cerebral impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, ranging from long-term alterations in mildly infected individuals (orbitofrontal cortical atrophy, neurocognitive impairment, excessive fatigue and anxiety symptoms) to severe acute damage confirmed in brain tissue samples extracted from the orbitofrontal region (via endonasal transethmoidal access) from individuals who died of COVID-19. In an independent cohort of 26 individuals who died of COVID-19, we used histopathological signs of brain damage as a guide for possible SARS-CoV-2 brain infection and found that among the 5 individuals who exhibited those signs, all of them had genetic material of the virus in the brain. Brain tissue samples from these five patients also exhibited foci of SARS-CoV-2 infection and replication, particularly in astrocytes. Supporting the hypothesis of astrocyte infection, neural stem cell–derived human astrocytes in vitro are susceptible to SARS-CoV-2 infection through a noncanonical mechanism that involves spike–NRP1 interaction. SARS-CoV-2–infected astrocytes manifested changes in energy metabolism and in key proteins and metabolites used to fuel neurons, as well as in the biogenesis of neurotransmitters. Moreover, human astrocyte infection elicits a secretory phenotype that reduces neuronal viability. Our data support the model in which SARS-CoV-2 reaches the brain, infects astrocytes, and consequently, leads to neuronal death or dysfunction. These deregulated processes could contribute to the structural and functional alterations seen in the brains of COVID-19 patients.
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Affiliation(s)
- Fernanda Crunfli
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Victor C. Carregari
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Flavio P. Veras
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Lucas S. Silva
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Mateus Henrique Nogueira
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | | | - Pedro Henrique Vendramini
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | | | - Caroline Brandão-Teles
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Giuliana da Silva Zuccoli
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Guilherme Reis-de-Oliveira
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Lícia C. Silva-Costa
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Verônica Monteiro Saia-Cereda
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Bradley J. Smith
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Ana Campos Codo
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Gabriela F de Souza
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Stéfanie P. Muraro
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Pierina Lorencini Parise
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Daniel A. Toledo-Teixeira
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | | | - Bruno Marcel Melo
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Glaucia M. Almeida
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | | | - Isadora Marques Paiva
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | | | - Rafaela Mano Guimarães
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Niele D. Mendes
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Raíssa L. Ludwig
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Gabriel P. Ruiz
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Thiago L. Knittel
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Gustavo G. Davanzo
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Jaqueline Aline Gerhardt
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Patrícia Brito Rodrigues
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Julia Forato
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Mariene Ribeiro Amorim
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Natália S. Brunetti
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Matheus Cavalheiro Martini
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Maíra Nilson Benatti
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Sabrina S. Batah
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Li Siyuan
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Rafael B. João
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Ítalo K. Aventurato
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Mariana Rabelo de Brito
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Maria J. Mendes
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Beatriz A. da Costa
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Marina K. M. Alvim
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - José Roberto da Silva Júnior
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Lívia L. Damião
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Iêda Maria P. de Sousa
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Elessandra D. da Rocha
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Solange M. Gonçalves
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Luiz H. Lopes da Silva
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Vanessa Bettini
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Brunno M. Campos
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Guilherme Ludwig
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Lucas Alves Tavares
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | | | | | - Ronaldo B. Martins
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Andre Schwambach Vieira
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | | | - Eurico Arruda
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | | | - Marcelo Volpon Santos
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Luciano Neder
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - André Damasio
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Stevens Rehen
- D'Or Institute for Research and Education, 04502001, Brazil
- Institute of Biomedical Science, Federal University of Rio de Janeiro, Rio de Janeiro, 21941590, Brazil
| | - Marco Aurélio Ramirez Vinolo
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | | | - Paulo Louzada-Junior
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Renê Donizeti Oliveira
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Fernando Q. Cunha
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | | | - Thais Mauad
- University of São Paulo, São Paulo, 05508-220, Brazil
| | | | | | | | | | - Alessandro S. Farias
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Fernando Cendes
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Pedro Manoel M. Moraes-Vieira
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Alexandre T. Fabro
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Adriano Sebollela
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - José L. Proença-Modena
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Clarissa L. Yasuda
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Marcelo A. Mori
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
| | - Thiago M. Cunha
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Daniel Martins-de-Souza
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, 13083862, Brazil
- D'Or Institute for Research and Education, 04502001, Brazil
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