Introduction
At present, novel coronavirus is widespread globally and has caused serious health, economic, and social problems. Experts and scientists around the world are rapidly working to expand scientific knowledge about the new virus. The primary clinical symptoms of SARS-CoV-2 include cough, fever, and severe pulmonary infection, followed by sputum production and fatigue [
1]. The first step of SARS-CoV-2 infection is that the virus enters human cells. These coronaviruses have a similar spike protein three-dimensional structure and are thought to have a strong binding affinity with the human cell receptor angiotensin-converting enzyme 2 (ACE2). Human ACE2 is the docking and entry receptor of severe acute respiratory syndrome coronavirus (SARS-CoV) in human cells [
2,
3] and may also be the cell receptor of a new coronavirus (SARS-CoV-2) [
4]. It plays an important role in the process of cell entry into the human body [
5]. ACE2-expressing cells may serve as target cells and may be susceptible to SARS-CoV-2 infection, as reported in literature [
6]. Therefore, organs with a high expression of ACE2 should be considered as organs with potential high risk for SARS-CoV-2 infection. ACE2 is expressed in bronchial epithelial cells, oral epithelial cells, absorbent intestinal cells of ileum and colon, hepatobiliary duct cells, and proximal renal tubule cells [
6,
7].
To investigate the potential pathway of novel coronavirus to infect epithelial cells in alveolar lavage fluid, we used the dataset GSE145926 from the comprehensive database Omnibus [Gene Expression Omnibus (GEO)]. Single-cell sequencing samples were included from tracheoalveolar lavage fluid from patients with different degrees of SARS-CoV-2 infection and healthy individuals. Through a series of analyses, we explored the expression of ACE2 in alveolar lavage fluid epithelial cells and the composition and proportion of cells expressing ACE2. By comparing the genetic characteristics and functional differences of epithelial cells, and the cell communication relationship with immune cells, we explored the potential molecular mechanism of the onset of SARS-CoV-2 and provided clues about possible infection pathways.
Discussion
Coronavirus infections have caused multiple outbreaks, including human respiratory tract infections, such as severe acute respiratory syndrome (SARS) in 2002 and middle east respiratory syndrome (MERS) in 2012. In December 2019, a novel corona virus (SARS-CoV-2) caused a pneumonia outbreak in Wuhan, China, again posing a public health risk from coronavirus [
13]. The pathway and pathogenesis of this corona virus infection are still not fully understood; so, it is of great significance to deepen our knowledge of it. Although healthcare professionals and researchers worldwide are working hard to do so, thus far, the WHO has reported that there have been more than 4 million deaths worldwide due to SARS-CoV-2. One of the main methods of transmission of the new coronavirus is through inhaling the virus into the lungs, which causes inflammation of the lungs. However, its infection route and pathogenesis are not yet fully understood. Here, we focused on the changes in lung epithelial cells after virus infection, as well as the interaction between epithelial cells and other immune cells.
In this study, data from the public Bulk-Seq RNA dataset of two groups of patients with SARS-CoV-2 infection of different severities and a control group were analyzed. We found that there were relatively more epithelial cells in the lavage fluid of the severely infected group and a relatively high proportion of cells with positive ACE2 expression in the epithelial cells. Organs with high expression of ACE2 should be considered as potentially high-risk organs for novel coronavirus infection [
6]. A large number of reports note the effects of ACE2 as the main receptor of SARS-CoV-2 infected cells on the renin-angiotensin system and other systems [
14,
15]. It has been confirmed that ACE2 is mainly expressed in type II alveolar cells, hepatic bile duct cells, colonic epithelial cells, esophageal keratinocytes, ileal endothelial cells, rectal endothelial cells, gastric epithelial cells, and proximal tubules of the kidney and embryonic primordial germ cells [
16‐
18]. These cells expressing ACE2 are also the main source of cells attacked by SARS-COV-2. We similarly found that CHP2, ECM1, SLC23 A1, C1QB, CRLF1, and other genes were relatively highly expressed in epithelial cell clusters 1, 3, and 7, which highly expressed ACE2. Moreover, in the severe group (S), the up-regulated genes were mainly related to signaling pathways such as regulation of cell migration, defense response to virus, response to virus and the type I interferon signaling pathway, apoptosis, the IL-17 signaling pathway, fluid sheer stress atherosclerosis, and the TNF signaling pathway. These pathways strongly indicate that in the severe group of patients’ lung epithelial cells, they are all related to apoptosis and cell inflammation.
Here, through a pseudo-time analysis, we also described the relationship and functional changes of the seven lung epithelial cell clusters after being attacked by the virus. The epithelial cell-type clusters 4 and 5 expressed a small amount of ACE2, which may be the first target of SARS-CoV-2. After being infected with the virus, the epithelial cells turned to epithelial cell clusters 1 and 3, among which cluster 7 may be an intermediate transition subtype. Correspondingly, signaling pathways such as the p53 signaling pathway, pathogenic Escherichia coli infection, and the IL-17 signaling pathway were activated, and the cells began to strongly manifest as apoptosis and inflammation.
We also noticed that in clusters 2 and 6 of the epithelial cells that appeared in the severe group, ACE2 was almost not expressed. However, they also showed the activation of the TGF-β signaling pathway, TNF signaling pathway, human-cell leukemia virus 1 infection, and other signaling pathways. These pathways are closely related to the activation of inflammation and immune function. Through the pseudo-time analysis, we found that clusters 4 and 5 were the original state, and there were two differentiation directions—one was cluster 2, and the other included clusters 1, 3, and 6; cluster 7 was an intermediate state. The results of similarity analysis confirmed this. The similarity between clusters 1, 3, 6, and 7 was high (> 0.9), and clusters 4 and 5 were relatively similar, while cluster 2 was relatively independent.
The above results showed that although the group S had a lot of epithelial cells, there was a difference between different subsets. Among them, the inflammatory response of clusters 1, 3, and 6 was more similar, the response for clusters 4 and 5 was relatively normal, and cluster 2 was relatively independent. However, from the perspective of cell apoptosis, the apoptotic ability of clusters 5 and 6 was relatively weak, the apoptotic ability of cluster 2 was the strongest, and clusters 1, 3, 4, and 7 showed a certain degree of apoptosis. In addition, these cell-type clusters were different in gene expression, and previous reports also point out the effects of virus infection on T cells and macrophages [
9,
19]. Therefore, do different clusters of epithelial cells also present different communication and interaction relationships with other cells? Is the communication relationship between the independent cluster 2 and other cells significantly different from other clusters? The results showed the communication relationship between cluster 2 epithelial cells and T cells, NK cells, and macrophages.
We found that clusters of different epithelial cell types and immune cells exhibited a strong intercellular communication relationship. Among them, the ligand MIF was highly expressed in cluster 2 epithelial cells, and its receptor TNFSRSF14 was expressed in macrophages. Macrophages highly expressed the ligand GRN, while the EGFR receptor was expressed in cluster 2 epithelial cells. The ligand-receptor expression pattern of MIF-TNFSRSF14 and GRN-EGFR allowed cluster 2 epithelial cells and macrophages to form an intercellular communication relationship. Unlike other clusters, the cluster 2 epithelial cells and macrophages, but not T cells and NK cells, had a special inter-cell regulatory relationship.
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