The syndrome of acute respiratory insufficiency caused by a coronavirus 2 types (SARS-CoV-2) led to emergency situation in the field of public health care. The Koronavirusny infection became the reason of the pandemic which affected millions of people worldwide, having the international value. Nevertheless, our knowledge of a pathophysiology of a disease and possible ways of treatment is still limited. Though huge efforts for understanding of biology of an infection of SARS-CoV-2 at molecular level were made, use of the corresponding experimental models was limited. Limited understanding of mechanisms of a pathophysiology of a disease became a hindrance for development of effective preventive and therapeutic strategy.
As is well-known today, infection of SARS-CoV-2 happens during the linking and introduction of protein of an aculeiform shoot of a virus with a receptor of a human angiotensin-converting enzyme 2 (APF-2) on a membrane of a host cell. It is confirmed that defeat of bodies and manifestation of a disease are connected with an expression of a receptor of SARS-CoV and to - receptors on a membrane of target cells. Protein of an aculeiform shoot (further S-protein) which is responsible for a koronapodobny form of coronaviruses, promotes fixing of receptors of a virus on a cell membrane. APF-2 was identified as the main receptor used by SARS-CoV-2 and SARS-CoV-1 for penetration into a cell. Also recent researches with use of cellular lines of the person and animals showed that SARS-CoV-2 uses serinovy TMPRSS2 protease for S-protein preparation before APF-2 promotes introduction. Researches after epidemic of SARS-CoV-1 show that at APF-2 inactivation penetration of a virus into lungs of the mice infected with a virus considerably decreases. Recently a number of authors noted increase in APF-2 level in cells of heart of the adult, such as cardiomyocytes, fibroblasts, pericytes and cells of smooth muscles of vessels. It is interesting that at the patients with heart failure participating in clinical trials on COVID-19, APF-2 level in cardiomyocytes is increased.
Lethal complications are consequences of injury of vitals with the high level of an expression APF-2, including lungs, heart and kidneys with the subsequent development of multiorgan insufficiency. Multiorgan insufficiency is SARS-CoV-2 infection complication with the highest degree of lethality. Early reports from China show high death rate among patients at whom the injury of a myocardium correlating with increase in blood serum of level of a troponin of T developed. Besides patients with injuries of heart with high probability initially had cardiovascular diseases — such as hypertension or heart failure.
There are two important observations concerning COVID-19 pandemic: higher prevalence of heavy complications at men and relative immunity at children. Clinical trials identified a male one of the main factors of risk of development of complications at SARS-CoV-2. About 70% of patients for IVL in intensive care units were men. Clinical data of patients with a koronavirusny disease-2019 (COVID-19) showed that high levels of androgens were connected with serious complications and injuries of heart. These conclusions provide important understanding of the origins of hypersensitivity of male patients to COVID-19 and define inhibition of receptors of an androgen as possible therapeutic strategy.
To understand potential impact of the androgenic alarm system on complications for male patients with COVID-19, the group of researchers identified communication between signaling of male sex hormones and regulation of a receptor of SARS-CoV-2 APF2 and to - TMPRSS2 receptor, providing an expected explanation for these observations. Scientists found in men considerable positive dependence between the level of free androgens and risk of acute course of COVID-19 and also between prostate diseases as substitute of disturbance of regulation of an androgen and abnormal level of a troponin of T in blood. Data of these authors show potential communication between the clinical observations and algorithms participating in COVID-19 pathogeny. Results of researches fix delay of the alarm system of an androgenic receptor as the potential therapeutic strategy for slowing down of penetration of the SARS-CoV-2 virus and prevention of acute manifestations of a disease at patients with COVID-19.
Thus, further carrying out researches in this direction can be useful to development of new methods of treatment of COVID-19.