Contractility of rat gubernacula affected by calcitonin gene-related peptide and beta-agonist

The regulation of testicular descent and the effects of cryptorchidism

The first half of this review examines the boundary between endocrinology and embryonic development, with the aim of highlighting the way hormones and signaling systems regulate the complex morphological changes to enable the intra-abdominal fetal testes to reach the scrotum. The genitoinguinal ligament, or gubernaculum, first enlarges to hold the testis near the groin, and then it develops limb-bud-like properties and migrates across the pubic region to reach the scrotum. Recent advances show key roles for insulin-like hormone 3 in the first step, with androgen and the genitofemoral nerve involved in the second step. The mammary line may also be involved in initiating the migration. The key events in early postnatal germ cell development are then reviewed because there is mounting evidence for this to be crucial in preventing infertility and malignancy later in life. We review the recent advances in what is known about the etiology of cryptorchidism and summarize the syndromes where a specific molecular cause has been found. Finally, we cover the recent literature on timing of surgery, the issues around acquired cryptorchidism, and the limited role of hormone therapy. We conclude with some observations about the differences between animal models and baby boys with cryptorchidism.

The role of cremaster muscle in testicular descent in humans and animal models

Testicular descent is a complex developmental process involving anatomical and hormonal regulation. The gubernaculum undergoes a "swelling reaction" during the transabdominal phase and is mainly under the control of Insulin-Like Peptide 3 (INSL-3) and Mullerian Inhibitory Substance/Anti-Mullerian Hormone (MIS/AMH). The second phase of testicular descent is regulated by androgens and calcitonin gene-related peptide (CGRP) release from the sensory nucleus of the genitofemoral nerve (GFN). In rodents, the active proliferation of the gubernacular tip and cremaster muscle, its rhythmic contraction, as well as the chemotactic gradient provided by the CGRP result in eventual migration of the testis into the scrotum. This review illustrates the structural aspects and hormonal control of cremaster muscle development to better understand the mechanism of testicular descent in normal rodents and humans, compared to diseased rodent models. The analysis showed the cremaster muscle is formed from mesenchymal differentiation of the gubernacular tip and is not a direct passive extension of internal oblique muscle. Cremaster muscle matures slower than other body muscles, and the persistence of immature myogenic proteins seen in cardiac muscle allows rhythmic contraction to guide the testis into the scrotum. Finally, remodelling of the cremaster muscle enables gubernacular eversion. Further understanding of the molecular regulators governing the structural and hormonal changes in the cremaster muscle may lead to new advances in the treatment of undescended testes.

Structural analysis of gubernaculum testis in cryptorchid patients submitted to treatment with human chorionic gonadotrophin

OBJECTIVES

To make a histological and stereological analysis of gubernaculum testis elastic system fibers, collagen and striated muscle cells in patients with cryptorchidism treated with human chorionic gonadotrophin (hCG).

MATERIALS AND METHODS

Gubernacula tissue samples were obtained from 12 patients with cryptorchidism. Patients' ages ranged from 1 to 3 years (mean 1.8). Of the 12 patients, 6 were treated with hCG. The samples were stained with Masson's trichrome to highlight muscle fibers and collagen, and Weigert's resorcin-fuchsin to highlight the elastic system fibers. The volumetric density of these components was determined by stereological methods.

RESULTS

The volumetric density of collagen was increased in patients treated with hCG, ranging from 85.62% to 94.48%, while in patients not submitted to hCG treatment the volume density ranged from 52.12% to 89.46% (p=0.0052). The volumetric density of the elastic system fibers was higher in patients treated with hCG, ranging from 9.62% to 19.62%, while patients not submitted to hCG treatment the volume density of elastic system fibers was between 10.38% and 12.38% (p=0.0030). The volume density of striated muscle fibers in patients treated with hCG ranged from 4.76% to 39.16%, while and in patients not treated hCG it ranged from 3.24% to 11.14% (p=0.0052).

CONCLUSION

Gubernacular components alter significantly when submitted to treatment with hCG. Patients who underwent hCG treatment and had no complete testicular migration had an increase in the concentration of elastic and striated muscle fibers and a decrease in the volumetric density of collagen.

Exogenous calcitonin gene-related peptide perturbs the direction and length of gubernaculum in capsaicin-treated rats

Calcitonin gene-related peptide (CGRP) released from the genitofemoral nerve (GFN) is proposed to control gubernacular migration to the scrotum during inguinoscrotal descent. As previous studies suggested that both CGRP and androgens are necessary to stimulate gubernacular elongation and proliferation, this study aimed to test whether CGRP perturbed growth of the gubernaculum by exogenous injection in a rat model of GFN blockade with an intact androgen pathway. Sprague-Dawley rats (day 0, n = 34) were injected with capsaicin (sensory neurotixin) or vehicle. CGRP (25 microl of 2 x 10 5 molar concentration) Or castor oil was administered at the umbilicus 24 h later, then every other day thereafter for 10 days. Groups of rats were sacrified on days 8 and 28, and the tip of the gubernaculunx was identified in relation to the scrotum and umbilicus. The length of the processus vaginalis (PV) was measured. In group 1 (capsaicin and CGRP), at 8 days of age (n = 8) the testes were found in the intraabdominal or suprainguinal position in 87.5% (14 testes) and the tip of the gubernaculum was oriented more laterally than normal. However the mean PV length was 5.1 mm, which was shorter than control groups (9-10.8 mm) (P < 0.001, t-test). On the other hand, at day 28, the testes were located proximal to the internal inguinal ring in 66.7% (8 testes) with their gubernacular tip oriented in part towards the umbilicus. The mean of the PV length was 12.2 mm, which was significantly decreased compared to other groups (P < 0.001, t-test). In group 2 (capsaicin and castor oil) and group 3 (vehicle and CGRP) the testes of one rat in each group at 28 days of age were located in the abdomen at the internal inguinal ring with the distal gubernacular attachment lying free and directed caudally towards the scrotum, while the rest of the testes were found in the normal location. These findings suggest that chemical interruption of sensory nerves followed by CGRP injections in rats can perturb gubernacular growth and can change the direction of migration.

The role of sympathetic innervation in the developing rat gubernaculum

BACKGROUND

Testicular descent occurs in several steps, but the mechanism remains unknown. Recently, sympathetic nerves have been proposed to have a role. This study aimed to see if adrenergic agonists and antagonists affected the neonatal rat gubernacular cremaster sac in organ culture.

METHODS

Cremaster sacs were collected from 2-day-old Sprague-Dawley male rats (n = 90) and placed in organ culture with/without (1) calcium chloride (0.45-1.8 mmol/L), (2) rat calcitonin gene-related peptide (CGRP) (714 nmol/L), (3) nifedipine (0.1-100 nmol/L), (4) isopreneline (10 micromol/L), and (5) guanethidine (10 micromol/L). Gubernacula were observed over 2 days for rhythmic peristalsis (>120 beats per minute for >1 minute).

RESULTS

Addition of CGRP stimulated rhythmic contractility but only in the presence of calcium, with a dose-response to the level of calcium ions. Contractions induced by CGRP with calcium could be obliterated in a dose-response by nifedipine. Isoprenaline caused some increase in contractions with calcium but less than that seen with CGRP. No augmentation of effect was seen with CGRP and isopreneline together, and the level of contractility was the same with guanethidine.

CONCLUSIONS

Calcitonin gene-related peptide is the main effector for contractility of the rat cremaster sac, as long as calcium ions are present. Adrenergic agonists and antagonists had limited effects. Contractility could be inhibited with nifedipine, consistent with CGRP acting via a calcium-dependent pathway.

Does chemical sympathectomy alter the ontogeny of gubernacular migration in vivo?

BACKGROUND

Testicular descent occurs in several stages, but the exact mechanism remains obscure. Sympathetic nerves have been proposed to have a role by a possible action on developing cremaster muscle, following observations of sympathetic dysfunction in cremaster from boys with cryptorchidism. This study aimed to see if chemical sympathectomy affected testicular descent in rats.

METHODS

Sprague-Dawley dams were injected with 6-hydroxydopamine (days 15-19; 75 microg/kg) or control vehicle alone, and male pups examined at 0 to 10, 20, 30, and 60 days of age. The length of the processus vaginalis was measured and sections taken for histology.

RESULTS

No difference in processus vaginalis growth was found between experimental and control groups, both macro- and microscopically. Chemical sympathectomy was confirmed by loss of adrenergic fibres in the adrenal cortex of experimental, but not control, animals.

CONCLUSIONS

These studies suggest that sympathetic innervation is not an important part of testicular descent in the rat but does not exclude a pathologic role in undescended testes or effects in humans only.