{"id":3691,"date":"2020-11-06T16:43:05","date_gmt":"2020-11-06T15:43:05","guid":{"rendered":"https:\/\/www.mc-praha.cz\/mcp\/?p=3691"},"modified":"2020-11-13T10:02:28","modified_gmt":"2020-11-13T09:02:28","slug":"rs-cov-2-pusobi-vice-na-muze-nez-na-zeny","status":"publish","type":"post","link":"https:\/\/www.mc-praha.cz\/mcp\/rs-cov-2-pusobi-vice-na-muze-nez-na-zeny\/","title":{"rendered":"SARS-CoV-2 p\u016fsob\u00ed v\u00edce na mu\u017ee ne\u017e na \u017eeny"},"content":{"rendered":"<p><strong>Studie z jara 2020 nazna\u010dily, \u017ee jsou mu\u017ei k\u00a0nemoci COVID-19 n\u00e1chyln\u011bj\u0161\u00ed ne\u017e \u017eeny. V\u00fdsledky nov\u00e9 studie \u201eSexual Dimorphism of Coronavirus 19 Morbidity and Lethality\u201c ze z\u00e1\u0159\u00ed 2020 ukazuj\u00ed, \u017ee jsou pohlavn\u00ed hormony potenci\u00e1ln\u00edmi faktory ur\u010duj\u00edc\u00edmi klinick\u00fd pr\u016fb\u011bh infekce. Tato studie rovn\u011b\u017e popisuje, jak se pr\u016fb\u011bh t\u00e9to nemoci r\u016fzn\u00ed mezi pohlav\u00edmi v\u00a0z\u00e1vislosti na v\u011bku.<\/strong><\/p>\n<p>V prvn\u00edch studi\u00edch z\u00a0dubna\u2013kv\u011btna 2020 vy\u0161lo najevo, \u017ee jsou \u017eeny m\u00e9n\u011b n\u00e1chyln\u00e9 k\u00a0infekci virem SARS-CoV-2 ne\u017e mu\u017ei. P\u0159\u00edtomnost dvou X chromoz\u00f3m\u016f u \u017een posiluje imunitn\u00ed syst\u00e9m, p\u0159esto\u017ee je jeden z\u00a0chromoz\u00f3m\u016f inaktivov\u00e1n. U mu\u017e\u016f se jedn\u00e1 o tzv. \u201emodel imunitn\u00edho handicapu\u201c, kter\u00fd p\u0159edpokl\u00e1d\u00e1, \u017ee se n\u011bkter\u00e9 typicky mu\u017esk\u00e9 znaky, podm\u00edn\u011bn\u00e9 vy\u0161\u0161\u00ed hladinou testosteronu, vyvinuly na \u00fakor kvality mu\u017esk\u00e9 imunitn\u00ed odpov\u011bdi. D\u00edky gen\u016fm k\u00f3dovan\u00fdm X chromozomem, kter\u00e9 reguluj\u00ed imunitn\u00ed odpov\u011b\u010f, vykazuj\u00ed \u017eeny ni\u017e\u0161\u00ed hodnoty virov\u00e9 n\u00e1lo\u017ee (po\u010det virov\u00fdch \u010d\u00e1stic p\u0159\u00edtomn\u00fdch v\u00a0organismu) a ni\u017e\u0161\u00ed z\u00e1n\u011btlivou aktivitu ne\u017e mu\u017ei. Z\u00e1rove\u0148 maj\u00ed \u017eeny vy\u0161\u0161\u00ed hladinu CD4+ T bun\u011bk, kter\u00e9 maj\u00ed lep\u0161\u00ed imunitn\u00ed odpov\u011b\u010f. \u017deny rovn\u011b\u017e dok\u00e1\u017e\u00ed produkovat vy\u0161\u0161\u00ed hladiny protil\u00e1tek schopn\u00fdch v\u00a0t\u011ble d\u00e9le cirkulovat. Aktivace imunitn\u00edch bun\u011bk v\u00a0t\u011ble je podm\u00edn\u011bn\u00e1 TLR7 (toll-like receptorem 7) a produkc\u00ed interferon\u016f a n\u00e1sledn\u011b produkc\u00ed cytokin\u016f IL-6 (interleukin 6) a IL-1 (interleukin 1). U \u017een je produkce proz\u00e1n\u011btliv\u00e9ho IL-6 ni\u017e\u0161\u00ed ne\u017e u mu\u017e\u016f, co\u017e je rovn\u011b\u017e spojov\u00e1no s dlouhov\u011bkost\u00ed. Do budoucna se pravd\u011bpodobn\u011b budou vyu\u017e\u00edvat l\u00e9ky blokuj\u00edc\u00ed receptory t\u011bchto IL-6 a IL-1.<\/p>\n<p>Bylo tak\u00e9 zji\u0161t\u011bno, \u017ee se mikroorganismy, ob\u00fdvaj\u00edc\u00ed lidsk\u00fd gastrointestin\u00e1ln\u00ed trakt, li\u0161\u00ed typov\u011b v\u00a0z\u00e1vislosti na pohlav\u00ed jedince. Tento odli\u0161n\u00fd mikrobiom (nebo t\u00e9\u017e \u201emicrogenderome\u201c) se rozv\u00edj\u00ed v\u00a0pubert\u011b, kdy se hladina pohlavn\u00edch hormon\u016f zvy\u0161uje, a \u00fa\u010dastn\u00ed se regulace lok\u00e1ln\u00edho i syst\u00e9mov\u00e9ho z\u00e1n\u011btu a imunitn\u00ed odpov\u011bdi.<\/p>\n<p>V\u00a0neposledn\u00ed \u0159ad\u011b bylo zji\u0161t\u011bno, \u017ee odli\u0161nosti pohlav\u00ed hraj\u00ed roli p\u0159i infek\u010dnosti SARS-CoV-2 tak\u00e9 v\u00a0z\u00e1vislosti na populac\u00edch mitochondri\u00ed. Mitochondrie jsou nejen bioenergetick\u00e9 a biosyntetick\u00e9 organely, ale jsou i nezbytn\u00fdmi regul\u00e1tory a tv\u016frci imunitn\u00edch odpov\u011bd\u00ed. Jedna z teori\u00ed, pro\u010d jsou mu\u017ei n\u00e1chyln\u011bj\u0161\u00ed k nemoci COVID-19 je, \u017ee mitochondrie se d\u011bd\u00ed v\u00fdhradn\u011b po matce a p\u0159i formov\u00e1n\u00ed a zr\u00e1n\u00ed vaj\u00ed\u010dka doch\u00e1z\u00ed u v\u0161ech sav\u010d\u00edch samic k\u00a0reparaci mitochondri\u00ed a vy\u0159azen\u00ed takov\u00fdch, kter\u00e9 nesou mutace pro samici \u0161kodliv\u00e9. M\u016f\u017ee v\u0161ak doj\u00edt k\u00a0ponech\u00e1n\u00ed mutac\u00ed, kter\u00e9 jsou \u0161kodliv\u00e9 pro samce, zat\u00edmco pro samice nikoli (tzv. \u201emat\u010dina kletba\u201c). To m\u00e1 za n\u00e1sledek ovlivn\u011bn\u00ed kvality imunitn\u00ed odpov\u011bdi u samc\u016f, respektive mu\u017e\u016f, co\u017e op\u011bt vede ke zv\u00fd\u0161en\u00e9 n\u00e1chylnosti k\u00a0onemocn\u011bn\u00ed COVID-19. Byl prok\u00e1z\u00e1n pozitivn\u00ed \u00fa\u010dinek melatoninu na COVID-19, proto\u017ee tato l\u00e1tka m\u00e1 velice dobr\u00e9 \u00fa\u010dinky na homeost\u00e1zu mitochondri\u00ed, t\u00edm se zvy\u0161uje produkce antioxida\u010dn\u00edch enzym\u016f a produkce adenosin trifosf\u00e1tu.<\/p>\n<p>Fungov\u00e1n\u00ed hormon\u00e1ln\u00edho syst\u00e9mu se s\u00a0v\u011bkem m\u011bn\u00ed. U mu\u017e\u016f s v\u011bkem kles\u00e1 hladina testosteronu (v\u00fdrazn\u011b sn\u00ed\u017een\u00e1 je u 15\u201320 % mu\u017e\u016f mezi 49.\u201375. rokem), zvy\u0161uje se hladina SHBG (pohlavn\u00edch hormon\u016f v\u00e1zaj\u00edc\u00edch globulin) a LH (luteiniza\u010dn\u00edho hormonu). Bylo zji\u0161t\u011bno, \u017ee ACE2 (angiotenzin konvertuj\u00edc\u00ed enzym 2), je\u017e je kritick\u00fdm receptorem pro SARS-CoV-2, je produkov\u00e1n Leydigov\u00fdmi bu\u0148kami a t\u00edm tento virus dok\u00e1\u017ee ovliv\u0148ovat produkci testosteronu. Sn\u00ed\u017een\u00e1 produkce testosteronu b\u00fdv\u00e1 v\u011bt\u0161inou spojov\u00e1na se sn\u00ed\u017eenou aktivitou d\u00fdchac\u00edch sval\u016f a sn\u00ed\u017eenou toleranc\u00ed fyzick\u00e9 z\u00e1t\u011b\u017ee. Sn\u00ed\u017een\u00e1 hladina testosteronu u mu\u017e\u016f je rovn\u011b\u017e spojena s\u00a0vy\u0161\u0161\u00edm v\u00fdskytem obezity, diabetu II. typu a chronick\u00e9 obstruk\u010dn\u00ed plicn\u00ed nemoci, co\u017e jsou z\u00e1rove\u0148 rizikov\u00e9 faktory pro z\u00e1va\u017en\u011bj\u0161\u00ed pr\u016fb\u011bh COVID-19.<\/p>\n<p>U postmenopauz\u00e1ln\u00edch \u017een je nejv\u00edce zastoupen hormon estron, zat\u00edmco hladina estradiolu, testosteronu i SHBG kles\u00e1. Vyskytuj\u00ed se u nich tak\u00e9 vysok\u00e9 hodnoty FSH (folikuly stimuluj\u00edc\u00edho hormonu), LH, i ACE2 produkovan\u00e9ho\u00a0granul\u00f3zn\u00edmi bu\u0148kami ov\u00e1ri\u00ed. Na rozd\u00edl od mu\u017e\u016f, pohlavn\u00ed hormony \u017een maj\u00ed protektivn\u00ed efekt p\u0159ed COVIDEM-19.<\/p>\n<p>Imprinting testosteronu a estrogen\u016f u mu\u017e\u016f a \u017een v\u00a0mlad\u0161\u00edm v\u011bku m\u016f\u017ee hr\u00e1t roli v\u00a0dimorfn\u00ed letalit\u011b COVID-19 v\u00a0pozd\u011bj\u0161\u00edm v\u011bku.<\/p>\n<p>U mu\u017e\u016f testosteron s\u00e1m o sob\u011b napom\u00e1h\u00e1 progresi nemoci COVID-19. Androgenn\u00ed receptory aktivuj\u00ed transkripci TMPRSS2 (transmembr\u00e1nov\u00e9 serin-2 prote\u00e1zy), jej\u00ed\u017e aktivita je kl\u00ed\u010dov\u00e1 pro agresivn\u00ed pr\u016fb\u011bh nemoci u naka\u017een\u00e9ho jedince.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Ing. V\u00edt Smejkal<\/strong><\/p>\n<p><strong>MUDr. Jana \u0160imkov\u00e1<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p>Zdroje:<\/p>\n<ul>\n<li>Kloc M, Ghobrial RM, Kubiak JZ (2020): The role of genetic sex and mitochondria in response to COVID-19 infection. International Archives of Allergy and Immunology, 181, 629-634<\/li>\n<li>Conti P, Younes A (2020): Coronavirus COV-19\/SARS-CoV-2 affects women less than men: clinical response to viral infection. Journal of Biological Regulators and Homeostatic Agents, 34, 339-343<\/li>\n<li>Brandi ML, Giustina A (2020): Sexual dimorphism of coronavirus 19 morbidity and lethality. Trends in Endocrynology and Metabolism. doi: <a href=\"https:\/\/doi.org\/10.1016\/j.tem.2020.09.003\">1016\/j.tem.2020.09.003<\/a>.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Studie z jara 2020 nazna\u010dily, \u017ee jsou mu\u017ei k\u00a0nemoci COVID-19 n\u00e1chyln\u011bj\u0161\u00ed ne\u017e \u017eeny. V\u00fdsledky nov\u00e9 [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"image","meta":{"_uag_custom_page_level_css":""},"categories":[1],"tags":[],"uagb_featured_image_src":{"full":false,"thumbnail":false,"medium":false,"medium_large":false,"large":false,"1536x1536":false,"2048x2048":false,"boldthemes_grid":false,"boldthemes_grid_11":false,"boldthemes_grid_22":false,"boldthemes_grid_21":false,"boldthemes_grid_12":false,"boldthemes_latest_posts":false,"boldthemes_grid_gallery":false},"uagb_author_info":{"display_name":"Jbednar","author_link":"https:\/\/www.mc-praha.cz\/mcp\/author\/jbednar\/"},"uagb_comment_info":0,"uagb_excerpt":"Studie z jara 2020 nazna\u010dily, \u017ee jsou mu\u017ei k\u00a0nemoci COVID-19 n\u00e1chyln\u011bj\u0161\u00ed ne\u017e \u017eeny. V\u00fdsledky nov\u00e9 [&hellip;]","post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts\/3691"}],"collection":[{"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/comments?post=3691"}],"version-history":[{"count":2,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts\/3691\/revisions"}],"predecessor-version":[{"id":3701,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts\/3691\/revisions\/3701"}],"wp:attachment":[{"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/media?parent=3691"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/categories?post=3691"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/tags?post=3691"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}