TMPRSS2 and TMPRSS4 promote SARS-CoV-2 infection of human small intestinal enterocytes

R Zang, MFG Castro, BT McCune, Q Zeng… - Science …, 2020 - science.org
R Zang, MFG Castro, BT McCune, Q Zeng, PW Rothlauf, NM Sonnek, Z Liu, KF Brulois
Science immunology, 2020science.org
Gastrointestinal symptoms and fecal shedding of SARS-CoV-2 RNA are frequently observed
in COVID-19. However, it is unclear whether SARS-CoV-2 replicates in the human intestine
and contributes to possible fecal-oral transmission. Here, we report productive infection of
SARS-CoV-2 in ACE2+ mature enterocytes in human small intestinal enteroids. Expression
of two mucosa-specific serine proteases, TMPRSS2 and TMPRSS4, facilitated SARS-CoV-2
spike fusogenic activity and promoted virus entry into host cells. We also demonstrate that …
Gastrointestinal symptoms and fecal shedding of SARS-CoV-2 RNA are frequently observed in COVID-19. However, it is unclear whether SARS-CoV-2 replicates in the human intestine and contributes to possible fecal-oral transmission. Here, we report productive infection of SARS-CoV-2 in ACE2+ mature enterocytes in human small intestinal enteroids. Expression of two mucosa-specific serine proteases, TMPRSS2 and TMPRSS4, facilitated SARS-CoV-2 spike fusogenic activity and promoted virus entry into host cells. We also demonstrate that viruses released into the intestinal lumen were inactivated by simulated human colonic fluid, and infectious virus was not recovered from the stool specimens of patients with COVID-19. Our results highlight the intestine as a potential site of SARS-CoV-2 replication, which may contribute to local and systemic illness and overall disease progression.
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