MP35-16 DOES FEMINIZING HORMONE THERAPY REDUCE ACE2 RECEPTOR EXPRESSION?: A HISTOLOGIC STUDY USING TRANSGENDER WOMEN’S TESTICLE TISSUE AFTER ORCHIECTOMY, AND, IMPLICATIONS FOR POSSIBLE USE FOR COVID19 TREATMENT AND/OR PREVENTION

INTRODUCTION AND OBJECTIVE: Invasion of cells by SARS-CoV-2 is mediated by the ACE2 receptor (ACE2r), which is highly expressed in testicle tissue. It has been proposed that men hospitalized with COVID19 be treated with estrogen (E) or E and Progesterone (P), however results of these trials remain unknown. Transgender women (TW) (male to female) are routinely treated with E or E+P regimens for feminization. We analyzed differences in ACE2r expression in testicles of TW taking E or E+P. METHODS: Orchiectomy specimens were collected from TW undergoing gender-affirming surgery, who were taking E or E+P preoperatively. For controls, we used benign orchiectomy specimens from cis-gender men. All specimens were stained with H&E, Trichrome (fibrosis), insulin-liken3 antibody (INS) (Leydig cell), and ACE2r IHC. Cells per high-powered field (HPF) were counted by cell type (Leydig, Sertoli, Germ). Stain intensity was rated on a 0-2 scale. IHC scoring was performed in a blinded fashion by a senior GU Pathologist. Mean cell type/HPF and stain intensity were compared across cohorts using Student's t-test (p 40). RESULTS: On IHC for Leydig cells and ACE2r staining the EP cohort had fewer Leydig cells compared to controls. The EP cohort also had greater degree of tissue fibrosis compared to controls and the E cohort. On intra-cohort analysis, TW >age 40 had lower Sertoli cell (H&E, ACE2r) and Germ cell (ACE2r) counts, and lower ACE2r stain intensity on Leydig cells. The EP cohort of TW >age 40 also showed increased fibrosis to TW age

Keywords:

• Hormone therapy
• receptor expression
• Orchiectomy
• Oncology
• Medicine
• Testicle
• 2019 20 coronavirus outbreak
• Internal medicine
• Coronavirus disease 2019
• transgender women
• severe acute respiratory syndrome coronavirus 2

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