Cited by 101COVID-19 Clinical Research StudiesTelomeres, Telomerase, and SenescenceSARS-CoV-2 and COVID-19 Research

Pulmonary infection by SARS-CoV-2 induces senescence accompanied by an inflammatory phenotype in severe COVID-19: possible implications for viral mutagenesis

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Evangelou, Konstantinos, Veroutis, Dimitris, Paschalaki, Koralia, Foukas, Periklis G., Lagopati, Nefeli, Dimitriou, Marios, Papaspyropoulos, Angelos, Konda, Bindu +15 more·2022·European Respiratory Journal

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of the respiratory system can progress to a multisystemic disease with aberrant inflammatory response. Cellular senescence promotes chronic inflammation, named senescence-associated secretory phenotype (SASP). We investigated whether coronavirus disease 2019 (COVID-19) is associated with cellular senescence and SASP. Methods: Autopsy lung tissue samples from 11 COVID-19 patients and 43 age-matched non-COVID-19 controls with similar comorbidities were analysed by immunohistochemistry for SARS-CoV-2, markers of senescence and key SASP cytokines. Virally induced senescence was functionally recapitulated in vitro , by infecting epithelial Vero-E6 cells and a three-dimensional alveosphere system of alveolar type 2 (AT2) cells with SARS-CoV-2 strains isolated from COVID-19 patients. Results: SARS-CoV-2 was detected by immunocytochemistry and electron microscopy predominantly in AT2 cells. Infected AT2 cells expressed angiotensin-converting enzyme 2 and exhibited increased senescence (p16 INK4A and SenTraGor positivity) and interleukin (IL)-1β and IL-6 expression. In vitro , infection of Vero-E6 cells with SARS-CoV-2 induced senescence (SenTraGor), DNA damage (γ-H2AX) and increased cytokine (IL-1β, IL-6, CXCL8) and apolipoprotein B mRNA-editing (APOBEC) enzyme expression. Next-generation sequencing analysis of progenies obtained from infected/senescent Vero-E6 cells demonstrated APOBEC-mediated SARS-CoV-2 mutations. Dissemination of the SARS-CoV-2-infection and senescence was confirmed in extrapulmonary sites (kidney and liver) of a COVID-19 patient. Conclusions: We demonstrate that in severe COVID-19, AT2 cells infected by SARS-CoV-2 exhibit senescence and a proinflammatory phenotype. In vitro , SARS-CoV-2 infection induces senescence and inflammation. Importantly, infected senescent cells may act as a source of SARS-CoV-2 mutagenesis mediated by APOBEC enzymes. Therefore, SARS-CoV-2-induced senescence may be an important molecular mechanism of severe COVID-19, disease persistence and mutagenesis.

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Crossref · 10.1183/13993003.02951-2021

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  • SARS-CoV-2 directly induces senescence in vitro in Vero kidney cells, shown by increased lipofuscin, SASP factors, γH2A.X, and loss of Ki67.

    “The direct induction of senescence through infection with SARS-CoV-2 was demonstrated in vitro with a SARS-CoV-2-susceptible kidney cell line (Vero) as detected by an increase in lipofuscin (Box 1), the secretion of SASP factors, including IL-1β, IL-6 and IL-8, and the DNA damage mark γH2A.X, as well as a loss of Ki67 expression44”

    From COVID-19 and cellular senescence (2023) · cites this paper as [44]

  • Lung specimens from COVID-19 patients show much stronger signs of senescence than SARS-CoV-2 negative controls.

    “Similar analyses of lung specimens from patients with COVID-19, consistent with multiple independent patient datasets29,44,52, also showed much stronger signs of senescence compared to SARS-CoV-2 negative controls28.”

    From COVID-19 and cellular senescence (2023) · cites this paper as [44]

  • A panel of senescence markers distinguishes nasopharyngeal mucosa from COVID-19 patients versus pre-pandemic controls, with higher reactivity in COVID-19 samples.

    “when comparing samples of nasopharyngeal mucosa from patients with COVID-19 to pre-pandemic biopsy samples from individuals without a manifest respiratory tract infection, a panel of senescence markers was shown to robustly discriminate these two groups, with significantly higher reactivity in samples from patients with COVID-19 (refs.28,29,44,52).”

    From COVID-19 and cellular senescence (2023) · cites this paper as [44]

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Authors
Evangelou, K., Veroutis, D., Paschalaki, K., Foukas, P. G., Lagopati, N., Dimitriou, M., Papaspyropoulos, A., Konda, B., Hazapis, O., Polyzou, A., Havaki, S., Kotsinas, A., Kittas, C., Tzioufas, A. G., de Leval, L., Vassilakos, D., Tsiodras, S., Stripp, B. R., Papantonis, A., Blandino, G., Karakasiliotis, I., Barnes, P. J., & Gorgoulis, V. G.
Affiliations
  • National and Kapodistrian University of Athens (GR)
  • Imperial College London (GB)
  • Democritus University of Thrace (GR)
  • Cedars-Sinai Medical Center (US)
  • University of Cologne (DE)
  • Instituto Nazionale Tumori Regina Elena (IT)
Corresponding author
Gorgoulis, Vassilis G.
Venue
European Respiratory Journal
Published
2022-01-27
Volume
60
Issue
2
Pages
2102951
ISSN
  • 0903-1936 (ISSN-L)
  • 1399-3003
OpenAlex
W4210558603
Cited by
98
References
66
Citations by year
2026: 9 · 2025: 17 · 2024: 21 · 2023: 31 · 2022: 20
FWCI
11.23
Type
journal article
Language
en
Open access
Locations
  • European Respiratory Journal (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
  • SERVAL (Université de Lausanne) (publishedVersion, cc-by)
  • IRIS (submittedVersion, cc-by)
Funders
  • National Public Investment Program of the Ministry of Development and Investment / General Secretariat for Research and Technology, in the framework of the Flagship Initiative to address SARS-CoV-2 (2020ΣΕ01300001)
  • H2020 Marie Skłodowska-Curie Actions (722729 (SYNTRAIN))
  • Welfare Foundation for Social & Cultural Sciences, Athens, Greece
  • Hellenic Foundation for Research and Innovation (3782, 70/3/8916, 775, NKUA-SARG grant)
  • H. Pappas
Topics
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Physiology › Telomeres, Telomerase, and Senescence
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
Keywords
SARS-CoV-2, COVID-19 pandemic, cellular senescence, senescence-associated secretory phenotype, alveolar type II cells, APOBEC mutagenesis, viral mutagenesis, APOBEC3G, APOBEC3F, interleukin-6, IL-1β, interleukin-8, p16INK4a, ACE2, lung tissue, extrapulmonary dissemination, chronic inflammation
MeSH terms
COVID-19, SARS-CoV-2, Humans, Inflammation, Lung, Phenotype, Interleukin-6, Cytokines, Mutagenesis, Cellular Senescence

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