Andrology and Urogynecology Clinic, Santa Maria Terni Hospital, University of Perugia, Terni, Italy.
Andrologia. 2020 Jul;52(6):e13654. doi: 10.1111/and.13654. Epub 2020 May 21.
The pandemic caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to several hypotheses of functional alteration of different organs. The direct influence of this virus on the male urogenital organs is still to be evaluated. However some hypotheses can already be made, especially in the andrological field, for the biological similarity of the SARS-CoV and SARS-CoV2. As well as SARS-CoV, SARS CoV-2 uses the 'Angiotensin Converting Enzyme-2' (ACE2) as a receptor to enter human cells. It was found that ACE2, Angiotensin (1-7) and its MAS receptors are present, over in the lung, also in the testicles, in particular in Leydig and Sertoli cells. A first hypothesis is that the virus could enter the testicle and lead to alterations in testicular functionality. A second hypothesis is that the binding of the virus to the ACE2 receptor, could cause an excess of ACE2 and give rise to a typical inflammatory response. The inflammatory cells could interfere with the function of Leydig and Sertoli cells. Both hypotheses should be evaluated and confirmed, in order to possibly monitor fertility in patients COVID-19+.
由严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 引起的大流行导致了对不同器官功能改变的几种假设。该病毒对男性泌尿生殖器官的直接影响仍有待评估。然而，由于 SARS-CoV 和 SARS-CoV2 的生物学相似性，一些假设已经可以做出，特别是在男科领域。与 SARS-CoV 一样，SARS-CoV-2 使用“血管紧张素转换酶 2”（ACE2）作为受体进入人体细胞。人们发现 ACE2、血管紧张素（1-7）及其 MAS 受体不仅存在于肺部，也存在于睾丸中，特别是在睾丸间质细胞和支持细胞中。第一个假设是病毒可能进入睾丸并导致睾丸功能改变。第二个假设是病毒与 ACE2 受体的结合可能导致 ACE2 过量，并引发典型的炎症反应。炎症细胞可能会干扰睾丸间质细胞和支持细胞的功能。这两种假设都应该进行评估和验证，以便有可能监测 COVID-19+患者的生育能力。
