A recent review study carried by the researcher at the Gazi University Institute of Health Sciencesin Ankara, Turkey, found a negative correlation between SARS-CoV-2 and male reproductive health.

The findings of the analysis, published in the Journal of Medical Virology , stated that angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) may play in infection since both of these proteins, which are involved in viral entry, are highly expressed in the male reproductive system.

ACE2 receptors proteins to which SARS-CoV-2 clings on to proliferate in the host’s cell. TMPRSS2 is an endothelial cell surface protein that is involved in the viral entry and spread of coronaviruses, including SARS-CoV-2. Blocking TMPRSS2 could potentially be an effective clinical therapy for Covid-19.

Lead researchers Cemile Seymen noted that further studies are needed to investigate the roles that the host cell proteins.

“There is a very limited number of data about the effects of Covid-19 on male fertility, so it has become an important topic for researchers,” says Seymen.

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Some studies have also demonstrated increased levels of the autophagy receptor SQSTM1 in cells infected with SARS-CoV-2, indicating a fall in autophagy flux.

Autophagy is the body’s way of cleaning out damaged cells, in order to regenerate newer, healthier cells

“As a result, SARS-CoV-2 may cause male reproductive disorders by regulating the level of autophagy in male germ cells,” wrote Seymen.

“Because the male genital system presents high ACE 2 expression, the importance of this pathway increases in Covid-19 cases,” she noted.

Role of TMPRSS2

Seymen further highlighted the role of TMPRSS2 in helping SARS-CoV-2 infection spread in the prostate.

She mentioned that a previous study found that this enzyme, which cleaves the spike protein in preparation for virus and host membrane fusion, is highly expressed in the prostate's epithelium.

This gland secretes prostate fluid, one of the main components of the seminal fluid. Muscles within the gland are responsible for pushing the seminal fluid through the urethra during ejaculation.

The high expression of TMPRSS2 within the prostate could increase the likelihood of SARS-CoV-2 infection in this gland, which may affect its ability to secrete these fluids, explained Seymen.

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Seymen also believes that the virus can have a negative impact on male fertility indirectly. This could be through mechanisms involving the nervous system.

She explained that depression and anxiety are associated with increased levels of cortisol and prolactin, as well as a lower sperm count and semen volume. This has also contributed to sexual dysfunction.

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