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Human galectin-9 potently enhances SARS-CoV-2 replication and inflammation in airway epithelial cells
Li Du1,2 , Mohamed S. Bouzidi1,2 , Akshay Gala1,2 , Fred Deiter3,4 , Jean-Noël Billaud5 , Stephen T. Yeung6 , Prerna Dabral1,2 , Jing Jin1,2 , Graham Simmons1,2 , Zain Y. Dossani1,2 , Toshiro Niki7 , Lishomwa C. Ndhlovu6 , John R. Greenland3,4 , Satish K. Pillai1,2,*
1Vitalant Research Institute, San Francisco, CA 94105, USA
2Department of Laboratory Medicine, University of California, San Francisco, CA 94143-0134, USA
3Department of Medicine, University of California, San Francisco, CA 94143-0410, USA
4Veterans Affairs Health Care System, San Francisco, CA 94121, USA
5QIAGEN Digital Insights, Redwood City, CA 94063, USA
6Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA
7Department of Immunology, Kagawa University, Kagawa 760-0016, Japan
*Correspondence to:Satish K. Pillai , Email:satish.pillai@ucsf.edu
J Mol Cell Biol, Volume 15, Issue 4, April 2023, mjad030,  https://doi.org/10.1093/jmcb/mjad030
Keyword: SARS-CoV-2, galectin-9, inflammation, airway epithelial cells Topic: inflammationepithelial cellsairway deviceairway structuresars-cov-2covid-19

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused a global economic and health crisis. Recently, plasma levels of galectin-9 (Gal-9), a β-galactoside-binding lectin involved in immune regulation and viral immunopathogenesis, were reported to be elevated in the setting of severe COVID-19 disease. However, the impact of Gal-9 on SARS-CoV-2 infection and immunopathology remained to be elucidated. In this study, we demonstrate that Gal-9 treatment potently enhances SARS-CoV-2 replication in human airway epithelial cells (AECs), including immortalized AECs and primary AECs cultured at the air–liquid interface. Gal-9–glycan interactions promote SARS-CoV-2 attachment and entry into AECs in an angiotensin-converting enzyme 2 (ACE2)-dependent manner, enhancing the binding of the viral spike protein to ACE2. Transcriptomic analysis revealed that Gal-9 and SARS-CoV-2 infection synergistically induced the expression of key pro-inflammatory programs in AECs, including the IL-6, IL-8, IL-17, EIF2, and TNFα signaling pathways. Our findings suggest that manipulation of Gal-9 should be explored as a therapeutic strategy for SARS-CoV-2 infection.