Evidence map›Paper›PMID 33706759›Full record

ArticleParticle and fibre toxicology2021

Upregulation of ACE2 and TMPRSS2 by particulate matter and idiopathic pulmonary fibrosis: a potential role in severe COVID-19.

Hsin-Hsien Li, Chen-Chi Liu, Tien-Wei Hsu, Jiun-Han Lin, Jyuan-Wei Hsu, Anna Fen-Yau Li, Yi-Chen Yeh, Shih-Chieh Hung, Han-Shui Hsu

Open access · goldAbstract read
In one paragraph

Article in Particle and fibre toxicology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 2 pooled it
5.3field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.

  1. Impact of air pollution on COVID-19 severity: a systematic review of underlying biological mechanisms.European respiratory review : an official journal of the European Respiratory Society · 2025
    Pooled it
  2. Pooled it
  3. Review
  4. A case-crossover analysis of short-term PMCommunications medicine · 2025
    Article
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  9. Chitosan Nanoparticle-EncapsulatedInternational journal of molecular sciences · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Hsin-Hsien LiInstitute of Emergency and Critical Care Medicine, School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 112, Taiwan.
Chen-Chi LiuInstitute of Emergency and Critical Care Medicine, School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 112, Taiwan.
Tien-Wei HsuInstitute of Emergency and Critical Care Medicine, School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 112, Taiwan.
Jiun-Han LinInstitute of Emergency and Critical Care Medicine, School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 112, Taiwan.
Jyuan-Wei HsuDivision of Traumatology, Emergency Department, Taipei Veteran General Hospital, Taipei, Taiwan.
Anna Fen-Yau LiFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Yi-Chen YehFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Shih-Chieh HungInstitute of New Drug Development, Biomedical Sciences, China Medical University, 7F, No. 6, Xueshi Rd., North Dist., Taichung, 404, Taiwan. hung3340@gmail.com.ORCID 0000-0003-1813-4616
Han-Shui HsuInstitute of Emergency and Critical Care Medicine, School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 112, Taiwan. hsuhs@vghtpe.gov.tw.
National Yang Ming Chiao Tung University · TWChina Medical University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAir pollution exposure and idiopathic pulmonary fibrosis (IPF) cause a poor prognosis after SARS-CoV-2 infection, but the underlying mechanisms are not well explored. Angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) are the keys to the entry of SARS-CoV-2. We therefore hypothesized that air pollution exposure and IPF may increase the expression of ACE2 and TMPRSS2 in the lung alveolar region. We measured their expression levels in lung tissues of control non-IPF and IPF patients, and used murine animal models to study the deterioration of IPF caused by particulate matter (PM) and the molecular pathways involved in the expression of ACE2 and TMPRSS2.

resultsIn non-IPF patients, cells expressing ACE2 and TMPRSS2 were limited to human alveolar cells. ACE2 and TMPRSS2 were largely upregulated in IPF patients, and were co-expressed by fibroblast specific protein 1 (FSP-1) + lung fibroblasts in human pulmonary fibrotic tissue. In animal models, PM exposure increased the severity of bleomycin-induced pulmonary fibrosis. ACE2 and TMPRSS2 were also expressed in FSP-1+ lung fibroblasts in bleomycin-induced pulmonary fibrosis, and when combined with PM exposure, they were further upregulated. The severity of pulmonary fibrosis and the expression of ACE2 and TMPRSS2 caused by PM exposure were blocked by deletion of KC, a murine homologue of IL-8, or treatment with reparixin, an inhibitor of IL-8 receptors CXCR1/2.

conclusionsThese data suggested that risk of SARS-CoV-2 infection and COVID-19 disease severity increased by air pollution exposure and underlying IPF. It can be mediated through upregulating ACE2 and TMPRSS2 in pulmonary fibroblasts, and prevented by blocking the IL-8/CXCR1/2 pathway.

Indexed as

SARS-CoV-2Angiotensin-Converting Enzyme 2AnimalsCOVID-19HumansIdiopathic Pulmonary FibrosisInterleukin-8MaleMiceMice, Inbred C57BLParticulate MatterPulmonary AlveoliSerine EndopeptidasesUp-RegulationACE2 protein, humanAngiotensin-Converting Enzyme 2Interleukin-8Particulate MatterSerine EndopeptidasesTMPRSS2 protein, humanACE2Air pollutionCOVID-19Idiopathic pulmonary fibrosisTMPRSS2

Identifiers

PMID33706759
PMCPMC7948665
OpenAlexW3110804062

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.