Profiling ACE2 expression in colon tissue of healthy adults and colorectal cancer patients by single-cell transcriptome analysis

Abstract

A newly identified novel coronavirus (2019-nCoV) has caused numerous acute respiratory syndrome cases in Wuhan China from December 2019 to Feb 2020. Its fast spreading to other provinces in China and overseas is very likely causing a pandemic. Since the novel coronavirus has been reported to be capable of endangering thousands of lives, it is extremely important to find out how the coronavirus is transmitted in human organs. Apart from fever and respiratory complications, gastrointestinal symptoms are observed in some patients with 2019-nCoV but the significance remains undetermined. The cell receptor angiotensin covering enzyme II (ACE2), which is the major receptor of SARS-nCoV, has been reported to be a cellular entry receptor of 2019-nCoV as well. Here, to more precisely explore the potential pathogen transmission route of the 2019-nCoV infections in the gastrointestinal tract, we analyzed the ACE2 RNA expression profile in the colon tissue of healthy adults and colorectal cancer patients of our cohort and other databases. The data indicates that ACE2 is mainly expressed in epithelial cells of the colon. The expression of ACE2 is gradually increased from healthy control, adenoma to colorectal cancer patients in our cohort as well as in the external Asian datasets.According to the expression profile of ACE2 in colon epithelial cells, we speculate adenoma and colorectal cancer patients are more likely to be infected with 2019-nCoV than healthy people. Our data may provide a theoretical basis for the classification and management of future 2019-nCoV susceptibility people in clinical application.

A comparative‐descriptive analysis of clinical characteristics in 2019‐coronavirus‐infected children and adults

“…19 Some scholars speculate that 2019-nCoV may interact with ACE2 receptor in gastrointestinal tract, impair the intestinal mucous membrane barrier and increase the inflammatory cytokines production. 20 In laboratory tests, we found that children had different laboratory parameters than adults. It was observed that white blood count was frequently elevated among children contrary to adults, majority of which showed leucopenia.…”

Neurological manifestations of patients with COVID-19: potential routes of SARS-CoV-2 neuroinvasion from the periphery to the brain

“…As mentioned above, ACE2 is not only expressed in alveolar epithelial cells but also in intestinal epithelial cells. Single-cell RNA sequencing data show that expression of ACE2 in colon cells is positively correlated with genes regulating virus infection, and innate and cellular immunity, but negatively correlated with virus transcription, protein translation, humoral immunity, phagocytosis, and complement activation [46]. Based on these findings, SARS-CoV-2 may interact with ACE2 in the gastrointestinal tract and destroy the gastrointestinal epithelial cell barrier, increase the production of inflammatory cytokines, decrease gastrointestinal absorptive capacity, and increase secretion by the gastrointestinal mucosa.…”

Digestive system involvement of novel coronavirus infection: Prevention and control infection from a gastroenterology perspective

“…The results indicate that ACE2 is highly expressed in absorptive intestinal epithelial cells in the ileum and colon as well as in lung cells and esophageal upper and stratified epithelial cells. Interestingly, compared with healthy adults, the expression of ACE2 is higher in the epithelial cells of the colon of patients with adenomas or colorectal cancer, which may predict a higher probability of being infected with SARS-CoV-2 15. One group16 also found ACE2 played a dual role in mediating SARS-CoV-2 infection in the colon after analyzing single cell-RNA sequencing data from patients with colitis or IBD.…”