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实锤了！香港院士团队发现，奥密克戎引起睾丸急性损伤和萎缩！

2022-02-24 Swagpp MedSci原创

睾丸损伤新冠病毒疫苗保护
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即感即伤，精子数量最多下降83%！

今天（2月24日）起，英国英格兰将结束对新冠感染者的隔离义务，并于4月1日取消免费检新冠检测包的供应（弱势群体除外），正式宣告“与新冠共存”。瑞士、丹麦、德国等众多欧洲国家也加入了“与新冠共存”的大军。
 
与此同时，在新确诊病例和住院人数于过去两周分别下降了67%和38%的情况下，美国多州取消了口罩令，加州更是“首当其冲”地将新冠作为地方病来看待。“尽管仍有风险，但美国是时候开始逐步恢复正常了。”美国传染病专家、白宫疫情顾问福奇在周三时表示。
 
图片
 
全球都在陆续开放，真的不用担心新冠病毒带来的风险了吗？
 
此前， 《纽约邮报》有消息称“美国一男子在感染新冠病毒后，他的生殖器缩水了1.5英寸（约合3.8cm）”。消息一出，在网上引起一众恐慌。但由于是极个别的例子，这一说法站不住脚。
 
然而，来自香港大学李嘉诚医学院的袁国勇院士团队最新研究提示，即使是轻度新冠病毒感染，都可能引起急性睾丸损伤，伴随慢性不对称睾丸萎缩以及相关激素水平的变化。该论文于2月18日刊登在Clinical Infectious Diseases上。
 
图片

DOI: 10.1093/cid/ciac142

 
实验中，研究者们通过鼻内感染或直接睾丸感染两种途径，给仓鼠接种新冠病毒（包括原始毒株，Delta以及Omicron两种变异株），并选用流感病毒H1N1作为对照组，监测仓鼠睾丸的病毒学、免疫学和病理学变化。
 
图片新冠病毒感染睾丸
 
无论是对照组还是实验组，仓鼠均发生了自限性（指疾病在发生发展到一定程度后能自动停止并逐渐恢复痊愈，不需特殊治疗）呼吸道感染。这里可以理解为轻症。
 
虽然睾丸中的病毒载量和新冠病毒N蛋白的表达明显低于肺组织，但直接向睾丸接种新冠后，可以在睾丸间质细胞和附睾上皮细胞中检测出N蛋白的表达，意味着新冠能直接攻击睾丸。
 
图片
睾丸和肺部的病毒载量
 
研究者在给仓鼠的鼻内接种新冠病毒后的第4-7天，仓鼠精子数量急剧下降，仅为感染前的约54%，与生殖相关的激素——血清睾酮与抑制素B同样降低明显。
 
在感染后的42-120天，睾丸萎缩明显，体积和重量减少约32%，精子数量急剧降低至最初的17%左右。并伴随睾丸急性炎症、出血、曲细精管坏死和精子产生中断。
 
图片
感染第1-7天后的精子数量和重量
图片
感染第42-120天后的精子数量和重量
 
观察睾丸细胞切片发现，给仓鼠接种的病毒量越高，出现睾丸损伤的情况越严重。在增加对仓鼠感染的病毒浓度后，仅感染1天，便能在33%的仓鼠中观察到睾丸间质间隙水肿，以及生殖细胞的轻微改变。感染4天后，18.7%的仓鼠出现严重的睾丸出血，43.8%出现生精小管严重坏死。
 
类似的情况出现在仓鼠感染Delta和Omicron变异株后，但上述睾丸的感染或损害均未出现在感染H1N1的对照组中。
 
图片
Delta和Omicron对睾丸质量和精子数量的影响
 
难道只能“坐以待毙”了吗？并不是。研究学者给仓鼠接种了2针灭活疫苗后，发现获得免疫后的仓鼠即使感染了新冠病毒，也可以有效防止睾丸组织的病理损伤的发生。也就是说，睾丸损伤可以通过接种新冠疫苗来预防。
 
图片
疫苗对睾丸的保护作用
 
综上所述，本研究从动物试验的层面，证明了即使轻度的新冠病毒感染，也会引起急性睾丸损伤，进一步导致性激素水平改变以及性腺机能减退，但这一现象可以通过接种疫苗来预防。
 
本论文的通讯作者、中国工程院院士袁国勇表示，在新冠感染后的康复期，男性患者应该重视可能出现的性腺机能减退（性欲低下）和生育能力降低的情况。而新冠疫苗的接种，可以有效预防这种并发症。
 
近日，香港疫情不断发酵，短短时间内确诊病例急剧上升。根据23日香港卫生署发布的数据，截至当日零时，香港新增新冠确诊病例8674例，累计确诊75,248例。由于疫苗接种率低和老年人口占比高，此轮疫情所致的死亡数相当惊人，仅昨日一天香港新增死亡24例，累计死亡153例。
 
图片
图源：中新网
 
查询新冠疫苗接种率可以发现，香港两针疫苗的接种率不达80%。在这种情况下，由于没有免疫保护，新冠引起的后遗症（如上述提到的睾丸损伤）也很成问题。
 

参考文献：

Li C, Ye Z, Zhang AJ, et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections by intranasal or testicular inoculation induces testicular damage preventable by vaccination in golden Syrian hamsters [published online ahead of print, 2022 Feb 18]. Clin Infect Dis. 2022;ciac142. doi:10.1093/cid/ciac142

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1696040, encodeId=338e169604060, content=<a href='/topic/show?id=03b98809697' target=_blank style='color:#2F92EE;'>#萎缩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88096, encryptionId=03b98809697, topicName=萎缩)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53fc29868494, createdName=chendoc252, createdTime=Thu Dec 29 03:26:35 CST 2022, time=2022-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1200228, encodeId=97051200228f9, content=全球人口下滑，与此有关？？, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=医者仁者, createdTime=Mon Mar 07 14:38:37 CST 2022, time=2022-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368417, encodeId=c052136841e16, content=<a href='/topic/show?id=2fa7e3068b9' target=_blank style='color:#2F92EE;'>#睾丸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73068, encryptionId=2fa7e3068b9, topicName=睾丸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Sat Feb 26 00:26:35 CST 2022, time=2022-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1398289, encodeId=c24b13982899e, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat Feb 26 00:26:35 CST 2022, time=2022-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1197159, encodeId=32ba119e1590f, content=梅斯医学, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8a1c5563873, createdName=以上, createdTime=Fri Feb 25 10:38:58 CST 2022, time=2022-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1197158, encodeId=5a82119e15843, content=积极接种新冠疫苗，预防相关并发症, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26762630048, createdName=578830034, createdTime=Fri Feb 25 10:36:49 CST 2022, time=2022-02-25, status=1, ipAttribution=)]
    2022-12-29 chendoc252

    #萎缩#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1696040, encodeId=338e169604060, content=<a href='/topic/show?id=03b98809697' target=_blank style='color:#2F92EE;'>#萎缩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88096, encryptionId=03b98809697, topicName=萎缩)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53fc29868494, createdName=chendoc252, createdTime=Thu Dec 29 03:26:35 CST 2022, time=2022-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1200228, encodeId=97051200228f9, content=全球人口下滑，与此有关？？, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=医者仁者, createdTime=Mon Mar 07 14:38:37 CST 2022, time=2022-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368417, encodeId=c052136841e16, content=<a href='/topic/show?id=2fa7e3068b9' target=_blank style='color:#2F92EE;'>#睾丸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73068, encryptionId=2fa7e3068b9, topicName=睾丸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Sat Feb 26 00:26:35 CST 2022, time=2022-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1398289, encodeId=c24b13982899e, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat Feb 26 00:26:35 CST 2022, time=2022-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1197159, encodeId=32ba119e1590f, content=梅斯医学, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8a1c5563873, createdName=以上, createdTime=Fri Feb 25 10:38:58 CST 2022, time=2022-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1197158, encodeId=5a82119e15843, content=积极接种新冠疫苗，预防相关并发症, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26762630048, createdName=578830034, createdTime=Fri Feb 25 10:36:49 CST 2022, time=2022-02-25, status=1, ipAttribution=)]
    2022-03-07 医者仁者

    全球人口下滑，与此有关？？

    0

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    2022-02-26 zhangph

    #睾丸#

    0

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    2022-02-26 ms3046638856685384

    #损伤#

    0

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    2022-02-25 以上

    梅斯医学

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1696040, encodeId=338e169604060, content=<a href='/topic/show?id=03b98809697' target=_blank style='color:#2F92EE;'>#萎缩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88096, encryptionId=03b98809697, topicName=萎缩)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53fc29868494, createdName=chendoc252, createdTime=Thu Dec 29 03:26:35 CST 2022, time=2022-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1200228, encodeId=97051200228f9, content=全球人口下滑，与此有关？？, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=医者仁者, createdTime=Mon Mar 07 14:38:37 CST 2022, time=2022-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368417, encodeId=c052136841e16, content=<a href='/topic/show?id=2fa7e3068b9' target=_blank style='color:#2F92EE;'>#睾丸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73068, encryptionId=2fa7e3068b9, topicName=睾丸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Sat Feb 26 00:26:35 CST 2022, time=2022-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1398289, encodeId=c24b13982899e, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat Feb 26 00:26:35 CST 2022, time=2022-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1197159, encodeId=32ba119e1590f, content=梅斯医学, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8a1c5563873, createdName=以上, createdTime=Fri Feb 25 10:38:58 CST 2022, time=2022-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1197158, encodeId=5a82119e15843, content=积极接种新冠疫苗，预防相关并发症, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26762630048, createdName=578830034, createdTime=Fri Feb 25 10:36:49 CST 2022, time=2022-02-25, status=1, ipAttribution=)]
    2022-02-25 578830034

    积极接种新冠疫苗，预防相关并发症

    0

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