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Lunardi F, Fortarezza F, Vedovelli L, Pezzuto F, Boscolo A, Rossato M, Vettor R, Cattelan AM, Del Vecchio C, Crisanti A, Navalesi P, Gregori D, Calabrese F. Lower Gene Expression of Angiotensin Converting Enzyme 2 Receptor in Lung Tissues of Smokers with COVID-19 Pneumonia. Biomolecules 2021; 11:796. [PMID: 34073591 PMCID: PMC8226817 DOI: 10.3390/biom11060796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/17/2021] [Accepted: 05/24/2021] [Indexed: 01/08/2023] Open
Abstract
Angiotensin-converting enzyme 2 (ACE-2) is the main cell entry receptor for severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2), thus playing a critical role in causing Coronavirus disease 2019 (COVID-19). The role of smoking habit in the susceptibility to infection is still controversial. In this study we correlated lung ACE-2 gene expression with several clinical/pathological data to explore susceptibility to infection. This is a retrospective observational study on 29 consecutive COVID-19 autopsies. SARS-CoV-2 genome and ACE-2 mRNA expression were evaluated by real-time polymerase chain reaction in lung tissue samples and correlated with several data with focus on smoking habit. Smoking was less frequent in high than low ACE-2 expressors (p = 0.014). A Bayesian regression also including age, gender, hypertension, and virus quantity confirmed that smoking was the most probable risk factor associated with low ACE-2 expression in the model. A direct relation was found between viral quantity and ACE-2 expression (p = 0.028). Finally, high ACE-2 expressors more frequently showed a prevalent pattern of vascular injury than low expressors (p = 0.049). In conclusion, ACE-2 levels were decreased in the lung tissue of smokers with severe COVID-19 pneumonia. These results point out complex biological interactions between SARS-CoV-2 and ACE-2 particularly concerning the aspect of smoking habit and need larger prospective case series and translational studies.
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Affiliation(s)
- Francesca Lunardi
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, 35128 Padova, Italy; (F.L.); (F.F.); (L.V.); (F.P.); (D.G.)
| | - Francesco Fortarezza
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, 35128 Padova, Italy; (F.L.); (F.F.); (L.V.); (F.P.); (D.G.)
| | - Luca Vedovelli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, 35128 Padova, Italy; (F.L.); (F.F.); (L.V.); (F.P.); (D.G.)
| | - Federica Pezzuto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, 35128 Padova, Italy; (F.L.); (F.F.); (L.V.); (F.P.); (D.G.)
| | - Annalisa Boscolo
- Department of Medicine, University of Padova Medical School, 35128 Padova, Italy; (A.B.); (M.R.); (R.V.); (A.M.C.); (P.N.)
| | - Marco Rossato
- Department of Medicine, University of Padova Medical School, 35128 Padova, Italy; (A.B.); (M.R.); (R.V.); (A.M.C.); (P.N.)
| | - Roberto Vettor
- Department of Medicine, University of Padova Medical School, 35128 Padova, Italy; (A.B.); (M.R.); (R.V.); (A.M.C.); (P.N.)
| | - Anna Maria Cattelan
- Department of Medicine, University of Padova Medical School, 35128 Padova, Italy; (A.B.); (M.R.); (R.V.); (A.M.C.); (P.N.)
| | - Claudia Del Vecchio
- Department of Molecular Medicine, University of Padova Medical School, 35121 Padova, Italy; (C.D.V.); (A.C.)
| | - Andrea Crisanti
- Department of Molecular Medicine, University of Padova Medical School, 35121 Padova, Italy; (C.D.V.); (A.C.)
| | - Paolo Navalesi
- Department of Medicine, University of Padova Medical School, 35128 Padova, Italy; (A.B.); (M.R.); (R.V.); (A.M.C.); (P.N.)
| | - Dario Gregori
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, 35128 Padova, Italy; (F.L.); (F.F.); (L.V.); (F.P.); (D.G.)
| | - Fiorella Calabrese
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, 35128 Padova, Italy; (F.L.); (F.F.); (L.V.); (F.P.); (D.G.)
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