The latest medical research on Respiratory Medicine

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ACE2 expression is elevated in airway epithelial cells from older and male healthy individuals but reduced in asthma.

Respirology

COVID-19 is complicated by acute lung injury, and death in some individuals. It is caused by SARS-CoV-2 that requires the ACE2 receptor and serine proteases to enter AEC. We determined what factors are associated with ACE2 expression particularly in patients with asthma and COPD.

We obtained lower AEC from 145 people from two independent cohorts, aged 2-89 years, Newcastle (n = 115) and Perth (n = 30), Australia. The Newcastle cohort was enriched with people with asthma (n = 37) and COPD (n = 38). Gene expression for ACE2 and other genes potentially associated with SARS-CoV-2 cell entry was assessed by qPCR, and protein expression was confirmed with immunohistochemistry on endobronchial biopsies and cultured AEC.

Increased gene expression of ACE2 was associated with older age (P = 0.03) and male sex (P = 0.03), but not with pack-years smoked. When we compared gene expression between adults with asthma, COPD and healthy controls, mean ACE2 expression was lower in asthma patients (P = 0.01). Gene expression of furin, a protease that facilitates viral endocytosis, was also lower in patients with asthma (P = 0.02), while ADAM-17, a disintegrin that cleaves ACE2 from the surface, was increased (P = 0.02). ACE2 protein expression was also reduced in endobronchial biopsies from asthma patients.

Increased ACE2 expression occurs in older people and males. Asthma patients have reduced expression. Altered ACE2 expression in the lower airway may be an important factor in virus tropism and may in part explain susceptibility factors and why asthma patients are not over-represented in those with COVID-19 complications.

What Is Idiopathic Pulmonary Fibrosis? IPF Part 1

ATS ICU

American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 2, Page P5-P6, January 15, 2021.

Reply to Kawada: Weight Loss and Upper Airway Anatomy in Patients with Obstructive Sleep Apnea

ATS ICU

American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 2, Page 270-271, January 15, 2021.

Weight Loss and Upper Airway Anatomy in Patients with Obstructive Sleep Apnea

ATS ICU

American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 2, Page 269-270, January 15, 2021.

Reply to Vozoris: Opioids for Dyspnea in Chronic Obstructive Pulmonary Disease: Short on the Details

ATS ICU

American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 2, Page 267-269, January 15, 2021.

Opioids for Dyspnea in Chronic Obstructive Pulmonary Disease: Short on the Details

ATS ICU

American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 2, Page 266-267, January 15, 2021.

Positive Bubble Study in Severe COVID-19 Indicates the Development of Anatomical Intrapulmonary Shunts in Response to Microvascular Occlusion

ATS ICU

American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 2, Page 263-265, January 15, 2021.

Reply to Sanfilippo et al. and to Caviedes et al.

ATS ICU

American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 2, Page 261-263, January 15, 2021.

Pulmonary Vasculature: A Target for COVID-19

ATS ICU

American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 2, Page 260-261, January 15, 2021.

Pulmonary Vascular Changes in Acute Respiratory Distress Syndrome due to COVID-19

ATS ICU

American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 2, Page 259-260, January 15, 2021.

Pulmonary Angiopathy in Severe COVID-19: Physiological Conclusions Derived from Ventilatory Ratio?

ATS ICU

American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 2, Page 258-259, January 15, 2021.