Pericyte-specific vascular expression of SARS-CoV-2 receptor ACE2 – implications for microvascular inflammation and hypercoagulopathy in COVID-19

Liqun He, Maarja Andaloussi Mäe, Lars Muhl, Ying Sun, Riikka Pietilä, Khayrun Nahar, Elisa Vázquez Liébanas, Malin Jonsson Fagerlund, Anders Oldner, Jianping Liu, Guillem Genové, Lei Zhang, Yuan Xie, Stefanos Leptidis, Giuseppe Mocci, Simon Stritt, Ahmed M. Osman, Andrey Anisimov, Karthik Amudhala Hemanthakumar, Markus RäsänenOlivier Mirabeau, Emil M. Hansson, Johan L. M. Bjorkegren, Michael Vanlandewijck, Klas Blomgren, Taija Mäkinen, Xiao-Rong Peng, Thomas D. Arnold, Kari Alitalo, Lars I Eriksson, Urban Lendahl, Christer Betsholtz

Research output: Contribution to journalArticleScientific


Accumulating clinical observations implicatevascular inflammation as an underlyingcause of coagulopathyin severely ill COVID-19 patientsand it was recently suggested that SARS-CoV-2 virus particles infect endothelial cells.Here, we show thatendothelial cells do not expressangiotensin-converting enzyme-2 (ACE2), the SARS-CoV-2 receptor. Instead, pericytes and microvascular smooth muscle cells express ACE2 in an organotypic manner.Pericyte deficiency leads toincreased endothelial expression and releaseof Von Willebrand factorand intravascular platelet and fibrin aggregation,suggesting thatpericyteslimit endothelial pro-thromboticresponses. That pericytes and not endothelial cells express ACE2 may provide important clues tothe pathologyofCOVID-19, as pericytes are normally shielded behind anendothelial barrier and may get infected only whenthis barrier is compromisedby COVID-19 risk factors.
Original languageEnglish
JournalbioRxiv : the preprint server for biology
Number of pages44
Publication statusPublished - 26 Jul 2020
MoE publication typeB1 Journal article

Fields of Science

  • 3111 Biomedicine
  • covid-19

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