COVID-19: role of adipose tissue

What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes? This project addresses the link between severe COVID-19 disease and obesity/diabetes. Specifically, ACE2, the receptor for the spike protein on SARS-CoV-2 is highly expressed in subcutaneous and visceral adipose tissue, which may allow for viral entry and replication. Particularly in peri-organ fat depots, inflammation, vasoconstriction and fibrosis as a consequence of viral infection and downregulation of ACE2 may contribute to organ damage including heart, gut, liver, and kidney. As such, the goal of this project is to determine whether SARS-CoV-2 infects human adipocytes from subcutaneous (SAT), visceral (VAT), and epicardial adipose tissue (EAT), whether infection incites inflammation, and whether pharmacologic compounds that target the renin-angiotensin system (RAS)/ACE2 alter infectivity and inflammation. If a person with diabetes were to ask you how your project will help them in the future, how would you respond? Many patients with diabetes (my patients) ask the following questions to which we do not have answers: 1. Are lean type 1 and/or type 2 are at as high risk as obese type 2 with metabolic syndrome features? 2. Is obesity a risk factor? 3. Are individuals with prediabetes at risk? 4. Is it safe to take ACEi or ARB? Why is it important for you, personally, to become involved in diabetes research? What role will this award play in your research efforts? I study diabetes and obesity and felt compelled to address the obesity link since it has been identified as the strongest risk factor besides age for severe COVID-19. Indeed, obesity, in which excess adipose tissue serves as a viral reservoir and/or source of inflammation , may represent the increased risk seen in individuals with type 2 diabetes. Because I study human fat cells/tissue and have access to cultivated virus and BSL3 where we can infect cells with SARS-CoV-2, and because nobody to date has demonstrated that this virus infects human fat cells and/or other cells that reside in human adipose tissue, I felt compelled to turn my efforts to this project, since I know that our group is uniquely capable of addressing this question. In what direction do you see the future of diabetes research going? Diabetes research will continue to expand in many directions that include the role of incretin physiology, beta cell, glucagon, and insulin resistance/obesity, along with the role of new technologies such as wearables and artificial intelligence that will enhance treatment.