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Increased placental expression of angiotensin-converting enzyme 2, the receptor of SARS-CoV-2, associated with hypoxia in twin anemia-polycythemia sequence (TAPS).
Mao, Quanfu; Chu, Sharon; Shapiro, Svetlana; Bliss, Joseph M; De Paepe, Monique E.
  • Mao Q; From the Departments of Pathology and Pediatrics, Women and Infants Hospital; and the Department of Pathology and Laboratory Medicine and the Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA.
  • Chu S; From the Departments of Pathology and Pediatrics, Women and Infants Hospital; and the Department of Pathology and Laboratory Medicine and the Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA.
  • Shapiro S; From the Departments of Pathology and Pediatrics, Women and Infants Hospital; and the Department of Pathology and Laboratory Medicine and the Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA.
  • Bliss JM; From the Departments of Pathology and Pediatrics, Women and Infants Hospital; and the Department of Pathology and Laboratory Medicine and the Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA.
  • De Paepe ME; From the Departments of Pathology and Pediatrics, Women and Infants Hospital; and the Department of Pathology and Laboratory Medicine and the Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA. Electronic address: mdepaepe@wihri.org.
Placenta ; 105: 7-13, 2021 02.
Article in English | MEDLINE | ID: covidwho-1047776
ABSTRACT

INTRODUCTION:

Recent reports suggest SARS-CoV-2, the virus causing COVID-19, may be transmittable from pregnant mother to placenta and fetus, albeit rarely. The efficacy of vertical transmission of SARS-CoV-2 critically depends on the availability of its receptor, ACE2, in the placenta. In the present study, we tested the hypothesis that placental ACE2 expression is oxygenation-dependent by studying the expression of ACE2 and associated cell entry regulators in the monochorionic twin anemia-polycythemia (TAPS) placenta, a model of discordant placental oxygenation.

METHODS:

We performed a retrospective comparative immunohistochemical, immunofluorescence and Western blot analysis of ACE2, TMPRSS2 and Cathepsin B expression in anemic and polycythemic territories of TAPS placentas (N = 14).

RESULTS:

ACE2 protein levels were significantly higher in the anemic twin territories than in the corresponding polycythemic territories, associated with upregulation of the key ACE2-related cell entry regulators, TMPRSS2 and Cathepsin B, immunolocalized to villous trophoblastic and stromal cells. Cellular colocalization of ACE2 and TMPRSS2, suggestive of functionality of this cell entry axis, was demonstrated by double immunofluorescence studies.

DISCUSSION:

Placental hypoxia is associated with upregulation of ACE2 expression, concomitant with increased expression of its key cell entry proteases. ACE2-regulated placental functions, both infection- and non-infection related, may be highly oxygenation-dependent.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Placenta / Polycythemia / Fetal Diseases / Pregnancy, Twin / Angiotensin-Converting Enzyme 2 / Anemia / Hypoxia Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Infant, Newborn / Pregnancy Language: English Journal: Placenta Year: 2021 Document Type: Article Affiliation country: J.placenta.2021.01.008

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Placenta / Polycythemia / Fetal Diseases / Pregnancy, Twin / Angiotensin-Converting Enzyme 2 / Anemia / Hypoxia Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Infant, Newborn / Pregnancy Language: English Journal: Placenta Year: 2021 Document Type: Article Affiliation country: J.placenta.2021.01.008