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Chen H, Wang Y, Lyu Q, Ai A, Fu Y, Tian H, Cai R, Hong Q, Chen Q, Shoham Z, Kuang Y. Comparison of live-birth defects after luteal-phase ovarian stimulation vs. conventional ovarian stimulation for in vitro fertilization and vitrified embryo transfer cycles. Fertil Steril 2015; 103:1194-1201.e2. [DOI: 10.1016/j.fertnstert.2015.02.020] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 01/28/2015] [Accepted: 02/16/2015] [Indexed: 10/23/2022]
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Zhang L, Wang XH, Zheng XM, Liu TZ, Zhang WB, Zheng H, Chen MF. Maternal gestational smoking, diabetes, alcohol drinking, pre-pregnancy obesity and the risk of cryptorchidism: a systematic review and meta-analysis of observational studies. PLoS One 2015; 10:e0119006. [PMID: 25798927 PMCID: PMC4370654 DOI: 10.1371/journal.pone.0119006] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 01/26/2015] [Indexed: 11/29/2022] Open
Abstract
Background Maternal gestational smoking, diabetes, alcohol drinking, and pre-pregnancy obesity are thought to increase the risk of cryptorchidism in newborn males, but the evidence is inconsistent. Method We conducted a systematic review and meta-analysis of studies on the association between maternal gestational smoking, diabetes, alcohol drinking, and pre-pregnancy obesity and the risk of cryptorchidism. Articles were retrieved by searching PubMed and ScienceDirect, and the meta-analysis was conducted using Stata/SE 12.0 software. Sensitivity analysis was used to evaluate the influence of confounding variables. Results We selected 32 articles, including 12 case—control, five nested case—control, and 15 cohort studies. The meta-analysis showed that maternal smoking (OR = 1.17, 95% CI: 1.11–1.23) or diabetes (OR = 1.21, 95%CI: 1.00–1.46) during pregnancy were associated with increased risk of cryptorchidism. Overall, the association between maternal alcohol drinking (OR = 0.97, 95% CI: 0.87–1.07), pre-pregnancy body mass index (OR = 1.02, 95% CI: 0.95–1.09) and risk of cryptorchidism were not statistically significant. Additional analysis showed reduced risk (OR = 0.89, 95% CI: 0.82–0.96) of cryptorchidism with moderate alcohol drinking during pregnancy. No dose—response relationship was observed for increments in body mass index in the risk of cryptorchidism. Sensitivity analysis revealed an unstable result for the association between maternal diabetes, alcohol drinking and cryptorchidism. Moderate heterogeneity was detected in studies of the effect of maternal alcohol drinking and diabetes. No publication bias was detected. Conclusion Maternal gestational smoking, but not maternal pre-pregnancy overweight or obesity, was associated with increased cryptorchidism risk in the offspring. Moderate alcohol drinking may reduce the risk of cryptorchidism while gestational diabetes may be a risk factor, but further studies are needed to verify this.
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Affiliation(s)
- Lin Zhang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
- * E-mail:
| | - Xing-Huan Wang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Xin-Min Zheng
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Tong-Zu Liu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Wei-Bin Zhang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Hang Zheng
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Mi-Feng Chen
- Department of Obstetrical, Jingmen No. 2 People’s Hospital, Jingmen Hubei, People’s Republic of China
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Arrebola JP, Molina-Molina JM, Fernández MF, Sáenz JM, Amaya E, Indiveri P, Hill EM, Scholze M, Orton F, Kortenkamp A, Olea N. A novel biomarker for anti-androgenic activity in placenta reveals risks of urogenital malformations. Reproduction 2015; 149:605-13. [PMID: 25784770 DOI: 10.1530/rep-14-0525] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 03/17/2015] [Indexed: 01/05/2023]
Abstract
It has been hypothesized that the rise in male reproductive disorders over recent decades may at least be partially attributable to environmental factors, including chemical exposures, but observed associations with single chemicals were rather weak. The aim of this case-control study was to explore the relationship between exposure to mixtures of (anti-)androgenic chemicals during pregnancy and the risk of cryptorchidism and/or hypospadias in offspring, using the total effective xenobiotic burden of anti-androgens (TEXB-AA) as a biomarker. A subsample of 29 cases (16 of cryptorchidism, 12 of hypospadias, and one of both disorders) and 60 healthy controls was nested in a cohort of male newborns recruited between October 2000 and July 2002. The (anti-)androgenic activity of placenta samples collected at delivery was assessed using TEXB-AA biomarker, combined with a bioassay-directed fractionation protocol that separated endogenous hormones from most (anti-)androgenic chemicals by normal-phase HPLC. The bioassay measures the androgen-induced luciferase activity and the inhibition of this pathway by (anti-)androgens. First, we collected 27 HPLC fractions in each placenta extract, which were all tested in the bioassay. The multivariable statistical analyses indicated a statistically significant positive dose-response association between the potent anti-androgenic activity of the HPLC fraction collected during minutes 1-2 (F2) and the risk of malformations (odds ratio: 2.33, 95% CI: 1.04-5.23). This study represents a novel approach for the estimation of combined effects of the total anti-androgenic load and the associations suggest an effect of environmental pollutants on the development of fetal reproductive tract.Free Spanish abstract: A Spanish translation of this abstract is freely available at http://www.reproduction-online.org/content/149/6/605/suppl/DC1.
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Affiliation(s)
- Juan P Arrebola
- Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK
| | - José M Molina-Molina
- Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK
| | - Mariana F Fernández
- Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK
| | - Jose M Sáenz
- Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK
| | - Esperanza Amaya
- Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK
| | - Paolo Indiveri
- Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK
| | - Elizabeth M Hill
- Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK
| | - Martin Scholze
- Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK
| | - Frances Orton
- Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK
| | - Andreas Kortenkamp
- Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK
| | - Nicolás Olea
- Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK Instituto de Investigación Biosanitaria ibs.GRANADASan Cecilio University Hospital, University of Granada, 18071 Granada, SpainCIBER en Epidemiología y Salud Pública (CIBERESP)Madrid, SpainSchool of Life SciencesUniversity of Sussex, Falmer, Brighton BN1 9QG, UKInstitute of the EnvironmentHealth and Societies, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UKBiosciencesCollege of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK
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Hypospadias in offspring is associated with chronic exposure of parents to organophosphate and organochlorine pesticides. Toxicol Lett 2014; 230:139-45. [DOI: 10.1016/j.toxlet.2013.10.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 09/16/2013] [Accepted: 10/16/2013] [Indexed: 11/21/2022]
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55
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Jorgez CJ, Rosenfeld JA, Wilken NR, Vangapandu HV, Sahin A, Pham D, Carvalho CMB, Bandholz A, Miller A, Weaver DD, Burton B, Babu D, Bamforth JS, Wilks T, Flynn DP, Roeder E, Patel A, Cheung SW, Lupski JR, Lamb DJ. Genitourinary defects associated with genomic deletions in 2p15 encompassing OTX1. PLoS One 2014; 9:e107028. [PMID: 25203062 PMCID: PMC4159299 DOI: 10.1371/journal.pone.0107028] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 08/06/2014] [Indexed: 02/08/2023] Open
Abstract
Normal development of the genitourinary (GU) tract is a complex process that frequently goes awry. In male children the most frequent congenital GU anomalies are cryptorchidism (1-4%), hypospadias (1%) and micropenis (0.35%). Bladder exstrophy and epispadias complex (BEEC) (1∶47000) occurs less frequently but significantly impacts patients' lives. Array comparative genomic hybridization (aCGH) identified seven individuals with overlapping deletions in the 2p15 region (66.0 kb-5.6 Mb). Six of these patients have GU defects, while the remaining patient has no GU defect. These deletions encompass the transcription factor OTX1. Subjects 2-7 had large de novo CNVs (2.39-6.31 Mb) and exhibited features similar to those associated with the 2p15p16.1 and 2p15p14 microdeletion syndromes, including developmental delay, short stature, and variable GU defects. Subject-1 with BEEC had the smallest deletion (66 kb), which deleted only one copy of OTX1. Otx1-null mice have seizures, prepubescent transient growth retardation and gonadal defects. Two subjects have short stature, two have seizures, and six have GU defects, mainly affecting the external genitalia. The presence of GU defects in six patients in our cohort and eight of thirteen patients reported with deletions within 2p14p16.1 (two with deletion of OTX1) suggest that genes in 2p15 are important for GU development. Genitalia defects in these patients could result from the effect of OTX1 on pituitary hormone secretion or on the regulation of SHH signaling, which is crucial for development of the bladder and genitalia.
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Affiliation(s)
- Carolina J. Jorgez
- Center for Reproductive Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, United States of America
- * E-mail: (CJJ); (DJL)
| | - Jill A. Rosenfeld
- Signature Genomic Laboratories, PerkinElmer, Inc., Spokane, Washington, United States of America
| | - Nathan R. Wilken
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, United States of America
| | - Hima V. Vangapandu
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, United States of America
| | - Aysegul Sahin
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, United States of America
| | - Dung Pham
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, United States of America
| | - Claudia M. B. Carvalho
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, United States of America
| | - Anne Bandholz
- Signature Genomic Laboratories, PerkinElmer, Inc., Spokane, Washington, United States of America
| | - Amanda Miller
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - David D. Weaver
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Barbara Burton
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, United States of America
| | - Deepti Babu
- University of Alberta, Edmonton, Alberta, Canada
| | | | - Timothy Wilks
- Madigan Army Medical Center, Department of Pediatrics, Tacoma, Washington, United States of America
| | - Daniel P. Flynn
- Department of Children's Endocrinology, St. Luke's Children's Specialty Center, Boise, Idaho, United States of America
| | - Elizabeth Roeder
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
| | - Ankita Patel
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, United States of America
| | - Sau W. Cheung
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, United States of America
| | - James R. Lupski
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, United States of America
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
| | - Dolores J. Lamb
- Center for Reproductive Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, United States of America
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, United States of America
- * E-mail: (CJJ); (DJL)
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Is bisphenol S a safe substitute for bisphenol A in terms of metabolic function? An in vitro study. Toxicol Appl Pharmacol 2014; 280:224-35. [PMID: 25111128 DOI: 10.1016/j.taap.2014.07.025] [Citation(s) in RCA: 133] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 07/29/2014] [Accepted: 07/31/2014] [Indexed: 01/08/2023]
Abstract
As bisphenol A (BPA) has been shown to induce adverse effects on human health, especially through the activation of endocrine pathways, it is about to be withdrawn from the European market and replaced by analogues such as bisphenol S (BPS). However, toxicological data on BPS is scarce, and so it is necessary to evaluate the possible effects of this compound on human health. We compared the effect of BPA and BPS on obesity and hepatic steatosis processes using low doses in the same range as those found in the environment. Two in vitro models were used, the adipose cell line 3T3-L1 and HepG2 cells, representative of hepatic functions. We analyzed different parameters such as lipid and glucose uptakes, lipolysis, leptin production and the modulation of genes involved in lipid metabolism and energy balance. BPA and BPS induced an increase in the lipid content in the 3T3-L1 cell line and more moderately in the hepatic cells. We also observed a decrease in lipolysis after bisphenol treatment of adipocytes, but only BPS was involved in the increase in glucose uptake and leptin production. These latter effects could be linked to the modulation of SREBP-1c, PPARγ, aP2 and ERRα and γ genes after exposure to BPA, whereas BPS seems to target the PGC1α and the ERRγ genes. The findings suggest that both BPA and BPS could be involved in obesity and steatosis processes, but through two different metabolic pathways.
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57
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Schooling CM, Zhao J. Estrogenic endocrine disruptors and autoimmune disease. Int J Epidemiol 2014; 44:363-4. [PMID: 24997209 DOI: 10.1093/ije/dyu133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- C Mary Schooling
- School of Public Health, Li KaShing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China and City University of New York School of Public Health and Hunter College, New York, USA School of Public Health, Li KaShing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China and City University of New York School of Public Health and Hunter College, New York, USA
| | - Jie Zhao
- School of Public Health, Li KaShing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China and City University of New York School of Public Health and Hunter College, New York, USA
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Toppari J, Rodprasert W, Virtanen HE. Cryptorchidism --disease or symptom? ANNALES D'ENDOCRINOLOGIE 2014; 75:72-6. [PMID: 24786701 DOI: 10.1016/j.ando.2014.04.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Testes descend to the scrotum normally before birth. When they fail to do so, the boy is cryptorchid and has an increased risk for testicular germ cell cancer and subfertility later in life. Early correction of maldescent by orchiopexy operation improves the spermatogenetic capacity of the testis but does not return the testicular cancer risk to the control level. Testicular descent is regulated by testis-derived hormones testosterone and insulin-like peptide 3. Cryptorchidism can therefore be considered a symptom of impaired testicular function that may also be linked to other testicular diseases, such as germ cell cancer and subfertility. Early orchiopexy can alleviate the effects of cryptorchidism on spermatogenesis, but alertness for testicular cancer should be maintained. In searching the genetic and environmental reasons for these diseases, it is useful to consider their connection with each other.
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Affiliation(s)
- Jorma Toppari
- Departments of physiology and pediatrics, University of Turku, Turku, Findland.
| | - Wiwat Rodprasert
- Departments of physiology and pediatrics, University of Turku, Turku, Findland
| | - Helena E Virtanen
- Departments of physiology and pediatrics, University of Turku, Turku, Findland
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59
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Bouvattier C. [Micropenis]. Arch Pediatr 2014; 21:665-9. [PMID: 24768548 DOI: 10.1016/j.arcped.2014.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 03/10/2014] [Accepted: 03/25/2014] [Indexed: 10/25/2022]
Abstract
Micropenis represents a clinical sign that should be diagnosed at birth (or in utero) by the detection of a normally structured penis with a length 2.5 SD below the mean for age. Micropenis can be classified as due to deficient testosterone secretion or action. Evaluation of the gonadotropic and testicular function during the mini-puberty is often helpful in evaluating the etiology. Management of micropenis should focus on achieving a suitable penis length, in order to allow an adequate urination, normal sexual intercourses and a good self-body image. Irrespective of the underlying cause, a short course of T should be tried in patients with micropenis to assess the ability of the penis to respond to it. Topical 5a-dihydrotestosterone gel has also been reported to be effective. Children with hypopituitarism and GH deficiency respond to appropriate hormonal therapy. Psychological counseling is helpful and often necessary.
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Affiliation(s)
- C Bouvattier
- Endocrinologie pédiatrique, faculté de médecine Paris 11, centre de référence des anomalies du développement sexuel, hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
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60
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Thankamony A, Lek N, Carroll D, Williams M, Dunger DB, Acerini CL, Ong KK, Hughes IA. Anogenital distance and penile length in infants with hypospadias or cryptorchidism: comparison with normative data. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:207-11. [PMID: 24316680 PMCID: PMC3915266 DOI: 10.1289/ehp.1307178] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 12/03/2013] [Indexed: 05/04/2023]
Abstract
BACKGROUND Anogenital distance (AGD) in animals is a sensitive biomarker of fetal endocrine disruption and the associated testicular dysgenesis syndrome (TDS). However, AGD in human infants with cryptorchidism and hypospadias, which are potential manifestations of TDS during childhood, is not clearly described. OBJECTIVE Our aim was to compare AGD in boys with cryptorchidism or hypospadias against normative data. METHODS Boys with isolated cryptorchidism (n = 71, age 13.4 ± 5.8 months) or hypospadias (n = 81, age 11.4 ± 6.2 months) were recruited from a tertiary center for measurement of AGD and penile length; they were compared with 487 healthy full-term boys from a birth cohort by deriving age-specific standard deviation scores (SDS). RESULTS Boys with cryptorchidism were older (p = 0.048) compared with boys with hypospadias. Boys with hypospadias had shorter mean AGD and penile length SDS than healthy boys (both p < 0.0001). Mean AGD and penile length SDS values in boys with cryptorchidism were longer than mean values in boys with hypospadias (both p < 0.01) and shorter than mean values in healthy boys (both p < 0.0001). Mean penile length SDS decreased as the severity of hypospadias increased (ptrend = 0.078). CONCLUSIONS In the study population, AGD and penile length were reduced in boys with hypospadias or cryptorchidism relative to normative data derived from a longitudinal birth cohort. The findings support the use of AGD as a quantitative biomarker to examine the prenatal effects of exposure to endocrine disruptors on the development of the male reproductive tract.
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Affiliation(s)
- Ajay Thankamony
- Department of Paediatrics, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom
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61
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Agopian AJ, Langlois PH, Ramakrishnan A, Canfield MA. Epidemiologic features of male genital malformations and subtypes in Texas. Am J Med Genet A 2014; 164A:943-9. [PMID: 24458943 DOI: 10.1002/ajmg.a.36389] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 11/14/2013] [Indexed: 11/10/2022]
Abstract
Although distinct categories of male genital malformations share some common risk factors, few studies have systematically compared epidemiologic features across phenotypes. We evaluated the relationship between several maternal and infant characteristics and five categories of male genital malformations: second- or third-degree hypospadias, hypospadias (regardless of degree), small penis, cryptorchidism, and any male genital malformation. Data for 16,813 cases with isolated male genital malformations and 1,945,841 male live births delivered from 1999 to 2008 were obtained from the Texas Birth Defects Registry. For each phenotype category, 13 maternal and infant variables were assessed, and adjusted prevalence ratios were estimated based on the same multivariable Poisson regression model. A significant negative association was observed between previous live births versus no previous live births and four phenotypes (e.g., adjusted prevalence ratio [aPR] for any male genital malformation: 0.78, 95% confidence interval [CI]: 0.75-0.81). The prevalence of 4 of the phenotypes was significantly higher among multiple versus singleton pregnancies (e.g., aPR for any male genital malformation: 1.35, 95% CI: 1.25-1.47). We also observed significant associations between multiple phenotypes and residential region at delivery, delivery year, month of conception, and maternal age, race/ethnicity, education, and birthplace, including significant associations for trends (maternal age, maternal education, and birth year modeled ordinally). Our results allow for comparison of characteristics across phenotypes and suggest that there may be some common risk factors for multiple male genital malformations (e.g., characteristics related to maternal estrogen levels), while other risk factors may be unique to specific defects.
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Affiliation(s)
- A J Agopian
- Division of Epidemiology, Human Genetics and Environmental Sciences, Human Genetics Center, University of Texas School of Public Health, Houston, Texas
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Garabedian C, Vaast P, Bigot J, Sfeir R, Michaud L, Gottrand F, Verpillat P, Coulon C, Subtil D, Houfflin Debarge V. [Esophageal atresia: prevalence, prenatal diagnosis and prognosis]. ACTA ACUST UNITED AC 2014; 43:424-30. [PMID: 24440126 DOI: 10.1016/j.jgyn.2013.11.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 11/10/2013] [Accepted: 11/19/2013] [Indexed: 01/29/2023]
Abstract
Esophageal atresia (EA) is a rare congenital malformation (1 in 2,500 to 3,500 births). Prenatal diagnosis (PN) is particularly interesting allowing search for associated malformations related to worse prognosis forms (reference ultrasound, MRI and amniocentesis) and planning the birth in an adapted medico-surgical center. Diagnosis of EA is usually suspected because of indirect and non-specific signs: association of polyhydramnios and absent or small stomach bubble. The visualization in ultrasound or MRI of cervical or thoracic fluid image corresponding to the expansion of the bottom of upper esophageal ("pouch sign") increases the specificity of diagnosis. However, prenatal diagnosis remains difficult and less than 50 % of EA are diagnosed prenatally. Biochemical analysis could improve these results. If EA is confirmed at birth, surgical management consists in a primary end-to-end anastomosis in first days of life, or in two-steps surgery if the defect is too large. Although current prognosis of EA is good, frequency of surgical complications and esophageal lesions secondary to gastroesophageal reflux justify a systematic and multidisciplinary extended follow-up.
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Affiliation(s)
- C Garabedian
- Pôle femme-mère-nouveau-né, clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France.
| | - P Vaast
- Pôle femme-mère-nouveau-né, clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France
| | - J Bigot
- Service d'imagerie de la femme, pôle de radiologie, hôpital Jeanne-de-Flandre, CHRU de Lille, 59037 Lille, France
| | - R Sfeir
- Centre de référence des affections congénitales et malformatives de l'œsophage, hôpital Jeanne-de-Flandre, 59037 Lille, France
| | - L Michaud
- Centre de référence des affections congénitales et malformatives de l'œsophage, hôpital Jeanne-de-Flandre, 59037 Lille, France; Université Lille Nord de France, 59037 Lille, France
| | - F Gottrand
- Centre de référence des affections congénitales et malformatives de l'œsophage, hôpital Jeanne-de-Flandre, 59037 Lille, France; Université Lille Nord de France, 59037 Lille, France
| | - P Verpillat
- Service d'imagerie de la femme, pôle de radiologie, hôpital Jeanne-de-Flandre, CHRU de Lille, 59037 Lille, France
| | - C Coulon
- Pôle femme-mère-nouveau-né, clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France
| | - D Subtil
- Pôle femme-mère-nouveau-né, clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France; Université Lille Nord de France, 59037 Lille, France
| | - V Houfflin Debarge
- Pôle femme-mère-nouveau-né, clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France; Université Lille Nord de France, 59037 Lille, France
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63
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Huisma F, Thomas M, Armstrong L. Severe hypospadias and its association with maternal-placental factors. Am J Med Genet A 2013; 161A:2183-7. [PMID: 23913586 DOI: 10.1002/ajmg.a.36050] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 04/25/2013] [Indexed: 11/07/2022]
Abstract
The neonate born small for gestational age (SGA, birth weight <10th centile) with severe hypospadias, and without the presence of other malformations, is a presentation which clinical geneticists are asked to assess. However, this combination is not well addressed in the literature. Epidemiological studies point to an increased incidence and severity of hypospadias in SGA infants, but leave open the possibility that the association is attributable to the population subset who have multiple congenital abnormalities or genetic syndromes. Epidemiological studies unselected for birth weight have also identified an association between hypospadias with some risk factors tied to SGA, including prematurity, preeclampsia, and placental insufficiency. This study was developed after being involved in the care of several boys with SGA and severe hypospadias who were premature, with gestational histories of maternal hypertension and oligohydramnios. No underlying syndromes, hormonal abnormalities, or contributory family histories could be found. We hypothesized that severe hypospadias may in some cases be causally related to maternal-placental factors rather than primary fetal abnormalities. A retrospective study of a cohort of singletons born SGA with unexplained hypospadias was conducted. We compared their gestational histories and hypospadias severities with those born at normal birth weights. The cohort with SGA had an increased ratio of severe to mild hypospadias. Further, within the cohort of SGA boys, there was a higher prevalence of prematurity, maternal hypertension, and oligohydramnios among those with severe vs mild hypospadias. Small sample sizes are limiting.
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Affiliation(s)
- Felicity Huisma
- Provincial Medical Genetics Program, Children's and Women's Health Centre of British Columbia, University of British Columbia, Vancouver, Canada.
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64
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Abstract
Esophageal atresia (EA) is a rare congenital malformation consisting of a lack of continuity between the upper and lower esophageal pouches, frequently associated with tracheoesophageal fistula. The prevalence of such rare abnormalities is established by global birth surveillance programs over the world. EUROCAT is a European program covering 1.7 million births since its creation. The prevalence of EA in Europe seems stable over decades. The National Birth Defects Prevention Network in the USA also shows a stable prevalence with a wide range between states or regions. In France, with the implementation of the national rare diseases plan, a reference center for congenital abnormalities of the esophagus was created in 2006 and a national registry for EA began patient inclusion in 2008. This has resulted in the establishment of the national live birth prevalence for EA, prenatal diagnosis rates, and clinical characteristics of EA patients, early survival, and early morbidity. Prevalence rates seem stable all over the world since many decades. Continuous surveillance of congenital abnormalities and specific registries are useful for epidemiologic data but also for public health authorities for helping families of rare diseases patients.
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Affiliation(s)
- R Sfeir
- Reference center for congenital esophageal abnormalities CRACMO, University of Lille 2, Lille, France.
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65
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Agopian AJ, Lupo PJ, Canfield MA, Langlois PH. Case-control study of maternal residential atrazine exposure and male genital malformations. Am J Med Genet A 2013; 161A:977-82. [PMID: 23494929 DOI: 10.1002/ajmg.a.35815] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 11/15/2012] [Indexed: 01/20/2023]
Abstract
Exposure to endocrine disrupting chemicals has been associated with risk for male genital malformations. However, residential prenatal exposure to atrazine, an endocrine disrupting pesticide, has not been evaluated. We obtained data from the Texas Birth Defects Registry for 16,433 cases with isolated male genital malformations and randomly selected, population-based controls delivered during 1999-2008. County-level estimates of atrazine exposure from the United States Geological Survey were linked to all subjects. We evaluated the relationship between estimated maternal residential atrazine exposure and risk for male genital malformations in offspring. Separate unconditional logistic regression analyses were conducted for hypospadias, cryptorchidism, and small penis. We observed modest, but consistent, associations between medium-low and/or medium levels of estimated periconceptional maternal residential atrazine exposure and every male genital malformation category evaluated (e.g., adjusted odds ratio for medium compared to low atrazine levels and all male genital malformations: 1.2, 95% confidence interval: 1.1-1.3). Previous literature from animal and epidemiological studies supports our findings. Our results provide further evidence of a suspected teratogenic role of atrazine.
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Affiliation(s)
- A J Agopian
- Human Genetics Center, Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
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66
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Behl M, Rao D, Aagaard K, Davidson TL, Levin ED, Slotkin TA, Srinivasan S, Wallinga D, White MF, Walker VR, Thayer KA, Holloway AC. Evaluation of the association between maternal smoking, childhood obesity, and metabolic disorders: a national toxicology program workshop review. ENVIRONMENTAL HEALTH PERSPECTIVES 2013; 121:170-80. [PMID: 23232494 PMCID: PMC3569686 DOI: 10.1289/ehp.1205404] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 12/04/2012] [Indexed: 05/15/2023]
Abstract
BACKGROUND An emerging literature suggests that environmental chemicals may play a role in the development of childhood obesity and metabolic disorders, especially when exposure occurs early in life. OBJECTIVE Here we assess the association between these health outcomes and exposure to maternal smoking during pregnancy as part of a broader effort to develop a research agenda to better understand the role of environmental chemicals as potential risk factors for obesity and metabolic disorders. METHODS PubMed was searched up to 8 March 2012 for epidemiological and experimental animal studies related to maternal smoking or nicotine exposure during pregnancy and childhood obesity or metabolic disorders at any age. A total of 101 studies-83 in humans and 18 in animals-were identified as the primary literature. DISCUSSION Current epidemiological data support a positive association between maternal smoking and increased risk of obesity or overweight in offspring. The data strongly suggest a causal relation, although the possibility that the association is attributable to unmeasured residual confounding cannot be completely ruled out. This conclusion is supported by findings from laboratory animals exposed to nicotine during development. The existing literature on human exposures does not support an association between maternal smoking during pregnancy and type 1 diabetes in offspring. Too few human studies have assessed outcomes related to type 2 diabetes or metabolic syndrome to reach conclusions based on patterns of findings. There may be a number of mechanistic pathways important for the development of aberrant metabolic outcomes following perinatal exposure to cigarette smoke, which remain largely unexplored. CONCLUSIONS From a toxicological perspective, the linkages between maternal smoking during pregnancy and childhood overweight/obesity provide proof-of-concept of how early-life exposure to an environmental toxicant can be a risk factor for childhood obesity.
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Affiliation(s)
- Mamta Behl
- Kelly Government Solutions, Research Triangle Park, North Carolina, USA
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67
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Ahmed SF, Bashamboo A, Lucas-Herald A, McElreavey K. Understanding the genetic aetiology in patients with XY DSD. Br Med Bull 2013; 106:67-89. [PMID: 23529942 DOI: 10.1093/bmb/ldt008] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Disorders of sex development (DSD) consist of a wide range of disorders and are commoner in those with an XY karyotype. In over half of these cases who have a 46,XY karyotype and who are raised as boys, the underlying aetiology remains unclear. AREAS OF AGREEMENT Identification of the underlying genetic abnormality may predict long-term outcome. However, genetic abnormalities that are associated with XY DSD manifest themselves with a wide range of phenotype. To understand the aetiology as well as the phenotypic variation, there is a need to harness the advanced genetic technology that is now available. AREAS OF CONTROVERSY The point at which genetic analysis should be undertaken in the course of investigations is unclear. In addition, there is little agreement on the most effective approach for genetic analysis that will be of clinical benefit to the patient. AREAS TIMELY FOR DEVELOPING RESEARCH There is a need to understand and improve the clinical utility of genetic analysis in the clinical setting of the patient with a suspected DSD. This will be even more important when parallel gene sequencing identifies variations in multiple genes.
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Affiliation(s)
- S F Ahmed
- School of Medicine, University of Glasgow, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK.
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68
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N'Tumba-Byn T, Moison D, Lacroix M, Lecureuil C, Lesage L, Prud'homme SM, Pozzi-Gaudin S, Frydman R, Benachi A, Livera G, Rouiller-Fabre V, Habert R. Differential effects of bisphenol A and diethylstilbestrol on human, rat and mouse fetal leydig cell function. PLoS One 2012; 7:e51579. [PMID: 23284716 PMCID: PMC3524173 DOI: 10.1371/journal.pone.0051579] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 11/01/2012] [Indexed: 01/23/2023] Open
Abstract
Endocrine disruptors (ED) have been incriminated in the current increase of male reproductive alterations. Bisphenol A (BPA) is a widely used weak estrogenic environmental ED and it is debated whether BPA concentrations within the average internal exposure are toxic. In the present study we investigated the effects of 10(-12) to 10(-5) M BPA concentrations on fetal Leydig cell function, as fetal life is a critical period of sensitivity to ED effects on male reproductive function. To this aim, fetal testes from human at 6.5-10.5 gestational weeks (GW) or from rat and mouse at a comparable critical period of development (14.5 days post-coitum (dpc) for rat and 12.5 dpc for mouse) were explanted and cultured using our validated organotypic culture system in the presence or absence of BPA for 1-3 days. BPA concentrations as low as 10(-8) M reduced testosterone secretion by human testes from day 1 of culture onwards, but not by mouse and rat testes where concentrations equal to 10(-5) M BPA were required. Similarly, 10(-8) M BPA reduced INSL3 mRNA levels only in human cultured testes. On the contrary, 10(-5) and 10(-6) M diethylstilbestrol (DES), a classical estrogenic compound, affected testosterone secretion only in rat and mouse testis cultures, but not in human testis cultures. Lastly, contrarily to the DES effect, the negative effect of BPA on testosterone produced by the mouse fetal testis was maintained after invalidation of estrogen receptor α (ERα). In conclusion, these results evidenced i) a deleterious effect of BPA on fetal Leydig cells function in human for concentrations from 10(-8) M upwards, ii) species-specific differences raising concerns about extrapolation of data from rodent studies to human risk assessment, iii) a specific signaling pathway for BPA which differs from the DES one and which does not involve ERα.
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Affiliation(s)
- Thierry N'Tumba-Byn
- Université Paris Diderot, Sorbonne Paris Cité, Laboratory of Development of the Gonads, Unit of Stem Cells and Radiation, Fontenay-aux-Roses, France
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69
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Rolland M, Le Moal J, Wagner V, Royère D, De Mouzon J. Decline in semen concentration and morphology in a sample of 26,609 men close to general population between 1989 and 2005 in France. Hum Reprod 2012; 28:462-70. [PMID: 23213178 DOI: 10.1093/humrep/des415] [Citation(s) in RCA: 190] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
STUDY QUESTION Are temporal trends and values of semen quality parameters in France identifiable in partners of totally infertile women? SUMMARY ANSWER Among a sample of 26 609 partners of totally infertile women undergoing an assisted reproductive technology (ART) procedures in the whole of France over a 17-year period, there was a continuous decrease in semen concentration of about 1.9% per year and a significant decrease in the percentage with morphologically normal forms but no global trend for motility. WHAT IS KNOWN ALREADY A global decrease in human sperm quality is still debated as geographical differences have been shown, and many criticisms have risen concerning studies with small and biased study populations or inappropriate statistical methodology. However, growing biological, toxicological, experimental and human exposure data support the endocrine disruptors' hypothesis assuming that fetal exposure to endocrine disruptors could impair reproductive outcomes. STUDY DESIGN, SIZE, DURATION This was a retrospective and descriptive study using data registered by Fivnat, the professional association in charge of statistics for ART in France during the 1989-2005 study period. Data were provided by 126 main ART centres over the whole metropolitan territory. The source population included 154 712 men, aged 18-70, who were partners of couples undergoing their first ART cycle and for whom semen quality indicators (concentration, total motility and percentage of morphologically normal forms), measured on fresh ejaculated semen, were available. PARTICIPANTS/MATERIALS, SETTING, METHODS The study population was 26 609 partners of women who had both tubes either absent or blocked. The temporal trends for each indicator of semen quality were modelled using a generalized additive model that allowed for nonlinear relationships between variables and were adjusted for season and age. In-depth sensitivity analyses included the reiteration of the analysis on data from a second spermiogram available for each man and on another subsample of men diagnosed as fertile. Variables such as centre, technique (standard in vitro fertilization or intra-cytoplasmic sperm injection) and an interaction factor between technique and time were also included in the model. MAIN RESULTS AND THE ROLE OF CHANCE There was a significant and continuous decrease in sperm concentration of 32.2% [26.3-36.3] during the study period. Projections indicate that concentration for a 35-year-old man went from an average of 73.6 million/ml [69.0-78.4] in 1989 to 49.9 million/ml [43.5-54.7] in 2005. A significant, but not quantifiable, decrease in the percentage of sperm with morphologically normal forms along the 17-year period was also observed. There was no global trend but a slight, significant increase in total motility between 1994 and 1998 was observed. The results were robust after sensitivity analysis. LIMITATIONS, REASONS FOR CAUTION Socioeconomic status could not be controlled for. Despite universal access to medical services in France, couples undergoing ART are expected to have a higher educational level on average compared with those of the general population. Therefore, the real values in the general population could be slightly lower than those presented and the decrease possibly stronger, as the population study is less likely to smoke or be overweight, two factors known to impair semen quality. WIDER IMPLICATIONS OF THE FINDINGS As the men were selected without a priori knowledge regarding their semen quality characteristics, the results are expected to be close to the values in the general French population. The very large sample size and the robustness of the results confer great statistical power and credibility to the results. To our knowledge, it is the first study concluding a severe and general decrease in sperm concentration and morphology at the scale of a whole country over a substantial period. This constitutes a serious public health warning. The link with the environment particularly needs to be determined.
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Affiliation(s)
- M Rolland
- Environmental Health Department, Institut de Veille Sanitaire (InVS), F-94415 Saint Maurice, France
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70
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Orton F, Rosivatz E, Scholze M, Kortenkamp A. Competitive androgen receptor antagonism as a factor determining the predictability of cumulative antiandrogenic effects of widely used pesticides. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:1578-84. [PMID: 23008280 PMCID: PMC3556629 DOI: 10.1289/ehp.1205391] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 09/10/2012] [Indexed: 05/04/2023]
Abstract
BACKGROUND Many pesticides in current use have recently been revealed as in vitro androgen receptor (AR) antagonists, but information about their combined effects is lacking. OBJECTIVE We investigated the combined effects and the competitive AR antagonism of pesticide mixtures. METHODS We used the MDA-kb2 assay to test a combination of eight AR antagonists that did not also possess AR agonist properties ("pure" antagonists; 8 mix: fludioxonil, fenhexamid, ortho-phenylphenol, imazalil, tebuconazole, dimethomorph, methiocarb, pirimiphos-methyl), a combination of five AR antagonists that also showed agonist activity (5 mix: cyprodinil, pyrimethanil, vinclozolin, chlorpropham, linuron), and all pesticides combined (13 mix). We used concentration addition (CA) and independent action (IA) to formulate additivity expectations, and Schild plot analyses to investigate competitive AR antagonism. RESULTS A good agreement between the effects of the mixture of eight "pure" AR antagonists and the responses predicted by CA was observed. Schild plot analysis revealed that the 8 mix acted by competitive AR antagonism. However, the observed responses of the 5 mix and the 13 mix fell within the "prediction window" boundaries defined by the predicted regression curves of CA and IA. Schild plot analysis with these mixtures yielded anomalous responses incompatible with competitive receptor antagonism. CONCLUSIONS A mixture of widely used pesticides can, in a predictable manner, produce combined AR antagonist effects that exceed the responses elicited by the most potent component alone. Inasmuch as large populations are regularly exposed to mixtures of antiandrogenic pesticides, our results underline the need for considering combination effects for these substances in regulatory practice.
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Affiliation(s)
- Frances Orton
- Centre for Toxicology, School of Pharmacy, London, United Kingdom.
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71
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Blaschko SD, Cunha GR, Baskin LS. Molecular mechanisms of external genitalia development. Differentiation 2012; 84:261-8. [PMID: 22790208 DOI: 10.1016/j.diff.2012.06.003] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 05/09/2012] [Accepted: 06/16/2012] [Indexed: 12/21/2022]
Abstract
External genitalia development occurs through a combination of hormone independent, hormone dependent, and endocrine pathways. Perturbation of these pathways can lead to abnormal external genitalia development. We review human and animal mechanisms of normal and abnormal external genitalia development, and we evaluate abnormal mechanisms that lead to hypospadias. We also discuss recent laboratory findings that further our understanding of animal models of hypospadias.
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Affiliation(s)
- Sarah D Blaschko
- University of California San Francisco, Department of Urology, 400 Parnassus Avenue, A610, San Francisco, CA 94143, USA
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72
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Sfeir R, Michaud L, Salleron J, Dagry B, Gottrand F. Épidémiologie de l'atrésie de l'œsophage. Arch Pediatr 2012. [DOI: 10.1016/s0929-693x(12)71137-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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73
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Virtanen HE, Adamsson A. Cryptorchidism and endocrine disrupting chemicals. Mol Cell Endocrinol 2012; 355:208-20. [PMID: 22127307 DOI: 10.1016/j.mce.2011.11.015] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Revised: 11/11/2011] [Accepted: 11/11/2011] [Indexed: 10/15/2022]
Abstract
Prospective clinical studies have suggested that the rate of congenital cryptorchidism has increased since the 1950s. It has been hypothesized that this may be related to environmental factors. Testicular descent occurs in two phases controlled by Leydig cell-derived hormones insulin-like peptide 3 (INSL3) and testosterone. Disorders in fetal androgen production/action or suppression of Insl3 are mechanisms causing cryptorchidism in rodents. In humans, prenatal exposure to potent estrogen diethylstilbestrol (DES) has been associated with increased risk of cryptorchidism. In addition, epidemiological studies have suggested that exposure to pesticides may also be associated with cryptorchidism. Some case-control studies analyzing environmental chemical levels in maternal breast milk samples have reported associations between cryptorchidism and chemical levels. Furthermore, it has been suggested that exposure levels of some chemicals may be associated with infant reproductive hormone levels.
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74
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Wohlfahrt-Veje C, Andersen HR, Jensen TK, Grandjean P, Skakkebaek NE, Main KM. Smaller genitals at school age in boys whose mothers were exposed to non-persistent pesticides in early pregnancy. ACTA ACUST UNITED AC 2012; 35:265-72. [PMID: 22394112 DOI: 10.1111/j.1365-2605.2012.01252.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Endocrine disrupting chemicals are believed to play a role in the development of the testicular dysgenesis syndrome. Many pesticides are known to have endocrine disrupting abilities. In a previous study, sons of women who were occupationally exposed to non-persistent pesticides in early pregnancy showed signs of impaired reproductive function (reduced genital size and altered serum hormone concentrations) at three months of age. To assess the possible long-term effects of prenatal pesticide exposure, the boys were re-examined at 6-11 years. The 94 boys (59 exposed, 35 unexposed) underwent genital examinations including ultrasound of testicular volumes, puberty staging (Tanner), anthropometry, and blood sampling. Only a few of the boys had reached puberty (n = 3). Among prepubescent boys, testicular volume and penile length (age- and weight-adjusted) were reduced if mothers were exposed to pesticides. The effects were associated with the maternal exposure levels, so that high-exposed boys had smaller genitals than medium-exposed boys, who had smaller genitals than those who were unexposed. Boys of mothers in the high exposure group (n = 23) had 24.7% smaller testes (95% CI: -62.2; -10.1) and 9.4% shorter penile length (95% CI: -16.8; -1.1) compared with the unexposed. The testicular volume and penile length at school age could be tracked to measures from the same boys made at 3 months, e.g. those that had small testes at school age also had small testes at 3 months. Pituitary and testicular hormone serum concentrations did not differ between exposed and unexposed boys. Eight prenatally exposed boys had genital malformations (no unexposed). These boys had smaller testis, shorter penile length and lower inhibin B concentrations than prepubertal boys without genital malformations. The findings support the results obtained at three months of age and indicate that prenatal pesticide exposure has long-term effects on reproductive function in boys.
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Affiliation(s)
- C Wohlfahrt-Veje
- University Department of Growth and Reproduction, Rigshospitalet, Copenhagen Ø, Denmark.
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75
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Gaspari L, Sampaio DR, Paris F, Audran F, Orsini M, Neto JB, Sultan C. High prevalence of micropenis in 2710 male newborns from an intensive-use pesticide area of Northeastern Brazil. ACTA ACUST UNITED AC 2012; 35:253-64. [DOI: 10.1111/j.1365-2605.2011.01241.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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