tetano
Editor, Senior Moderator
J Cutan Pathol
. 2020 Sep 7.
doi: 10.1111/cup.13866. Online ahead of print.
Discordant anti-SARS-CoV-2 spike protein and RNA staining in cutaneous perniotic lesions suggests endothelial deposition of cleaved spike protein
Christine J Ko[SUP] 1 2 [/SUP], Malini Harigopal[SUP] 2 [/SUP], Jeff R Gehlhausen[SUP] 1 [/SUP], Marcus Bosenberg[SUP] 1 2 [/SUP], Jennifer M McNiff[SUP] 1 2 [/SUP], William Damsky[SUP] 1 2 [/SUP]
Affiliations
Abstract
Background: Prior studies have shown the presence of immunohistochemical staining for the SARS-CoV-2 spike protein (SP) in endothelial cells and eccrine epithelium of acral perniosis classified as "COVID toes". Yet, other studies have been unable to detect SARS-CoV-2 RNA in skin biopsies of "COVID toes" by reverse-transcriptase polymerase chain reaction testing.
Objective: In order to address these apparently conflicting findings, we compared detection of SARS-CoV-2 SP, through RNA in situ hybridization (ISH) vs immunohistochemistry (IHC), in skin biopsies of acral perniotic lesions presenting during the COVID-19 pandemic.
Results: Three of six cases showed positive immunohistochemical labeling of endothelial cells, with 1 of 3 cases with sufficient depth also having labeling of eccrine glands, using an anti-SP SARS-CoV-2 antibody. These three cases positive with IHC were negative for SP by RNA ISH.
Conclusion: While the gold standard for detection of SARS-CoV-2 in tissue sections has yet to be determined, the detection of SARS-CoV-2 SP alone without spike RNA suggests cleaved SP may be present in cutaneous endothelial cells and eccrine epithelium, providing a potential pathogenetic mechanism of COVID-19 endotheliitis. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; RNA in situ hybridization; SARS-CoV-2; coronavirus; spike protein.
. 2020 Sep 7.
doi: 10.1111/cup.13866. Online ahead of print.
Discordant anti-SARS-CoV-2 spike protein and RNA staining in cutaneous perniotic lesions suggests endothelial deposition of cleaved spike protein
Christine J Ko[SUP] 1 2 [/SUP], Malini Harigopal[SUP] 2 [/SUP], Jeff R Gehlhausen[SUP] 1 [/SUP], Marcus Bosenberg[SUP] 1 2 [/SUP], Jennifer M McNiff[SUP] 1 2 [/SUP], William Damsky[SUP] 1 2 [/SUP]
Affiliations
- PMID: 32895985
- DOI: 10.1111/cup.13866
Abstract
Background: Prior studies have shown the presence of immunohistochemical staining for the SARS-CoV-2 spike protein (SP) in endothelial cells and eccrine epithelium of acral perniosis classified as "COVID toes". Yet, other studies have been unable to detect SARS-CoV-2 RNA in skin biopsies of "COVID toes" by reverse-transcriptase polymerase chain reaction testing.
Objective: In order to address these apparently conflicting findings, we compared detection of SARS-CoV-2 SP, through RNA in situ hybridization (ISH) vs immunohistochemistry (IHC), in skin biopsies of acral perniotic lesions presenting during the COVID-19 pandemic.
Results: Three of six cases showed positive immunohistochemical labeling of endothelial cells, with 1 of 3 cases with sufficient depth also having labeling of eccrine glands, using an anti-SP SARS-CoV-2 antibody. These three cases positive with IHC were negative for SP by RNA ISH.
Conclusion: While the gold standard for detection of SARS-CoV-2 in tissue sections has yet to be determined, the detection of SARS-CoV-2 SP alone without spike RNA suggests cleaved SP may be present in cutaneous endothelial cells and eccrine epithelium, providing a potential pathogenetic mechanism of COVID-19 endotheliitis. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; RNA in situ hybridization; SARS-CoV-2; coronavirus; spike protein.