ACE2 Expression in Kidney and Testis May Cause Kidney and Testis Infection in COVID-19 Patients

Fan, Caibin; Lu, Wei; Li, Kai; Ding, Yanhong; Wang, Jianqing

doi:10.3389/fmed.2020.563893

Cited by 180 publications

(133 citation statements)

References 36 publications

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“…They are composed of sperm-producing cells (spermatogonia) and the supporting Sertoli cells. ACE2 is highly expressed in testicular cells, mainly distributed in spermatogonia, Leydig, and Sertoli cells ( 4 , 5 , 67 ), which indicates that the testis could be a potential target for SARS-CoV-2. If the virus causes damage to these cells, the spermatogenesis process will be affected.…”

Section: Discussionmentioning

confidence: 99%

Effect of COVID-19 on Male Reproductive System – A Systematic Review

Wang

Ren

et al. 2021

Front. Endocrinol.

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BackgroundAngiotensin-converting enzyme II (ACE2), a receptor for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) to enter host cells, is widely expressed in testes and prostate tissues. The testis and prostate produce semen. At present, there are contradictory reports about whether SARS-CoV-2 can exist in the semen of infected men.ObjectiveTo provide a comprehensive overview of the topic of whether COVID-19 can impact on male reproductive system.MethodsWe reviewed the relevant publications on the possible impact of Coronavirus Disease 2019 (COVID-19) on male reproductive system and summarized the latest and most important research results so far. Literature published in English from December 2019 to January 31, 2021 regarding the existence of SARS-CoV-2 in semen, testis, and prostatic fluid and the effects of COVID-19 on male reproductive were included.ResultsWe identified 28 related studies, only one of which reported the presence of SARS-CoV-2 in semen. The study found that the semen quality of patients with moderate infection was lower than that of patients with mild infection and healthy controls. The impaired semen quality may be related to fever and inflammation. Pathological analysis of the testis/epididymis showed that SARS-CoV-2 viral particles were positive in 10 testicular samples, and the spermatogenic function of the testis was impaired. All 94 expressed prostatic secretion (EPS) samples were negative for SARS-CoV-2 RNA.ConclusionThe likelihood of SARS-CoV-2 in the semen of COVID-19 patients is very small, and semen should rarely be regarded as a carrier of SARS-CoV-2 genetic material. However, COVID-19 may cause testicular spermatogenic dysfunction via immune or inflammatory reactions. Long-term follow-up is needed for COVID-19 male patients and fetuses conceived during the father’s infection period.

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Section: Discussionmentioning

confidence: 99%

Effect of COVID-19 on Male Reproductive System – A Systematic Review

Wang

Ren

et al. 2021

Front. Endocrinol.

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“…The kidney is another organ with elevated ACE-2 expression. The renal tubular cells are known to express high levels of ACE-2 [69]; however, no research evidence has been reported for the SARS-CoV-2 invoked kidney injury. In a statistical survey of 1099 COVID-19 patients, 0.5% reported acute kidney injury with a severity rate of 83.3%.…”

Section: Angiotensin-converting Enzyme 2 (Ace-2)mentioning

confidence: 99%

“…In a statistical survey of 1099 COVID-19 patients, 0.5% reported acute kidney injury with a severity rate of 83.3%. In some COVID-19 patients, SARS-CoV-2 was detected in the urine [69]. Additional studies are immediately warranted to test whether SARS-CoV-2 infections cause kidney damage, if so, the mechanisms involved in such cellular damage.…”

Section: Angiotensin-converting Enzyme 2 (Ace-2)mentioning

confidence: 99%

A Review on SARS-CoV-2-Induced Neuroinflammation, Neurodevelopmental Complications, and Recent Updates on the Vaccine Development

et al. 2021

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Coronavirus disease 2019 (COVID-19) is a devastating viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The incidence and mortality of COVID-19 patients have been increasing at an alarming rate. The mortality is much higher in older individuals, especially the ones suffering from respiratory distress, cardiac abnormalities, renal diseases, diabetes, and hypertension. Existing evidence demonstrated that SARS-CoV-2 makes its entry into human cells through angiotensin-converting enzyme 2 (ACE-2) followed by the uptake of virions through cathepsin L or transmembrane protease serine 2 (TMPRSS2). SARS-CoV-2-mediated abnormalities in particular cardiovascular and neurological ones and the damaged coagulation systems require extensive research to develop better therapeutic modalities. As SARS-CoV-2 uses its S-protein to enter into the host cells of several organs, the S-protein of the virus is considered as the ideal target to develop a potential vaccine. In this review, we have attempted to highlight the landmark discoveries that lead to the development of various vaccines that are currently under different stages of clinical progression. Besides, a brief account of various drug candidates that are being tested to mitigate the burden of COVID-19 was also covered. Further, in a dedicated section, the impact of SARS-CoV-2 infection on neuronal inflammation and neuronal disorders was discussed. In summary, it is expected that the content covered in this article help to understand the pathophysiology of COVID-19 and the impact on neuronal complications induced by SARS-CoV-2 infection while providing an update on the vaccine development.

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“…There are two ACE isoenzymes in the testis, namely the somatic (sACE) and testicular (tACE) isoforms, whereas the testicular and somatic isoforms of ACE2 are identical. Among all the tissues in the body, the testes have nearly the highest levels of ACE2 mRNA and protein expression (Fan et al 2021). Interestingly, the testicular expression of ACE2 is age related and is highest in men in their 30s and lowest in men in their 60s.…”

Section: Testicular Ace2mentioning

confidence: 99%

Physiological implications of COVID-19 in reproduction: angiotensin-converting enzyme 2 a key player

Sharma

Chandra

Mankuzhy

et al. 2021

Reprod. Fertil. Dev.

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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 17b-oestradiol for the same.

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ACE2 Expression in Kidney and Testis May Cause Kidney and Testis Infection in COVID-19 Patients

Cited by 180 publications

References 36 publications

Effect of COVID-19 on Male Reproductive System – A Systematic Review

Effect of COVID-19 on Male Reproductive System – A Systematic Review

A Review on SARS-CoV-2-Induced Neuroinflammation, Neurodevelopmental Complications, and Recent Updates on the Vaccine Development

Physiological implications of COVID-19 in reproduction: angiotensin-converting enzyme 2 a key player

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