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SARS-CoV-2 infection risk assessment in the endometrium: viral infection-related gene expression across the menstrual cycle.
Fertil Steril. 2020 08; 114(2):223-232.FS

Abstract

OBJECTIVE

To determine the susceptibility of the endometrium to infection by-and thereby potential damage from-SARS-CoV-2.

DESIGN

Analysis of SARS-Cov-2 infection-related gene expression from endometrial transcriptomic data sets.

SETTING

Infertility research department affiliated with a public hospital.

PATIENT(S)

Gene expression data from five studies in 112 patients with normal endometrium collected throughout the menstrual cycle.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Gene expression and correlation between viral infectivity genes and age throughout the menstrual cycle.

RESULT(S)

Gene expression was high for TMPRSS4, CTSL, CTSB, FURIN, MX1, and BSG; medium for TMPRSS2; and low for ACE2. ACE2, TMPRSS4, CTSB, CTSL, and MX1 expression increased toward the window of implantation. TMPRSS4 expression was positively correlated with ACE2, CTSB, CTSL, MX1, and FURIN during several cycle phases; TMPRSS2 was not statistically significantly altered across the cycle. ACE2, TMPRSS4, CTSB, CTSL, BSG, and MX1 expression increased with age, especially in early phases of the cycle.

CONCLUSION(S)

Endometrial tissue is likely safe from SARS-CoV-2 cell entry based on ACE2 and TMPRSS2 expression, but susceptibility increases with age. Further, TMPRSS4, along with BSG-mediated viral entry into cells, could imply a susceptible environment for SARS-CoV-2 entry via different mechanisms. Additional studies are warranted to determine the true risk of endometrial infection by SARS-CoV-2 and implications for fertility treatments.

Links

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Authors+Show Affiliations

Henarejos-Castillo I
Department of Genomic and Systems Reproductive Medicine, IVI-RMA IVI Foundation, Valencia, Spain; Instituto de Investigación Sanitaria Hospital Universitario y Politécnico La Fe, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynaecology, University of Valencia, Valencia, Spain.
Sebastian-Leon P
Department of Genomic and Systems Reproductive Medicine, IVI-RMA IVI Foundation, Valencia, Spain; Instituto de Investigación Sanitaria Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Devesa-Peiro A
Department of Genomic and Systems Reproductive Medicine, IVI-RMA IVI Foundation, Valencia, Spain; Instituto de Investigación Sanitaria Hospital Universitario y Politécnico La Fe, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynaecology, University of Valencia, Valencia, Spain.
Pellicer A
Department of Genomic and Systems Reproductive Medicine, IVI-RMA IVI Foundation, Valencia, Spain; Instituto de Investigación Sanitaria Hospital Universitario y Politécnico La Fe, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynaecology, University of Valencia, Valencia, Spain.
Diaz-Gimeno P
Department of Genomic and Systems Reproductive Medicine, IVI-RMA IVI Foundation, Valencia, Spain; Instituto de Investigación Sanitaria Hospital Universitario y Politécnico La Fe, Valencia, Spain. Electronic address: patricia.diaz@ivirma.com.

MeSH

AdultAge FactorsAngiotensin-Converting Enzyme 2BetacoronavirusCOVID-19Coronavirus InfectionsEndometriumFemaleGene Expression Regulation, ViralHumansMenstrual CycleMiddle AgedPandemicsPeptidyl-Dipeptidase APneumonia, ViralRisk AssessmentSARS-CoV-2Virus InternalizationYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32641214

Citation

Henarejos-Castillo, Ismael, et al. "SARS-CoV-2 Infection Risk Assessment in the Endometrium: Viral Infection-related Gene Expression Across the Menstrual Cycle." Fertility and Sterility, vol. 114, no. 2, 2020, pp. 223-232.
Henarejos-Castillo I, Sebastian-Leon P, Devesa-Peiro A, et al. SARS-CoV-2 infection risk assessment in the endometrium: viral infection-related gene expression across the menstrual cycle. Fertil Steril. 2020;114(2):223-232.
Henarejos-Castillo, I., Sebastian-Leon, P., Devesa-Peiro, A., Pellicer, A., & Diaz-Gimeno, P. (2020). SARS-CoV-2 infection risk assessment in the endometrium: viral infection-related gene expression across the menstrual cycle. Fertility and Sterility, 114(2), 223-232. https://doi.org/10.1016/j.fertnstert.2020.06.026
Henarejos-Castillo I, et al. SARS-CoV-2 Infection Risk Assessment in the Endometrium: Viral Infection-related Gene Expression Across the Menstrual Cycle. Fertil Steril. 2020;114(2):223-232. PubMed PMID: 32641214.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - SARS-CoV-2 infection risk assessment in the endometrium: viral infection-related gene expression across the menstrual cycle. AU - Henarejos-Castillo,Ismael, AU - Sebastian-Leon,Patricia, AU - Devesa-Peiro,Almudena, AU - Pellicer,Antonio, AU - Diaz-Gimeno,Patricia, Y1 - 2020/06/17/ PY - 2020/05/24/received PY - 2020/06/11/revised PY - 2020/06/15/accepted PY - 2020/7/10/pubmed PY - 2020/8/12/medline PY - 2020/7/10/entrez KW - ACE2 KW - COVID-19 KW - SARS-CoV-2 KW - coronavirus KW - endometrial transcriptomics SP - 223 EP - 232 JF - Fertility and sterility JO - Fertil Steril VL - 114 IS - 2 N2 - OBJECTIVE: To determine the susceptibility of the endometrium to infection by-and thereby potential damage from-SARS-CoV-2. DESIGN: Analysis of SARS-Cov-2 infection-related gene expression from endometrial transcriptomic data sets. SETTING: Infertility research department affiliated with a public hospital. PATIENT(S): Gene expression data from five studies in 112 patients with normal endometrium collected throughout the menstrual cycle. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Gene expression and correlation between viral infectivity genes and age throughout the menstrual cycle. RESULT(S): Gene expression was high for TMPRSS4, CTSL, CTSB, FURIN, MX1, and BSG; medium for TMPRSS2; and low for ACE2. ACE2, TMPRSS4, CTSB, CTSL, and MX1 expression increased toward the window of implantation. TMPRSS4 expression was positively correlated with ACE2, CTSB, CTSL, MX1, and FURIN during several cycle phases; TMPRSS2 was not statistically significantly altered across the cycle. ACE2, TMPRSS4, CTSB, CTSL, BSG, and MX1 expression increased with age, especially in early phases of the cycle. CONCLUSION(S): Endometrial tissue is likely safe from SARS-CoV-2 cell entry based on ACE2 and TMPRSS2 expression, but susceptibility increases with age. Further, TMPRSS4, along with BSG-mediated viral entry into cells, could imply a susceptible environment for SARS-CoV-2 entry via different mechanisms. Additional studies are warranted to determine the true risk of endometrial infection by SARS-CoV-2 and implications for fertility treatments. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/32641214/SARS_CoV_2_infection_risk_assessment_in_the_endometrium:_viral_infection_related_gene_expression_across_the_menstrual_cycle_ DB - PRIME DP - Unbound Medicine ER -