Roles of steroid receptors in the lung and COVID-19

Damien A Leach1, Greg N Brooke1,2, Charlotte L Bevan1

  • 1Division of Cancer, Imperial Centre for Translational and Experimental Medicine, Imperial College London, Hammersmith Hospital Campus, London W12 0NN, U.K.

Insights

Steroid hormone receptors influence COVID-19 lung damage by affecting viral entry proteins. Clinical trials are exploring steroid receptor ligands as potential treatments for COVID-19.

Area of Science:

  • Pulmonary Medicine
  • Endocrinology
  • Virology

Background:

  • COVID-19 (Coronavirus Disease 2019) primarily affects the lungs, leading to significant mortality.
  • SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus 2) infection of lung cells depends on host proteins like ACE2 (angiotensin-converting enzyme 2) and TMPRSS2 (transmembrane serine protease 2).
  • Steroid hormone receptors (SRs) play crucial roles in lung development, function, and immunity, and influence the expression of ACE2 and TMPRSS2.

Purpose of the Study:

  • To review the role of steroid hormone receptors (androgen receptor, glucocorticoid receptor, progesterone receptor, mineralocorticoid receptor, oestrogen receptor) in the lung.
  • To examine how SRs affect host cell proteins involved in SARS-CoV-2 entry.
  • To summarize ongoing clinical trials investigating SR ligands for COVID-19 treatment.

Main Methods:

  • Literature review of existing research on steroid hormone receptors and COVID-19.
  • Analysis of the impact of SRs on ACE2 and TMPRSS2 expression and function.
  • Survey of current clinical trials involving SR ligands for COVID-19.

Main Results:

  • Steroid hormone receptors are implicated in lung physiology and the immune response relevant to COVID-19.
  • SRs modulate the expression and activity of ACE2 and TMPRSS2, key mediators of SARS-CoV-2 entry.
  • Several clinical trials are evaluating the therapeutic potential of various SR ligands in COVID-19 patients.

Conclusions:

  • Steroid hormone receptors are critical regulators in the lung's response to SARS-CoV-2 infection.
  • Targeting SR pathways with specific ligands presents a promising therapeutic strategy for managing COVID-19.
  • Further research and clinical evaluation are essential to establish the efficacy of SR-based treatments for COVID-19.

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