SARS-CoV-2 requires cholesterol for viral entry and pathological syncytia formation

  1. David W Sanders
  2. Chanelle C Jumper
  3. Paul J Ackerman
  4. Dan Bracha
  5. Anita Donlic
  6. Hahn Kim
  7. Devin Kenney
  8. Ivan Castello-Serrano
  9. Saori Suzuki
  10. Tomokazu Tamura
  11. Alexander H Tavares
  12. Mohsan Saeed
  13. Alex S Holehouse
  14. Alexander Ploss
  15. Ilya Levental
  16. Florian Douam
  17. Robert F Padera
  18. Bruce D Levy
  19. Clifford P Brangwynne  Is a corresponding author
  1. Princeton University, United States
  2. Boston University, United States
  3. University of Virginia, United States
  4. Washington University School of Medicine, United States
  5. Harvard Medical School, United States

Abstract

Many enveloped viruses induce multinucleated cells (syncytia), reflective of membrane fusion events caused by the same machinery that underlies viral entry. These syncytia are thought to facilitate replication and evasion of the host immune response. Here, we report that co-culture of human cells expressing the receptor ACE2 with cells expressing SARS-CoV-2 spike, results in synapse-like intercellular contacts that initiate cell-cell fusion, producing syncytia resembling those we identify in lungs of COVID-19 patients. To assess the mechanism of spike/ACE2-driven membrane fusion, we developed a microscopy-based, cell-cell fusion assay to screen ~6000 drugs and >30 spike variants. Together with quantitative cell biology approaches, the screen reveals an essential role for biophysical aspects of the membrane, particularly cholesterol-rich regions, in spike-mediated fusion, which extends to replication-competent SARS-CoV-2 isolates. Our findings potentially provide a molecular basis for positive outcomes reported in COVID-19 patients taking statins, and suggest new strategies for therapeutics targeting the membrane of SARS-CoV-2 and other fusogenic viruses.

Data availability

All data generated or analyzed during this study are included in the manuscript and supporting files with the exception of raw imaging data (>400,000 Nikon ND2 files), which is not feasible to post online given its massive size (>1.5 TB). This data is available from the lead contact upon request, assuming the interested party provides a server with sufficient storage capacity. Raw data (computed fusion scores) from the drug repurposing screen is available in Supplemental File 1; bioinformatics, Supplemental File 3.

Article and author information

Author details

  1. David W Sanders

    Princeton University, Princeton, United States
    Competing interests
    No competing interests declared.
  2. Chanelle C Jumper

    Princeton University, Princeton, United States
    Competing interests
    No competing interests declared.
  3. Paul J Ackerman

    Princeton University, Princeton, United States
    Competing interests
    No competing interests declared.
  4. Dan Bracha

    Princeton University, Princeton, United States
    Competing interests
    No competing interests declared.
  5. Anita Donlic

    Princeton University, Princeton, United States
    Competing interests
    No competing interests declared.
  6. Hahn Kim

    Princeton University, Princeton, United States
    Competing interests
    No competing interests declared.
  7. Devin Kenney

    Boston University, Boston, United States
    Competing interests
    No competing interests declared.
  8. Ivan Castello-Serrano

    University of Virginia, Charlottesville, United States
    Competing interests
    No competing interests declared.
  9. Saori Suzuki

    Princeton University, Princeton, United States
    Competing interests
    No competing interests declared.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-5233-6604
  10. Tomokazu Tamura

    Princeton University, Princeton, United States
    Competing interests
    No competing interests declared.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-1395-6610
  11. Alexander H Tavares

    Boston University, Boston, United States
    Competing interests
    No competing interests declared.
  12. Mohsan Saeed

    Boston University, Boston, United States
    Competing interests
    No competing interests declared.
  13. Alex S Holehouse

    Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St Louis, United States
    Competing interests
    Alex S Holehouse, A.S.H. is a consultant for Dewpoint Therapeutics..
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-4155-5729
  14. Alexander Ploss

    Princeton University, Princeton, United States
    Competing interests
    No competing interests declared.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-9322-7252
  15. Ilya Levental

    University of Virginia, Charlottesville, United States
    Competing interests
    No competing interests declared.
  16. Florian Douam

    Princeton University, Princeton, United States
    Competing interests
    No competing interests declared.
  17. Robert F Padera

    Harvard Medical School, Boston, United States
    Competing interests
    No competing interests declared.
  18. Bruce D Levy

    Harvard Medical School, Boston, United States
    Competing interests
    No competing interests declared.
  19. Clifford P Brangwynne

    Princeton University, Princeton, United States
    For correspondence
    cbrangwy@princeton.edu
    Competing interests
    Clifford P Brangwynne, C.P.B. is a scientific founder and consultant for Nereid Therapeutics..
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-1350-9960

Funding

National Institute of General Medical Sciences (GM095467)

  • Bruce D Levy

National Heart, Lung, and Blood Institute (HL122531)

  • Bruce D Levy

National Institute of General Medical Sciences (GM134949)

  • Ilya Levental

National Institute of General Medical Sciences (GM124072)

  • Ilya Levental

Howard Hughes Medical Institute

  • Clifford P Brangwynne

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Ethics

Human subjects: Human pathology studies were performed with the approval of the Institutional Review Board at Brigham and Women's Hospital. Clinical autopsies with full anatomic dissection were performed on SARS-CoV-2 decedents by a board-certified anatomic pathologist (RFP) with appropriateinfectious precautions.

Copyright

© 2021, Sanders et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

Metrics

  • 18,611
    views
  • 1,719
    downloads
  • 162
    citations

Views, downloads and citations are aggregated across all versions of this paper published by eLife.

Download links

A two-part list of links to download the article, or parts of the article, in various formats.

Downloads (link to download the article as PDF)

Open citations (links to open the citations from this article in various online reference manager services)

Cite this article (links to download the citations from this article in formats compatible with various reference manager tools)

  1. David W Sanders
  2. Chanelle C Jumper
  3. Paul J Ackerman
  4. Dan Bracha
  5. Anita Donlic
  6. Hahn Kim
  7. Devin Kenney
  8. Ivan Castello-Serrano
  9. Saori Suzuki
  10. Tomokazu Tamura
  11. Alexander H Tavares
  12. Mohsan Saeed
  13. Alex S Holehouse
  14. Alexander Ploss
  15. Ilya Levental
  16. Florian Douam
  17. Robert F Padera
  18. Bruce D Levy
  19. Clifford P Brangwynne
(2021)
SARS-CoV-2 requires cholesterol for viral entry and pathological syncytia formation
eLife 10:e65962.
https://doi.org/10.7554/eLife.65962

Share this article

https://doi.org/10.7554/eLife.65962

Further reading

    1. Cell Biology
    2. Developmental Biology
    Evgenia Leikina, Jarred M Whitlock ... Leonid Chernomordik
    Research Article

    The bone-resorbing activity of osteoclasts plays a critical role in the life-long remodeling of our bones that is perturbed in many bone loss diseases. Multinucleated osteoclasts are formed by the fusion of precursor cells, and larger cells – generated by an increased number of cell fusion events – have higher resorptive activity. We find that osteoclast fusion and bone resorption are promoted by reactive oxygen species (ROS) signaling and by an unconventional low molecular weight species of La protein, located at the osteoclast surface. Here, we develop the hypothesis that La’s unique regulatory role in osteoclast multinucleation and function is controlled by an ROS switch in La trafficking. Using antibodies that recognize reduced or oxidized species of La, we find that differentiating osteoclasts enrich an oxidized species of La at the cell surface, which is distinct from the reduced La species conventionally localized within cell nuclei. ROS signaling triggers the shift from reduced to oxidized La species, its dephosphorylation and delivery to the surface of osteoclasts, where La promotes multinucleation and resorptive activity. Moreover, intracellular ROS signaling in differentiating osteoclasts oxidizes critical cysteine residues in the C-terminal half of La, producing this unconventional La species that promotes osteoclast fusion. Our findings suggest that redox signaling induces changes in the location and function of La and may represent a promising target for novel skeletal therapies.

    1. Cell Biology
    Xiaojiao Hua, Chen Zhao ... Yan Zhou
    Research Article

    The β-catenin-dependent canonical Wnt signaling is pivotal in organ development, tissue homeostasis, and cancer. Here, we identified an upstream enhancer of Ctnnb1 – the coding gene for β-catenin, named ieCtnnb1 (intestinal enhancer of Ctnnb1), which is crucial for intestinal homeostasis. ieCtnnb1 is predominantly active in the base of small intestinal crypts and throughout the epithelia of large intestine. Knockout of ieCtnnb1 led to a reduction in Ctnnb1 transcription, compromising the canonical Wnt signaling in intestinal crypts. Single-cell sequencing revealed that ieCtnnb1 knockout altered epithelial compositions and potentially compromised functions of small intestinal crypts. While deletion of ieCtnnb1 hampered epithelial turnovers in physiologic conditions, it prevented occurrence and progression of Wnt/β-catenin-driven colorectal cancers. Human ieCTNNB1 drove reporter gene expression in a pattern highly similar to mouse ieCtnnb1. ieCTNNB1 contains a single-nucleotide polymorphism associated with CTNNB1 expression levels in human gastrointestinal epithelia. The enhancer activity of ieCTNNB1 in colorectal cancer tissues was stronger than that in adjacent normal tissues. HNF4α and phosphorylated CREB1 were identified as key trans-factors binding to ieCTNNB1 and regulating CTNNB1 transcription. Together, these findings unveil an enhancer-dependent mechanism controlling the dosage of Wnt signaling and homeostasis in intestinal epithelia.