UEG Week Virtual 2020 Congress Review - 4

UEG Week Congress Review

Scientific Programme Highlights
COVID-19: GI researchers
join the quest for a better
understanding of SARS-CoV-2
and its global impact
The GI research community has joined the worldwide quest to
understand the biology of SARS-CoV-2 and to assess the impact
of the COVID-19 pandemic on clinical practice.
This year's UEG Week dedicated multiple scientific sessions to
COVID-19-related research, shedding new light on how SARS-CoV-2
infection impacts patients with digestive diseases and how GI practice
has adapted in the new COVID-19 era. Here we present a small taste
of the research.

ACE2 upregulation could facilitate SARS-CoV-2 entry
via the inflamed colon of IBD patients
The upregulation of the SARS-CoV-2
receptor, angiotensin converting enzyme 2
(ACE2), in the inflamed colon could impact
entry of the virus in patients with active
UC or Crohn's disease (CD), according to
a team of research scientists from Leuven
in Belgium. The team performed RNA
sequencing on inflamed and uninflamed
mucosal biopsies from 193 individuals
with CD and 158 with ulcerative colitis (UC)
and matched to biopsies from 51 people
without inflammatory bowel disease (IBD).
Mucosal ACE2 expression was found to be
higher in the inflamed CD and UC colons
compared with the control colons (fold
change [FC]=1.4, p=2.5e-0.2 and FC=1.4,
p=2.5e-02, respectively), while expression
levels in the uninflamed IBD colons did not
differ from those in the controls (p=2.0e-01).
In the inflamed CD ileum, ACE2 expression
was found to be slightly decreased
compared with the control ileum (FC=-2.8,
p=4.4e-07). Expression of transmembrane
serine protease 2 (TMPRSS2), which
facilitates cellular entry of SARS-CoV-2, was
upregulated in both the inflamed CD ileum
and uninflamed IBD ileum compared with
controls (FC=1.4, p=1.8e-03 and FC=1.2,
4

p=3.4e-02, respectively), however, no
dysregulation was observed for colonic
TMPRSS2 across the different study groups.
In a further analysis of organoids derived
from colonic biopsies from eight UC
patients and eight non-IBD controls,
exposure to an inflammatory mix (tumor
necrosis factor-α 100 mg/mL, interleukin1β 20 ng/mL, flagellin 1 μg/mL) induced
transcriptional activation of ACE2 in the
organoids of UC origin (inflamed and
uninflamed) but not in those from nonIBD controls. TMPRSS2 was upregulated
after inflammatory stimulation in all three
groups.
"We demonstrated that inflammation
could alter the expression of SARS-CoV-2
entry mechanisms in the intestinal
epithelium, with opposing effects seen in
both ileum and colon," said Sare Verstockt
from the Katholieke Universiteit (KU)
Leuven in Belgium. "The ACE2 upregulation
in inflamed colon could potentially impact
the viral cell entry in active UC and CD
patients with colonic involvement, but
of course more functional studies are
needed."

COVID-related
delays to colorectal
cancer (CRC)
screening causing
a 11.9% increase in
death rates
Researchers from the University
of Bologna produced a model to
forecast the impact of time delays
in CRC screening, caused by
COVID-19, on CRC mortality. The
results found that moderate (7-12
months) and large (>12 months)
delays in screening caused a 3%
and 7% increase in advanced
stage CRC, respectively.
Based on survival rates at 5
years for stage III-IV CRC, the
results showed a significant
11.9% increase in deaths when
comparing a 0-3 month delay to
a >12 month delay.
Lead author of the study and
Chair of the UEG Research
Committee, Luigi Ricciardiello,
commented, "Across the globe,
healthcare systems are facing
serious difficulties while dealing
with COVID-19 and it is imperative
that support is given to the public
and patients throughout the
crisis, including for high-impact
diseases such as CRC."
"Early-stage diagnosis for CRC
is crucial - it's far easier to treat
and enhances optimal patient
outcomes. It is therefore essential
that vital diagnosis tools, like
screening programmes, continue
and help to prevent mortality
rates from rising even further."
CRC is Europe's second largest
cancer killer, and is the most
common digestive cancer.
Annually, there are 375,000 newly
diagnosed cases in the EU and it
claims the lives of over 170,000
people.
Catch up on COVID-19-related
sessions
https://ueg.meta-dcr.com/library/congressresources?q=COVID-19 https://ueg.meta-dcr.com/library/congressresources?q=COVID-19
UEG Week Virtual 2020 Congress Review

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