Journal
GASTROENTEROLOGY
Volume 160, Issue 1, Pages 287-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.gastro.2020.09.029
Keywords
COVID-19; GI Tract; Network Analyses; IBD Medications
Categories
Funding
- NIH/NIDDK [R01 123749]
- Career Development Award from the Crohn's and Colitis Foundation
- Litwin Pioneers award grant
- Leona M. and Harry B. Helmsley Charitable Trust
- Digestive Disease Research Foundation
- [K23KD111995]
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The study shows that the COVID-19 virus has the ability to invade the intestines, and medications used by IBD patients do not significantly affect receptor expression in uninflamed intestines. There are shared molecular networks between COVID-19 infection and IBD.
BACKGROUND AND AIMS: The presence of gastrointestinal symptoms and high levels of viral RNA in the stool suggest active severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication within enterocytes. METHODS: Here, in multiple, large cohorts of patients with inflammatory bowel disease (IBD), we have studied the intersections between Coronavirus Disease 2019 (COVID-19), intestinal inflammation, and IBD treatment. RESULTS: A striking expression of ACE2 on the small bowel enterocyte brush border supports intestinal infectivity by SARS-CoV-2. Commonly used IBD medications, both biologic and nonbiologic, do not significantly impact ACE2 and TMPRSS2 receptor expression in the uninflamed intestines. In addition, we have defined molecular responses to COVID-19 infection that are also enriched in IBD, pointing to shared molecular networks between COVID-19 and IBD. CONCLUSIONS: These data generate a novel appreciation of the confluence of COVID-19- and IBD-associated inflammation and provide mechanistic insights supporting further investigation of specific IBD drugs in the treatment of COVID-19.
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