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Xiao Y, Wang L, Li SX, Fang SS, Luo F, Chen SL, Zou X, Ye L, Hou W. Conditional reprogrammed human limbal epithelial cell model for anti-SARS-CoV-2 drug screening. Heliyon 2024; 10:e30044. [PMID: 38698981 PMCID: PMC11064458 DOI: 10.1016/j.heliyon.2024.e30044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/15/2024] [Accepted: 04/18/2024] [Indexed: 05/05/2024] Open
Abstract
To minimize the global pandemic COVID-19 spread, understanding the possible transmission routes of SARS-CoV-2 and discovery of novel antiviral drugs are necessary. We describe here that the virus can infect ocular surface limbal epithelial, but not other regions. Limbal supports wild type and mutant SARS-CoV-2 entry and replication depending on ACE2, TMPRSS2 and possibly other receptors, resulting in slight CPE and arising IL-6 secretion, which symbolizes conjunctivitis in clinical symptoms. With this limbal model, we have screened two natural product libraries and discovered several unreported drugs. Our data reveal important commonalities between COVID-19 and ocular infection with SARS-CoV-2, and establish an ideal cell model for drug screening and mechanism research.
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Affiliation(s)
- Yu Xiao
- Shenzhen Research Institute, Wuhan University, Shenzhen 518057, Guangdong Province, China
- Department of Clinical Laboratory, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518107, China
| | - Ling Wang
- Shenzhen Eye Hospital, Shenzhen 518040, Guangdong Province, China
| | - Shi-xu Li
- Shenzhen Eye Hospital, Shenzhen 518040, Guangdong Province, China
| | - Shi-song Fang
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, Guangdong Province, China
| | - Fan Luo
- State Key Laboratory of Virology/Institute of Medical Virology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, Hubei Province, China
| | - Shu-liang Chen
- State Key Laboratory of Virology/Institute of Medical Virology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, Hubei Province, China
| | - Xuan Zou
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, Guangdong Province, China
| | - Lin Ye
- Shenzhen Eye Hospital, Shenzhen 518040, Guangdong Province, China
| | - Wei Hou
- Shenzhen Research Institute, Wuhan University, Shenzhen 518057, Guangdong Province, China
- State Key Laboratory of Virology/Institute of Medical Virology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, Hubei Province, China
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So M, Goldberg SA, Lu S, Garcia-Knight M, Davidson MC, Tassetto M, Murray VW, Anglin K, Pineda-Ramirez J, Chen JY, Rugart PR, Richardson ET, Briggs-Hagen M, Midgley CM, Andino R, Seitzman GD, Gonzales J, Peluso MJ, Martin JN, Kelly JD. Prevalence, Patterns, and Predictors of SARS-CoV-2 RNA and Culturable Virus in Tears of a Case-Ascertained Household Cohort. Am J Ophthalmol 2024; 265:48-53. [PMID: 38663502 DOI: 10.1016/j.ajo.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 03/30/2024] [Accepted: 04/14/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE To investigate the prevalence, patterns, and predictors of SARS-CoV-2 RNA and culturable virus in tears of a case-ascertained household cohort. DESIGN Prospective, longitudinal case-ascertained household cohort identified through convenience sampling. METHODS This analysis was restricted to individuals who were non-hospitalized, symptomatic, and tested positive for SARS-CoV-2 by nasal RT-PCR. Tears and anterior nasal biospecimens were serially collected throughout the acute period. Tears specimens were collected by the study staff using Schirmer test strips, and nasal specimens were self-collected. For both, SARS-CoV-2 RNA was quantified using qRT-PCR, and culturable virus was detected using presence of cytopathic effect (CPE) in tissue culture; positive CPE was confirmed by a qRT-PCR step. A series of cross-sectional unadjusted analyses were performed investigating the relationship between different sociodemographic determinants and biological factors associated with tears RNA positivity. RESULTS Among the 83 SARS-CoV-2 infected participants, 10 (12%) had at least one RNA-positive tears specimen. Amongst these 10, 5 (50%) had concurrent presence of culturable virus, at a median of 7 days postsymptom onset (IQR: 4-7 days) (absolute range: 4-8 days). CONCLUSIONS In this longitudinal cohort, we found evidence of culturable virus in the tears of a small proportion of nonhospitalized SARS-CoV-2 infected individuals. Current public health infection precautions do not account for transmission via tears, so these findings may improve our understanding of potential sources of SARS-CoV-2 transmission and contribute to developing future guidelines.
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Affiliation(s)
- Matthew So
- Institute for Global Health Sciences (M.S, S.A.G, S.L, K.A, J.P.-R, J.Y.C, J.D.K), University of California, San Francisco, California, USA
| | - Sarah A Goldberg
- Institute for Global Health Sciences (M.S, S.A.G, S.L, K.A, J.P.-R, J.Y.C, J.D.K), University of California, San Francisco, California, USA; Department of Epidemiology and Biostatistics (S.A.G, S.L, P.R.R, J.N.M, J.D.K), University of California, San Francisco, San Francisco, California, USA
| | - Scott Lu
- Institute for Global Health Sciences (M.S, S.A.G, S.L, K.A, J.P.-R, J.Y.C, J.D.K), University of California, San Francisco, California, USA; Department of Epidemiology and Biostatistics (S.A.G, S.L, P.R.R, J.N.M, J.D.K), University of California, San Francisco, San Francisco, California, USA
| | - Miguel Garcia-Knight
- Department of Microbiology and Immunology (M.G.-K, M.T), University of California, San Francisco, San Francisco, California, USA
| | - Michelle C Davidson
- School of Medicine (M.C.D), University of California, San Francisco, San Francisco, California, USA
| | - Michel Tassetto
- Department of Microbiology and Immunology (M.G.-K, M.T), University of California, San Francisco, San Francisco, California, USA
| | - Victoria Wong Murray
- School of Medicine (V.W.M), Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Khamal Anglin
- Institute for Global Health Sciences (M.S, S.A.G, S.L, K.A, J.P.-R, J.Y.C, J.D.K), University of California, San Francisco, California, USA
| | - Jesus Pineda-Ramirez
- Institute for Global Health Sciences (M.S, S.A.G, S.L, K.A, J.P.-R, J.Y.C, J.D.K), University of California, San Francisco, California, USA
| | - Jessica Y Chen
- Institute for Global Health Sciences (M.S, S.A.G, S.L, K.A, J.P.-R, J.Y.C, J.D.K), University of California, San Francisco, California, USA
| | - Paulina R Rugart
- Department of Epidemiology and Biostatistics (S.A.G, S.L, P.R.R, J.N.M, J.D.K), University of California, San Francisco, San Francisco, California, USA
| | - Eugene T Richardson
- Department of Global Health and Social Medicine (E.T.R), Harvard Medical School, Boston, Massachusetts, USA; Division of Infectious Diseases (E.T.R), Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Melissa Briggs-Hagen
- Coronavirus and Other Respiratory Viruses Division (M.B.H, C.M.M), National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Claire M Midgley
- Coronavirus and Other Respiratory Viruses Division (M.B.H, C.M.M), National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Raul Andino
- Department of Microbiology and Immunology (M.G.-K, M.T), University of California, San Francisco, San Francisco, California, USA
| | - Gerami D Seitzman
- F.I. Proctor Foundation (G.D.S, J.G, J.D.K), University of California, San Francisco, San Francisco, California, USA; Department of Ophthalmology (G.D.S, J.G), University of California, San Francisco, California, USA
| | - John Gonzales
- F.I. Proctor Foundation (G.D.S, J.G, J.D.K), University of California, San Francisco, San Francisco, California, USA; Department of Ophthalmology (G.D.S, J.G), University of California, San Francisco, California, USA
| | - Michael J Peluso
- Division of HIV, Infectious Diseases and Global Medicine (M.J.P), Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Jeffrey N Martin
- Department of Epidemiology and Biostatistics (S.A.G, S.L, P.R.R, J.N.M, J.D.K), University of California, San Francisco, San Francisco, California, USA
| | - John Daniel Kelly
- Institute for Global Health Sciences (M.S, S.A.G, S.L, K.A, J.P.-R, J.Y.C, J.D.K), University of California, San Francisco, California, USA; Department of Epidemiology and Biostatistics (S.A.G, S.L, P.R.R, J.N.M, J.D.K), University of California, San Francisco, San Francisco, California, USA; F.I. Proctor Foundation (G.D.S, J.G, J.D.K), University of California, San Francisco, San Francisco, California, USA; Division of Hospital Medicine (J.D.K), San Francisco Veterans Affairs Medical Center, San Francisco, California, USA.
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Angmo D, Mahalingam K, Kakkar A, Rathod A, Meena SK, Kaur A, Choudhary A, Sharma P, Dar L, Samaddar A, Trikha A, Saxena R, Titiyal JS, Sharma N. Virological and cytological changes in tears and conjunctiva of patients with COVID-19. Indian J Ophthalmol 2023; 71:2436-2442. [PMID: 37322656 PMCID: PMC10417966 DOI: 10.4103/ijo.ijo_2133_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/29/2022] [Accepted: 04/06/2023] [Indexed: 06/17/2023] Open
Abstract
Purpose To analyze the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in tears/conjunctival epithelium and assess the cytomorphological changes in the conjunctival epithelium of coronavirus disease 2019 (COVID-19) patients. Methods In this pilot study, patients with moderate to severe COVID-19 were recruited from the COVID ward/intensive care unit of the institute. Tears and conjunctival swabs were collected from COVID-19 patients and sent to the virology laboratory for reverse transcription polymerase chain reaction (RT-PCR) testing. Conjunctival swabs were used to prepare smears, which underwent cytological evaluation and immunocytochemistry for SARS-CoV-2 nucleocapsid protein. Results Forty-two patients were included. The mean age of participants was 48.61 (range: 5-75) years. Seven (16.6%) patients tested positive for SARS-CoV-2 ribonucleic acid in tears samples, four (9.5%) of which were positive on conjunctival swab by RT-PCR in the first test. Cytomorphological changes were observed significantly more in smears from patients with positive RT-PCR on tear samples, including bi-/multi-nucleation (p = 0.01), chromatin clearing (p = 0.02), and intra-nuclear inclusions (p < 0.001). One case (3.2%) showed immunopositivity for SARS-CoV-2; this patient had severe disease and the lowest Ct values for tear and conjunctival samples among all positive cases. Conclusion Conjunctival smears from patients with COVID-19 revealed cytomorphological alterations, even in the absence of clinically significant ocular infection. However, viral proteins were demonstrated within epithelial cells only rarely, suggesting that although the conjunctival epithelium may serve as a portal for entry, viral replication is possibly rare or short-lived.
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Affiliation(s)
- Dewang Angmo
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Karthikeyan Mahalingam
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Aanchal Kakkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Aishwarya Rathod
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Suman Kumari Meena
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Avneet Kaur
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Aashish Choudhary
- Department of Virology, All India Institute of Medical Sciences, New Delhi, India
| | - Puneet Sharma
- Department of Virology, All India Institute of Medical Sciences, New Delhi, India
| | - Lalit Dar
- Department of Virology, All India Institute of Medical Sciences, New Delhi, India
| | - Arpan Samaddar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Anjan Trikha
- Department of Anaethesia and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Saxena
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Jeewan S Titiyal
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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