The SARS-CoV-2 Spike protein disrupts human cardiac pericytes function through CD147-receptor-mediated signalling

Severe coronavirus disease 2019 (COVID-19) manifests as a life-threatening microvascular syndrome.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) uses the Spike (S) protein to
engage with its receptors and infect host cells. To date, it is still not known whether heart vascular
pericytes (PCs) are infected by SARS-CoV-2, and if the S protein alone provokes PC dysfunction. Here,
we aimed to investigate the effects of the S protein on primary human cardiac PC signalling and
function. Results show, for the first time, that cardiac PCs are not permissive to SARS-CoV-2 infection
in vitro, whilst a recombinant S protein alone elicits functional alterations in PCs. This was documented
as: (1) increased migration, (2) reduced ability to support endothelial cell (EC) network formation on
Matrigel, (3) secretion of pro-inflammatory molecules typically involved in the cytokine stormand (4)
production of pro-apoptotic factors responsible for EC death. Next, adopting a blocking strategy against
the S protein receptors angiotensin-converting enzyme 2 (ACE2) and CD147, we discovered that the S
protein stimulates the phosphorylation/activation of the extracellular signal-regulated kinase 1/2
(ERK1/2) through the CD147 receptor, but not ACE2, in PCs. The neutralisation of CD147, either using
a blocking antibody or mRNA silencing, reduced ERK1/2 activation and rescued PC function in the
presence of the S protein. In conclusion, our findings suggest that circulating S protein prompts vascular
PC dysfunction, potentially contributing to establishing microvascular injury in organs distant from the
site of infection. This mechanism may have clinical and therapeutic implications.

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Доказательная медицина, COVID-19, ЗОЖ