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Yang J, Jiang X, Liao X. Letter to the editor for the article "Tamsulosin 0.8 mg daily dose in management of BPH patients with failed tamsulosin 0.4 mg monotherapy and unfit for surgical intervention". World J Urol 2024; 42:414. [PMID: 39012525 DOI: 10.1007/s00345-024-05110-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 07/17/2024] Open
Affiliation(s)
- Jianghua Yang
- Department of Urology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
| | - Xiaofeng Jiang
- Department of Urology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
| | - Xiaoxing Liao
- Department of Urology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China.
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Service CA, Puri D, Hsieh TC, Patel DP. Emerging concepts in male contraception: a narrative review of novel, hormonal and non-hormonal options. Ther Adv Reprod Health 2023; 17:26334941221138323. [PMID: 36909934 PMCID: PMC9996746 DOI: 10.1177/26334941221138323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/20/2022] [Indexed: 03/14/2023] Open
Abstract
Access to reliable contraception is a pillar of modern society. The burden of unintended pregnancy has fallen disproportionately on the mother throughout human history; however, recent legal developments surrounding abortion have sparked a renewed interest in male factor contraceptives beyond surgical sterilization and condoms. Modern efforts to develop reversible male birth control date back nearly a century and initially focused on altering the hypothalamic-pituitary-testes axis. These hormonal contraceptives faced multiple barriers, including systemic side effects, challenging dosing regimens, unfavorable routes of delivery, and the public stigma surrounding steroid use. Novel hormonal agents are seeking to overcome these barriers by limiting the side effects and simplifying use. Non-hormonal contraceptives are agents that target various stages of spermatogenesis; such as inhibitors of retinoic acid, Sertoli cell-germ cell interactions, sperm ion channels, and other small molecular targets. The identification of reproductive tract-specific genes associated with male infertility has led to more targeted drug development, made possible by advances in CRISPR and proteolysis targeting chimeras (PROTACs). Despite multiple human trials, no male birth control agents have garnered regulatory approval in the United States or abroad. This narrative review examines current and emerging male contraceptives, including hormonal and non-hormonal agents.
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Affiliation(s)
- C Austin Service
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Dhruv Puri
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Tung-Chin Hsieh
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Darshan P Patel
- Department of Urology, University of California San Diego, 9333 Genesee Avenue, Suite 320, La Jolla, CA 92121, USA
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Abstract
Within the family of purinergic receptors, the P2X1 receptor is a ligand-gated ion channel that plays a role in urogenital, immune and cardiovascular function. Specifically, the P2X1 receptor has been implicated in controlling smooth muscle contractions of the vas deferens and therefore has emerged as an exciting drug target for male contraception. In addition, the P2X1 receptor contributes to smooth muscle contractions of the bladder and is a target to treat bladder dysfunction. Finally, platelets and neutrophils have populations of P2X1 receptors that could be targeted for thrombosis and inflammatory conditions. Drugs that specifically target the P2X1 receptor have been challenging to develop, and only recently have small molecule antagonists of the P2X1 receptor been available. However, these ligands need further biological validation for appropriate selectivity and drug-like properties before they will be suitable for use in preclinical models of disease. Although the atomic structure of the P2X1 receptor has yet to be determined, the recent discovery of several other P2X receptor structures and improvements in the field of structural biology suggests that this is now a distinct possibility. Such efforts may significantly improve drug discovery efforts at the P2X1 receptor.
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Borate GM, Meshram A. Cryopreservation of Sperm: A Review. Cureus 2022; 14:e31402. [DOI: 10.7759/cureus.31402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/11/2022] [Indexed: 11/14/2022] Open
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Eise NT, Simpson JS, Thompson PE, Ventura S. Aqueous extracts of Urtica dioica (stinging nettle) leaf contain a P2-purinoceptor antagonist—Implications for male fertility. PLoS One 2022; 17:e0271735. [PMID: 35900970 PMCID: PMC9333203 DOI: 10.1371/journal.pone.0271735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Abstract
Stinging nettle root and leaf extracts were tested for their effect on prostatic smooth muscle contractility. Root extract did not affect electrical field stimulation induced-nerve mediated contractions of isolated rat prostates. On the other hand, leaf extract attenuated electrical field stimulation-induced contractions at all frequencies. Similarly, contractions elicited by exogenous administration of ATP and αβ-methylene ATP were inhibited by leaf extract, whereas contractions elicited by exogenous administration of noradrenaline or acetylcholine were unaffected. The active component was present within the aqueous phase of the leaf extract. In mouse mating studies, stinging nettle leaf extract (50 mg p.o. daily) reduced male fertility by 53% compared to vehicle-treated male mice. Cardiovascular parameters were unaffected by administration of stinging nettle leaf extract (p ≥ 0.057). Treated mice exhibited normal mating behaviour. Bladder and testes weighed less in stinging nettle leaf extract treated mice. All other organs and total body weight were unaffected. It is concluded that stinging nettle leaf extract reduces contractility of genitourinary smooth muscle by acting as an antagonist at postjunctional P2X1-purinoceptors. These data indicates that blocking sperm transport through pharmacological blockade of P2X1-purinoceptors via oral administration is consistent with an effective and convenient biological strategy male contraception.
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Affiliation(s)
- Nicole T. Eise
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia
- Medicinal Chemistry, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia
| | - Jamie S. Simpson
- Medicinal Chemistry, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia
| | - Philip E. Thompson
- Medicinal Chemistry, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia
| | - Sabatino Ventura
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia
- * E-mail:
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Reynolds-Wright JJ, Anderson R. Male contraception: where are we going and where have we been? BMJ SEXUAL & REPRODUCTIVE HEALTH 2019; 45:bmjsrh-2019-200395. [PMID: 31537614 PMCID: PMC6892591 DOI: 10.1136/bmjsrh-2019-200395] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/13/2019] [Accepted: 08/30/2019] [Indexed: 05/22/2023]
Abstract
Progress in developing new reversible male contraception has been slow. While the hormonal approach has been clearly shown to be capable of providing effective and reversible contraception, there remains no product available. Currently, trials of a self-administered gel combination of testosterone and the progestogen Nestorone® are under way, complementing the largely injectable methods previously investigated. Novel long-acting steroids with both androgenic and progestogenic activity are also in early clinical trials. The non-hormonal approach offers potential advantages, with potential sites of action on spermatogenesis, and sperm maturation in the epididymis or at the vas, but remains in preclinical testing. Surveys indicate the willingness of men, and their partners, to use a new male method, but they continue to lack that opportunity.
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Affiliation(s)
- John Joseph Reynolds-Wright
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Richard Anderson
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
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Khourdaji I, Zillioux J, Eisenfrats K, Foley D, Smith R. The future of male contraception: a fertile ground. Transl Androl Urol 2018; 7:S220-S235. [PMID: 29928620 PMCID: PMC5989114 DOI: 10.21037/tau.2018.03.23] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The continued and rapid expansion of the Earth’s population mandates the need for safe and effective measures of contraception. While a plethora of options exist for women, methods of contraception for the male partner are limited to condoms and vasectomy. The sequela of this discrepancy has led to the family planning burden falling disproportionately on the female partner. For the past several decades, extensive research has been undertaken exploring the feasibility of hormonal male contraception. This proposed method of contraception has focused on suppressing spermatogenesis by exploiting the hypothalamic-pituitary-gonadal (HPG) axis. Beginning with proof of concept studies in the early nineties, administration of testosterone in healthy male subjects has been shown to be an efficacious method of inducing sterility. Owing to ethnic differences in spermatogenesis suppression and the comparatively low rate of azoospermia in Caucasian men with androgen-only regimens, investigators have explored the addition of progestins to further enhance the efficacy of hormonal contraception. Though studies have revealed promise with androgen-progestin regimens, the lack of long-term studies has precluded the development of a marketable product. Recently, more research has been directed towards identifying non-hormonal alternatives to male contraception. These non-hormonal options have ranged from the development of devices facilitating reversible occlusion of the vas deferens lumen to medications disrupting various pathways in the process of spermatogenesis. Underlying the development of hormonal and non-hormonal strategies is the shared enthusiasm men and women have towards these male directed methods. The willingness of couples to pursue these alternatives combined with the global need to reduce the psychological and socioeconomic implications of unintended pregnancy ensures that research will continue to bring this goal to fruition.
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Affiliation(s)
- Iyad Khourdaji
- Department of Urology, University of Virginia Healthcare System, Charlottesville, VA, USA
| | - Jacqueline Zillioux
- Department of Urology, University of Virginia Healthcare System, Charlottesville, VA, USA
| | | | - Daniel Foley
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Ryan Smith
- Department of Urology, University of Virginia Healthcare System, Charlottesville, VA, USA.,Contraline, Inc., Charlottesville, VA, USA.,University of Virginia School of Medicine, Charlottesville, VA, USA
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Rayburn ER, Gao L, Ding J, Ding H, Shao J, Li H. FDA-approved drugs that are spermatotoxic in animals and the utility of animal testing for human risk prediction. J Assist Reprod Genet 2018; 35:191-212. [PMID: 29063992 PMCID: PMC5845034 DOI: 10.1007/s10815-017-1062-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 10/05/2017] [Indexed: 01/18/2023] Open
Abstract
PURPOSE This study reviews FDA-approved drugs that negatively impact spermatozoa in animals, as well as how these findings reflect on observations in human male gametes. METHODS The FDA drug warning labels included in the DailyMed database and the peer-reviewed literature in the PubMed database were searched for information to identify single-ingredient, FDA-approved prescription drugs with spermatotoxic effects. RESULTS A total of 235 unique, single-ingredient, FDA-approved drugs reported to be spermatotoxic in animals were identified in the drug labels. Forty-nine of these had documented negative effects on humans in either the drug label or literature, while 31 had no effect or a positive impact on human sperm. For the other 155 drugs that were spermatotoxic in animals, no human data was available. CONCLUSION The current animal models are not very effective for predicting human spermatotoxicity, and there is limited information available about the impact of many drugs on human spermatozoa. New approaches should be designed that more accurately reflect the findings in men, including more studies on human sperm in vitro and studies using other systems (ex vivo tissue culture, xenograft models, in silico studies, etc.). In addition, the present data is often incomplete or reported in a manner that prevents interpretation of their clinical relevance. Changes should be made to the requirements for pre-clinical testing, drug surveillance, and the warning labels of drugs to ensure that the potential risks to human fertility are clearly indicated.
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Affiliation(s)
| | - Liang Gao
- Department of Clinical Laboratory Sciences, Nantong Maternity and Child Health Hospital, Nantong, 226018, China
| | - Jiayi Ding
- Department of Reproductive Medicine, Nantong Maternity and Child Health Hospital, Nantong, 226018, China
| | - Hongxia Ding
- Pharmacodia (Beijing) Co., Ltd, Beijing, 100085, China
| | - Jun Shao
- Department of Reproductive Medicine, Nantong Maternity and Child Health Hospital, Nantong, 226018, China
| | - Haibo Li
- Department of Clinical Laboratory Sciences, Nantong Maternity and Child Health Hospital, Nantong, 226018, China.
- Department of Reproductive Medicine, Nantong Maternity and Child Health Hospital, Nantong, 226018, China.
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Rozati H, Handley T, Jayasena CN. Process and Pitfalls of Sperm Cryopreservation. J Clin Med 2017; 6:jcm6090089. [PMID: 28925939 PMCID: PMC5615282 DOI: 10.3390/jcm6090089] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 08/31/2017] [Accepted: 09/12/2017] [Indexed: 12/12/2022] Open
Abstract
Sperm cryopreservation has been utilized routinely for over 40 years to preserve fertility in men undergoing cancer therapy and allow conception for infertile couples. This article provides a concise and up-to-date review of the literature and covers the latest advances in sperm cryopreservation and its array of clinical indications. Over recent years, the scope of clinical indications used for sperm cryopreservation has expanded widely. Consequently, more patient groups are eligible for sperm freezing, requiring specialist resources and higher running costs. Although sperm cryopreservation prior to cancer therapy is readily available in many countries, referral rates by oncology specialists and levels of patient engagement with cryopreservation services are both reported as low. Furthermore, sperm banking continues to raise ethical issues such whether sperm donation should be anonymous and whether sperm can be utilized posthumously by the surviving partner without consent from the patient. This review focuses on the technological advances and ethical controversies in sperm cryopreservation, and how better understanding of these issues could lead to improved access to fertility preserving treatment for patients.
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Affiliation(s)
- Hamoun Rozati
- Section of Investigative Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.
| | - Thomas Handley
- Section of Investigative Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.
| | - Channa N Jayasena
- Section of Investigative Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.
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Odili AN, Abdullahi B. Antihypertensive Drugs. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/b978-0-444-63407-8.00020-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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