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. 2020 Sep 10;11(5):e01928-20.
doi: 10.1128/mBio.01928-20.

Antiviral Activity of Type I, II, and III Interferons Counterbalances ACE2 Inducibility and Restricts SARS-CoV-2

Affiliations

Antiviral Activity of Type I, II, and III Interferons Counterbalances ACE2 Inducibility and Restricts SARS-CoV-2

Idoia Busnadiego et al. mBio. .

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), is a recently emerged respiratory coronavirus that has infected >23 million people worldwide with >800,000 deaths. Few COVID-19 therapeutics are available, and the basis for severe infections is poorly understood. Here, we investigated properties of type I (β), II (γ), and III (λ1) interferons (IFNs), potent immune cytokines that are normally produced during infection and that upregulate IFN-stimulated gene (ISG) effectors to limit virus replication. IFNs are already in clinical trials to treat COVID-19. However, recent studies highlight the potential for IFNs to enhance expression of host angiotensin-converting enzyme 2 (ACE2), suggesting that IFN therapy or natural coinfections could exacerbate COVID-19 by upregulating this critical virus entry receptor. Using a cell line model, we found that beta interferon (IFN-β) strongly upregulated expression of canonical antiviral ISGs, as well as ACE2 at the mRNA and cell surface protein levels. Strikingly, IFN-λ1 upregulated antiviral ISGs, but ACE2 mRNA was only marginally elevated and did not lead to detectably increased ACE2 protein at the cell surface. IFN-γ induced the weakest ISG response but clearly enhanced surface expression of ACE2. Importantly, all IFN types inhibited SARS-CoV-2 replication in a dose-dependent manner, and IFN-β and IFN-λ1 exhibited potent antiviral activity in primary human bronchial epithelial cells. Our data imply that type-specific mechanisms or kinetics shape IFN-enhanced ACE2 transcript and cell surface levels but that the antiviral action of IFNs against SARS-CoV-2 counterbalances any proviral effects of ACE2 induction. These insights should aid in evaluating the benefits of specific IFNs, particularly IFN-λ, as repurposed therapeutics.IMPORTANCE Repurposing existing, clinically approved, antiviral drugs as COVID-19 therapeutics is a rapid way to help combat the SARS-CoV-2 pandemic. Interferons (IFNs) usually form part of the body's natural innate immune defenses against viruses, and they have been used with partial success to treat previous new viral threats, such as HIV, hepatitis C virus, and Ebola virus. Nevertheless, IFNs can have undesirable side effects, and recent reports indicate that IFNs upregulate the expression of host ACE2 (a critical entry receptor for SARS-CoV-2), raising the possibility that IFN treatments could exacerbate COVID-19. Here, we studied the antiviral- and ACE2-inducing properties of different IFN types in both a human lung cell line model and primary human bronchial epithelial cells. We observed differences between IFNs with respect to their induction of antiviral genes and abilities to enhance the cell surface expression of ACE2. Nevertheless, all the IFNs limited SARS-CoV-2 replication, suggesting that their antiviral actions can counterbalance increased ACE2.

Keywords: ACE2; COVID-19; SARS-CoV-2; coronavirus; immunotherapy; interferons; receptors.

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Figures

FIG 1
FIG 1
Replication of SARS-CoV-2 in primary human differentiated bronchial epithelial cells and its restriction by type I, II, and III interferons. (A) Primary human bronchial epithelial cells (BEpCs) were differentiated and grown at an air-liquid interface (ALI) for 28 days. TEER was monitored at the time points indicated, with data representing means ± standard deviations (error bars) from three independent wells. (B) Differentiated BEpCs were fixed and stained for ciliated cells (β-tubulin; turquoise), tight junctions (ZO-1; magenta) and nuclei (4′,6′-diamidino-2-phenylindole [DAPI]; blue). Bars, 25 μm. (C) Differentiated BEpCs grown on 6.5-mm filter inserts were infected with 6,000 PFU of SARS-CoV-2 from the apical side. At the indicated times postinfection, apical washes were harvested and virus titers were determined by plaque assay. Data represent means plus standard deviations from two independent replicates. (D) Differentiated BEpCs were treated on the apical side with 1,000 IU/ml type I (β), type II (γ), or type III (λ1) IFN (or left untreated [Untr.]) for 16 h before total RNA was harvested and the levels of MX1, RSAD2 and ACE2 were quantified by RT-qPCR. Data represent means plus standard deviations from two independent replicates. (E and F) Differentiated BEpCs were treated with 1,000 IU/ml type I (β), type II (γ), or type III (λ1) IFN (or left untreated) for 16 h prior to infection with 6,000 PFU of SARS-CoV-2 from the apical side. At the indicated times postinfection, apical washes (E) and basolateral samples (F) were harvested and virus titers were determined by plaque assay. Data represent means plus standard deviations from two independent replicates. The limit of detection (LoD) is indicated by the dotted lines.
FIG 2
FIG 2
Antiviral activity of type I, II, and III interferons counterbalances ACE2 induction to restrict SARS-CoV-2 replication in Calu-3 cells. (A) Basal ACE2 mRNA expression in BEpCs and Calu-3 cells was measured by RT-qPCR, and the levels in BEpCs were set at 100% for comparison. Data represent means ± standard deviations from three independent BEpC samples and five independent Calu-3 samples. (B) Calu-3 cells were treated with 10, 100, or 1,000 IU/ml of type I (β), type II (γ), or type III (λ1) IFN (or left untreated [Untr.]) for 16 h before total RNA was harvested and mRNA levels of MX1, RSAD2, and ACE2 were determined by RT-qPCR. Data represent means plus standard deviations from three independent replicates. Statistical significance was determined for cells treated with each IFN compared to untreated cells using two-way ANOVA following log transformation (ns, not significant; *, P < 0.05; **, P < 0.002; ***, P < 0.0002; ****, P < 0.0001). (C) Calu-3 cells were treated with 1,000 IU/ml of IFN-β for 24 h (left) or 72 h (right) before ACE2 surface levels were assessed by FACS. (D) Calu-3 cells were treated with 1,000 IU/ml of IFN-γ (left) or IFN-λ1 (right) for 72 h before ACE2 surface levels were assessed by FACS. (E) Mean fluorescence intensity (MFI) values from Calu-3 cells treated with 1,000 IU/ml of type I (β), type II (γ), or type III (λ1) IFN (or left untreated [Untr.]) for 72 h and analyzed by FACS for ACE2 surface levels. Data represent means plus standard deviations from three independent replicates. The limit of detection (LoD) is indicated by the dotted line. Statistical significance was determined for cells treated with each IFN compared to untreated cells by one-way ANOVA (ns, not significant; **, P < 0.0002). (F) Calu-3 cells were treated with the indicated amounts of type I (β) or type III (λ1) IFN (or left untreated [Untr.]) before total RNA was harvested at the indicated times and mRNA levels of MX1, RSAD2, and ACE2 were determined by RT-qPCR. Data represent means plus standard deviations from three independent replicates. (G and H) Calu-3 cells treated for 24 h (G) or 72 h (H) with 10, 100, or 1,000 IU/ml of type I (β), type II (γ), or type III (λ1) IFN (or left untreated [Untr.]) were lysed, and the levels of MxA and actin were determined by Western blotting. Data shown are representative of two independent replicates. (I) Calu-3 cells treated for 72 h with 10, 100, or 1,000 IU/ml of type I (β), type II (γ), or type III (λ1) IFN (or left untreated [Untr.]) were infected with SARS-CoV-2 at an MOI of 1 PFU/cell. Virus was harvested at 24 h postinfection, and titers were determined by plaque assay. Data represent means plus standard deviations from three independent replicates. Statistical significance was determined for cells treated with each IFN compared to untreated cells by two-way ANOVA following log transformation (ns, not significant; *, P < 0.05; **, P < 0.002; ****, P < 0.0001).

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