The Value of Kidney Biopsies to Empower New Discoveries in Diabetic Kidney Disease: Insight into COVID-19 kidney damage
4:30 p.m. CT Monday, June 15
COVID-19 shows a high excessive morbidity and mortality in patients with diabetes and kidney disease. Coronaviruses need specific keys, cellular receptors, to infect cells. During previous virus outbreaks, like the HIV pandemic, kidneys were a primary target of infection, with devastating complications for survivors. SARS-CoV-2 uses ACE2 and associated proteases to infect cells. Learning how these receptors are regulated might give clues on novel treatment option and who is at highest risk for complications. Using kidney biopsies from T2D patients and healthy controls, we identify specific kidney tubular epithelial cells that selectively up-regulate the SARS-CoV-2 receptor ACE2 in diabetes using single-cell RNA-sequencing technology. However, common blood pressure medication did not up-regulate the receptor further. The receptor-associated key molecular pathways provide insight into how the coronavirus infects kidney cells, takes over their metabolism, replicates and eventually destroys the infected cells, and are searchable at hb.flatironinstitute.org/covid-kidney. The same single-cell technology is used to study the transcriptional machinery in kidney cells recovered from urine samples from patient with active COVID-19. This data now allows us to map disease-associated pathways in kidney cells to monitor the effect of drugs currently tested and identify new targets for therapeutic development.