Dados do Trabalho

Título

Roux-en-Y Gastric Bypass Downregulates Angiotensin-Converting Enzyme 2 (ACE2) Gene Expression in Subcutaneous White Adipose Tissue: A Putative Protective Mechanism Against Severe COVID-19 in Severe Obesity.

Introdução

The angiotensin-converting enzyme 2 (ACE2) is the receptor for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is highly expressed in adipose tissue. The greater volume of adipose tissue in obesity might increase the exposure to the virus and serve as a viral reservoir during infection, possibly associated with progression to severe forms of coronavirus disease 2019 (COVID-19) in patients with obesity.

Objetivo

To study ACE2 gene expression in subcutaneous white adipose tissue (sWAT), before and after Roux-en-Y gastric bypass surgery (RYGB), using publicly available gene expression data.

Método

We searched the Gene Expression Omnibus (GEO) Datasets to study ACE2 gene expression in sWAT, before and after RYGB, compared to matched control individuals. Log-fold changes (logFC) were calculated.

Resultados

We reanalyzed the GSE59034 series containing microarray data from sWAT biopsies from 16 women before and 2 years after RYGB, and 16 control subjects matched to the post-surgery patients by sex, age and BMI. RYGB led to a significant weight and fat mass loss and adipocytes volume reduction. After RYGB there was a significant decrease in ACE2 gene expression in sWAT (logFC=-0.4175, p=0.0015). Additionally, ACE2 gene expression in sWAT was significantly lower after RYGB compared to matched controls (LogFC=-0.32875, p=0.0014), despite similar BMI and percentage of body fat.

Conclusão

RYGB provides for a significant reduction in fat mass, as well as downregulation of ACE2 gene expression in sWAT. Our data adds to the well-known benefits of RYGB, a potential protective mechanism against COVID-19.

Palavras-Chave

Bariatric Surgery; COVID-19; SARS-CoV-2; ACE-2; Obesity; RYGB; gastric bypass.