It is known that infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cause coronavirus disease 2019 (COVID-19). It is widely reported that Alzheimer's disease (AD) is associated with the highest risk of COVID-19 infection, hospitalization and mortality. However, it remains largely unclear about the link between AD and COVID-19. ACE2 is an entry receptor for SARS-CoV-2. We consider that there may be a link between AD and COVID-19 through the expression of ACE2. Here, we summarize recent findings about the ACE2 expression especially in AD and COVID-19, and shows that (1) ACE2 shows mRNA and protein expression in human brain tissues, especially in neurons and non-neuron cells; (2) low ACE2 mRNA and protein expression are sufficient for SARS-CoV-2 entry into the human brain through the neural route (olfactory and/or vagal) and the hematogenous route; (3) SARS-CoV-2 RNA and protein were detected in brains of COVID-19 patients; (4) SARS-CoV-2 infects and replicates in human brain dependent on ACE2; (5) SARS-CoV-2 viral RNA load shows a positive association with ACE2 mRNA levels and COVID-19 severity; (6) ACE2 shows increased expression in AD compared with controls in human brain; (7) ACE2 shows increased expression in COVID-19 compared with controls in human brain; (8) ACE2 expression levels affect COVID-19 outcomes. Together, ACE2 shows significantly increased mRNA and protein expression in AD compared with controls in human brain. Consequently, the increased expression of ACE2 would facilitate infection with SARS-CoV-2, and play a role in the context of COVID-19. These findings suggest that the expression of ACE2 may partly explain the link of AD with COVID-19 infection, hospitalization and mortality.
基金:
This work was supported by funding from the National Key R&D Program of China
(No. 2023YFC3605200, and 2023YFC3605202), National Science and Technology
Major Project (2023ZD0505306), National Natural Science Foundation of China (No.
82471449, 82071212, and 82371305), Beijing Natural Science Foundation (No.
JQ21022 and Z240021).
第一作者机构:[1]Capital Med Univ, Xuanwu Hosp, Dept Neurol, Beijing, Peoples R China[2]Capital Med Univ, Beijing Inst Brain Disorders, Collaborat Innovat Ctr Brain Disorders, Lab Brain Disorders,Minist Sci & Technol, Beijing 100069, Peoples R China
共同第一作者:
通讯作者:
通讯机构:[8]Shengli Oilfield Cent Hosp, Dongying Branch, Ctr Collaborat Innovat Ctr Brain Disorders, 31 Jinan Rd, Dongying 257034, Shandong, Peoples R China[9]Capital Med Univ, Xuanwu Hosp, Beijing Inst Brain Disorders, Collaborat Innovat Ctr Brain Disorders,Minist Sci, Beijing 100069, Peoples R China[10]Chengdu Univ Tradit Chinese Med, Affiliated Peoples Hosp 5, Chengdu Fifth Peoples Hosp, Clin Med Translat Res Inst,Geriatr Dis Inst Chengd, 33, Ma Shi St, Chengdu 611137, Sichuan, Peoples R China
推荐引用方式(GB/T 7714):
Li Sijie,Sun Jingyi,Li He,et al.Expression of SARS-CoV-2 entry receptor ACE2 in human brain and its association with Alzheimer's disease and COVID-19[J].MOLECULAR PSYCHIATRY.2025,30(7):3257-3268.doi:10.1038/s41380-025-03006-z.
APA:
Li, Sijie,Sun, Jingyi,Li, He,Han, Zhifa,Wang, Tao...&Liu, Guiyou.(2025).Expression of SARS-CoV-2 entry receptor ACE2 in human brain and its association with Alzheimer's disease and COVID-19.MOLECULAR PSYCHIATRY,30,(7)
MLA:
Li, Sijie,et al."Expression of SARS-CoV-2 entry receptor ACE2 in human brain and its association with Alzheimer's disease and COVID-19".MOLECULAR PSYCHIATRY 30..7(2025):3257-3268