COVID-19 doubtlessly has unfavorable impacts on male fertility
An evaluation just lately revealed within the Journal of Medical Virology has mentioned among the results that infection with extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) – the agent that causes coronavirus illness 2019 (COVID-19) – might have on male fertility.
Within the paper, Cemile Seymen from Gazi College Institute of Well being Sciences, in Ankara, Turkey, summarizes examine findings exhibiting how the infection can negatively have an effect on male reproductive well-being.
Seymen says additional research is wanted to research the roles that the host cell proteins angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) might play in infection since each of those proteins, that are concerned in viral entry, are extremely expressed within the male reproductive system.
Little or no information can be found on the consequences of COVID-19 on male fertility
Since SARS-CoV-2 was first recognized in Wuhan, China, late final 12 months (2019), research have proven that the virus not solely causes respiratory illness however can have an effect on numerous completely different organs, together with these of the male reproductive system.
“There’s a very restricted variety of information concerning the results of COVID-19 on male fertility, so it has turn into an vital matter for researchers,” says Seymen.
ACE2 is very expressed within the male genital tract
To realize viral entry, SARS-CoV-2 makes use of a floor construction referred to as the spike protein to bind to the ACE2 receptor current on host cells.
One examine revealed earlier this 12 months confirmed that ACE2 messenger RNA was expressed in each germ and somatic cells of the testis. Different research have discovered that ACE2 is expressed in spermatogonia, Leydig cells, and Sertoli cells.
One examine that used electron microscopy to look at autopsy tissues from the testes of twelve COVID-19 sufferers demonstrated swelling, vacuolation, and cytoplasmic dilution within the Sertoli cells and a discount within the variety of Leydig cells, in contrast with sufferers who didn’t have COVID-19.
Some research have additionally demonstrated elevated ranges of the autophagy receptor SQSTM1 in cells contaminated with SARS-CoV-2, indicating a fall in autophagy flux.
“In consequence, SARS-CoV-2 might trigger male reproductive issues by regulating the extent of autophagy in male germ cells,” writes Seymen.
Researchers have additionally proposed that a rise in testicular temperature as an oblique impact of irritation has unfavorable impacts on the testes amongst COVID-19 sufferers.
What about TMPRSS2?
Seymen additionally discusses the position that TMPRSS2 might play in SARS-CoV-2 an infection of the prostate.
One examine discovered that this enzyme, which cleaves the spike protein in preparation for virus and host membrane fusion, is very expressed within the prostate’s epithelium.
This gland secretes prostate fluid, one of many major elements of the seminal fluid. Muscle mass inside the gland are chargeable for pushing the seminal fluid by way of the urethra throughout ejaculation.
The excessive expression of TMPRSS2 inside the prostate might improve the chance of SARS-CoV-2 an infection on this gland, which can have an effect on its skill to secrete these fluids, says Seymen.
Results on the nervous system might have an effect on male fertility
Seymen factors out that SARS-CoV-2 might additionally exert unfavorable impacts on male fertility not directly, by way of mechanisms involving the nervous system.
For instance, most viruses permeate the blood-brain barrier and experiences have proven that glial cells and neurons additionally categorical ACE2 receptors, doubtlessly making them a goal for neuronal demise induced by SARS-CoV-2.
Importantly, the central nervous system performs an important position in endocrine management and spermatogenesis. Neurons within the hypothalamus secrete a gonadotropin-releasing hormone (GnRH), for instance, which triggers the discharge of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland.
Low ranges of GnRH end in decreased FSH and LH, which in flip impacts the operation of Sertoli cells and Leydig cells.
Seymen additionally factors out that melancholy and anxiousness (which many individuals are experiencing through the present pandemic) are related to elevated ranges of cortisol and prolactin, in addition to a decreased sperm rely on and semen quantity, all of which have been proven to contribute to sexual dysfunction.
Additional research is wanted
Seymen says that taken collectively, these examine findings counsel that the COVID-19 pandemic impacts the male reproductive system in each direct and oblique method.
“Extra research are essential to reply all of the questions and additional investigations are warranted, however ACE2 and TMPRSS2 play an vital position within the mobile entry of SARS-CoV-2. As a result of the male genital system presents excessive ACE 2 expression, the significance of this pathway will increase in COVID-19 instances,” she concludes.