Department of Physiology, Indian Council of Agricultural Research (ICAR) - Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttarpradesh, India; and Corresponding author. Email:
Department of Physiology, Indian Council of Agricultural Research (ICAR) - Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttarpradesh, India.
Reprod Fertil Dev. 2021 Apr;33(6):381-391. doi: 10.1071/RD20274.
The COVID-19 outbreak, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was first identified in China, and it has quickly become a global threat to public health due to its rapid rate of transmission and fatalities. Angiotensin-converting enzyme 2 (ACE2) has been identified as a receptor that mediates the entry of SARS-CoV-2 into human cells, as in the case of severe acute respiratory syndrome coronavirus (SARS-CoV). Several studies have reported that ACE2 expression is higher in Leydig, Sertoli and seminiferous ductal cells of males, as well as in ovarian follicle cells of females, suggesting possible potential pathogenicity of the coronavirus in the reproductive system. Higher ACE2 expression in the human placenta and reports of vertical transmission of SARS-CoV-2 among clinical cases have increased the relevance of further studies in this area. This review focuses on the interaction between SARS-CoV-2 and the ACE2 receptor and speculates on the mechanistic interplay in association with male and female reproductive physiology. In addition, based on the available literature, we discuss the alleged sex differences in terms of the infectivity of SARS-CoV-2, which is claimed greater among males, and further explore the physiological role of ACE2 and 17β-oestradiol for the same.
新型冠状病毒病（COVID-19）疫情由严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）引发，最初在中国被发现，由于其传播速度快、致死率高，迅速成为全球公共卫生的威胁。血管紧张素转化酶 2（ACE2）已被鉴定为介导 SARS-CoV-2 进入人体细胞的受体，就像严重急性呼吸系统综合征冠状病毒（SARS-CoV）一样。几项研究报告称，男性的睾丸间质细胞、支持细胞和精母细胞以及女性的卵巢滤泡细胞中 ACE2 的表达更高，这表明冠状病毒可能对生殖系统具有潜在的致病性。人类胎盘 ACE2 表达增加，以及临床病例中 SARS-CoV-2 的垂直传播报告，增加了该领域进一步研究的相关性。本综述重点关注 SARS-CoV-2 与 ACE2 受体的相互作用，并推测与男性和女性生殖生理学相关的机制相互作用。此外，根据现有文献，我们讨论了 SARS-CoV-2 感染的所谓性别差异，据称男性感染率更高，并进一步探讨 ACE2 和 17β-雌二醇的相同生理作用。
