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ERJ Open Res . Nicotine upregulates ACE2 expression and increases competence for SARS-CoV-2 in human pneumocytes

tetano

Editor, Senior Moderator
ERJ Open Res


. 2021 Apr 12;7(2):00713-2020.
doi: 10.1183/23120541.00713-2020. eCollection 2021 Apr.
Nicotine upregulates ACE2 expression and increases competence for SARS-CoV-2 in human pneumocytes


Fabrizio Maggi[SUP] 1 2 [/SUP], Alfredo Rosellini[SUP] 3 [/SUP], Pietro Giorgio Spezia[SUP] 4 [/SUP], Daniele Focosi[SUP] 5 [/SUP], Lisa Macera[SUP] 3 4 [/SUP], Michele Lai[SUP] 4 [/SUP], Mauro Pistello[SUP] 3 4 [/SUP], Antonio de Iure[SUP] 6 [/SUP], Carlo Tomino[SUP] 7 [/SUP], Stefano Bonassi[SUP] 8 9 [/SUP], Patrizia Russo[SUP] 8 9 [/SUP]



Affiliations

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has a variable degree of severity according to underlying comorbidities and life-style. Several research groups have reported an association between cigarette smoking and increased severity of COVID-19. The exact mechanism of action is largely unclear. We exposed low angiotensin-converting enzyme 2 (ACE2)-expressing human pulmonary adenocarcinoma A549 epithelial cells to nicotine and assessed ACE2 expression at different times. We further used the nicotine-exposed cells in a virus neutralisation assay. Nicotine exposure induces rapid and long-lasting increases in gene and protein expression of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor ACE2, which in turn translates into increased competence for SARS-CoV-2 replication and cytopathic effect. These findings show that nicotine worsens SARS-CoV-2 pulmonary infection and have implications for public health policies.
 
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