J Pediatr Gastroenterol Nutr 2020 Dec 23;Publish Ahead of Print. Epub 2020 Dec 23.
Department of Bioengineering, Department of Pediatrics, University of California Division of Allergy, Immunology, Department of Pediatrics, University of California, San Diego, Rady Children's Hospital, San Diego Division of Allergy, Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati Division of Gastroenterology and Hepatology, Scripps Clinic Department of Pediatrics, Division of Gastroenterology, Children's Hospital of Philadelphia Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC Division of Gastroenterology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Division of Gastroenterology, Indiana University School of Medicine, Riley Hospital for Children ????? Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital Colorado, Gastrointestinal Eosinophilic Disease Program, Mucosal Inflammation Program, University of Colorado School of Medicine, Aurora, CO Division of Allergy, Immunology, Department of Medicine, University of California, San Diego Appendix 1.
Abstract: Infection with SARS-CoV-2 can lead to COVID-19. The gastrointestinal tract is now an appreciated portal of infection. SARS-CoV-2 enters host cells via angiotensin converting enzyme-2 (ACE2) and the serine protease TMPRSS2. Eosinophilic gastrointestinal disorders are inflammatory conditions caused by chronic type 2 (T2) inflammation. However, the effects of the T2 atopic inflammatory milieu on SARS-COV-2 viral entry gene expression in the GI tract is poorly understood. We analyzed tissue ACE2 and TMPRSS2 gene expression in pediatric eosinophilic esophagitis (EoE), eosinophilic gastritis (EG) and in normal adult esophagi using publicly available RNA sequencing datasets. Similar to findings evaluating the airway, there was no difference in tissue ACE2/TMPRSS2 expression in EoE or EG when compared to control non-EoE/EG esophagus/stomach. ACE2 gene expression was significantly lower in esophagi from children with or without EoE and from adults with EoE as compared to normal adult esophagi. Type 2 immunity and pediatric age could be protective for infection by SARS-CoV-2 in the gastrointestinal tract due to decreased expression of ACE2.