Delayed SARS-CoV-2 Spread and Olfactory Cell Lineage Impairment in Close-Contact Infection Syrian Hamster Models

ObjectivesClose contact with patients with COVID-19 is speculated to be the most common cause of viral transmission, but the pathogenesis of COVID-19 by close contact remains to be elucidated. In addition, despite olfactory impairment being a unique complication of COVID-19, the impact of SARS-CoV-2 on the olfactory cell lineage has not been fully validated. This study aimed to elucidate close-contact viral transmission to the nose and lungs and to investigate the temporal damage in the olfactory receptor neuron (ORN) lineage caused by SARS-CoV-2. MethodsSyrian hamsters were orally administered SARS-CoV-2 as direct-infection models. On day 7 after inoculation, infected and uninfected hamsters were housed in the same cage for 30 minutes. These uninfected hamsters were subsequently assigned to a close-contact group. First, viral presence in the nose and lungs was verified in the infection and close-contact groups at several time points. Next, the impacts on the olfactory epithelium, including olfactory progenitors, immature ORNs, and mature ORNs, were examined histologically. Then, the viral transmission status and chronological changes in tissue damage were compared between the direct-infection and close-contact groups. ResultsIn the close-contact group, viral presence could not be detected in both the nose and lungs on day 3, and the virus was identified in both tissues on day 7. In the direct-infection group, the viral load was highest in the nose and lungs on day 3, decreased on day 7, and was no longer detectable on day 14. Histologically, in the direct-infection group, mature ORNs were most depleted on day 3 (p < 0.001) and showed a recovery trend on day 14, with similar trends for olfactory progenitors and immature ORNs. In the close-contact group, there was no obvious tissue damage on day 3, but on day 7, the number of all ORN lineage cells significantly decreased (p < 0.001). ConclusionSARS-CoV-2 was transmitted even after brief contact and subsequent olfactory epithelium and lung damage occurred more than 3 days after the trigger of infection. The present study also indicated that SARS-CoV-2 damages all ORN lineage cells, but this damage can begin to recover approximately 14 days post infection.

Prolonged and extended impacts of SARS-CoV-2 on the olfactory neurocircuit

The impact of SARS-CoV-2 on the olfactory pathway was studied over several time points using Syrian golden hamsters. We found an incomplete recovery of the olfactory sensory neurons, prolonged activation of glial cells in the olfactory bulb, and a decrease in the density of dendritic spines within the hippocampus. These data may be useful for elucidating the mechanism underlying long-lasting olfactory dysfunction and cognitive impairment as a post-acute COVID-19 syndrome.

Expression of Ace2, Tmprss2, and Furin in mouse ear tissue

ObjectivesIntracellular entry of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) depends on the interaction between its spike protein to a cellular receptor named angiotensin-converting enzyme 2 (ACE2) and depends on Furin-mediated spike 23 protein cleavage and spike protein priming by host cell proteases including 24 transmembrane protease serine 2 (TMPRSS2). Tmprss1, Tmprss3, and Tmprss5 are expressed in the spiral ganglion neurons and the organ of Corti in the inner ear; however, Ace2, Tmprss2, and Furin expression profiles in the middle ear remain unclear. Therefore, this study aimed to analyze Ace2, Tmprss2, and Furin expression in the middle and inner ear of mice. Study DesignAnimal research. SettingDepartment of Otolaryngology and Head and Neck Surgery, University of Tokyo. MethodsWe performed immunohistochemical analysis to examine the distribution of Ace2, Tmprss2, and Furin in the eustachian tube, middle ear space, and cochlea of mice. ResultsAce2 was expressed in the cytoplasm in the middle ear epithelium, eustachian tube epithelium, stria vascularis, and spiral ganglion. Tmprss2 and Furin were widely expressed in the middle ear spaces and the cochlea. ConclusionCo-expression of Ace2, Tmprss2, and Furin in the middle ear indicates that the middle ear is susceptible to SARS-CoV-2 infections, thus warranting the use of personal protective equipment during mastoidectomy for coronavirus disease (COVID-19) patients.

Background mechanisms of olfactory dysfunction in COVID-19: expression of ACE2, TMPRSS2, and Furin in the nose and olfactory bulb in human and mice

Background Anosmia is a frequent symptom in patients with the coronavirus disease 2019 (COVID-19) driven by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and mostly recovers within weeks. This clinical figure is significantly different from that of anosmia after upper respiratory infection, which occurs in only a small proportion of patients and does not recover or requires months to recover. The background mechanisms of COVID-19 induced olfactory dysfunction have not been elucidated.Methods To address the unique pathophysiology of olfactory dysfunction associated with COVID-19, we examined the existence and distribution of ACE2 (virus binding receptor), TMPRSS2 and Furin (proteases to facilitate virus entry) in the nasal mucosa, composed of the respiratory mucosa (RM) and olfactory mucosa (OM), and the olfactory bulb (OB) in mouse and human tissues by immunohistochemistry and gene analyses.Results Ace2, Tmprss2, and Furin gene expressions were confirmed in the nasal mucosa and OB. ACE2 was widely expressed all in the RM, OM and OB. Co-expression of ACE2, TMPRSS2, and Furin was observed in the RM including the RE and subepithelial glands and in the OM, especially in the supporting cells on the olfactory epithelium and the Bowman’s glands. Notably, the olfactory receptor neurons (ORNs) in the OM were positive for ACE2 but almost negative for TMPRSS2 and Furin. The cells in the OB expressed ACE2 strongly and Furin weakly and did not express TMPRSS2.Conclusions ACE2 was widely expressed in the RM, OM and OB, but TMPRSS2 and Furin were expressed in certain types of cells and were absent in the ORNs. These findings, together with clinically reported ones, suggest that COVID-19 related anosmia can occur due to mainly sensorineural and central dysfunction and, to some extent, conductive olfactory dysfunction. That the ORNs express ACE2 but not TMPRSS2 or Furin may explain the early recovery of anosmia.Short Summary Protein expression patterns of ACE2, TMPRSS, and Furin suggest that COVID-19 related anosmia can occur due to mainly sensorineural dysfunction without olfactory neuronal damage.Competing Interest StatementThe authors have declared no competing interest.View Full Text

Expression of ACE2 and TMPRSS2 proteins in the upper and lower aerodigestive tracts of rats

Objective Patients with coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), exhibit not only respiratory symptoms but also symptoms of chemo-sensitive disorders and kidney failure. Cellular entry of SARS-CoV-2 depends on the binding of its spike protein to a cellular receptor named angiotensin-converting enzyme 2 (ACE2), and the subsequent spike protein-priming by host cell proteases, including transmembrane protease serine 2 (TMPRSS2). Thus, high expression of ACE2 and TMPRSS2 are considered to enhance the invading capacity of SARS-CoV-2.Methods To elucidate the underlying histological mechanisms of the aerodigestive disorders caused by SARS-CoV-2, we investigated the expression of ACE2 and TMPRSS2 proteins in the aerodigestive tracts of the tongue, hard palate with partial nasal tissue, larynx with hypopharynx, trachea, esophagus, lung, and kidney of rats through immunohistochemistry.Results Strong co-expression of ACE2 and TMPRSS2 proteins was observed in the nasal respiratory epithelium, trachea, bronchioles, alveoli, kidney, and taste buds of the tongue. Remarkably, TMPRSS2 expression was much stronger in the peripheral alveoli than in the central alveoli. These results coincide with the reported clinical symptoms of COVID-19, such as the loss of taste, loss of olfaction, respiratory dysfunction, and acute nephropathy.Conclusions A wide range of organs have been speculated to be affected by SARS-CoV-2 depending on the expression levels of ACE2 and TMPRSS2. Differential distribution of TMPRSS2 in the lung indicated the COVID-19 symptoms to possibly be exacerbated by TMPRSS2 expression. This study might provide potential clues for further investigation of the pathogenesis of COVID-19.Level of Evidence NACompeting Interest StatementThe authors have declared no competing interest.View Full Text

Morphological alterations of the tendon and pulley on ultrasound after intrasynovial injection of betamethasone for trigger digit

PURPOSE: The aim of this study was to elucidate whether intrasynovial corticosteroid injections for trigger digit reduced the volume of the tendon and pulley on high-resolution ultrasonography. METHODS: Twenty-three digits of 20 patients with trigger digit were included. Each affected finger was graded clinically according to the following classification: grade I for pre-triggering, grade II for active triggering, grade III for passive triggering, and grade IV for presence of contracture. Axial ultrasound examinations were performed before an intrasynovial corticosteroid injection and at an average of 31 days after the injection. The transverse diameter, thickness, and cross-sectional area of the tendon and the thickness of the pulley were measured by two independent, blinded researchers. RESULTS: At least 1 grade of improvement was achieved in this study group by the time of the second examination. The transverse diameter and cross-sectional area of the tendon and the thickness of the pulley significantly decreased (P < 0.05). CONCLUSION: The injection of a single dose of betamethasone improved clinical symptoms by reducing the volume of both the tendon and pulley, which may be related to the fact that tendon and pulley ruptures are delayed by corticosteroid injections.

Desarrollo de indicadores estratégicos en ciencia y tecnología: principales problemas

En este artículo propone que los indicadores estratégicos para los países menos desarrollados deben considerar las especificidades de estos países de ahí que no se trata tan sólo de reproducir los indicadores utilizados por la Organización para la Cooperación y el Desarrollo Económico. Con este objetivo, en el presente trabajo se utiliza un nuevo marco conceptual que demuestra la importancia de un equilibrio entre la eficiencia económica y el bienestar social. Se enumeran varios motivos razonables para desarrollar indicadores estratégicos, se demuestran cómo cada uno de ellos se basan en suposiciones no necesariamente válidas para todos los países y fundamenta la necesidad de adoptar un nuevo enfoque conceptual. Después de discutirse las características principales del modelo propuesto, se demuestra de qué manera este nuevo marco puede ayudar a identificar los tipos de indicadores necesarios. Finalmente se sugiere cómo el enfoque pudiera también ser útil para un proyecto orientado a evaluar publicaciones científicas.

This paper propounds that strategic indicators for less developed countries should take into consideration the specificities of these countries, hence should not just replicate the indicators used by the OECD. With this purpose, it uses a new conceptual framework stressing the importance of a balance between economic efficiency and social welfare. It lists several sensible reasons to develop strategic indicators, shows how each of them is based on assumptions that are not necessarily valid to all countries, and shows why a new conceptual approach is needed. Then, after discussing the main features of the proposed model, it shows how the new framework can help identifying the kinds of new indicators needed. Finally, the paper suggests how the approach could also be useful to a project trying to evaluate scientific publications.