Interaction of SARS-CoV-2 With RAS / ACE2 in the Female Reproductive System.

Objective: The purpose of this review was to investigate current knowledge of COVID-19 by highlighting its effect on female reproductive tract. Materials and methods: In this study, all articles related to the effect of SARS, MERS, and CoV-19 viruses on the female reproductive system from 2003 to 2021 were reviewed. Results: The coronavirus enters the host cell by binding to the enzyme that is most abundant in the host lung. The corona or spike (S) protein of this virus is the main tool for binding to the receptor in the host cell membrane and facility the entrance of CoV into the target cells. This receptor is the Angiotensin-Converting Enzyme-2 (ACE2), but the high expression of this receptor can be a mystery to increase infection in host cells. The overexpression of ACE2 in different tissues has a close connection to the severity of this viral infection. Infection in the female reproductive system requires more attention because it may affect the generation and future progeny by damaged gametes. Conclusion: The existing evidence proposes that ACE2 is widely expressed in the reproductive tract includes: ovary, uterus, vagina, and placenta.

Deregulated Brain's Central Clock Management on Sleep-Wake Behavior in Women With Polycystic Ovary Syndrome: Melatonin & Sleep Pattern.

The aim of this narrative review is to investigate the reciprocal correlation between melatonin through the brain's central clock management on sleep-wake behavior in women with polycystic ovary syndrome (PCOS). Biological clocks are genetically programmed physiological systems that permit organisms to live in harmony with natural rhythms. The most important function of a biological clock is to regulate overt circadian biological rhythms. Circadian rhythms orchestrate the body's rhythmic physiologic functions like sleep-wake and menstruation cycle. Stress hormones, beta-endorphins, and melatonin which can easily affect the woman's reproductive system. For example, amplitude changes in the luteal phase are one of the results of menstrual-related disorders that occur through this circadian fluctuation. Many reports indicate that levels of melatonin and stress hormones are altered in women with PCOS. The melatonin metabolites are significantly raised in the level of night-time urinary in women with PCOS, which is associated with a significant reduction of sleep quality compared to normal women. The result of this narrative review showed the circadian rhythm as a normal coordinated function is a regulator of the natural structure of sleep-wake architecture. Disruption of this natural pattern can lead to phasic activation of the HPA axis, which increases the continuation of circadian activation; which there is in women with PCOS.

Estradiol and COVID-19: Does 17-Estradiol Have an Immune-Protective Function in Women Against Coronavirus?

Objective: Female sex hormones have a pro-inflammatory effect, which may help to minimize inflammation. Estrogen's immunoregulatory properties play a significant role in the bi-directional neuroendocrine-immune activity in females. As a result, sex hormones can play a role in men's high mortality rate from coronavirus-2019 (COVID-19). It is aimed to clarify the role of 17-estradiol (E2) in the battle against COVID-19. Materials and methods: Until April 2021, a study on PubMed was performed. COVID-19, 17-estradiol (E2), immunoregulatory properties, pregnancy, menopausal symptoms, hormonal therapy, ER/ expression on immune cells, and mortality were some of the concepts used in the search. Results: Regulation of pro-inflammatory immune processes against COVID-19 appears to be associated with increased immune function (pro-inflammatory), anti-inflammatory regulation, and antiviral defense. Women with a severe coronavirus infection had higher serum IgG antibody levels than men, and their IgG production was faster in the early stages of infection. 17-estradiol (E2) levels of blood will increase by 100-fold during pregnancy. COVID-19 in pregnant women had a 15-fold lower mortality rate than other women. While menopause replacement therapy (MRT) for pre/post-menopausal women and its effectiveness in reducing COVID-19 infection is debatable. Conclusion: MRT may be considered as a viable treatment option for pre/post-menopause women with coronavirus, referring to the fact that sex hormones reduce inflammatory responses and modulate ACE2 expression. The task's difficulty and achieving the desired outcome seem to be challenging.

Polycystic ovary syndrome and circulating inflammatory markers.

BACKGROUND: Human and experimental studies suggest that the sympathetic regulatory drive in the ovary may be unbalanced (hyperactivity) in polycystic ovary syndrome (PCOS). Dysfunctional secretion of interleukin (IL) -1 (α & ß) or related cytokines may thus be related to abnormal ovulation and luteinization. OBJECTIVE: The aim of this study was the evaluation of cytokines' pattern in PCOS women and discussion about the explanation of cross-talk between two super systems: sympathetic and immune systems and explanation sympatho-excitation and relationship with interleukins. MATERIALS AND METHODS: In this study, 171 PCOS women aged between 20-40 years were studied the. Their body mass index was <28. The patients were divided into two groups: study group (n=85, PCOS women) and control group (n=86 normal women). The blood sample was obtained on the 3rd day of menstruation cycle. IL-17, IL-1α, IL-1ß, and TNF-α concentrations were determined in both groups. RESULTS: The median serum level of IL-1α in the PCOS group was higher than the control group (293.3 and 8.0, respectively, p<0.001). Also, the median serum level of IL-1ß was higher than the control group (5.9 and 3.1 respectively). But the median serum of level IL-17 in women with PCOS was significantly lower than the control group (p<0.001). CONCLUSION: Our results confirm that PCOS is a low-level chronic inflammation.

Locus coeruleus lesions and PCOS: role of the central and peripheral sympathetic nervous system in the ovarian function of rat.

BACKGROUND: "Polycystic ovary syndrome (PCOS) is a complex endocrine and metabolic disorder associated with ovulatory dysfunction". "Autonomic and central nervous systems play important roles in the regulation of ovarian physiology". The noradrenergic nucleus locus coeruleus (LC) plays a central role in the regulation of the sympathetic nervous system and synaptically connected to the preganglionic cell bodies of the ovarian sympathetic pathway and its activation is essential to trigger spontaneous or induced LH surges. This study evaluates sympathetic outflow in central and peripheral pathways in PCO rats. OBJECTIVE: Our objectives in this study were (1) to estimate LC activity in rats with estradiol valerate (EV)-induced PCO; (2) to antagonized alpha2a adrenoceptor in systemic conditions with yohimbine. MATERIALS AND METHODS: Forty two rats were divided into two groups: 1) LC and yohimbine and 2) control. Every group subdivided in two groups: eighteen rats were treated with estradiol valerate for induction of follicular cysts and the remainders were sesame oil groups. RESULTS: Estradiol concentration was significantly augmented by the LC lesion in PCO rats (p<0.001), while LC lesion could not alter serum concentrations of LH and FSH, like yohimbine. The morphological observations of ovaries of LC lesion rats showed follicles with hyperthecosis, but yohimbine reduced the number of cysts, increased corpus lutea and developed follicles. CONCLUSION: Rats with EV-induced PCO increased sympathetic activity. LC lesion and yohimbine decreased the number of cysts and yohimbine increased corpus lutea and developed follicles in PCO rats.