Pisani Laura Francesca, Albertini Petroni Gugliemo, Crespi Giorgia, Mola Silvia, Annunziata Maria Laura, Caprioli Flavio Andrea, Porta Chiara, Pastorelli Luca
Unit of Immunology and Functional Genomics, Centro Cardiologico Monzino IRCCS, Milan, Italy.
Gastroenterology and Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
Inflamm Bowel Dis. 2025 Jun 13;31(6):1690-1701. doi: 10.1093/ibd/izaf079.
BACKGROUND: Long-term immunosuppressive therapy typically increases the risk of viral infection, yet during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, inflammatory bowel disease (IBD) patients showed reduced severe coronavirus disease 2019 (COVID-19) susceptibility. This suggests potential overlapping molecular mechanisms between IBD and COVID-19 that warrant investigation. METHODS: From April 2020 to April 2022, we enrolled 363 IBD patients and 146 healthy donors. Serum samples were analyzed by enzyme-linked immunoadsorption assay to determine the presence of anti-SARS-CoV-2 antibodies and to measure concentrations of the host-soluble factors sACE2 and mannose-binding lectin (MBL), which have SARS-CoV-2 neutralizing activity. Furthermore, colonic mucosa biopsies were analyzed by real-time PCR to confirm the upregulation of MBL2 as well as to assess the expression of genes encoding SARS-CoV-2 entry molecules (ie, ACE2, TMPRSS2, TMPRSS4, ADAM17, AGTR1). RESULTS: Intestinal mucosa expression of ACE2, TMPRSS2, and TMPRSS4 genes was significantly lower in IBD than in healthy individuals, regardless of the type of medication, while ADAM17 and AGT1R were similar across groups. Serum sACE2 levels changed minimally, whereas circulating MBL levels were significantly higher in CD and somewhat elevated in UC patients versus controls. Parallel trends in MBL2 gene expression were observed in IBD patients' intestinal mucosa. CONCLUSIONS: Overall, our study indicates that the presence of higher basal circulating levels of MBL in CD patients and the decreased intestinal mucosa expression of the SARS-CoV-2 receptor ACE2 and the host cell priming proteases TMPRSS2 and TMPRSS4 in both CD and UC patients may reduce COVID-19 risk, underscoring the potential protective role of these biomarkers in IBD populations against SARS-CoV-2 infection.
背景:长期免疫抑制治疗通常会增加病毒感染风险,但在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)大流行期间,炎症性肠病(IBD)患者感染新型冠状病毒肺炎(COVID-19)的易感性降低。这表明IBD和COVID-19之间可能存在重叠的分子机制,值得研究。 方法:2020年4月至2022年4月,我们招募了363例IBD患者和146名健康供体。通过酶联免疫吸附测定法分析血清样本,以确定抗SARS-CoV-2抗体的存在,并测量具有SARS-CoV-2中和活性的宿主可溶性因子可溶性血管紧张素转换酶2(sACE2)和甘露糖结合凝集素(MBL)的浓度。此外,通过实时聚合酶链反应分析结肠黏膜活检样本,以确认MBL2的上调,并评估编码SARS-CoV-2进入分子(即ACE2、跨膜丝氨酸蛋白酶2(TMPRSS2)、跨膜丝氨酸蛋白酶4(TMPRSS4)、肿瘤坏死因子α转换酶(ADAM17)、血管紧张素Ⅱ受体1型(AGTR1))的基因的表达。 结果:无论使用何种药物,IBD患者肠道黏膜中ACE2、TMPRSS2和TMPRSS4基因的表达均显著低于健康个体,而ADAM17和AGT1R在各组中相似。血清sACE2水平变化极小,而与对照组相比,克罗恩病(CD)患者循环MBL水平显著更高,溃疡性结肠炎(UC)患者略有升高。在IBD患者的肠道黏膜中观察到MBL2基因表达的平行趋势。 结论:总体而言,我们的研究表明,CD患者基础循环MBL水平较高,以及CD和UC患者肠道黏膜中SARS-CoV-2受体ACE2和宿主细胞启动蛋白酶TMPRSS2和TMPRSS4的表达降低,可能会降低COVID-19风险,突出了这些生物标志物在IBD人群中对SARS-CoV-2感染的潜在保护作用。
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