PDF(Pubmed)
Abstract：
Since 2019, Coronavirus Disease 2019(COVID-19) has affected millions of people worldwide. Except for acute respiratory distress syndrome, dysgeusis is also a common symptom of COVID-19 that burdens patients for weeks or permanently. However, the mechanisms underlying taste dysfunctions remain unclear. Here, we performed complete autopsies of five patients who died of COVID-19. Integrated tongue samples, including numerous taste buds, salivary glands, vessels, and nerves were collected to map the pathology, distribution, cell tropism, and receptor distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the tongue. Our results revealed that all patients had moderate lymphocyte infiltration around the salivary glands and in the lamina propria adjacent to the mucosa, and pyknosis in the epithelia of taste buds and salivary glands. This may be because the serous acini, salivary gland ducts, and taste buds are the primary sites of SARS-CoV-2 infection. Multicolor immunofluorescence showed that SARS-CoV-2 readily infects Keratin (KRT)7+ taste receptor cells in taste buds, secretory cells in serous acini, and inner epithelial cells in the ducts. The major receptors, angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine subtype 2 (TMPRSS2), were both abundantly expressed in these cells. Viral antigens and receptor were both rarely detected in vessels and nerves. This indicates that SARS-CoV-2 infection triggers pathological injury in the tongue, and that dysgeusis may be directly related to viral infection and cellular damage.
摘要：
自2019年以来，2019年冠状病毒病(COVID-19)已经影响到全球数百万人。除急性呼吸窘迫综合征外,病态也是COVID-19的常见症状，会给患者带来数周或永久性的负担。然而,味觉功能障碍的潜在机制仍不清楚。这里,我们对5例死于COVID-19的患者进行了完整的尸检.综合舌头样本，包括许多味蕾，唾液腺,船只,收集神经来绘制病理学图，分布，细胞嗜性，和严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在舌中的受体分布。我们的结果显示，所有患者在唾液腺周围和粘膜附近的固有层中都有中度淋巴细胞浸润，味蕾和唾液腺上皮中的固缩。这可能是因为严重的acini，唾液腺管,味蕾是SARS-CoV-2感染的主要部位。多色免疫荧光显示SARS-CoV-2容易感染味蕾中的角蛋白（KRT）7味觉受体细胞，浆液性腺分泌细胞，和导管中的内部上皮细胞。主要受体，血管紧张素转换酶2（ACE2）和跨膜蛋白酶丝氨酸亚型2（TMPRSS2），都在这些细胞中大量表达。在血管和神经中很少检测到病毒抗原和受体。这表明SARS-CoV-2感染会引发舌头的病理损伤，并且这种畸形可能与病毒感染和细胞损伤直接相关。
