Jia Cui, Hongzhen Tang, Shuai Zhao, Tao Wang, Ruochen Zang, Haijing Deng, Triantafyllia R. Karakousi, Maria E. Kaczmarek, Tina Tianjiao Su, Ze Zhang, Jia Liu, Xufeng Chen, Michael S. Diamond, Zemin Zhang, Fei Tang, Sergei B. Koralov, Jun Wang, Shumin Jin, Kenneth A. Stapleford, Peter Cresswell, Qiang Zhou, Rita E. Chen, Alberto Herrera, Qi Xie, Stephen T. Yeung, Xianwen Ren, Jianzhu Ma, Marianna Teplova, Jack C.-C. Hsu, Xiaojuan Ran, Ming Zhou, Zhilin Long, Peng Lin, Jianbo Dong, Leopoldo N. Segal, Qiao Lu, Maria Florencia Gomez Castro, Iannis Aifantis, Renhong Yan, Betty Huang, Jasper Du, Tenny Mudianto, Juhee Son, Broc T. McCune, Payal Damani-Yokota, Maudry Laurent-Rolle, Yue Liu, James Zhu, Kamal M. Khanna, and Siyuan Ding
Despite mounting evidence for SARS-CoV-2 engagement with immune cells, most express little, if any, of the canonical receptor of SARS-CoV-2, ACE2. Here, using a myeloid-cell receptor-focused ectopic expression screen, we identified several C-type lectins (DC-SIGN, L-SIGN, LSECtin, ASGR1, and CLEC10A) and Tweety family member 2 (TTYH2) as glycan-dependent binding partners of the SARS-CoV-2 spike. Except for TTYH2, these molecules primarily interacted with spike via regions outside of the receptor-binding domain. Single-cell RNA-sequencing analysis of pulmonary cells from COVID-19 patients indicated predominant expression of these molecules on myeloid cells. Although these receptors do not support active replication of SARS-CoV-2, their engagement with virus induced robust proinflammatory responses in myeloid cells that correlated with COVID-19 severity. We also generated a bispecific anti-spike nanobody that not only blocked ACE2-mediated infection but also the myeloid receptors-mediated proinflammatory responses. Our findings suggest SARS-CoV-2-myeloid receptor interactions promote immune hyper-activation, which represents potential targets for COVID-19 therapy., Graphical Abstract, Most immune cells express little, if any, of the canonical SARS-CoV-2 receptor, ACE2. Lu et al. report that C-type lectins and TTYH2 act as SARS-CoV-2 myeloid cell-interacting partners that trigger immune hyper-activation, but not infection. These findings raise the possibility that these virus-myeloid cell interactions are directly involved in COVID-19 immunopathogenesis and could be targeted for COVID-19 therapy.