ACE2 and TMPRSS2 are expressed on the human ocular surface, suggesting susceptibility to SARS-CoV-2 infection.,The Ocular Surface

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ACE2 and TMPRSS2 are expressed on the human ocular surface, suggesting susceptibility to SARS-CoV-2 infection.
The Ocular Surface ( IF 5.9 ) Pub Date : 2020-06-13 , DOI: 10.1016/j.jtos.2020.06.007
Lingli Zhou ₁ , Zhenhua Xu ₂ , Gianni M Castiglione ₂ , Uri S Soiberman ₂ , Charles G Eberhart ₃ , Elia J Duh ₂

Affiliation

Purpose

Conjunctival signs and symptoms are observed in a subset of patients with COVID-19, and SARS-CoV-2 has been detected in tears, raising concerns regarding the eye both as a portal of entry and carrier of the virus. The purpose of this study was to determine whether ocular surface cells possess the key factors required for cellular susceptibility to SARS-CoV-2 entry/infection.

Methods

We analyzed human post-mortem eyes as well as surgical specimens for the expression of ACE2 (the receptor for SARS-CoV-2) and TMPRSS2, a cell surface-associated protease that facilitates viral entry following binding of the viral spike protein to ACE2.

Results

Across all eye specimens, immunohistochemical analysis revealed expression of ACE2 in the conjunctiva, limbus, and cornea, with especially prominent staining in the superficial conjunctival and corneal epithelial surface. Surgical conjunctival specimens also showed expression of ACE2 in the conjunctival epithelium, especially prominent in the superficial epithelium, as well as weak or focal expression in the substantia propria. All eye and conjunctival specimens also expressed TMPRSS2. Finally, Western blot analysis of protein lysates from human corneal epithelium obtained during refractive surgery confirmed expression of ACE2 and TMPRSS2.

Conclusions

Together, these results suggest that ocular surface cells including conjunctiva are susceptible to infection by SARS-CoV-2, and could therefore serve as a portal of entry as well as a reservoir for person-to-person transmission of this virus. This highlights the importance of safety practices including face masks and ocular contact precautions in preventing the spread of COVID-19 disease.

中文翻译：

ACE2和TMPRSS2在人眼表面表达，表明对SARS-CoV-2感染易感。

目的

在一部分患有COVID-19的患者中观察到结膜体征和症状，并且在眼泪中发现了SARS-CoV-2，这引起了人们对于眼睛作为病毒的入口和携带者的担忧。这项研究的目的是确定眼表细胞是否具有细胞对SARS-CoV-2进入/感染易感性所需的关键因素。

方法

我们分析了人的验尸眼睛和手术标本中ACE2（SARS-CoV-2的受体）和TMPRSS2的表达，TMPRSS2是一种细胞表面相关的蛋白酶，可促进病毒刺突蛋白与ACE2结合后的病毒进入。

结果

在所有眼睛标本中，免疫组化分析显示ACE2在结膜，角膜缘和角膜中表达，在结膜浅层和角膜上皮表面尤为突出。手术结膜标本还显示了ACE2在结膜上皮中的表达，特别是在浅表上皮中突出，以及在固有层中的弱或局灶性表达。所有眼睛和结膜标本也表达了TMPRSS2。最后，在屈光手术中获得的人角膜上皮蛋白裂解物的蛋白质印迹分析证实了ACE2和TMPRSS2的表达。