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. 2023 Jun 23;10(2):129–132. doi: 10.1055/s-0043-1770767

Epigenetics of Hypogonadotropic Hypogonadism: Molecular Mimicry between Severe Acute Respiratory Syndrome Coronavirus 2 and KISSR

Darja Kanduc 1,
PMCID: PMC10289852  PMID: 37360005

Abstract

This study analyzed KISS1 and its receptor KISSR for peptide sharing with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was found that SARS-CoV-2 shares numerous minimal immune pentapeptide determinants with KISSR only. The peptide sharing has a high immunologic potential since almost all the common peptides are present in 101 SARS-CoV-2-derived immunoreactive epitopes. Data are in favor of configuring molecular mimicry as an epigenetic factor that can alter KISSR thus causing the hypogonadotropic hypogonadism syndrome with which altered KISSR associates.

Keywords: KISSR, SARS-CoV-2, autoimmunity: hypogonadotropic hypogonadism

Introduction

The human kisspeptin protein (here referred to as KISS1) and the human kisspeptin receptor protein (here referred to as KISSR) form the hypothalamic system that regulates the gonadotropic axis at puberty and in adulthood. 1 As reviewed by Szydełko-Gorzkowicz et al, 2 KISS1 and KISSR participate in different biological processes in that KISS1 plays an essential role in governing pubertal onset and human reproduction, while alterations of KISSR are responsible for the development of hypogonadotropic hypogonadism syndrome that includes dysfunction of fertility, absent or incomplete sexual maturation, and puberty disorders. 3 4

Recently, clinical reports 5 6 7 8 described the ex novo insurgence of hypogonadotropic hypogonadism disorders such as precocious accelerated puberty, hypothalamic amenorrhea, and male hypogonadism, during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. In spite of the importance of these clinical data, the issue has been overlooked 9 and, to the best of this author's knowledge, no molecular mechanism that might link the hypogonadotropic hypogonadism syndrome to the exposure to SARS-CoV-2 has been investigated and/or proposed.

Based on these observations, the present study posed a question: could SARS-CoV-2 infection/vaccination play a causal role via molecular mimicry and cross-reactivity in the diseases canonically ascribed to potential genetic variants of KISS1 and KISSR?

Consequently, molecular mimicry analyses were performed as follows. The amino acid (aa) sequences of KISS1 (Uniprot entry number: Q15726, 138 aa) and KISSR (Uniprot entry number: Q969F8, 398 aa) were retrieved from www.uniprot.org/ 10 and dissected into sequential pentapeptides offset by one residue (i.e., MNSLV, NSLVS, SLVSW, and so forth). The resulting pentapeptides were analyzed for occurrences in the SARS-CoV-2 proteome using the peptide match program (research.bioinformatics.udel.edu/peptidematch/index.jsp). 11 Human coronavirus 229E, Human respiratory syncytial virus B, and Mumps virus were utilized as controls. Pentapeptides were used as probes since a peptide formed by 5 aa residues defines a minimal immune determinant that can induce specific antibodies and specific antigen-antibody interaction. 12 13 14 15 The immunological potential of the peptide matching was analyzed by searching the Immune Epitope DataBase (IEDB, www.iedb.org/ ) 16 for SARS-CoV-2 immunoreactive epitopes hosting the shared pentapeptides.

The results of the molecular mimicry analyses are reported in Table 1 . As a first notable point, Table 1 shows that KISSR is the focus of an intense and specific peptide sharing with SARS-CoV-2. Numerically, 8 pentapeptides are common to the SARS-CoV-2 proteome and KISSR, while no sharing occurs with KISS1. In this regard, it has to be underscored that such a dimension of peptide sharing between SARS-CoV-2 and KISSR is unexpected and mathematically impossible. Indeed, assuming that all aa occur with the same frequency, the probability that one identical pentapeptide may occur in two proteins is 1 out of 20 5 (or 1 in 3,200,000 or 0.0000003125), that is, it is close to zero.

Table 1. Peptide sharing between SARS-CoV-2 and KISS1 and its receptor KISSR.

Virus Peptides a shared with:
KISS1 KISSR
Human coronavirus 229E
(NCBI:txid11137)
CACYA
Human respiratory syncytial virus B
(NCBI:txid79692)
Mumps virus
(NCBI:txid11171
AAYAL
SARS-CoV-2
(NCBI:txid2697049)
ANLAA, AVVLL, LALHR, LFLVL, LRLGS, NLAAT, NPLLY, TVATS
a

Peptides given in 1-letter code.

Then, the peptide commonality between SARS-CoV-2 and KISSR finds a logical scientific explanation in the close phenetic relationship between viruses and the origin of the eukaryotic cell. In fact, according to the endosymbiotic theory, 17 the first eukaryotic cell (our lineage) originated as a consortium consisting of an archaeal ancestor of the eukaryotic cytoplasm, a bacterial ancestor of mitochondria and a viral ancestor of the nucleus. Evolutionary, such a phenetic relationship, resulted in a sparse distribution of viral sequences in the human proteome. Immunologically, this means that targeting a viral protein inevitably leads to targeting human proteins, thus causing autoimmunity, 18

A second noteworthy point of the present study is the high immunological potential of peptide sharing. Indeed, exploration of IEDB revealed that all shared pentapeptides but one (namely, LRLGS) recur in 101 experimentally validated immunoreactive SARS-CoV-2-derived epitopes ( Table 2 ). That is, the potential immunologic cross-reactivity between SARS-CoV-2 and KISSR is high and powerfully suggests an autoimmune context for the hypogonadotropic hypogonadism disorders linked to KISSR alterations.

Table 2. SARS-CoV-2-derived epitopes containing peptide sequences common to KISSR.

IEDB ID a Epitope b c
1349 aflLFLVLi
4321 asANLAATk
26759 ikdlpkeiTVATSrt
37279 lLFLVLiml
48051 pkeiTVATSrtlsyy
48052 pkeiTVATSrtlsyykl
66952 TVATSrtlsy
100428 qliraaeirasANLAATk
531518 eiTVATSrtlsyykl
533455 rasANLAATkmsecv
1068860 aaeirasANLAATkm
1072541 sANLAATkmsecvlg
1074838 aeirasANLAATk
1074974 lLALHRsyl
1074999 mielslidfylcflaflLFLVLiml
1075003 NPLLYdanyflcw
1075083 TVATSrtlsyyk
1087755 tqqliraaeirasANLAA
1309418 aeirasANLAATkmsecvlg
1309534 nitrfqtlLALHRsyltpgd
1309938 rasANLAATkmsecvl
1310253 aeirasANLAATkms
1310513 itrfqtlLALHRsyl
1310529 keiTVATSrtlsyyk
1310547 kNPLLYdanyflcwh
1310592 lLALHRsyltpgdss
1310865 trfqtlLALHRsylt
1312358 eirasANLAATkmse
1312746 initrfqtlLALHRs
1312773 iraaeirasANLAAT
1313188 myasAVVLL
1313810 TVATSrtlsyyklga
1322562 NPLLYdany
1323750 rasANLAATk
1329417 fqtlLALHRsyltpg
1329597 iraaeirasANLAATk
1331140 crskNPLLY
1331247 dfylcflaflLFLVL
1332969 NPLLYdanyfl
1334248 vmyasAVVLL
1334326 yasAVVLLi
1334458 dikdlpkeiTVATSrt
1354273 ginitrfqtlLALHRsy
1377484 aghhlgrcdikdlpkeiTVATSrtls
1378052 cdikdlpkeiTVATSr
1382649 ikdlpkeiTVATSrtl
1383272 kdlpkeiTVATSrtls
1384629 lLALHRsyltpgdsss
1387524 rcdikdlpkeiTVATS
1392223 ikdlpkeiTVATSrtlsyyk
1394016 qtlLALHRsyltpgdss
1407859 aeirasANLAAT
1415369 cdikdlpkeiTVATS
1427956 eirasANLAATk
1464013 LALHRsyltpgd
1464014 LALHRsyltpgdsssgwt
1468599 lLALHRsyltpg
1496551 rasANLAATkms
1518333 trfqtlLALHRs
1539641 AVVLLilmtartvyd
1539752 crskNPLLYdanyfl
1539916 dlpkeiTVATSrtls
1541665 myasAVVLLilmtar
1542193 qtlLALHRsyltpgd
1542507 skNPLLYdanyflcw
1543352 wkcrskNPLLYdany
1584233 qliraaeirasANLAATkm
1596090 nitrfqtlLALHRsyltpgdsssgwtagaa
1596567 yvtqqliraaeirasANLAATkmsecvl
1597725 LALHRsyltpgdsssgwtagaaayy
1598225 aeirasANLAATkmsecv
1605379 ginitrfqtlLALHRsyl
1626811 pkeiTVATSrtlsyyk
1643627 aeirasANLAATkmse
1651464 dlpkeiTVATSrtlsy
1654327 eirasANLAATkmsec
1667866 irasANLAATkmsecv
1673173 LALHRsyltpgdsssg
1688275 qliraaeirasANLAA
1692097 sANLAATkmsecvlgq
1699067 tlLALHRsyltpgdss
1835518 trfqtlLALHRsyltpgdsss
1860045 tlLALHRsy
1865417 eirasANLAATkmsecvlgq
1866712 initrfqtlLALHRsyltpg
1870005 tqqliraaeirasANLAATk
1870081 TVATSrtlsyyklgasqrva
1871461 eirasANLAATkm
1873723 TVATSrtlsyykl
2001009 dikdlpkeiTVATSr
2001075 ginitrfqtlLALHR
2001123 irasANLAATkmsec
2001183 liraaeirasANLAA
2060884 rasANLAATkmsecvlgqsk
2116235 NLAATkmsecvlgqskrvdfcg
2116260 qtlLALHRsyltpgdsssgwta
2116290 tqqliraaeirasANLAATkms
2132218 LALHRsyltpgdsss
2133990 aeirasANLAA
2134243 qtlLALHRsyl
2135541 rfqtlLALHRsyltpgdsss
a

Epitope IEDB IDs are listed in ascending numerical order. Details and references available at http://www.iedb.org/ .

b

Epitope peptide sequences given in 1-letter code.

c

Shared peptides given in capital letters.

Conclusions

Starting from 2000, 19 this author's lab continuously reported that a massive peptide overlap exists between human and pathogen proteins, thus calling attention to the molecular mimicry and cross-reactivity issues in immunology and vaccinal protocols. 19 20 21 22 23 24 25 26 Here, this study describes the molecular mimicry and the immunologic cross-reactive potential between SARS-CoV-2 and KISSR, alterations of which are responsible for hypogonadotropic hypogonadism syndrome. 3 4

In essence, this study scientifically explains the clinical reports 5 6 7 8 on the onset of hypothalamic-pituitary dysfunctions following the SARS-CoV-2 pandemic and warrants further investigations, also in light of the scarce attention paid to the topic in relation to the emerging infectious disease outbreaks. 9 Clinically, the present data (1) lead to the inclusion of the hypogonadotropic hypogonadism syndrome among the SARS-CoV-2-related disorders that collectively form the coronavirus disease 2019 diseasome and (2) permit to catalog as autoimmune a syndrome until now defined idiopathic. 3 27 28

Funding Statement

Funding None

Footnotes

Conflict of Interest None declared.

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