Single-Cell RNA-seq Identifies Cell Subsets in Human Placenta That Highly Expresses Factors Driving Pathogenesis of SARS-CoV-2
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Abstract
Infection by the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) results in the novel coronavirus disease COVID-19,. Infection of SARS-CoV-2 during pregnancy is associated with complications such as preterm labor and premature rupture of membranes, and a proportion of neonates born to infected mothers are also positive for the virus. During pregnancy, the placental barrier protects the fetus from pathogens. To predict if the placenta is permissive to SARS-CoV-2, we utilized publicly available single-cell RNA-seq data to identify if the placental cells express the factors required for infection. SARS-CoV-2 binding receptor ACE2 and the S protein priming protease TMPRSS2 are co-expressed by a subset of syncytiotrophoblasts (STB) in the first trimester and extravillous trophoblasts (EVT) in the second trimester . In addition, the non-canonical receptor BSG/CD147 and other proteases (CTSL, CTSB and FURIN) are detected in most of the placental cells. Other coronavirus family receptors (ANPEP and DPP4) were also expressed in the first and second trimester placental cells. Additionally, the term placenta of multiple species including humans expressed ACE2, DPP4 and ANPEP along with the viral S protein proteases. The ACE2- and TMPRSS2-positive (ACE2+TMPRSS2+) placental subsets expressed mRNA for proteins involved in viral budding and replication. These cells also had the mRNA for proteins that physically interact with SARS-CoV-2 in host cells. Further, we discovered unique signatures of genes in ACE2+TMPRSS2+ STBs and EVTs. The ACE2+TMPRSS2+ STBs are highly differentiated cells and express genes involving mitochondrial metabolism and glucose transport. The second trimester ACE2+TMPRSS2+ EVTs are enriched for markers of endovascular trophoblasts. Both these subtypes abundantly expressed genes in the Toll-like receptor pathway. The second trimester EVTs are also enriched for components of the JAK-STAT pathway that drives inflammation. We carried out a systematic review and identified that in 12% of pregnant women with COVID-19, the placenta was infected with SARS-CoV-2, and the virus was detected in STBs. To conclude, herein we have uncovered the cellular targets for SARS-CoV-2 entry and have shown that these cells can potentially drive viremia in the developing human placenta. Our results provide a basic framework towards understanding the paraphernalia involved in SARS-CoV-2 infections in pregnancy.
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Other coronavirus receptors (ANPEP and DPP4) and several proteases (CTSL, CTSB, and Furin) are uniformly expressed in the placenta during the first and second trimesters, and genes needed for viral budding and replication are present, suggesting the placenta is vulnerable to productive infection.
“Interestingly, other coronavirus family member receptors (ANPEP and DPP4) and several proteases (CTSL, CTSB, and Furin) are uniformly expressed within the placenta throughout the first and second trimester, and genes necessary for viral budding and replication were also identified, strongly suggesting that the placenta is a vulnerable target for productive infection (Ashary et al., 2020).”
From COVID-19 and the human innate immune system (2021) · cites this paper as Ashary et al., 2020
The human placenta is highly susceptible to SARS-CoV-2 infection, but only non-immune cells, including first-trimester syncytiotrophoblasts and second-trimester extravillous trophoblasts, express ACE2 and TMPRSS2 and are cellular targets for the virus.
“Similarly, the human placenta is highly susceptible to SARS-CoV-2 infection, but only non-immune cells including syncytiotrophoblasts in the first trimester and extravillous trophoblasts in the second trimester express ACE2 and TMPRSS2 and have been identified as cellular targets for the virus (Ashary et al., 2020).”
From COVID-19 and the human innate immune system (2021) · cites this paper as Ashary et al., 2020
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COVID-19 and the human innate immune system
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Self-citationSARS-CoV-2 Footprints in the Placenta: What We Know after Three Years of the Pandemic
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- Authors
- Ashary, N., Bhide, A., Chakraborty, P., Colaco, S., Mishra, A., Chhabria, K., Jolly, M. K., & Modi, D.
- Affiliations
- ICMR National Institute for Research on Women's Health (IN)
- Indian Institute of Science Bangalore (IN)
- Corresponding author
- Modi, Deepak
- ORCID
- Venue
- Frontiers in Cell and Developmental Biology
- Publisher
- Frontiers Media SA
- Published
- 2020-08-19
- Volume
- 8
- Pages
- 783-783
- ISSN
- 2296-634X (ISSN-L)
- PMC
- PMC7466449
- OpenAlex
- W3020921931
- Cited by
- 121
- References
- 96
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 13 · 2023: 19 · 2022: 35 · 2021: 30 · 2020: 12
- FWCI
- 14.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Cell and Developmental Biology (publishedVersion, cc-by)
- Preprints.org (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Department of Science and Technology, Ministry of Science and Technology, India (SB/S2/RJN-049/2018)
- Indian Council of Medical Research
- University Grants Commission (2019., /2018)
- Science and Engineering Research Board (SB/S2/RJN 049/2018, IMP/2019/000115)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › COVID-19 Impact on Reproduction
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- SARS-CoV-2, COVID-19 in pregnancy, placenta, syncytiotrophoblast, extravillous trophoblast, ACE2, TMPRSS2, viral entry receptor, dipeptidyl peptidase IV, ANPEP, viral protease, placental infection, Toll-like receptor pathway, JAK/STAT signaling
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