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Human angiotensin-converting enzyme 2 transgenic mice infected with SARS-CoV-2 develop severe and fatal respiratory disease
Joseph W. Golden, Curtis R. Cline, Xiankun Zeng, Aura R. Garrison, Brian D. Carey, Eric M. Mucker, Lauren E. White, Joshua D. Shamblin, Rebecca L. Brocato, Jun Liu, April M. Babka, Hypaitia B. Rauch, Jeffrey M. Smith, Bradley S. Hollidge, Collin Fitzpatrick, Catherine V. Badger, Jay W. Hooper
Joseph W. Golden, Curtis R. Cline, Xiankun Zeng, Aura R. Garrison, Brian D. Carey, Eric M. Mucker, Lauren E. White, Joshua D. Shamblin, Rebecca L. Brocato, Jun Liu, April M. Babka, Hypaitia B. Rauch, Jeffrey M. Smith, Bradley S. Hollidge, Collin Fitzpatrick, Catherine V. Badger, Jay W. Hooper
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Research Article COVID-19 Infectious disease

Human angiotensin-converting enzyme 2 transgenic mice infected with SARS-CoV-2 develop severe and fatal respiratory disease

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Abstract

The emergence of SARS-CoV-2 has created an international health crisis, and small animal models mirroring SARS-CoV-2 human disease are essential for medical countermeasure (MCM) development. Mice are refractory to SARS-CoV-2 infection owing to low-affinity binding to the murine angiotensin-converting enzyme 2 (ACE2) protein. Here, we evaluated the pathogenesis of SARS-CoV-2 in male and female mice expressing the human ACE2 gene under the control of the keratin 18 promoter (K18). In contrast to nontransgenic mice, intranasal exposure of K18-hACE2 animals to 2 different doses of SARS-CoV-2 resulted in acute disease, including weight loss, lung injury, brain infection, and lethality. Vasculitis was the most prominent finding in the lungs of infected mice. Transcriptomic analysis from lungs of infected animals showed increases in transcripts involved in lung injury and inflammatory cytokines. In the low-dose challenge groups, there was a survival advantage in the female mice, with 60% surviving infection, whereas all male mice succumbed to disease. Male mice that succumbed to disease had higher levels of inflammatory transcripts compared with female mice. To our knowledge, this is the first highly lethal murine infection model for SARS-CoV-2 and should be valuable for the study of SARS-CoV-2 pathogenesis and for the assessment of MCMs.

Authors

Joseph W. Golden, Curtis R. Cline, Xiankun Zeng, Aura R. Garrison, Brian D. Carey, Eric M. Mucker, Lauren E. White, Joshua D. Shamblin, Rebecca L. Brocato, Jun Liu, April M. Babka, Hypaitia B. Rauch, Jeffrey M. Smith, Bradley S. Hollidge, Collin Fitzpatrick, Catherine V. Badger, Jay W. Hooper

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Figure 1

SARS-CoV-2 infection in K18-hACE2 transgenic mice.

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SARS-CoV-2 infection in K18-hACE2 transgenic mice.
(A) Male and female K...
(A) Male and female K18-hACE2 transgenic mice (day 0–3, n = 7/group; day 3+, n = 5/group) were infected with 2 × 104 PFU or 2 × 103 PFU of SARS-CoV-2 by the IN route. C57BL/6 and RAG2 KO mice (day 0–3, n = 8/ group; day 3+, n = 5/group) were infected with 2 × 104 PFU by the IN route. Survival and weight loss (± SEM) were monitored and plotted using Prism software. (B) Titers in lung (n = 2 mice/group) were examined on day 3 by qRT-PCR. Mean titers ± SEM of the genome molecules of viral RNA/mL were graphed. (C) Titers in lungs of individual K18-hACE2 mice. Numbers above bars denote day of death. Colors represent the 4 groups. (D) Monocyte chemoattractants and inflammatory cytokines were measured from the serum of SARS-CoV-3– infected mice on day 3 or at the time of euthanasia using a multiplex system. Mice from each group are aggregated from samples taken on day 3 (blue symbols) and when mice were euthanized (black symbols).

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