Drug Inhibition of SARS-CoV-2 Replication in Human Pluripotent Stem Cell-Derived Intestinal Organoids

COVID-19; Famotidine; Intestinal Organoids; Remdesivir; SARS-CoV-2.
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Jana Krüger, Rüdiger Groß, Carina Conzelmann, Janis A Müller, Lennart Koepke, Konstantin M J Sparrer, Tatjana Weil, Desiree Schütz, Thomas Seufferlein, Thomas F E Barth, Steffen Stenger, Sandra Heller, Jan Münch, Alexander Kleger

  • Cell Mol Gastroenterol Hepatol
  • 8.797
  • 2021;11(4):935-948.
  • Mouse
  • 流式
  • 呼吸系统
  • 干细胞
  • 新冠
  • IFN-γ

Abstract

Background and aims: The COVID-19 pandemic has spread worldwide and poses a severe health risk. While most patients present mild symptoms, descending pneumonia can lead to severe respiratory insufficiency. Up to 50% of patients show gastrointestinal symptoms like diarrhea or nausea, intriguingly associating with prolonged symptoms and increased severity. Thus, models to understand and validate drug efficiency in the gut of COVID-19 patients are of urgent need. Methods: Human intestinal organoids derived from pluripotent stem cells (PSC-HIOs) have led, due to their complexity in mimicking human intestinal architecture, to an unprecedented number of successful disease models including gastrointestinal infections. Here, we employed PSC-HIOs to dissect SARS-CoV-2 pathogenesis and its inhibition by remdesivir, one of the leading drugs investigated for treatment of COVID-19. Results: Immunostaining for viral entry receptor ACE2 and SARS-CoV-2 spike protein priming protease TMPRSS2 showed broad expression in the gastrointestinal tract with highest levels in the intestine, the latter faithfully recapitulated by PSC-HIOs. Organoids could be readily infected with SARS-CoV-2 followed by viral spread across entire PSC-HIOs, subsequently leading to organoid deterioration. However, SARS-CoV-2 spared goblet cells lacking ACE2 expression. Importantly, we challenged PSC-HIOs for drug testing capacity. Specifically, remdesivir effectively inhibited SARS-CoV-2 infection dose-dependently at low micromolar concentration and rescued PSC-HIO morphology. Conclusions: Thus, PSC-HIOs are a valuable tool to study SARS-CoV-2 infection and to identify and validate drugs especially with potential action in the gut.Keywords: COVID-19; Famotidine; Intestinal Organoids; Remdesivir; SARS-CoV-2.
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