Estradiol, Progesterone, Immunomodulation, and COVID-19 Outcomes

被引：191

作者：

Mauvais-Jarvis, Franck ^{[1
,2
]}

Klein, Sabra L. ^{[3
]}

Levin, Ellis R. ^{[4
,5
]}

机构：

[1] Tulane Univ, Sch Med, John W Deming Dept Med, Diabet Discovery & Sex Based Med Lab,Sect Endocri, New Orleans, LA 70112 USA

[2] Southeast Louisiana Vet Hlth Care Syst Med Ctr, New Orleans, LA 70119 USA

[3] Johns Hopkins Bloomberg Sch Publ Hlth, Harry Feinstone Dept Mol Microbiol & Immunol, Baltimore, MD 21205 USA

[4] Univ Calif Irvine, Dept Med & Biochem, Irvine, CA 92617 USA

[5] Long Beach VA Med Ctr, Long Beach, CA 90822 USA

来源：

ENDOCRINOLOGY | 2020年 / 161卷 / 09期

基金：

美国国家卫生研究院;

关键词：

estrogen; progesterone; immunomodulation; cytokine storm; COVID-19; sex difference; RESPIRATORY SYNDROME CORONAVIRUS; HORMONE REPLACEMENT THERAPY; BLOOD MONONUCLEAR-CELLS; CYTOKINE STORM; SEX-DIFFERENCES; ESTROGEN; SUSCEPTIBILITY; CHROMOSOME; INFLUENZA; PREGNANCY;

D O I：

10.1210/endocr/bqaa127

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Severe outcomes and death from the novel coronavirus disease 2019 (COVID-19) appear to be characterized by an exaggerated immune response with hypercytokinemia leading to inflammatory infiltration of the lungs and acute respiratory distress syndrome. Risk of severe COVID- 19 outcomes is consistently lower in women than men worldwide, suggesting that female biological sex is instrumental in protection. This mini-review discusses the immunomodulatory and anti-inflammatory actions of high physiological concentrations of the steroids 17 beta-estradiol (E2) and progesterone (P4). We review how E2 and P4 favor a state of decreased innate immune inflammatory response while enhancing immune tolerance and antibody production. We discuss how the combination of E2 and P4 may improve the immune dysregulation that leads to the COVID-19 cytokine storm. It is intended to stimulate novel consideration of the biological forces that are protective in women compared to men, and to therapeutically harness these factors to mitigate COVID-19 morbidity and mortality.

引用

页数：8

共 65 条

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