Elevated ACE2 expression in the olfactory neuroepithelium: implications for anosmia and upper respiratory SARS-CoV-2 entry and replication

Mengfei Chen; Wenjuan Shen; Nicholas R. Rowan; Heather M. Kulaga; Alexander T. Hillel; Murugappan Ramanathan; Andrew P. Lane

doi:10.1183/13993003.01948-2020

Molecular BiologyEuropean Respiratory JournalAug 18, 2020

Peer-reviewed journal article

Elevated ACE2 expression in the olfactory neuroepithelium: implications for anosmia and upper respiratory SARS-CoV-2 entry and replication

Mengfei Chen iD, Wenjuan Shen iD, Nicholas R. Rowan iD, Heather M. Kulaga iD, Alexander T. Hillel iD, Murugappan Ramanathan iD, Andrew P. Lane iD

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Abstract

The site of SARS-CoV-2 entry and replication critically impacts strategies for COVID-19 diagnosis, transmission mitigation, and treatment. We determined the cellular location of the SARS-CoV-2 target receptor protein, ACE2, in the human upper airway, finding striking enrichment (200-700 folds) in the olfactory neuroepithelium relative to nasal respiratory or tracheal epithelial cells. This cellular tropism of SARS-CoV-2 may underlie its high transmissibility and association with olfactory dysfunction, while suggesting a viral reservoir potentially amenable to intranasal therapy.