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病理性血糖水平增强进入因子表达及肝脏新冠病毒感染

Pathological Glucose Levels Enhance Entry Factor Expression and Hepatic SARS-CoV-2 Infection.

作者信息

Rao Guocheng, Sang Xiongbo, Zhu Xinyue, Zou Sailan, Zhang Yanyan, Cheng Wei, Tian Yan, Fu Xianghui

机构信息

Department of Endocrinology and Metabolism, Department of Biotherapy, Center for Diabetes and Metabolism Research, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Department of Endocrinology and Metabolism, Gansu Provincial Hospital, Lanzhou, China.

出版信息

J Cell Mol Med. 2025 Jun;29(11):e70581. doi: 10.1111/jcmm.70581.

Abstract

Accumulating clinical evidence suggests an intricate relationship between severe COVID-19 and preexisting metabolic complications, which share some metabolic dysregulations, including hyperglycaemia, hyperinsulinaemia and hyperlipidaemia. However, the potential role of these metabolic risk factors in SARS-CoV-2 infection and entry factor expression remains unknown. Here we report the implication of hyperglycaemia in SARS-CoV-2 infection and therapy. Hyperglycaemia, instead of hyperinsulinaemia and hyperlipidaemia, can significantly induce the expression of SARS-CoV-2 entry factors (Ace2, Tmprss2, Tmprss4, Furin and Nrp1) in liver cells, but not in lung and pancreatic cells, which is attenuated by mTOR inhibition. Correspondingly, pathological glucose levels promote SARS-CoV-2 entry into cultured hepatocytes in pseudovirus cell systems. Conversely, representative glucose-lowering drugs (metformin, dapagliflozin, sitagliptin and exenatide) are able to diminish the enhancement of entry factor expression and SARS-CoV-2 infection in cultured hepatocytes under pathological glucose conditions. Intriguingly, SARS-CoV-2 entry factors are increased in the livers of nonalcoholic fatty liver disease and diabetes patients. These results define hyperglycaemia as a key susceptibility factor for hepatic SARS-CoV-2 infection, and provide insights into the clinical application of glucose-lowering therapies in COVID-19 patients under comorbid hyperglycaemia conditions.

摘要

越来越多的临床证据表明,重症新型冠状病毒肺炎(COVID-19)与既往存在的代谢并发症之间存在复杂的关系,这些并发症存在一些代谢失调,包括高血糖、高胰岛素血症和高脂血症。然而,这些代谢危险因素在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染及进入因子表达中的潜在作用仍不清楚。在此,我们报告了高血糖在SARS-CoV-2感染及治疗中的影响。高血糖而非高胰岛素血症和高脂血症可显著诱导肝细胞中SARS-CoV-2进入因子(血管紧张素转换酶2(Ace2)、跨膜丝氨酸蛋白酶2(Tmprss2)、跨膜丝氨酸蛋白酶4(Tmprss4)、弗林蛋白酶(Furin)和神经纤毛蛋白1(Nrp1))的表达,但在肺细胞和胰腺细胞中则不然,雷帕霉素靶蛋白(mTOR)抑制可减弱这种诱导作用。相应地,病理血糖水平可促进SARS-CoV-2在假病毒细胞系统中进入培养的肝细胞。相反,代表性的降糖药物(二甲双胍、达格列净、西格列汀和艾塞那肽)能够减少病理血糖条件下培养的肝细胞中进入因子表达的增强及SARS-CoV-2感染。有趣的是,在非酒精性脂肪性肝病和糖尿病患者的肝脏中,SARS-CoV-2进入因子增加。这些结果将高血糖定义为肝脏SARS-CoV-2感染的关键易感因素,并为合并高血糖的COVID-19患者降糖治疗的临床应用提供了见解。

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