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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.
Abstract:
COVID-19 symptoms and mortality are largely due to its devastating effects in the lungs. The disease is caused by the SARS (Severe Acute Respiratory Syndrome)-CoV-2 coronavirus, which requires host cell proteins such as ACE2 (angiotensin-converting enzyme 2) and TMPRSS2 (transmembrane serine protease 2) for infection of lung epithelia. The expression and function of the steroid hormone receptor family is important in many aspects that impact on COVID-19 effects in the lung - notably lung development and function, the immune system, and expression of TMPRSS2 and ACE2. This review provides a brief summary of current knowledge on the roles of the steroid hormone receptors [androgen receptor (AR), glucocorticoid receptor (GR), progesterone receptor (PR), mineralocorticoid receptor (MR) and oestrogen receptor (ER)] in the lung, their effects on host cell proteins that facilitate SARS-CoV-2 uptake, and provides a snapshot of current clinical trials investigating the use of steroid receptor (SR) ligands to treat COVID-19.
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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