{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T09:43:43Z","timestamp":1779183823821,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Pregnant women can be infected by severe acute respiratory syndrome\u2009coronavirus 2 (SARS\u2010CoV\u20102), yet the incidence of perinatal infection is low. We hypothesized that this could be related to low expression of the membrane receptor for SARS\u2010CoV\u20102, angiotensin\u2010converting enzyme 2 (ACE2), in the fetoplacental unit. We evaluated protein expression of ACE2 at various gestational ages in both placentae and fetal organs from pregnancies not infected with SARS\u2010CoV\u20102.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In May 2020, using samples from a registered biobank, we performed immunohistochemical analysis for ACE2 in tissue samples from fetal organs and placentae from five cases of second\u2010 or third\u2010trimester medical termination of pregnancy in healthy women (performed between 15 and 38\u2009weeks' gestation), as well as a further two placentae, one from a 7\u2010week spontaneous miscarriage in a non\u2010infected woman and one from a symptomatic pregnant woman positive for SARS\u2010CoV\u20102 delivered by Cesarean section at 34\u2009weeks. Samples were paraffin\u2010embedded and organ tissues included kidney, brain, lung, intestinal tract, heart and testis. Matching tissues (kidney, intestinal tract, lung and testis) from autopsies of four 8\u2010year\u2010old children were tested as controls. Tissue sections were incubated with rabbit monoclonal anti\u2010ACE2, and protein expression of ACE2 was detected by immunohistochemistry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>ACE2 expression was detected in fetal kidney, rectum and ileum samples from 15\u2009weeks onwards and in the pediatric controls. It was barely detectable in fetal lung samples at 15\u2009+\u20095\u2009weeks' gestation and not detectable thereafter, and, in the pediatric controls, ACE2 was detectable only in type\u20102 pneumocytes. No ACE2 expression was found in the cerebral ependymal or parenchymal tissues or in cardiac tissues. ACE2 was expressed in placental syncytiotrophoblast and cytotrophoblast samples, but not in the amnion, from 7\u2009weeks onwards. The intensity and distribution of ACE2 staining in the placenta from the symptomatic SARS\u2010CoV\u20102 woman was similar to that in the non\u2010infected placentae.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Marked placental expression of ACE2 provides a rationale for vertical transmission at the cellular level. Absence of ACE2 expression in the fetal brain and heart is reassuring regarding the risk of congenital malformation. Clinical follow\u2010up of infected pregnant women and their children is needed to validate these observations. \u00a9 2020 International Society of Ultrasound in Obstetrics and Gynecology<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.22178","type":"journal-article","created":{"date-parts":[[2020,8,15]],"date-time":"2020-08-15T08:57:15Z","timestamp":1597481835000},"page":"242-247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Protein expression of angiotensin\u2010converting enzyme 2, a <scp>SARS\u2010CoV<\/scp>\u20102\u2010specific receptor, in fetal and placental tissues throughout gestation: new insight for perinatal counseling"],"prefix":"10.1002","volume":"57","author":[{"given":"V.","family":"Faure\u2010Bardon","sequence":"first","affiliation":[{"name":"EA 73\u201028 Universit\u00e9 de Paris  Paris France"},{"name":"AP\u2010HP, Department of Obstetrics and Fetal Medicine H\u00f4pital Necker\u2010Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Isnard","sequence":"additional","affiliation":[{"name":"AP\u2010HP, Department of Histology, Embryology and Cytogenetics H\u00f4pital Necker\u2010Enfants Malades  Paris France"},{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), U1151, CNRS UMR 8253, H\u00f4pital Necker\u2010Enfants Malades, Department of Growth and Signaling Universit\u00e9 de Paris  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Roux","sequence":"additional","affiliation":[{"name":"AP\u2010HP, Department of Histology, Embryology and Cytogenetics H\u00f4pital Necker\u2010Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Leruez\u2010Ville","sequence":"additional","affiliation":[{"name":"EA 73\u201028 Universit\u00e9 de Paris  Paris France"},{"name":"AP\u2010HP, Virology Laboratory H\u00f4pital Necker\u2010Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Molina","sequence":"additional","affiliation":[{"name":"AP\u2010HP, Department of Histology, Embryology and Cytogenetics H\u00f4pital Necker\u2010Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Bessieres","sequence":"additional","affiliation":[{"name":"AP\u2010HP, Department of Histology, Embryology and Cytogenetics H\u00f4pital Necker\u2010Enfants Malades  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5675-267X","authenticated-orcid":false,"given":"Y.","family":"Ville","sequence":"additional","affiliation":[{"name":"EA 73\u201028 Universit\u00e9 de Paris  Paris France"},{"name":"AP\u2010HP, Department of Obstetrics and Fetal Medicine H\u00f4pital Necker\u2010Enfants Malades  Paris 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