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Racial/Ethnic Variation in Nasal Gene Expression of Transmembrane Serine Protease 2 (TMPRSS2)

Educational Objective
To understand how racial/ethic variation in Nasal Gene Expression of Transmembrane Serine Protease 2 (TMPRSS2) affects COVID-19 infection rates
1 Credit CME

Coronavirus disease 2019 (COVID-19) has disproportionately affected communities of color.1,2 In many areas of the US, infection and death rates for COVID-19 are 2 to 3 times higher in Black individuals than their proportion of the population.1,2 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spread by airway contact and uses transmembrane serine protease 2 (TMPRSS2) to facilitate viral entry and spread.3 Host-expressed TMPRSS2 on nasal and bronchial epithelium activates the SARS-CoV-2 spike protein and cleaves the angiotensin-converting enzyme 2 receptor to which the virus binds, enabling SARS-CoV-2 to enter the body.3

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Article Information

Corresponding Author: Supinda Bunyavanich, MD, MPH, MPhil, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029 (supinda@post.harvard.edu).

Accepted for Publication: August 24, 2020.

Published Online: September 10, 2020. doi:10.1001/jama.2020.17386

Author Contributions: Dr Bunyavanich had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Bunyavanich.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Bunyavanich.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Bunyavanich.

Obtained funding: Bunyavanich.

Administrative, technical, or material support: Bunyavanich.

Supervision: Bunyavanich, Vicencio.

Conflict of Interest Disclosures: None reported.

Funding/Support: This study was funded by grant R01 AI118833 from the National Institutes of Health.

Role of the Funder/Sponsor: The National Institutes of Health had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank Robert Griffin, MD, PhD (Hospital for Special Surgery), and Anh Do, PhD, and Yoojin Chun, MS (both with the Icahn School of Medicine at Mount Sinai), for their assistance with manuscript preparation. None received compensation for their contributions.

References
1.
Yancy  CW .  COVID-19 and African Americans.   JAMA. 2020;323(19):1891-1892. doi:10.1001/jama.2020.6548PubMedGoogle ScholarCrossref
2.
Oppel  RA , Gebeloff  R , Lai  KKR , Wright  W , Smith  M . The fullest look yet at the racial inequality of coronavirus. Accessed August 31, 2020. https://www.nytimes.com/interactive/2020/07/05/us/coronavirus-latinos-african-americans-cdc-data.html
3.
Hoffmann  M , Kleine-Weber  H , Schroeder  S ,  et al.  SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor.   Cell. 2020;181(2):271-280.e8. doi:10.1016/j.cell.2020.02.052PubMedGoogle ScholarCrossref
4.
Yuan  J , Kensler  KH , Hu  Z ,  et al.  Integrative comparison of the genomic and transcriptomic landscape between prostate cancer patients of predominantly African or European genetic ancestry.   PLoS Genet. 2020;16(2):e1008641. doi:10.1371/journal.pgen.1008641PubMedGoogle Scholar
5.
Bunyavanich  S , Do  A , Vicencio  A .  Nasal gene expression of angiotensin-converting enzyme 2 in children and adults.   JAMA. 2020;323(23):2427-2429. doi:10.1001/jama.2020.8707PubMedGoogle ScholarCrossref
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