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Mucociliary transport deficiency and disease progression in Syrian hamsters with SARS-CoV-2 infection
Qian Li, Kadambari Vijaykumar, Scott E. Phillips, Shah S. Hussain, Nha V. Huynh, Courtney M. Fernandez-Petty, Jacelyn E. Peabody Lever, Jeremy B. Foote, Janna Ren, Javier Campos-Gómez, Farah Abou Daya, Nathaniel W. Hubbs, Harrison Kim, Ezinwanne Onuoha, Evan R. Boitet, Lianwu Fu, Hui Min Leung, Linhui Yu, Thomas W. Detchemendy, Levi T. Schaefers, Jennifer L. Tipper, Lloyd J. Edwards, Sixto M. Leal Jr., Kevin S. Harrod, Guillermo J. Tearney, Steven M. Rowe
Qian Li, Kadambari Vijaykumar, Scott E. Phillips, Shah S. Hussain, Nha V. Huynh, Courtney M. Fernandez-Petty, Jacelyn E. Peabody Lever, Jeremy B. Foote, Janna Ren, Javier Campos-Gómez, Farah Abou Daya, Nathaniel W. Hubbs, Harrison Kim, Ezinwanne Onuoha, Evan R. Boitet, Lianwu Fu, Hui Min Leung, Linhui Yu, Thomas W. Detchemendy, Levi T. Schaefers, Jennifer L. Tipper, Lloyd J. Edwards, Sixto M. Leal Jr., Kevin S. Harrod, Guillermo J. Tearney, Steven M. Rowe
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Research Article COVID-19

Mucociliary transport deficiency and disease progression in Syrian hamsters with SARS-CoV-2 infection

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Abstract

Substantial clinical evidence supports the notion that ciliary function in the airways is important in COVID-19 pathogenesis. Although ciliary damage has been observed in both in vitro and in vivo models, the extent or nature of impairment of mucociliary transport (MCT) in in vivo models remains unknown. We hypothesize that SARS-CoV-2 infection results in MCT deficiency in the airways of golden Syrian hamsters that precedes pathological injury in lung parenchyma. Micro-optical coherence tomography was used to quantitate functional changes in the MCT apparatus. Both genomic and subgenomic viral RNA pathological and physiological changes were monitored in parallel. We show that SARS-CoV-2 infection caused a 67% decrease in MCT rate as early as 2 days postinfection (dpi) in hamsters, principally due to 79% diminished airway coverage of motile cilia. Correlating quantitation of physiological, virological, and pathological changes reveals steadily descending infection from the upper airways to lower airways to lung parenchyma within 7 dpi. Our results indicate that functional deficits of the MCT apparatus are a key aspect of COVID-19 pathogenesis, may extend viral retention, and could pose a risk factor for secondary infection. Clinically, monitoring abnormal ciliated cell function may indicate disease progression. Therapies directed toward the MCT apparatus deserve further investigation.

Authors

Qian Li, Kadambari Vijaykumar, Scott E. Phillips, Shah S. Hussain, Nha V. Huynh, Courtney M. Fernandez-Petty, Jacelyn E. Peabody Lever, Jeremy B. Foote, Janna Ren, Javier Campos-Gómez, Farah Abou Daya, Nathaniel W. Hubbs, Harrison Kim, Ezinwanne Onuoha, Evan R. Boitet, Lianwu Fu, Hui Min Leung, Linhui Yu, Thomas W. Detchemendy, Levi T. Schaefers, Jennifer L. Tipper, Lloyd J. Edwards, Sixto M. Leal Jr., Kevin S. Harrod, Guillermo J. Tearney, Steven M. Rowe

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Figure 4

Tracheal injury after SARS-CoV-2 infection in hamsters.

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Tracheal injury after SARS-CoV-2 infection in hamsters.
After μOCT imagi...
After μOCT imaging in Figure 3, hamster tracheas were processed for histopathological analysis. Representative H&E images (A) and lesion quantitation by a blinded pathologist (B) are shown (n = 16, 2, 11, and 9 for mock, 2, 4, and 7 dpi, respectively). Red arrows indicate mononuclear inflammatory cells that expanded the submucosa and infiltrated the epithelial mucosal layer. Green arrows indicate apoptotic, desquamated epithelial cells that lost the attachment to adjacent epithelia. Unstained slides of tracheas and lungs from Figure 2 were labeled for α-tubulin by IHC to specifically focus on ciliary injury. Representative images are shown of trachea (C), and quantitation of cilia coverage along the apical surface of the tracheal (D, n = 14, 2, 10, and 9 for mock, 2, 4, and 7 dpi, respectively), bronchi (E, n = 13, 4, 11, and 4 for mock, 2, 4, and 7 dpi, respectively), and bronchiolar (F, n = 15, 4, 11, and 6 for mock, 2, 4, and 7 dpi, respectively) epithelia by a blinded investigator. Scale bars: 50 μm. Error bars indicate SEM. Squares indicate males and circles females. P < 0.0001 (B, D, and E) and P = 0.0047 (F) by 1-way ANOVA. *P < 0.05; **P < 0.01; ***P < 0.001; ****P < 0.0001 by Tukey’s post hoc test.

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