Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis
2004/05/07 by I Hamming, Inge Hamming, Wim Timens +8 · 5,929 citations
Medicine · #Angiotensin-converting enzyme 2 #Biology #COVID-19 Clinical Research Studies #COVID-19 Impact on Reproduction #Coronaviridae #Coronavirus #Coronavirus disease 2019 (COVID-19) #Disease #Immunology #Infectious disease (medical specialty) #Internal medicine #Lung #Medicine #Pathogenesis #Pathology #Receptor #SARS-CoV-2 and COVID-19 Research #Severe acute respiratory syndrome #Spleen
paper · pdf · doi:10.1002/path.1570
published in The Journal of Pathology 203(2), 631-637
openalex publication_date 2004/05/07 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/04
Abstract
Severe acute respiratory syndrome (SARS) is an acute infectious disease that spreads mainly via the respiratory route. A distinct coronavirus (SARS-CoV) has been identified as the aetiological agent of SARS. Recently, a metallopeptidase named angiotensin-converting enzyme 2 (ACE2) has been identified as the functional receptor for SARS-CoV. Although ACE2 mRNA is known to be present in virtually all organs, its protein expression is largely unknown. Since identifying the possible route of infection has major implications for understanding the pathogenesis and future treatment strategies for SARS, the present study investigated the localization of ACE2 protein in various human organs (oral and nasal mucosa, nasopharynx, lung, stomach, small intestine, colon, skin, lymph nodes, thymus, bone marrow, spleen, liver, kidney, and brain). The most remarkable finding was the surface expression of ACE2 protein on lung alveolar epithelial cells and enterocytes of the small intestine. Furthermore, ACE2 was present in arterial and venous endothelial cells and arterial smooth muscle cells in all organs studied. In conclusion, ACE2 is abundantly present in humans in the epithelia of the lung and small intestine, which might provide possible routes of entry for the SARS-CoV. This epithelial expression, together with the presence of ACE2 in vascular endothelium, also provides a first step in understanding the pathogenesis of the main SARS disease manifestations.
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