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Review

Air Pollution and COVID-19: A Possible Dangerous Synergy for Male Fertility

1
Andrology Unit and Service of Lifestyle Medicine in UroAndrology, Local Health Authority (ASL) Salerno, Coordination Unit of the Network for Environmental and Reproductive Health (EcoFoodFertility Project), “Oliveto Citra Hospital”, 84020 Oliveto Citra, Italy
2
PhD Program in Evolutionary Biology and Ecology, Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy
3
Unit of Hygiene, Epidemiology, and Public Health, Department of Medical and Surgical Specialties Radiological Sciences and Public Health, University of Brescia, 21100 Brescia, Italy
4
ISPRA, Italian Institute for Environmental Protection and Research, Via Vitaliano Brancati 60, 00144 Roma, Italy
5
Department of Biology, University of Naples Federico II, 80126 Napoli, Italy
6
Unit of Reproductive Medicine (UMR), 95030 Catania, Italy
7
Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
8
Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy
*
Authors to whom correspondence should be addressed.
These authors contribute equally (co-last).
Academic Editors: Riccardo Polosa, Pietro Ferrara, Luciana Albano and Venera Tomaselli
Int. J. Environ. Res. Public Health 2021, 18(13), 6846; https://doi.org/10.3390/ijerph18136846
Received: 20 May 2021 / Revised: 18 June 2021 / Accepted: 21 June 2021 / Published: 25 June 2021
Several studies indicate that semen quality has strongly declined in the last decades worldwide. Air pollution represents a significant co-factor with the COVID-19 impact and has negative effects on the male reproductive system, through pro-oxidant, inflammatory and immune-dysregulating mechanisms. It has recently been reported that chronic exposure to PM2.5 causes overexpression of the alveolar ACE2 receptor, the entry route of SARS-CoV-2 into the organism shared by the lungs and testis where expression is highest in the body. In the testis, the ACE2/Ang-(1–7)/MasR pathway plays an important role in the regulation of spermatogenesis and an indirect mechanism of testicular damage could be due to the blockade of the ACE2 receptor by SARS-CoV-2. This prevents the conversion of specific angiotensins, and their excess causes inflammation with the overproduction of cytokines. PM2.5-induced overexpression of the alveolar ACE2 receptor, in turn, could increase local viral load in patients exposed to pollutants, producing ACE2 receptor depletion and compromising host defenses. By presenting an overall view of epidemiological data and molecular mechanisms, this manuscript aims to interpret the possible synergistic effects of both air pollution and COVID-19 on male reproductive function, warning that the spread of SARS-CoV-2 in the fertile years may represent a significant threat to global reproductive health. All of this should be of great concern, especially for men of the age of maximum reproductive capacity, and an important topic of debate for policy makers. Altered environmental conditions, together with the direct and indirect short- and long-term effects of viral infection could cause a worsening of semen quality with important consequences for male fertility, especially in those areas with higher environmental impact. View Full-Text
Keywords: COVID-19; SARS-CoV-2; male fertility; semen quality; air pollution; ACE2 COVID-19; SARS-CoV-2; male fertility; semen quality; air pollution; ACE2
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MDPI and ACS Style

Montano, L.; Donato, F.; Bianco, P.M.; Lettieri, G.; Guglielmino, A.; Motta, O.; Bonapace, I.M.; Piscopo, M. Air Pollution and COVID-19: A Possible Dangerous Synergy for Male Fertility. Int. J. Environ. Res. Public Health 2021, 18, 6846. https://doi.org/10.3390/ijerph18136846

AMA Style

Montano L, Donato F, Bianco PM, Lettieri G, Guglielmino A, Motta O, Bonapace IM, Piscopo M. Air Pollution and COVID-19: A Possible Dangerous Synergy for Male Fertility. International Journal of Environmental Research and Public Health. 2021; 18(13):6846. https://doi.org/10.3390/ijerph18136846

Chicago/Turabian Style

Montano, Luigi, Francesco Donato, Pietro Massimiliano Bianco, Gennaro Lettieri, Antonino Guglielmino, Oriana Motta, Ian Marc Bonapace, and Marina Piscopo. 2021. "Air Pollution and COVID-19: A Possible Dangerous Synergy for Male Fertility" International Journal of Environmental Research and Public Health 18, no. 13: 6846. https://doi.org/10.3390/ijerph18136846

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