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Comparative Evaluation of Nasal and Small Intestine Expression of ACE2, TMPRSS2 and ACE1 and in Children and in Adults

10 Pages Posted: 10 Nov 2020

See all articles by Roberto Berni Canani

Roberto Berni Canani

University of Naples Federico II - Department of Translational Medical Sciences

Marika Comegna

University of Naples Federico II - CEINGE-Biotecnologie Avanzate s.c.ar.l.

Lorella Paparo

University of Naples Federico II - Department of Translational Medical Sciences

Gustavo Cernera

University of Naples Federico II - CEINGE-Biotecnologie Avanzate s.c.ar.l.

Cristina Bruno

University of Naples Federico II - Department of Translational Medical Sciences

Caterina Strisciuglio

University of Campania “Luigi Vanvitelli” - Department of Woman, Child and General and Specialistic Surgery

Immacolata Zollo

University of Naples Federico II - CEINGE-Biotecnologie Avanzate s.c.ar.l.

Antonietta Gravina

University of Campania "Luigi Vanvitelli" - Division of Hepatogastroenterology

Erasmo Miele

University of Naples Federico II - Department of Translational Medical Sciences

Elena Cantone

University of Naples Federico II - Department of Neuroscience, Reproductive and Odontostomatological Sciences

Nicola Gennarelli

University of Naples Federico II - Department of Clinical Medicine and Surgery

Rita Nocerino

University of Naples Federico II - Department of Translational Medical Sciences

Laura Carucci

University of Naples Federico II - Department of Translational Medical Sciences

Veronica Giglio

University of Naples Federico II - Department of Translational Medical Sciences

Felice Amato

University of Naples Federico II - CEINGE-Biotecnologie Avanzate s.c.ar.l.

Giuseppe Castaldo

University of Naples Federico II - CEINGE-Biotecnologie Avanzate s.c.ar.l.

More...

Abstract

Importance: Clinical severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection seems to be lower in children compared to that in adults. Defining the pathophysiological mechanisms of such disease patterns maybe relevant for development of effective public health strategies. It has been hypothesised that the lower severity of SARS-CoV-2 infection in children could be due to the differential expression of angiotensin-converting enzyme 2 (ACE2), which serves as a virus receptor.

Objective: To evaluate the expression of ACE2, ACE1, and TMPRSS2 genes at the level of the two most relevant entry sites for SARS-CoV-2, the upper respiratory tract and small intestine, in healthy children and adult subjects.

Design, Setting, and Participants: This prospective study included healthy individuals of both sexes, aged 1-10 years in the paediatric population (n=30) and 20-80 years in the adult population (n=30). The participants were consecutively evaluated at two tertiary centres for paediatrics, gastroenterology, and otolaryngology.

Main Measures: Expression of ACE2, ACE1, and TMPRSS2 genes in samples collected from the upper respiratory tract and small intestine.

Results: We found no difference in ACE2, ACE1, and TMPRSS2 expression in the nasal epithelium between children and adult subjects. ACE2 expression was more abundant in the small intestine of children compared to that in adults. ACE1 expression was higher in the small intestine of adults compared to that in children. Intestinal TMPRSS2 expression was similar in the two study populations.

Conclusions and Relevance: The general lower severity of SARS-CoV-2 infection in children does not seem to be related to a lower expression of ACE2 and/or TMPRSS2 in the respiratory tract or in the gastrointestinal tract. Other co-factors may confer protection against SARS-CoV-2 in children. The exploration of such factors is of pivotal importance for development of innovative protective strategies against SARS-CoV-2.

Funding Statement: This work was supported in part by a grant of Regione Campania POR FESR 2014/2020, Task Force Covid-19 DGR 140 – 17 March 2020.

Declaration of Interests: The authors have no other conflict of interests that are directly relevant to the content of this manuscript, which remains their sole responsibility.

Ethics Approval Statement: The study was approved by the Ethics Committee of the University Federico II of Naples, Italy. Written informed consent was obtained from the adult participants and from the parents/tutors of minors.

Suggested Citation

Canani, Roberto Berni and Comegna, Marika and Paparo, Lorella and Cernera, Gustavo and Bruno, Cristina and Strisciuglio, Caterina and Zollo, Immacolata and Gravina, Antonietta and Miele, Erasmo and Cantone, Elena and Gennarelli, Nicola and Nocerino, Rita and Carucci, Laura and Giglio, Veronica and Amato, Felice and Castaldo, Giuseppe, Comparative Evaluation of Nasal and Small Intestine Expression of ACE2, TMPRSS2 and ACE1 and in Children and in Adults. Available at SSRN: https://ssrn.com/abstract=3714641 or http://dx.doi.org/10.2139/ssrn.3714641

Roberto Berni Canani (Contact Author)

University of Naples Federico II - Department of Translational Medical Sciences ( email )

Naples, 80131
Italy

Marika Comegna

University of Naples Federico II - CEINGE-Biotecnologie Avanzate s.c.ar.l. ( email )

via Cinthia, 4
Naples, Caserta 80126
Italy

Lorella Paparo

University of Naples Federico II - Department of Translational Medical Sciences ( email )

Naples, 80131
Italy

Gustavo Cernera

University of Naples Federico II - CEINGE-Biotecnologie Avanzate s.c.ar.l. ( email )

via Cinthia, 4
Naples, Caserta 80126
Italy

Cristina Bruno

University of Naples Federico II - Department of Translational Medical Sciences ( email )

Naples, 80131
Italy

Caterina Strisciuglio

University of Campania “Luigi Vanvitelli” - Department of Woman, Child and General and Specialistic Surgery ( email )

Italy

Immacolata Zollo

University of Naples Federico II - CEINGE-Biotecnologie Avanzate s.c.ar.l. ( email )

via Cinthia, 4
Naples, Caserta 80126
Italy

Antonietta Gravina

University of Campania "Luigi Vanvitelli" - Division of Hepatogastroenterology ( email )

Italy

Erasmo Miele

University of Naples Federico II - Department of Translational Medical Sciences

via Cinthia, 4
Naples, 80126
Italy

Elena Cantone

University of Naples Federico II - Department of Neuroscience, Reproductive and Odontostomatological Sciences

via Cinthia, 4
Naples, 80126
Italy

Nicola Gennarelli

University of Naples Federico II - Department of Clinical Medicine and Surgery ( email )

via Cinthia, 4
Naples, Caserta 80126
Italy

Rita Nocerino

University of Naples Federico II - Department of Translational Medical Sciences ( email )

Naples, 80131
Italy

Laura Carucci

University of Naples Federico II - Department of Translational Medical Sciences ( email )

Naples, 80131
Italy

Veronica Giglio

University of Naples Federico II - Department of Translational Medical Sciences ( email )

Naples, 80131
Italy

Felice Amato

University of Naples Federico II - CEINGE-Biotecnologie Avanzate s.c.ar.l. ( email )

via Cinthia, 4
Naples, Caserta 80126
Italy

Giuseppe Castaldo

University of Naples Federico II - CEINGE-Biotecnologie Avanzate s.c.ar.l. ( email )

via Cinthia, 4
Naples, Caserta 80126
Italy

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