Anti-SARS-CoV-2 Action of 5α-Reductase Inhibitors May Be Mediated by Dehydroepiandrosterone

    February 2022 in “ The Journal of Urology ”
    Konstantinos Papadopoulos, Alexandra Papadopoulou, Warachaya Sutheesophon, T.C. Aw
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    TLDR Certain drugs like Dutasteride and Finasteride might help fight SARS-CoV-2 by increasing levels of a steroid called DHEA, which can protect the heart and increase nitric oxide to counteract the virus.
    The letter discusses the potential anti-SARS-CoV-2 effects of 5α-Reductase inhibitors, such as Dutasteride and Finasteride, which are known to increase steroid precursors like dehydroepiandrosterone (DHEA). DHEA and its sulfate form (DHEAS) are moderate endogenous sigma 1 receptor (S1R) agonists, and their administration may provide protection against SARS-CoV-2 through their S1R-mediated cardioprotective properties. Additionally, DHEA can be transformed into estrogen, leading to the upregulation of G protein-coupled estrogen receptor expression, which can prevent the development of nonalcoholic steatohepatitis. Both these mechanisms increase nitric oxide (NO) bioavailability, which can counteract SARS-CoV-2 infection at an early stage. The letter suggests that increasing eNOS activity and NO bioavailability through selected pharmaceutical interventions may protect patients from severe lung complications and provide cardio- and reno-protective effects in the course of SARS-CoV-2 infection.
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