{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:59:56Z","timestamp":1789153196934,"version":"build-2803163510"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T00:00:00Z","timestamp":1605657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R00HD080742"],"award-info":[{"award-number":["R00HD080742"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["RO1HD065435"],"award-info":[{"award-number":["RO1HD065435"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011912","name":"Washington University School of Medicine in St. Louis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011912","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The coronavirus disease 2019 (COVID-19) first appeared in December 2019 and rapidly spread throughout the world. The SARS-CoV-2 virus enters the host cells by binding to the angiotensin-converting enzyme 2 (ACE2). Although much of the focus is on respiratory symptoms, recent reports suggest that SARS-CoV-2 can cause pregnancy complications such as pre-term birth and miscarriages; and women with COVID-19 have had maternal vascular malperfusion and decidual arteriopathy in their placentas. Here, we report that the ACE2 protein is expressed in both endometrial epithelial and stromal cells in the proliferative phase of the menstrual cycle, and the expression increases in stromal cells in the secretory phase. It was observed that the ACE2 mRNA and protein abundance increased during primary human endometrial stromal cell (HESC) decidualization. Furthermore, HESCs transfected with ACE2-targeting siRNA impaired the full decidualization response, as evidenced by a lack of morphology change and lower expression of the decidualization markers PRL and IGFBP1. Additionally, in mice during pregnancy, the ACE2 protein was expressed in the uterine epithelial cells, and stromal cells increased through day 6 of pregnancy. Finally, progesterone induced Ace2 mRNA expression in mouse uteri more than vehicle or estrogen. These data establish a role for ACE2 in endometrial physiology, suggesting that SARS-CoV-2 may be able to enter endometrial stromal cells and elicit pathological manifestations in women with COVID-19, including an increased risk of early pregnancy loss.<\/jats:p>","DOI":"10.1093\/biolre\/ioaa211","type":"journal-article","created":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T04:55:24Z","timestamp":1605675324000},"page":"336-343","source":"Crossref","is-referenced-by-count":56,"title":["The SARS-CoV-2 receptor, angiotensin-converting enzyme 2, is required for human endometrial stromal cell decidualization\u2020"],"prefix":"10.1093","volume":"104","author":[{"given":"Sangappa B","family":"Chadchan","sequence":"first","affiliation":[{"name":"Center for Reproductive Health Sciences, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Popli","sequence":"additional","affiliation":[{"name":"Center for Reproductive Health Sciences, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vineet K","family":"Maurya","sequence":"additional","affiliation":[{"name":"Center for Reproductive Health Sciences, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramakrishna","family":"Kommagani","sequence":"additional","affiliation":[{"name":"Center for Reproductive Health Sciences, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,18]]},"reference":[{"key":"2021021110482870400_ref1","doi-asserted-by":"crossref","DOI":"10.1016\/S0140-6736(20)30311-1","article-title":"2019-nCoV epidemic: What about pregnancies?","volume":"395","author":"Favre","year":"2020","journal-title":"Lancet"},{"key":"2021021110482870400_ref2","doi-asserted-by":"crossref","first-page":"920","DOI":"10.5858\/arpa.2020-0211-SA","article-title":"Infections in Pregnancy with Covid-19 and Other Respiratory Rna Virus Diseases Are Rarely, if ever, Transmitted to the Fetus: Experiences with Coronaviruses, Hpiv, Hmpv Rsv, and Influenza","volume":"144","author":"Schwartz","year":"2020","journal-title":"Arch Pathol Lab Med"},{"key":"2021021110482870400_ref3","article-title":"Placental pathology in COVID-19","author":"Shanes","year":"2020","journal-title":"medRxiv"},{"key":"2021021110482870400_ref4","doi-asserted-by":"crossref","first-page":"2198","DOI":"10.1001\/jama.2020.7233","article-title":"Second-trimester miscarriage in a pregnant woman with SARS-CoV-2 infection","volume":"323","author":"Baud","year":"2020","journal-title":"JAMA"},{"key":"2021021110482870400_ref5","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1002\/path.1570","article-title":"Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. 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