SARS-CoV-2 receptor networks in diabetic and COVID-19-associated kidney disease. Author Rajasree Menon, Edgar Otto, Rachel Sealfon, Viji Nair, Aaron Wong, Chandra Theesfeld, Xi Chen, Yuan Wang, Avinash Boppana, Jinghui Luo, Yingbao Yang, Peter Kasson, Jennifer Schaub, Celine Berthier, Sean Eddy, Chrysta Lienczewski, Bradley Godfrey, Susan Dagenais, Ryann Sohaney, John Hartman, Damian Fermin, Lalita Subramanian, Helen Looker, Jennifer Harder, Laura Mariani, Jeffrey Hodgin, Jonathan Sexton, Christiane Wobus, Abhijit Naik, Robert Nelson, Olga Troyanskaya, Matthias Kretzler Publication Year 2020 Type Journal Article Abstract COVID-19 morbidity and mortality are increased via unknown mechanisms in patients with diabetes and kidney disease. SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE2) for entry into host cells. Because ACE2 is a susceptibility factor for infection, we investigated how diabetic kidney disease and medications alter ACE2 receptor expression in kidneys. Single cell RNA profiling of kidney biopsies from healthy living donors and patients with diabetic kidney disease revealed ACE2 expression primarily in proximal tubular epithelial cells. This cell-specific localization was confirmed by in situ hybridization. ACE2 expression levels were unaltered by exposures to renin-angiotensin-aldosterone system inhibitors in diabetic kidney disease. Bayesian integrative analysis of a large compendium of public -omics datasets identified molecular network modules induced in ACE2-expressing proximal tubular epithelial cells in diabetic kidney disease (searchable at hb.flatironinstitute.org/covid-kidney) that were linked to viral entry, immune activation, endomembrane reorganization, and RNA processing. The diabetic kidney disease ACE2-positive proximal tubular epithelial cell module overlapped with expression patterns seen in SARS-CoV-2-infected cells. Similar cellular programs were seen in ACE2-positive proximal tubular epithelial cells obtained from urine samples of 13 hospitalized patients with COVID-19, suggesting a consistent ACE2-coregulated proximal tubular epithelial cell expression program that may interact with the SARS-CoV-2 infection processes. Thus SARS-CoV-2 receptor networks can seed further research into risk stratification and therapeutic strategies for COVID-19-related kidney damage. Keywords Gene Expression Profiling, Humans, Female, Male, Adult, Diabetic Nephropathies, Host-Pathogen Interactions, Middle Aged, Gene Regulatory Networks, Aged, Case-Control Studies, COVID-19, SARS-CoV-2, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme 2, Angiotensin-Converting Enzyme Inhibitors, Kidney Tubules, Proximal Journal Kidney Int Volume 98 Issue 6 Pages 1502-1518 Date Published 2020 Dec ISSN Number 1523-1755 DOI 10.1016/j.kint.2020.09.015 Alternate Journal Kidney Int PMCID PMC7543950 PMID 33038424 PubMedPubMed CentralGoogle ScholarBibTeXEndNote X3 XML