title: Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2.
abstract: Infection of humans with the severe acute respiratory syndrome coronavirus (SARS-CoV) results in substantial morbidity and mortality, with death resulting primarily from respiratory failure. While the lungs are the major site of infection, the brain is also infected in some patients. Brain infection may result in long-term neurological sequelae, but little is known about the pathogenesis of SARS-CoV in this organ. We previously showed that the brain was a major target organ for infection in mice that are transgenic for the SARS-CoV receptor (human angiotensin-converting enzyme 2). Herein, we use these mice to show that virus enters the brain primarily via the olfactory bulb, and infection results in rapid, transneuronal spread to connected areas of the brain. This extensive neuronal infection is the main cause of death because intracranial inoculation with low doses of virus results in a uniformly lethal disease even though little infection is detected in the lungs. Death of the animal likely results from dysfunction and/or death of infected neurons, especially those located in cardiorespiratory centers in the medulla. Remarkably, the virus induces minimal cellular infiltration in the brain. Our results show that neurons are a highly susceptible target for SARS-CoV and that only the absence of the host cell receptor prevents severe murine brain disease.
authors.affiliation: Interdisciplinary Program in Immunology, University of Iowa,Iowa City, IA 52242, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Netland
authors.forename: David K
authors.initials: DK
authors.lastname: Meyerholz
authors.forename: Steven
authors.initials: S
authors.lastname: Moore
authors.forename: Martin
authors.initials: M
authors.lastname: Cassell
authors.forename: Stanley
authors.initials: S
authors.lastname: Perlman
mesh_terms: D000085962:Angiotensin-Converting Enzyme 2; D000818:Animals; D001921:Brain / Q000473:pathology / Q000821:virology; D016923:Cell Death; D006801:Humans; D008168:Lung / Q000473:pathology; D051379:Mice; D008810:Mice, Inbred C57BL; D008822:Mice, Transgenic; D009474:Neurons / Q000821:virology*; D009830:Olfactory Bulb / Q000473:pathology / Q000821:virology; D007703:Peptidyl-Dipeptidase A / Q000235:genetics / Q000502:physiology*; D011991:Receptors, Virus / Q000235:genetics / Q000502:physiology*; D045473:Severe acute respiratory syndrome-related coronavirus / Q000472:pathogenicity*; D045169:Severe Acute Respiratory Syndrome / Q000473:pathology*
chemical_list: D011991:Receptors, Virus; D007703:Peptidyl-Dipeptidase A; C000705307:ACE2 protein, human; C000705328:Ace2 protein, mouse; D000085962:Angiotensin-Converting Enzyme 2