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Discordant anti-SARS-CoV-2 spike protein and RNA staining in cutaneous perniotic lesions suggests endothelial deposition of cleaved spike protein
- Source :
- Journal of Cutaneous Pathology
- Publication Year :
- 2020
-
Abstract
- Background Prior studies have shown the presence of immunohistochemical staining for the SARS-CoV-2 spike protein (SP) in endothelial cells and eccrine epithelium of acral perniosis classified as "COVID toes." Yet, other studies have been unable to detect SARS-CoV-2 RNA in skin biopsies of "COVID toes" by reverse-transcriptase polymerase chain reaction testing. Objective In order to address these apparently conflicting findings, we compared detection of SARS-CoV-2 SP, through RNA in situ hybridization (ISH) vs immunohistochemistry (IHC), in skin biopsies of acral perniotic lesions presenting during the COVID-19 pandemic. Results Three of six cases showed positive immunohistochemical labeling of endothelial cells, with one of three cases with sufficient depth also having labeling of eccrine glands, using an anti-SP SARS-CoV-2 antibody. These three cases positive with IHC were negative for SP by RNA ISH. Conclusion While the gold standard for detection of SARS-CoV-2 in tissue sections has yet to be determined, the detection of SARS-CoV-2 SP alone without spike RNA suggests that cleaved SP may be present in cutaneous endothelial cells and eccrine epithelium, providing a potential pathogenetic mechanism of COVID-19 endotheliitis.
- Subjects :
- Adult
Male
Pathology
medicine.medical_specialty
Histology
In situ hybridization
Dermatology
Biology
Eccrine Glands
law.invention
Pathology and Forensic Medicine
030207 dermatology & venereal diseases
03 medical and health sciences
0302 clinical medicine
law
medicine
Humans
skin and connective tissue diseases
Polymerase chain reaction
Endotheliitis
In Situ Hybridization
Aged
Aged, 80 and over
SARS-CoV-2
RNA
COVID-19
Endothelial Cells
Middle Aged
Toes
medicine.disease
Immunohistochemistry
Epithelium
Staining
body regions
Chilblains
medicine.anatomical_structure
030220 oncology & carcinogenesis
Spike Glycoprotein, Coronavirus
biology.protein
RNA, Viral
Female
Antibody
Subjects
Details
- ISSN :
- 16000560
- Volume :
- 48
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of cutaneous pathologyREFERENCES
- Accession number :
- edsair.doi.dedup.....b7d087218450932988bcc793f0f24e7f