May 19, 2021
Over the past year, a multidisciplinary team at the British Columbia Centre for Disease Control has been investigating ACE2, a molecule with an important role in COVID-19. ACE2 is a molecule on the surface of human cells that is used by SARS-CoV-2 to attach itself. “Differences in ACE2 expression between individuals may impact how well the virus replicates, and this could affect susceptibility to infection and viral load,” explains Dr. Inna Sekirov, a medical microbiologist and leader of the project. “ACE2 also plays a crucial role in maintaining cardiovascular health and controlling inflammation, so these expression differences may influence how the body responds to COVID-19 and contribute to disease severity.”
With support from Genome BC and the UBC Faculty of Medicine, the BC CDC team measured ACE2 expression in British Columbians tested for COVID-19. This was one of the first studies in the world to measure ACE2 expression in real-world COVID-19 clinical specimens. “One of our major findings confirms that individuals with higher ACE2 expression facilitated higher viral replication,” says Kevin Kuchinski, a PhD candidate in UBC’s Department of Pathology and Laboratory Medicine.
The team also analyzed expression of an alternate version of ACE2 which is not bound to the surface of human cells. Higher expression of the alternate ACE2 was associated with lower viral replication. “This suggests it could behave as a decoy that protects cells from infection,” explains Aidan Nikiforuk, a PhD candidate at UBC’s School of Population of Public Health.
These findings, which were recently published in the Lancet’s EBioMedicine, show ACE2’s potential as a COVID-19 biomarker. The BC CDC team measured ACE2 expression using the same qPCR technology found in COVID-19 diagnostic tests. According to Dr. David Twa, a recent graduate from UBC’s MD/PhD program, this would allow an ACE2 measurement to be easily incorporated into existing tests. “These ACE2 measurements could provide clinicians and public health practitioners with valuable data about disease prognosis or personalized infection control practices.”

L to R: Aidan Nikiforuk, Kevin Kuchinski, Inna Sekirov, David Twa. Photo credit: Michael Donoghue.