What is it about?

Spike protein of SARS-CoV-2 is a key molecular for the entry and infection in the host. We found that the SARS-CoV-2 spike protein physically interacts with the cell surface and circulating GRP78 and increases the binding/accumulation in ACE2-expressing cells. GRP78 is highly expressed in adipose tissue and increases with older age, obesity, and diabetes. We suggest the possible involvement of adipose GRP78 in the pathology of COVID-19.

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Why is it important?

Older, obese, and diabetic people are all more vulnerable to COVID-19 and, while the reasons for this are still not completely clear. The research may account for this issue via a host factor GRP78 and the association with adipose tissue in older age, obesity, and diabetes.


Hyperinsulinemia is attributed to the high expression of GRP78, thus the management by anti-diabetic drugs and related lifestyle changes could ameliorate the expression in adipose tissue and might be a preventative and therapeutic target for COVID-19.

Jihoon Shin
Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan

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This page is a summary of: Possible Involvement of Adipose Tissue in Patients With Older Age, Obesity, and Diabetes With SARS-CoV-2 Infection (COVID-19) via GRP78 (BIP/HSPA5): Significance of Hyperinsulinemia Management in COVID-19, Diabetes, October 2021, American Diabetes Association,
DOI: 10.2337/db20-1094.
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