ArticleThe Journal of infectious diseases2021
Placental Expression of ACE2 and TMPRSS2 in Maternal Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Are Placental Defenses Mediated by Fetal Sex?
Article in The Journal of infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Fetoplacental transmission and placental response to SARS-CoV-2: Evidence from the literature.Frontiers in medicine · 2022Pooled it
- ACE2 downregulation contributes to adverse cardiovascular and reproductive outcomes in female mice on high-fat diet.American journal of physiology. Heart and circulatory physiology · 2026Article
- Review
- The Timing of Intrauterine Exposure to Maternal SARS-CoV-2 Infection Impacts Neurodevelopment and Growth Trajectories During the First Year of Life.Journal of clinical medicine · 2026Article
- COVID-19 and female reproductive health: pathophysiological mechanisms and clinical reproductive outcomes.Frontiers in medicine · 2026Review
- Placenta - A Competent, But Not Infallible, Antiviral and Antiparasitic Barrier.Reproductive sciences (Thousand Oaks, Calif.) · 2025Review
- Sexual dimorphism in immunity and longevity among the oldest old.Frontiers in immunology · 2025Review
- SARS-CoV-2 Footprints in the Placenta: What We Know after Three Years of the Pandemic.Journal of personalized medicine · 2023Review
- Transmission of SARS-CoV-2 from mother to fetus or neonate: What to know and what to do?Seminars in fetal & neonatal medicine · 2023Review
- Mitochondria Targeted Antioxidant Significantly Alleviates Preeclampsia Caused by 11β-HSD2 Dysfunction via OPA1 and MtDNA Maintenance.Antioxidants (Basel, Switzerland) · 2022Article
- Maternal SARS-CoV-2 infection elicits sexually dimorphic placental immune responses.Science translational medicine · 2021Article
Corrections and comments
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Authors and funding
16 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundExpression of angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), host molecules required for viral entry, may underlie sex differences in vulnerability to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We investigated whether placental ACE2 and TMPRSS2 expression vary by fetal sex in the presence of maternal SARS-CoV-2 infection.
methodsPlacental ACE2 and TMPRSS2 expression was quantified by quantitative reverse transcription polymerase chain reaction (RT-PCR) and by Western blot in 68 pregnant women (38 SARS-CoV-2 positive, 30 SARS-CoV-2 negative) delivering at Mass General Brigham from April to June 2020. The impact of fetal sex and maternal SARS-CoV-2 exposure on ACE2 and TMPRSS2 was analyzed by 2-way analysis of variance (ANOVA).
resultsMaternal SARS-CoV-2 infection impacted placental TMPRSS2 expression in a sexually dimorphic fashion (2-way ANOVA interaction, P = .002). We observed no impact of fetal sex or maternal SARS-CoV-2 status on ACE2. TMPRSS2 expression was significantly correlated with ACE2 expression in males (Spearman ρ = 0.54, P = .02) but not females (ρ = 0.23, P = .34) exposed to maternal SARS-CoV-2.
conclusionsSex differences in placental TMPRSS2 but not ACE2 were observed in the setting of maternal SARS-CoV-2 infection, which may have implications for offspring vulnerability to placental infection.
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Registered trials
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