The novel coronavirus responsible for COVID-19 enters the human body through airways in the lungs using a receptor called ACE-2. Dr. Janice Leung and Dr. Don Sin (who holds the De Lazzari Family Chair in Heart Lung Innovation) are both investigators at the Centre for Heart Lung Innovation (HLI) and respiratory physicians at St. Paul’s. Together, they have shown that smokers and people with chronic obstructive pulmonary disease (COPD), have increased levels of ACE-2 in their breathing tubes.
Since most severe cases of COVID-19 around the world have been found in people over 55 with underlying chronic conditions such as COPD, findings from this research will be particularly relevant.
The HLI team is now trying to figure out which drugs (e.g. hydroxychloroquine, steroids, ACE inhibitors, or angiotensin receptor blockers) can cause the ACE-2 receptors to disappear or become inhibited. If this occurs, the coronavirus may have difficulty getting into the host and causing pneumonia – one of the most serious complications of COVID-19.
“This work is made possible thanks to an extensive biobank of lung samples that are collected and housed at St. Paul’s,” explains Dr. Leung. “It’s amazing that right here at HLI in BC, we have one of the largest lung biobanks in the world, which we can now use to answer some of the most urgent questions regarding COVID-19.”
Dr. Leung and Dr. Sin will use bronchial epithelial cells, where the virus penetrates the airways and causes pneumonia, and test drugs to see if the receptor that accepts the virus can be modified and blocked. This will be helpful in identifying new potential therapeutics to fight COVID-19, and to determine which should be invested in and brought to clinical trial.
Another element of their research will attempt to determine whether inhaler use puts patients at an increased risk of more severe COVID-19, by pushing the virus down the throat and into the airways.
“We are hoping that findings from this part of the study will help to inform clinical decision-making, such as whether should patients continue to use inhalers or reduce their use etc. Right now we don’t have enough data yet to know what’s best,” she says.
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