Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 224, Issue -, Pages S642-S646Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiab164
Keywords
ACE2; TMPRSS2; placental expression; SARS-CoV-2
Categories
Funding
- Massachusetts General Hospital, Department of Pathology, Boston, MA
- Vickery-Colvin Award
- National Institutes of Health/National Institute of Child Health and Human Development (NIH/NICHD) [3R01HD100022-02S2]
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The study demonstrates that ACE2 and TMPRSS2 have specific localization and expression patterns in the placenta during late gestation. Early gestation pregnancies may be more vulnerable to infection compared to later gestation pregnancies.
We previously demonstrated that the late gestation placental expression pattern of ACE2 (the primary severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] receptor) is localized to the villous syncytiotrophoblast (ST), usually in a polarized membranous pattern at the ST base sparing the apical surface (that directly exposed to maternal blood). We found that the late gestation placental expression pattern of TMPRSS2 (the spike proteinase required for SARS-CoV-2 cellular infection), is usually absent in the trophoblast but is rarely, weakly expressed in the placental endothelium. We now show the developmental protein expression patterns of ACE2 and TMPRSS2 by immunohistochemistry throughout gestation, from the first through third trimester. We found that TMPRSS2 expression was rarely detectable in villous endothelium and very rarely detectable in the ST across gestation. We found that ACE2 expression varied during gestation with circumferential ST expression more common in early gestations and polarized expression more common in later gestation. Although this study is small, these preliminary results suggest that earlier gestation pregnancies may be more vulnerable to infection than later gestation pregnancies.
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