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The SARS-CoV-2 main protease M(pro) causes microvascular brain pathology by cleaving NEMO in brain endothelial cells #MMPMID34675436
Wenzel J; Lampe J; Muller-Fielitz H; Schuster R; Zille M; Muller K; Krohn M; Korbelin J; Zhang L; Ozorhan U; Neve V; Wagner JUG; Bojkova D; Shumliakivska M; Jiang Y; Fahnrich A; Ott F; Sencio V; Robil C; Pfefferle S; Sauve F; Coelho CFF; Franz J; Spiecker F; Lembrich B; Binder S; Feller N; Konig P; Busch H; Collin L; Villasenor R; Johren O; Altmeppen HC; Pasparakis M; Dimmeler S; Cinatl J; Puschel K; Zelic M; Ofengeim D; Stadelmann C; Trottein F; Nogueiras R; Hilgenfeld R; Glatzel M; Prevot V; Schwaninger M
Nat Neurosci 2021[Nov]; 24 (11): 1522-1533 PMID34675436show ga
Coronavirus disease 2019 (COVID-19) can damage cerebral small vessels and cause neurological symptoms. Here we describe structural changes in cerebral small vessels of patients with COVID-19 and elucidate potential mechanisms underlying the vascular pathology. In brains of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected individuals and animal models, we found an increased number of empty basement membrane tubes, so-called string vessels representing remnants of lost capillaries. We obtained evidence that brain endothelial cells are infected and that the main protease of SARS-CoV-2 (M(pro)) cleaves NEMO, the essential modulator of nuclear factor-kappaB. By ablating NEMO, M(pro) induces the death of human brain endothelial cells and the occurrence of string vessels in mice. Deletion of receptor-interacting protein kinase (RIPK) 3, a mediator of regulated cell death, blocks the vessel rarefaction and disruption of the blood-brain barrier due to NEMO ablation. Importantly, a pharmacological inhibitor of RIPK signaling prevented the M(pro)-induced microvascular pathology. Our data suggest RIPK as a potential therapeutic target to treat the neuropathology of COVID-19.