Alzheimer's proteinopathy in olfactory neuroepithelium from persistent
olfactory impairment SARS-CoV-2 patients
Abstract
Persistent olfactory impairment (POI) and dysgeusia are lingering
symptoms following recovery from Acute Respiratory Syndrome
Coronavirus-2 (SARS-CoV-2) infection. These symptoms, along with
neurological changes affecting mood, anxiety, cognitive function, and
sleep, have significant public health implications. However, the cause
of these symptoms is still unknown. For this reason, we investigated
whether the presence of certain proteins, such as amyloid Aβ and
α-synuclein in the olfactory mucosa tissue of POI patients, could be
associated with neurological changes. We conducted a study where we
collected tissue biopsies and cultured cells from patients with
normosmic non-cognitive impairment, hyposmic mild cognitive impairment
or Alzheimer’s disease, and persistent olfactory impairment (POI) who
had been infected with SARS-CoV-2 for 20 months or more. We then
examined the expression of amyloid Aβ, α-Synuclein, and tau proteins
using immuno-fluorescence and flow cytometry methodology. Our findings
revealed that for the first time, amyloid Aβ, α-Synuclein, and tau
proteins were detected in olfactory mucosa tissue sections and in
cultured olfactory-derived mesenchymal stromal cells from patients with
normosmia, hyposmia, and POI post-SARS-CoV-2 with neurological
alterations. We also observed that POI occurred in younger post-COVID-19
patients than in those with hyposmia-mild cognitive impairment and
normosmia non-cognitive impairment. Immunoreactive positive cells for
Aβ, α-syn, and tau proteins were observed in sustentacular-like cells,
intermediate cells, and parenchymal sub-lamina propria cells from
olfactory mucosa tissue. Our study suggests that the presence of these
biomarkers in middle-aged patients may indicate a protein dysmetabolism
that could contribute to the progression of a neurodegenerative
disorder.