Estradiol, Progesterone, Immunomodulation, and COVID-19 Outcomes
Abstract 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 cons...
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| Veröffentlicht in: | Endocrinology (Philadelphia) 2020-09, Vol.161 (9), p.1 |
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| creator | Mauvais-Jarvis, Franck Klein, Sabra L Levin, Ellis R |
| description | Abstract
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 17β-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. |
| doi_str_mv | 10.1210/endocr/bqaa127 |
| format | Article |
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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 17β-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.</description><identifier>ISSN: 0013-7227</identifier><identifier>ISSN: 1945-7170</identifier><identifier>EISSN: 1945-7170</identifier><identifier>DOI: 10.1210/endocr/bqaa127</identifier><identifier>PMID: 32730568</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>17β-Estradiol ; Antibodies ; Antibody Formation - immunology ; Betacoronavirus ; Contraceptives, Oral, Hormonal - therapeutic use ; Coronavirus Infections - drug therapy ; Coronavirus Infections - immunology ; Coronavirus Infections - mortality ; Coronavirus Infections - physiopathology ; Coronaviruses ; COVID-19 ; COVID-19 Drug Treatment ; Cytokine Release Syndrome - immunology ; Cytokine storm ; Cytokines ; Drug Repositioning ; Endocrinology ; Estradiol ; Estradiol - immunology ; Estradiol - therapeutic use ; Estrogen Replacement Therapy ; Estrogens - therapeutic use ; Female ; Health aspects ; Humans ; Immune response ; Immune system ; Immune Tolerance - immunology ; Immunity ; Immunity, Innate - immunology ; Immunological tolerance ; Immunomodulation ; Immunomodulation - immunology ; Inflammation ; Inflammatory response ; Male ; Men ; Mini-Reviews ; Morbidity ; Pandemics ; Pneumonia, Viral - drug therapy ; Pneumonia, Viral - immunology ; Pneumonia, Viral - mortality ; Pneumonia, Viral - physiopathology ; Pregnancy ; Pregnancy Complications, Infectious - immunology ; Progesterone ; Progesterone - immunology ; Progesterone - therapeutic use ; Progestins - therapeutic use ; Respiratory distress syndrome ; SARS-CoV-2 ; Selective Estrogen Receptor Modulators - therapeutic use ; Severity of Illness Index ; Sex Factors ; Sex hormones ; Steroid hormones ; Steroids ; Viral diseases ; Women</subject><ispartof>Endocrinology (Philadelphia), 2020-09, Vol.161 (9), p.1</ispartof><rights>Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2020</rights><rights>Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><rights>COPYRIGHT 2020 Oxford University Press</rights><rights>Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c547t-e62e31ea029d882cb37aa7db0b6539aa4341deed514d9a9c81f84fed1f30ac093</citedby><cites>FETCH-LOGICAL-c547t-e62e31ea029d882cb37aa7db0b6539aa4341deed514d9a9c81f84fed1f30ac093</cites><orcidid>0000-0002-0874-0754 ; 0000-0003-3015-4177</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32730568$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mauvais-Jarvis, Franck</creatorcontrib><creatorcontrib>Klein, Sabra L</creatorcontrib><creatorcontrib>Levin, Ellis R</creatorcontrib><title>Estradiol, Progesterone, Immunomodulation, and COVID-19 Outcomes</title><title>Endocrinology (Philadelphia)</title><addtitle>Endocrinology</addtitle><description>Abstract
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 17β-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.</description><subject>17β-Estradiol</subject><subject>Antibodies</subject><subject>Antibody Formation - immunology</subject><subject>Betacoronavirus</subject><subject>Contraceptives, Oral, Hormonal - therapeutic use</subject><subject>Coronavirus Infections - drug therapy</subject><subject>Coronavirus Infections - immunology</subject><subject>Coronavirus Infections - mortality</subject><subject>Coronavirus Infections - physiopathology</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 Drug Treatment</subject><subject>Cytokine Release Syndrome - immunology</subject><subject>Cytokine storm</subject><subject>Cytokines</subject><subject>Drug Repositioning</subject><subject>Endocrinology</subject><subject>Estradiol</subject><subject>Estradiol - immunology</subject><subject>Estradiol - therapeutic use</subject><subject>Estrogen Replacement Therapy</subject><subject>Estrogens - therapeutic use</subject><subject>Female</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Immune response</subject><subject>Immune system</subject><subject>Immune Tolerance - immunology</subject><subject>Immunity</subject><subject>Immunity, Innate - immunology</subject><subject>Immunological tolerance</subject><subject>Immunomodulation</subject><subject>Immunomodulation - immunology</subject><subject>Inflammation</subject><subject>Inflammatory response</subject><subject>Male</subject><subject>Men</subject><subject>Mini-Reviews</subject><subject>Morbidity</subject><subject>Pandemics</subject><subject>Pneumonia, Viral - drug therapy</subject><subject>Pneumonia, Viral - immunology</subject><subject>Pneumonia, Viral - mortality</subject><subject>Pneumonia, Viral - physiopathology</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Infectious - immunology</subject><subject>Progesterone</subject><subject>Progesterone - immunology</subject><subject>Progesterone - therapeutic use</subject><subject>Progestins - therapeutic use</subject><subject>Respiratory distress syndrome</subject><subject>SARS-CoV-2</subject><subject>Selective Estrogen Receptor Modulators - therapeutic use</subject><subject>Severity of Illness Index</subject><subject>Sex Factors</subject><subject>Sex hormones</subject><subject>Steroid hormones</subject><subject>Steroids</subject><subject>Viral diseases</subject><subject>Women</subject><issn>0013-7227</issn><issn>1945-7170</issn><issn>1945-7170</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1rFDEYxkNR2nXttUcZ8FJhp83XTCaX0rJWXSisB_UaMsk7a8pMsk1mBP97U3etrRRMDiHJ732S93kQOiH4jFCCz8HbYOJ5e6c1oeIAzYjkVSmIwC_QDGPCSkGpOEKvUrrNW845O0RHjAqGq7qZocvrNEZtXegXxecYNpBGiMHDolgNw-TDEOzU69EFvyi0t8Vy_W31viSyWE-jCQOk1-hlp_sEx_t1jr5-uP6y_FTerD-ullc3pam4GEuoKTACGlNpm4aalgmthW1xW1dMas0ZJxbAVoRbqaVpSNfwDizpGNYGSzZHFzvd7dQOYA34_O9ebaMbdPypgnbq6Y1339Um_FCCs0ZkI-bodC8Qw92U-1SDSwb6XnsIU1KUUykaxliT0bf_oLdhij63l6mqljgP8Zfa6B6U813I75p7UXVVc4llVf_WOnuGytPC4Ex2unP5_LkCE0NKEbqHHglW95mrXeZqn3kuePPYmQf8T8gZeLcDwrT9n9gvIIm2PQ</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Mauvais-Jarvis, Franck</creator><creator>Klein, Sabra L</creator><creator>Levin, Ellis R</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QG</scope><scope>7QP</scope><scope>7QR</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>7U7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0874-0754</orcidid><orcidid>https://orcid.org/0000-0003-3015-4177</orcidid></search><sort><creationdate>20200901</creationdate><title>Estradiol, Progesterone, Immunomodulation, and COVID-19 Outcomes</title><author>Mauvais-Jarvis, Franck ; Klein, Sabra L ; Levin, Ellis R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c547t-e62e31ea029d882cb37aa7db0b6539aa4341deed514d9a9c81f84fed1f30ac093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>17β-Estradiol</topic><topic>Antibodies</topic><topic>Antibody Formation - immunology</topic><topic>Betacoronavirus</topic><topic>Contraceptives, Oral, Hormonal - therapeutic use</topic><topic>Coronavirus Infections - drug therapy</topic><topic>Coronavirus Infections - immunology</topic><topic>Coronavirus Infections - mortality</topic><topic>Coronavirus Infections - physiopathology</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 Drug Treatment</topic><topic>Cytokine Release Syndrome - immunology</topic><topic>Cytokine storm</topic><topic>Cytokines</topic><topic>Drug Repositioning</topic><topic>Endocrinology</topic><topic>Estradiol</topic><topic>Estradiol - immunology</topic><topic>Estradiol - therapeutic use</topic><topic>Estrogen Replacement Therapy</topic><topic>Estrogens - therapeutic use</topic><topic>Female</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Immune response</topic><topic>Immune system</topic><topic>Immune Tolerance - immunology</topic><topic>Immunity</topic><topic>Immunity, Innate - immunology</topic><topic>Immunological tolerance</topic><topic>Immunomodulation</topic><topic>Immunomodulation - immunology</topic><topic>Inflammation</topic><topic>Inflammatory response</topic><topic>Male</topic><topic>Men</topic><topic>Mini-Reviews</topic><topic>Morbidity</topic><topic>Pandemics</topic><topic>Pneumonia, Viral - drug therapy</topic><topic>Pneumonia, Viral - immunology</topic><topic>Pneumonia, Viral - mortality</topic><topic>Pneumonia, Viral - physiopathology</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Infectious - immunology</topic><topic>Progesterone</topic><topic>Progesterone - immunology</topic><topic>Progesterone - therapeutic use</topic><topic>Progestins - therapeutic use</topic><topic>Respiratory distress syndrome</topic><topic>SARS-CoV-2</topic><topic>Selective Estrogen Receptor Modulators - therapeutic use</topic><topic>Severity of Illness Index</topic><topic>Sex Factors</topic><topic>Sex hormones</topic><topic>Steroid hormones</topic><topic>Steroids</topic><topic>Viral diseases</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mauvais-Jarvis, Franck</creatorcontrib><creatorcontrib>Klein, Sabra L</creatorcontrib><creatorcontrib>Levin, Ellis R</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Animal Behavior Abstracts</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Endocrinology (Philadelphia)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mauvais-Jarvis, Franck</au><au>Klein, Sabra L</au><au>Levin, Ellis R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Estradiol, Progesterone, Immunomodulation, and COVID-19 Outcomes</atitle><jtitle>Endocrinology (Philadelphia)</jtitle><addtitle>Endocrinology</addtitle><date>2020-09-01</date><risdate>2020</risdate><volume>161</volume><issue>9</issue><spage>1</spage><pages>1-</pages><issn>0013-7227</issn><issn>1945-7170</issn><eissn>1945-7170</eissn><abstract>Abstract
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 17β-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.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>32730568</pmid><doi>10.1210/endocr/bqaa127</doi><orcidid>https://orcid.org/0000-0002-0874-0754</orcidid><orcidid>https://orcid.org/0000-0003-3015-4177</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | 17β-Estradiol Antibodies Antibody Formation - immunology Betacoronavirus Contraceptives, Oral, Hormonal - therapeutic use Coronavirus Infections - drug therapy Coronavirus Infections - immunology Coronavirus Infections - mortality Coronavirus Infections - physiopathology Coronaviruses COVID-19 COVID-19 Drug Treatment Cytokine Release Syndrome - immunology Cytokine storm Cytokines Drug Repositioning Endocrinology Estradiol Estradiol - immunology Estradiol - therapeutic use Estrogen Replacement Therapy Estrogens - therapeutic use Female Health aspects Humans Immune response Immune system Immune Tolerance - immunology Immunity Immunity, Innate - immunology Immunological tolerance Immunomodulation Immunomodulation - immunology Inflammation Inflammatory response Male Men Mini-Reviews Morbidity Pandemics Pneumonia, Viral - drug therapy Pneumonia, Viral - immunology Pneumonia, Viral - mortality Pneumonia, Viral - physiopathology Pregnancy Pregnancy Complications, Infectious - immunology Progesterone Progesterone - immunology Progesterone - therapeutic use Progestins - therapeutic use Respiratory distress syndrome SARS-CoV-2 Selective Estrogen Receptor Modulators - therapeutic use Severity of Illness Index Sex Factors Sex hormones Steroid hormones Steroids Viral diseases Women |
| title | Estradiol, Progesterone, Immunomodulation, and COVID-19 Outcomes |
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