Mechanisms of Gastrointestinal COVID-19

NIH Pandemic-Era Grants

Pandemic Era Grants

2024

Document text

Principal Investigator: MATTHEW AARON CIORBA
Organization: WASHINGTON UNIVERSITY
Fiscal Year: 2024
Award: $625,575
Funding agency: National Institute of Allergy and Infectious Diseases

Project Summary
 Although coronavirus disease 2019 (COVID-19) is primarily defined as a respiratory illness, up to 50% of
patients experience clinical gastrointestinal symptoms, including nausea, abdominal pain, and diarrhea. We
recently found that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes
COVID-19, infects and replicates in human small bowel intestinal epithelial cells (IECs). However, the molecular
mechanisms by which SARS-CoV-2 drives gastrointestinal pathology and how that impacts the mucosal immune
responses and systemic diseases remain unclear.
 In this proposal, our overall objectives are to better define the cellular signaling of SARS-CoV-2 interactions
with IECs, enteric immune responses, and microbiome in the context of health or inflamed intestines (i.e.,
inflammatory bowel disease (IBD)). Our preliminary data suggest that compared to normal COVID-19 patients,
those with IBD who have higher expression of cathepsin L in IECs prior to infection, supported higher viral loads.
Our central hypothesis is that SARS-CoV-2 induces a distinctive intestinal pathology and mucosal immune
response that is shaped by host factors (IBD), luminal factors (bile salts and microbiome), and therapeutics.
Specifically, using healthy and IBD-derived organoids, COVID-19 patient fecal samples, SARS-CoV-2 variants,
and a highly tractable and innovative intraluminal injection mouse model, we aim to (1) define the host factors
and cellular mechanisms involved in SARS-CoV-2 infection of normal and IBD epithelium, (2) determine the
impact of intestinal SARS-CoV-2 infection on intestinal immune response and colitis, and (3) define the
environmental factors that influence intestinal infection with SARS-CoV-2.
With extensive and collaborative expertise in intestinal biology, virology, and mucosal immunology (including
IBD), we expect to address mechanistically interesting and clinically important questions regarding SARS-CoV-
2 enteric infection, immune responses, and intestinal pathology. We anticipate that the knowledge derived from
this study will further our understanding of SARS-CoV-2 interactions with the epithelial and immune cells to
explain COVID-19 GI symptoms with or without IBD. We also expect the new information gained from this project
will expand our understanding of acute and chronic gastrointestinal pathology and symptoms of COVID-19,
provide novel strategies to mitigate COVID-19 associated GI diseases, and create a foundational knowledge
and tool set for deeper investigations into COVID-19 and potentially pathogenic and emerging coronaviruses of
the future.

Terms: <16S gene sequencing><16S rRNA amplicon sequencing><16S rRNA gene amplicon sequencing><16S rRNA gene sequencing><16S rRNA genomic profiling><16S rRNA sequencing><16S ribosomal RNA gene sequencing><16S ribosomal RNA sequencing><16S sequencing><2019 novel corona virus><2019 novel coronavirus><2019-nCoV><2019-nCoV variant><2019-nCoV variant forms><2019-nCoV variant strains><ACE2><Abdominal Pain><Acute><Address><Affect><Alimentary Canal><Anti-Rejection Therapy><Autoregulation><B.1.617.2><Biology><Brazil P.1><Brazil variant><Brazilian variant><CATL><COVID disease severity><COVID infected patient><COVID patient><COVID positive patient><COVID severity><COVID-19><COVID-19 disease severity><COVID-19 infected patient><COVID-19 infection><COVID-19 patient><COVID-19 positive patient><COVID-19 severity><COVID-19 therapy><COVID-19 treatment><COVID-19 vaccination><COVID-19 variant><COVID-19 variant forms><COVID-19 variant strains><COVID-19 virus><COVID-19 virus infection><COVID19 disease severity><COVID19 infection><COVID19 patient><COVID19 positive patient><COVID19 severity><COVID19 virus><CTSL Protein><CV-19><Cathepsin L><Causality><Cell Body><Cell Communication and Signaling><Cell Death><Cell Signaling><Cells><Chronic><Clinical><CoV emergence><CoV-2><CoV2><Colitis><Colon><Coronaviridae><Coronavirus><Coronavirus Infectious Disease 2019><Crohn disease><Crohn's><Crohn's disease><Crohn's disorder><Data><Delta variant><Diarrhea><Digestive Tract><Disease><Disorder><Dysfunction><Emesis><Endosomes><Enteral><Enteric><Enterocytes><Environmental Factor><Environmental Risk Factor><Epithelial Cells><Epithelium><Etiology><Feces><Functional disorder><Future><GI Tract><GI microbiome><Gamma variant><Gastrointestinal Diseases><Gastrointestinal Physiology><Gastrointestinal Tract><Gastrointestinal tract structure><Genetic><Genotype><Granulomatous Enteritis><Groups at risk><Health><Homeostasis><Host Factor><Host Factor Protein><Household><Human><Immune><Immune response><Immunes><Immunological response><Immunology><Immunosuppressive Therapy><Impairment><Infection><Inflammation><Inflammatory Bowel Diseases><Inflammatory Bowel Disorder><Injections><Integration Host Factors><Intestinal><Intestinal Diseases><Intestinal Disorder><Intestines><Intracellular Communication and Signaling><Investigation><Knowledge><Liquid substance><Lower GI Tract><Lower Gastrointestinal Tract><Major Excreted Protein><Mice><Mice Mammals><Modeling><Modern Man><Molecular><Mucosa><Mucosal Immune Responses><Mucosal Immune System><Mucosal Inflammation><Mucosal Tissue><Mucositis><Mucous Membrane><Murine><Mus><Nausea><Observation research><Observation study><Observational Study><Observational research><Organ><Organoids><Outcome><P.1 strain><P.1 variant><Pathogenicity><Pathology><Pathway interactions><Patients><People at risk><Persons at risk><Phenotype><Physiological Homeostasis><Physiopathology><Populations at Risk><Pulmonary Body System><Pulmonary Organ System><Receptosomes><Reporter><Research Specimen><Respiratory System><Respiratory Tracts><Respiratory tract structure><Role><SARS corona virus 2><SARS-CO-V2><SARS-COVID-2><SARS-CoV-2><SARS-CoV-2 B.1.617.2><SARS-CoV-2 P.1><SARS-CoV-2 delta><SARS-CoV-2 disease severity><SARS-CoV-2 infected patient><SARS-CoV-2 infection><SARS-CoV-2 patient><SARS-CoV-2 positive patient><SARS-CoV-2 severity><SARS-CoV-2 therapy><SARS-CoV-2 treatment><SARS-CoV-2 vaccination><SARS-CoV-2 variant><SARS-CoV-2 variant forms><SARS-CoV-2 variant strains><SARS-CoV2><SARS-CoV2 infection><SARS-associated corona virus 2><SARS-associated coronavirus 2><SARS-coronavirus-2><SARS-related corona virus 2><SARS-related coronavirus 2><SARSCoV2><Severe Acute Respiratory Coronavirus 2><Severe Acute Respiratory Distress Syndrome CoV 2><Severe Acute Respiratory Distress Syndrome Corona Virus 2><Severe Acute Respiratory Distress Syndrome Coronavirus 2><Severe Acute Respiratory Syndrome CoV 2><Severe Acute Respiratory Syndrome-associated coronavirus 2><Severe Acute Respiratory Syndrome-related coronavirus 2><Severe acute respiratory syndrome associated corona virus 2><Severe acute respiratory syndrome coronavirus 2><Severe acute respiratory syndrome coronavirus 2 infection><Severe acute respiratory syndrome coronavirus 2 vaccination><Severe acute respiratory syndrome related corona virus 2><Severity of illness><Shapes><Signal Transduction><Signal Transduction Systems><Signaling><Site><Small Intestines><Specimen><Symptoms><Systemic disease><Testing><Therapeutic><Therapeutic immunosuppression><Transgenic Mice><Tropism><Viral Burden><Viral Load><Viral Load result><Viral reservoir><Virus><Virus reservoir><Vomiting><Wuhan coronavirus><acute infection><alimentary tract><angiotensin converting enzyme 2><angiotensin converting enzyme II><artificial immunosuppression><bile salts><biobank><biological signal transduction><biorepository><bowel><bowel inflammation><causation><corona virus><corona virus emergence><coronavirus disease 2019><coronavirus disease 2019 disease severity><coronavirus disease 2019 infected patient><coronavirus disease 2019 infection><coronavirus disease 2019 patient><coronavirus disease 2019 positive patient><coronavirus disease 2019 severity><coronavirus disease 2019 therapy><coronavirus disease 2019 treatment><coronavirus disease 2019 vaccination><coronavirus disease 2019 variant><coronavirus disease 2019 variant forms><coronavirus disease 2019 variant strains><coronavirus disease 2019 virus><coronavirus disease infected patient><coronavirus disease patient><coronavirus disease positive patient><coronavirus disease severity><coronavirus disease-19><coronavirus disease-19 patient><coronavirus disease-19 virus><coronavirus emergence><coronavirus infectious disease-19><coronavirus patient><diarrheal disease><diarrheal illness><differential expression><differentially expressed><digestive canal><digestive tract microbiome><disease causation><disease severity><eleocolitis><emergent CoV><emergent corona virus><emergent coronavirus><emerging CoV><emerging corona virus><emerging coronavirus><enteral infection><enteric infection><enteric microbiome><enteric pathogen infection><enteropathogen infection><enteropathogenic infection><environmental risk><experience><fecal sample><fluid><gastrointestinal><gastrointestinal disorder><gastrointestinal infection><gastrointestinal microbiome><gastrointestinal symptom><gut dysbiosis><gut inflammation><gut microbiome><gut-associated microbiome><hCoV19><host response><immune system response><immunoresponse><immunosuppression therapy><infected with COVID-19><infected with COVID19><infected with SARS-CoV-2><infected with SARS-CoV2><infected with coronavirus disease 2019><infected with enteropathogen><infected with severe acute respiratory syndrome coronavirus 2><infection rate><inflamed bowel><inflamed gut><inflamed intestine><inflammatory disease of the intestine><inflammatory disorder of the intestine><inhibitor><innovate><innovation><innovative><intestinal autoinflammation><intestinal biome><intestinal epithelium><intestinal infection><intestinal inflammation><intestinal microbiome><intestine disease><intestine disorder><intestine infection><liquid><microbial consortia><microbial flora><microbiome><microbiome intervention><microbiome therapeutics><microbiome therapy><microbiome treatment><microbiome-based intervention><microbiome-based therapeutic><microbiome-based therapy><microbiome-based treatment><microbiota><microflora><mouse model><multispecies consortia><murine model><nCoV><nCoV2><necrocytosis><new CoV><new approaches><new corona virus><new coronavirus><novel><novel CoV><novel approaches><novel corona virus><novel coronavirus><novel strategies><novel strategy><pathophysiology><pathway><patient infected with COVID><patient infected with COVID-19><patient infected with SARS-CoV-2><patient infected with coronavirus disease><patient infected with coronavirus disease 2019><patient infected with severe acute respiratory syndrome coronavirus 2><patient with COVID><patient with COVID-19><patient with COVID19><patient with SARS-CoV-2><patient with coronavirus disease><patient with coronavirus disease 2019><patient with severe acute respiratory distress syndrome coronavirus 2><pharmacologic><rate of infection><regional enteritis><respiratory><severe acute respiratory syndrome coronavirus 2 B.1.617.2><severe acute respiratory syndrome coronavirus 2 P.1><severe acute respiratory syndrome coronavirus 2 disease severity><severe acute respiratory syndrome coronavirus 2 infected patient><severe acute respiratory syndrome coronavirus 2 patient><severe acute respiratory syndrome coronavirus 2 positive patient><severe acute respiratory syndrome coronavirus 2 severity><severe acute respiratory syndrome coronavirus 2 therapy><severe acute respiratory syndrome coronavirus 2 treatment><severe acute respiratory syndrome coronavirus 2 variant><severe acute respiratory syndrome coronavirus 2 variant forms><severe acute respiratory syndrome coronavirus 2 variant strains><small bowel><social role><socio-economic><socio-economically><socioeconomically><socioeconomics><stool><stool sample><stool specimen><tool><transcriptional differences><treat COVID-19><treat SARS-CoV-2><treat coronavirus disease 2019><treat severe acute respiratory syndrome coronavirus 2><vaccinate against COVID-19><vaccinate against SARS-CoV-2><vaccinate against coronavirus disease 2019><vaccinate against severe acute respiratory syndrome coronavirus 2><vaccination against COVID-19><vaccination against SARS-CoV-2><vaccination against Severe acute respiratory syndrome coronavirus 2><vaccination against coronavirus disease 2019><viral microbiome><virology><virome><virus resource>