We confirmed the ability of CoV-2(B) to enter and replicate in both Vis AD and Sub AD cells using immunofluorescence detection of SARS-CoV-2 spike protein and double-stranded RNA (dsRNA) (Fig. 2b). Co-localization between spike and dsRNA was detected into the intracellular compartment and close to lipid droplets, indicating that SARS-CoV-2 can indeed infect and replicate in fully differentiated adipocytes (Fig. 2b). Remarkably, the viral load 24 hpi was 240-fold higher in Vis AD than in Sub AD cells (Fig. 2c). We performed plaque-forming assays using the conditioned medium of cells 24 hpi and found that Vis AD cells produced over 770-fold more infectious particles than Sub AD cells (Fig. 2d). Cell viability was maintained until day 3 post-infection and then reduced to 70% on days 4 and 5 in Vis AD and Sub AD cells (Supplementary Fig. 2f). These results demonstrate that although the degree of infection-induced cell death is similar when comparing cells from the two different adipose depots, adipose tissue cells originating from visceral fat are intrinsically more susceptible to SARS-CoV-2 infection than those from subcutaneous fat.
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Although the Reviewer raises an interesting observation, our experiments beyond the computational prediction do not support a role for CD8 in T lymphocyte infection. Hence, we decided not to focus on a potential interaction between CD8 and SARS-CoV spike protein, although this does not exclude that the interaction may exist. Indeed, a highly stable interaction between Spike and CD8 molecules could result in a 'stable' complex that would trap the viral particles outside the cell precluding infection. This would be consistent with T CD8 cells not being infected by SARS-CoV-2. However, we would need more experiments to prove this mechanism and this is beyond the scope of this manuscript, which focuses on the interaction between spike and CD4 and its role in CD4 T cell infection.
We appreciate the Reviewer's observation regarding the potential clashes between CD4 NTD and the full-length sCov2 in the last complex presented in Figure 2. In constructing the full model, we initially performed a superposition of the RBD domain onto the full-length sCov2. The primary criterion for selecting the final models was the kinetic stability analysis, as we aimed to identify the most stable configurations. We acknowledge that the compatibility between the docking model and the full-length sCov2, considering possible steric clashes, is an essential factor to consider. For the two most stable models, namely model95 and model148, we carefully examined their structures. In the case of model148, illustrated in Figure 2D, we did not observe any apparent clashes between CD4 NTD and the full-length sCov2.
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