Key result
Eosinophilic chronic rhinosinusitis was associated with a significant decrease in angiotensin-converting enzyme-2 messenger RNA expression in sinus mucosa compared to non-eosinophilic disease and controls.
Why the study?
SARS-CoV-2 uses angiotensin-converting enzyme-2 as a primary receptor for invasion, prompting investigation into its expression in the sinonasal mucosa of patients with chronic rhinosinusitis to evaluate susceptibility to infection.
Cross-Sectional (n=63)
No
p-value: p=<0.01
Patients with eosinophilic chronic rhinosinusitis exhibit decreased ACE2 expression in their sinus mucosa, which may influence their susceptibility to SARS-CoV-2 infection.
May alter SARS-CoV-2 susceptibility in eosinophilic CRS; leaves open whether expression changes affect clinical infection risk.
OBJECTIVE: Severe acute respiratory syndrome coronavirus-2 uses angiotensin-converting enzyme-2 as a primary receptor for invasion. This study investigated angiotensin-converting enzyme-2 expression in the sinonasal mucosa of patients with chronic rhinosinusitis, as this could be linked to a susceptibility to severe acute respiratory syndrome coronavirus-2 infection. METHODS: Ethmoid sinus specimens were obtained from 27 patients with eosinophilic chronic rhinosinusitis, 18 with non-eosinophilic chronic rhinosinusitis and 18 controls. The angiotensin-converting enzyme-2 and other inflammatory cytokine and chemokine messenger RNA levels were assessed by quantitative reverse transcription polymerase chain reaction. Angiotensin-converting enzyme-2 positive cells were examined immunohistologically. RESULTS: The eosinophilic chronic rhinosinusitis patients showed a significant decrease in angiotensin-converting enzyme-2 messenger RNA expression. In the chronic rhinosinusitis patients, angiotensin-converting enzyme-2 messenger RNA levels were positively correlated with tumour necrosis factor-α and interleukin-1β (r = 0.4971 and r = 0.3082, respectively), and negatively correlated with eotaxin-3 (r = -0.2938). Angiotensin-converting enzyme-2 immunoreactivity was mainly localised in the ciliated epithelial cells. CONCLUSION: Eosinophilic chronic rhinosinusitis patients with type 2 inflammation showed decreased angiotensin-converting enzyme-2 expression in their sinus mucosa. Angiotensin-converting enzyme-2 regulation was positively related to pro-inflammatory cytokines, especially tumour necrosis factor-α production, in chronic rhinosinusitis patients.
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Kawasumi et al. (2021) conducted a cross-sectional in Chronic rhinosinusitis (n=63). Eosinophilic chronic rhinosinusitis vs. Non-eosinophilic chronic rhinosinusitis and healthy controls was evaluated on Angiotensin-converting enzyme-2 (ACE2) messenger RNA expression in sinonasal mucosa (p=<0.01). Eosinophilic chronic rhinosinusitis was associated with a significant decrease in angiotensin-converting enzyme-2 messenger RNA expression in sinus mucosa compared to non-eosinophilic disease and controls.
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