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Ex vivo SARS-CoV-2 infection of human lung reveals heterogeneous host defense and therapeutic responses
Matthew A. Schaller, Yamini Sharma, Zadia Dupee, Duy Nguyen, Juan Urueña, Ryan Smolchek, Julia C. Loeb, Tiago N. Machuca, John A. Lednicky, David J. Odde, Robert F. Campbell, W. Gregory Sawyer, Borna Mehrad
Matthew A. Schaller, Yamini Sharma, Zadia Dupee, Duy Nguyen, Juan Urueña, Ryan Smolchek, Julia C. Loeb, Tiago N. Machuca, John A. Lednicky, David J. Odde, Robert F. Campbell, W. Gregory Sawyer, Borna Mehrad
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Research Article COVID-19 Inflammation

Ex vivo SARS-CoV-2 infection of human lung reveals heterogeneous host defense and therapeutic responses

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Abstract

Cell lines are the mainstay in understanding the biology of COVID-19 infection but do not recapitulate many of the complexities of human infection. The use of human lung tissue is one solution for the study of such novel respiratory pathogens. We hypothesized that a cryopreserved bank of human lung tissue would allow for the ex vivo study of the interindividual heterogeneity of host response to SARS-CoV-2, thus providing a bridge between studies with cell lines and studies in animal models. We generated a cryobank of tissues from 21 donors, many of whom had clinical risk factors for severe COVID-19. Cryopreserved tissues preserved 90% cell viability and contained heterogenous populations of metabolically active epithelial, endothelial, and immune cell subsets of the human lung. Samples were readily infected with HCoV-OC43 and SARS-CoV-2 and demonstrated comparable susceptibility to infection. In contrast, we observed a marked donor-dependent heterogeneity in the expression of IL6, CXCL8, and IFNB1 in response to SARS-CoV-2. Treatment of tissues with dexamethasone and the experimental drug N-hydroxycytidine suppressed viral growth in all samples, whereas chloroquine and remdesivir had no detectable effect. Metformin and sirolimus, molecules with predicted but unproven antiviral activity, each suppressed viral replication in tissues from a subset of donors. In summary, we developed a system for the ex vivo study of human SARS-CoV-2 infection using primary human lung tissue from a library of donor tissues. This model may be useful for drug screening and for understanding basic mechanisms of COVID-19 pathogenesis.

Authors

Matthew A. Schaller, Yamini Sharma, Zadia Dupee, Duy Nguyen, Juan Urueña, Ryan Smolchek, Julia C. Loeb, Tiago N. Machuca, John A. Lednicky, David J. Odde, Robert F. Campbell, W. Gregory Sawyer, Borna Mehrad

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Figure 1

Lung microtissues are viable after cryopreservation.

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Lung microtissues are viable after cryopreservation.
(A) The composition...
(A) The composition of cryopreserved lung was assessed by flow cytometry. Measured populations include type I and type II alveolar epithelial cells, endothelial cells, monocytes/macrophages, and T cell populations. (B) Proportion of viable cells in fresh and cryopreserved lung tissue from 5 donors. Samples were run in duplicate before and after cryopreservation. (C) The cellular composition of lung tissue, with a focus on the cell types depicted in A before and after cryopreservation for each of the 5 donors in B. Each line represents the average population present in 2–3 samples, consisting of 20–40 microtissues, from each donor. Error bars indicate variation in the technical replicates for each donor. (D) The cellular composition of cryopreserved samples from an additional 5 donors (separate from those in A and B) was assessed using the gating strategy depicted in C. (E) Viability of cryopreserved tissues was assessed by microscopy using Calcein AM and BOBO-3 iodide in microtissues cultured for 48 hours. Scale bar: 50 μm. (F) Tight junctions in cultured microtissues were also assessed using ZO-1 with costaining for actin and DAPI. Scale bar: 25 μm. (G) Microtissues stained with E-cadherin demonstrate the presence of epithelial cell populations within the cryopreserved samples. Scale bar: 100 μm.

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