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A potential impact of SARS-CoV-2 on pituitary glands and pituitary neuroendocrine tumors

Wei Ting Gu1, Fen Zhou2, Wan Qun Xie1

  • 1Department of Neurosurgery, Center of Pituitary Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China.

Endocrine
|March 31, 2021
PubMed
Abstract

Insights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may impact pituitary function, particularly corticotroph cells. COVID-19 patients showed altered adrenocorticotropic hormone (ACTH) levels, suggesting a link between SARS-CoV-2 and pituitary neuroendocrine tumors (PitNETs).

Area of Science:

  • Endocrinology
  • Virology
  • Oncology

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) utilizes Angiotensin-converting enzyme 2 (ACE2) as its cellular receptor.
  • The impact of SARS-CoV-2 on pituitary gland function and pituitary neuroendocrine tumors (PitNETs) remains largely unknown.
  • Understanding this interaction is crucial for managing patients with pre-existing PitNETs or those at risk.

Purpose of the Study:

  • To investigate the potential risks of SARS-CoV-2 infection on pituitary gland impairment.
  • To explore the relationship between SARS-CoV-2 and the development or function of PitNETs.
  • To analyze pituitary hormone levels in COVID-19 patients.

Main Methods:

  • Quantitative real-time PCR and immunohistochemistry were used to assess ACE2 and AGTR1 expression in PitNET and normal pituitary tissues.
  • Pituitary cell lines were treated with an ACE2 agonist (DIZE) to evaluate its effects.
  • Serum pituitary hormone levels (ACTH) were compared between 43 COVID-19 patients and 45 healthy controls.

Main Results:

  • Pituitary glands and most PitNET tissues exhibited low ACE2 expression, while AGTR1 was highly expressed in normal pituitary and corticotroph adenomas.
  • ACE2 agonist treatment upregulated ACTH secretion in pituitary cells by downregulating AGTR1.
  • COVID-19 patients showed significantly increased serum ACTH compared to controls, but decreased levels in critical cases.

Conclusions:

  • SARS-CoV-2 infection may have a significant impact on corticotroph cells and corticotroph adenomas.
  • Alterations in ACTH levels in COVID-19 patients suggest a functional link between the virus and the pituitary-adrenal axis.
  • Further research is warranted to fully elucidate the mechanisms and clinical implications.
Keywords:
Angiotensin II receptor type 1Angiotensin-converting enzyme 2Pituitary glandPituitary neuroendocrine tumorsSevere acute respiratory syndrome coronavirus 2

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