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Amato CM, Yao HHC. New uses for an old technique: live imaging on the slice organ culture to study reproductive processes†. Biol Reprod 2024; 110:1055-1064. [PMID: 38315794 DOI: 10.1093/biolre/ioae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/07/2024] Open
Abstract
Reproductive processes are dynamic and involve extensive morphological remodeling and cell-cell interactions. Live imaging of organs enhances our understanding of how biological processes occur in real time. Slice culture is a type of organ culture where thick slices are collected from an organ and cultured for several days. Slice culture is a useful and easy-to-implement technique for live imaging of reproductive events at cellular resolution. Here we describe a pipeline of live imaging on slice culture to visualize the process of urethra closure in mouse embryonic penis as a proof of principle. In combination with genetic reporter mice, nuclear stains, and exposure experiments, we demonstrate the feasibility of slice culture on a reproductive organ. We also provide a step-by-step protocol and troubleshooting guide to facilitate the adoption of slice culture with live imaging in other reproductive organs. Lastly, we discuss potential utilities and experiments that could be implemented with slice culture in reproductive sciences.
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Affiliation(s)
- Ciro Maurizio Amato
- Reproductive Developmental Biology Group, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Humphrey Hung-Chang Yao
- Reproductive Developmental Biology Group, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
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Inanc I, Avlan D, Eker D, Gurkan H. A Genetics Study in the Foreskin of Boys with Hypospadias. Mol Syndromol 2023; 14:185-190. [PMID: 37323199 PMCID: PMC10267525 DOI: 10.1159/000527405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/05/2022] [Indexed: 12/03/2023] Open
Abstract
Introduction Hypospadias is a malformation of the genitourinary system in males, characterized by the placement of the urethral opening in the ventral surface of the penis. Although controversies continue about etiology, endocrine disrupting chemicals that disrupt normal endocrine signaling at the receptor or signal transduction level are thought to play an essential role in etiology. This study aimed to investigate the receptor gene expressions of the sex hormones and FGFR2, HOXA13, and TGFB1, which are considered to play an essential role in developing hypospadias. Methods The samples from the foreskin of 26 patients with hypospadias and 26 healthy children who underwent circumcision operations were collected. ESR1, AR, FGFR2, HOXA13, and TGFB gene expressions were investigated by real-time PCR in samples obtained during surgery. Results In the hypospadias group, ESR1 expression was increased (p = 0.013), and AR and FGFR2 expressions were decreased, which were found to be statistically significant (p = 0.027 and p = 0.003, respectively). There was no statistically significant difference between hypospadias and control groups in TGFBand HOXA13expression levels (p > 0.05). Discussion The results suggest that sex hormone receptors and FGFR2 may play an essential role in developing male external genital structures at the gene level. The defects in the expression of these genes can contribute to understanding the development of hypospadias.
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Affiliation(s)
- Irem Inanc
- Department of Pediatric Surgery, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Dincer Avlan
- Division of Pediatric Urology, Department of Pediatric Surgery, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Damla Eker
- Department of Medical Genetics, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Hakan Gurkan
- Department of Medical Genetics, Trakya University Faculty of Medicine, Edirne, Turkey
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Amato CM, Yao HHC, Zhao F. One Tool for Many Jobs: Divergent and Conserved Actions of Androgen Signaling in Male Internal Reproductive Tract and External Genitalia. Front Endocrinol (Lausanne) 2022; 13:910964. [PMID: 35846302 PMCID: PMC9280649 DOI: 10.3389/fendo.2022.910964] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/25/2022] [Indexed: 11/13/2022] Open
Abstract
In the 1940s, Alfred Jost demonstrated the necessity of testicular secretions, particularly androgens, for male internal and external genitalia differentiation. Since then, our knowledge of androgen impacts on differentiation of the male internal (Wolffian duct) and external genitalia (penis) has been drastically expanded upon. Between these two morphologically and functionally distinct organs, divergent signals facilitate the establishment of tissue-specific identities. Conversely, conserved actions of androgen signaling are present in both tissues and are largely responsible for the growth and expansion of the organs. In this review we synthesize the existing knowledge of the cell type-specific, organ specific, and conserved signaling mechanisms of androgens. Mechanistic studies on androgen signaling in the Wolffian duct and male external genitalia have largely been conducted in mouse model organisms. Therefore, the majority of the review is focused on mouse model studies.
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Affiliation(s)
- Ciro M. Amato
- Reproductive Developmental Biology Group, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United States
| | - Humphrey H-C. Yao
- Reproductive Developmental Biology Group, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United States
| | - Fei Zhao
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, United States
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Akay MA, Yıldız GE. Impact of gestational and parental factors and maternal intake of progesterone on the development of hypospadias: A retrospective case-control study. Taiwan J Obstet Gynecol 2021; 60:894-898. [PMID: 34507668 DOI: 10.1016/j.tjog.2021.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE Impact of environmental, maternal, paternal, and fetal factors on the development of hypospadias have been questioned in association with disrupted hormonal balance. We aimed to examine the association between maternal progesterone use and the associated risk factors and hypospadias. MATERIALS AND METHODS There were 429 male children as the cases with hypospadias (n = 280, Group 1) and the controls without hypospadias (n = 149, Group 2). Those working in agriculture and industry, cleaners, and hairdressers were determined as risky occupational groups concerning the exposure of estrogenic endocrine disrupters. The association of progestin usage and the other risk factors with hypospadias were the study outcomes. RESULTS The median gestational age was significantly lower in Group 2 (p = 0.019). Prematurity was more common in Group 1 (p = 0.043). Although the median birth weight in Group 1 was significantly lower (p < 0.001), there was no significant difference between the ratios of low birth weight babies in the groups. The risky occupations were more frequently detected in Group 2 (p = 0.001). The rate and duration of progestin usage in Group 1 were significantly higher than that in Group 2 (p < 0.001). CONCLUSION Low birth weight and the use and duration of progestins during pregnancy were significantly associated with increased hypospadias risk.
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Affiliation(s)
- Mustafa Alper Akay
- Kocaeli University School of Medicine, Department of Pediatric Surgery, Kocaeli, Turkey.
| | - Gülşen Ekingen Yıldız
- Kocaeli University School of Medicine, Department of Pediatric Surgery, Kocaeli, Turkey.
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5
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Alderman MH, Taylor HS. Molecular mechanisms of estrogen action in female genital tract development. Differentiation 2021; 118:34-40. [PMID: 33707128 DOI: 10.1016/j.diff.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 12/29/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Abstract
The development of the female reproductive tract can be divided into three parts consisting of Müllerian duct organogenesis, pre-sexual maturation organ development, and post-sexual maturation hormonal regulation. In primates, Müllerian duct organogenesis proceeds in an estrogen independent fashion based on transcriptional pathways that are suppressed in males by the presence of AMH and SRY. However, clinical experience indicates that exposure to xenoestrogens such as diethylstilbestrol (DES) during critical periods including late organogenesis and pre-sexual maturational development can have substantial effects on uterine morphology, and confer increased risk of disease states later in life. Recent evidence has demonstrated that these effects are in part due to epigenetic regulation of gene expression, both in the form of aberrant CpG methylation, and accompanying histone modifications. While xenoestrogens and selective estrogen receptor modulators (SERMS) both can induce non-canonical binding confirmations in estrogen receptors, the primate specific fetal estrogens Estriol and Estetrol may act in a similar fashion to alter gene expression through tissue specific epigenetic modulation.
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Affiliation(s)
- Myles H Alderman
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, 06520, USA; Yale Stem Cell Center, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Hugh S Taylor
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, 06520, USA.
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Xiang H, Wang S, Kong X, Yu Y, Shen L, Long C, Liu X, Wei GH. c-Fos is upregulated in the genital tubercle of DEHP-induced hypospadiac rats and the prepuce of patients with hypospadias. Syst Biol Reprod Med 2021; 67:193-200. [PMID: 33618583 DOI: 10.1080/19396368.2020.1862356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aimed to investigate the expression of Fos proto-oncogene, AP-1 transcription factor subunit (c-Fos) in the genital tubercle (GT) of rats with di(2-ethylhexyl) phthalate (DEHP)-induced hypospadias and in the prepuce of patients with hypospadias compared with unaffected controls. Pregnant rats were given 750 mg/kg/day DEHP orally from gestational days 12-19. Western blotting showed that c-Fos expression was increased in DEHP-induced hypospadiac male offspring. In addition, 30 prepuce tissue specimens obtained during hypospadias repair surgery were divided into 2 groups: the mild hypospadias group (n = 15) and the severe hypospadias group (n = 15). Fifteen normal prepuce tissue specimens were harvested during elective circumcision as normal controls. Real-time quantitative polymerase chain reaction, western blotting and immunohistochemistry analyses were used to assess c-Fos expression. c-Fos protein levels were higher in the GT of DEHP-induced rats than in that of control rats. c-Fos mRNA and protein levels were also higher in the hypospadias groups than in the control group (p < 0.05, p < 0.001), and c-Fos protein levels were significantly higher in the severe hypospadias group than in the mild hypospadias group (p < 0.01). The expression of c-Fos was increased in both the GT of DEHP-induced hypospadiac rats and the prepuce of hypospadias patients. Thus, c-Fos overexpression might contribute to hypospadias.Abbreviations: DEHP: di(2-ethylhexyl) phthalate; c-Fos: Fos proto-oncogene, AP-1 transcription factor subunit; Mafb: the masculinization-regulatory gene v-maf musculoaponeurotic fibrosarcoma oncogene family, protein B; GT: genital tubercle; ED: embryonic day; AGD: anogenital distance; AGI: anogenital distance index; ED: embryonic day.
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Affiliation(s)
- Han Xiang
- Department of Urology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Child Urogenital Development and Tissue Engineering; Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Shao Wang
- Department of Urology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Child Urogenital Development and Tissue Engineering; Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoyan Kong
- Department of Urology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Child Urogenital Development and Tissue Engineering; Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yihang Yu
- Department of Urology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Child Urogenital Development and Tissue Engineering; Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Lianju Shen
- Department of Urology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Child Urogenital Development and Tissue Engineering; Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Chunlan Long
- Department of Urology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Child Urogenital Development and Tissue Engineering; Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xing Liu
- Department of Urology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Child Urogenital Development and Tissue Engineering; Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Guang-Hui Wei
- Department of Urology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Child Urogenital Development and Tissue Engineering; Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
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Maternal Exposure to Disinfection By-Products and Risk of Hypospadias in the National Birth Defects Prevention Study (2000-2005). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249564. [PMID: 33371304 PMCID: PMC7766973 DOI: 10.3390/ijerph17249564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/01/2020] [Accepted: 12/09/2020] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to estimate the association between 2nd and 3rd degree hypospadias and maternal exposure to disinfection by-products (DBPs) using data from a large case-control study in the United States. Concentration estimates for total trihalomethanes (TTHMs), the sum of the five most prevalent haloacetic acids (HAA5), and individual species of each were integrated with data on maternal behaviors related to water-use from the National Birth Defects Prevention Study (NBDPS) to create three different exposure metrics: (1) household DBP concentrations; (2) estimates of DBP ingestion; (3) predicted uptake (i.e., internal dose) of trihalomethanes (THMs) via ingestion, showering, and bathing. The distribution of DBP exposure was categorized as follows: (Q1/referent) < 50%; (Q2) ≥ 50% to < 75%; and (Q3) ≥ 75%. Logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Generally, null associations were observed with increasing TTHM or HAA5 exposure. An increased risk was observed among women with household bromodichloromethane levels in the second quantile (aOR: 1.8; 95% CI: 1.2, 2.7); however, this association did not persist after the inclusion of individual-level water-use data. Findings from the present study do not support the hypothesis that maternal DBP exposures are related to the occurrence of hypospadias.
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Baskin L, Sinclair A, Derpinghaus A, Cao M, Li Y, Overland M, Aksel S, Cunha GR. Estrogens and development of the mouse and human external genitalia. Differentiation 2020; 118:82-106. [PMID: 33092894 DOI: 10.1016/j.diff.2020.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 09/18/2020] [Indexed: 01/02/2023]
Abstract
The Jost hypothesis states that androgens are necessary for normal development of the male external genitalia. In this review, we explore the complementary hypothesis that estrogens can elicit abnormal development of male external genitalia. Herein, we review available data in both humans and mice on the deleterious effects of estrogen on external genitalia development, especially during the "window of susceptibility" to exogenous estrogens. The male and female developing external genitalia in both the human and mouse express ESR1 and ESR2, along with the androgen receptor (AR). Human clinical data suggests that exogenous estrogens can adversely affect normal penile and urethral development, resulting in hypospadias. Experimental mouse data also strongly supports the idea that exogenous estrogens cause penile and urethral defects. Despite key differences, estrogen-induced hypospadias in the mouse displays certain morphogenetic homologies to human hypospadias, including disruption of urethral fusion and preputial abnormalities. Timing of estrogenic exposure, or the "window of susceptibility," is an important consideration when examining malformations of the external genitalia in both humans and mice. In addition to a review of normal human and mouse external genital development, this article aims to review the present data on the role of estrogens in normal and abnormal development of the mouse and human internal and external genitalia. Based on the current literature for both species, we conclude that estrogen-dependent processes may play a role in abnormal genital development.
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Affiliation(s)
- Laurence Baskin
- University of California, San Francisco, Division of Pediatric Urology, Department of Urology, 550 16th St, 5th Floor, Mission Hall Pediatric Urology, San Francisco, CA, 94158, USA.
| | - Adriane Sinclair
- University of California, San Francisco, Division of Pediatric Urology, Department of Urology, 550 16th St, 5th Floor, Mission Hall Pediatric Urology, San Francisco, CA, 94158, USA
| | - Amber Derpinghaus
- University of California, San Francisco, Division of Pediatric Urology, Department of Urology, 550 16th St, 5th Floor, Mission Hall Pediatric Urology, San Francisco, CA, 94158, USA
| | - Mei Cao
- University of California, San Francisco, Division of Pediatric Urology, Department of Urology, 550 16th St, 5th Floor, Mission Hall Pediatric Urology, San Francisco, CA, 94158, USA
| | - Yi Li
- University of California, San Francisco, Division of Pediatric Urology, Department of Urology, 550 16th St, 5th Floor, Mission Hall Pediatric Urology, San Francisco, CA, 94158, USA
| | - Maya Overland
- University of California, San Francisco, Division of Pediatric Urology, Department of Urology, 550 16th St, 5th Floor, Mission Hall Pediatric Urology, San Francisco, CA, 94158, USA
| | - Sena Aksel
- University of California, San Francisco, Division of Pediatric Urology, Department of Urology, 550 16th St, 5th Floor, Mission Hall Pediatric Urology, San Francisco, CA, 94158, USA
| | - Gerald R Cunha
- University of California, San Francisco, Division of Pediatric Urology, Department of Urology, 550 16th St, 5th Floor, Mission Hall Pediatric Urology, San Francisco, CA, 94158, USA
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Chen Z, Lin X, Wang Y, Xie H, Chen F. Dysregulated expression of androgen metabolism genes and genetic analysis in hypospadias. Mol Genet Genomic Med 2020; 8:e1346. [PMID: 32515122 PMCID: PMC7434757 DOI: 10.1002/mgg3.1346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 12/18/2022] Open
Abstract
Background The aberrant expression of genes involved in androgen metabolism and genetic contribution are unclear in hypospadias. Methods We compared gene expression profiles by RNA sequencing from five non‐hypospadiac foreskins, five mild hypospadiac foreskins, and five severe hypospadiac foreskins. In addition, to identify rare coding variants with large effects on hypospadias risk, we carried out whole exome sequencing in three patients in a hypospadias family. Results The average expression of androgen receptor (AR) and CYP19A1 were significantly decreased in severe hypospadias (p < .01) and mild hypospadias (p < .05), whereas expression of several other androgen metabolism enzymes, including CYP3A4, HSD17B14, HSD3B7, HSD17B7, CYP11A1 were exclusively significantly expressed in severe hypospadias (p < .05). Compound rare damaging mutants of AR gene with HSD3B1 and SLC25A5 genes were identified in the different severe hypospadias. Conclusions In conclusion, our findings demonstrated that dysregulation of AR and CYP19A1 could play a crucial role in the development of hypospadias. Inconsistent AR expression may be caused by the feedback loop of ESR1 signaling or combined genetic effects with other risk genes. This findings complement the possible role of AR triggered mechanism in the development of hypospadias.
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Affiliation(s)
- Zhongzhong Chen
- Department of Urology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoling Lin
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yaping Wang
- Department of Urology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hua Xie
- Department of Urology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Fang Chen
- Department of Urology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.,Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Shanghai Eastern Urological Reconstruction and Repair Institute, Shanghai, China
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Cunha GR, Sinclair A, Cao M, Baskin LS. Development of the human prepuce and its innervation. Differentiation 2020; 111:22-40. [PMID: 31654825 PMCID: PMC6936222 DOI: 10.1016/j.diff.2019.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 10/03/2019] [Accepted: 10/08/2019] [Indexed: 01/12/2023]
Abstract
Development of the human prepuce was studied over the course of 9-17 weeks of gestation in 30 specimens. Scanning electron microscopy revealed subtle surface features that were associated with preputial development, namely the appearance of epidermal aggregates that appeared to be associated with formation of the preputial fold. Transverse and sagittal sections revealed that the epidermis of the glans is considerably thicker than that of the penile shaft. We described a novel morphogenetic mechanism of formation of the preputial lamina, namely the splitting of the thick epidermis of the glans into the preputial lamina and the epidermis via the intrusion of mesenchyme containing red blood cells and CD31-positive blood vessels. This process begins at 10-11 weeks of gestation in the proximal aspect of the glans and extends distally. The process is likely to be androgen-dependent and mediated via androgen receptors strategically localized to the morphogenetic process, but signaling through estrogen receptor may play a role. Estrogen receptor alpha (ESR1) has a very limited expression in the developing human glans and prepuce, while estrogen receptor beta (ESR2) is expressed more broadly in the developing preputial lamina, epidermis and urethra. Examination of the ontogeny of innervation of the glans penis and prepuce reveals the presence of the dorsal nerve of the penis as early as 9 weeks of gestation. Nerve fibers enter the glans penis proximally and extend distally over several weeks to eventually reach the distal aspect of the glans and prepuce by 14-16 weeks of gestation.
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Affiliation(s)
- Gerald R Cunha
- Department of Urology, University of California, 400 Parnassus Avenue, San Francisco, CA, 94143, USA.
| | - Adriane Sinclair
- Department of Urology, University of California, 400 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Mei Cao
- Department of Urology, University of California, 400 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Laurence S Baskin
- Department of Urology, University of California, 400 Parnassus Avenue, San Francisco, CA, 94143, USA
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Baskin L, Cao M, Sinclair A, Li Y, Overland M, Isaacson D, Cunha GR. Androgen and estrogen receptor expression in the developing human penis and clitoris. Differentiation 2020; 111:41-59. [PMID: 31655443 PMCID: PMC6926156 DOI: 10.1016/j.diff.2019.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/28/2019] [Accepted: 08/28/2019] [Indexed: 12/21/2022]
Abstract
To better understand how the human fetal penis and clitoris grows and remodels, we undertook an investigation to define active areas of cellular proliferation and programmed cell death spatially and temporally during development of human fetal external genitalia from the indifferent stage (8 weeks) to 18 weeks of gestation. Fifty normal human fetal penile and clitoral specimens were examined using macroscopic imaging, scanning electron microscopy and immunohistochemical localization for the cellular proliferation and apoptotic markers, Ki67 and Caspase-3. A number of hot spots of cellular proliferation characterized by Ki67 localization are present in the penis and clitoris especially early in development, most notably in the corporal body, glans, remodeling glanular urethra, the urethral plate, the roof of the urethral groove and the fully formed penile urethra. The 12-fold increase in penile length over 10 weeks of growth from 8 to 18 weeks of gestation based on Ki67 labelling appears to be driven by cellular proliferation in the corporal body and glans. Throughout all ages in both the developing penis and clitoris Ki67 labeling was consistently elevated in the ventral epidermis and ventral mesenchyme relative to the dorsal counterparts. This finding is consistent with the intense morphogenetic activity/remodeling in the ventral half of the genital tubercle in both sexes involving formation of the urethral/vestibular plates, canalization of the urethral/vestibular plates and fusion of the urethral folds to form the penile urethra. Areas of reduced or absent Ki67 staining include the urethral fold epithelium that fuses to form the penile tubular urethra. In contrast, the urethral fold mesenchyme is positive for Ki67. Apoptosis was rarely noted in the developing penis and clitoris; the only area of minimal Caspase-3 localization was in the epithelium of the ventral epithelial glanular channel remodeling.
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Affiliation(s)
- Laurence Baskin
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Division of Pediatric Urology, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, USA.
| | - Mei Cao
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Division of Pediatric Urology, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, USA
| | - Adriane Sinclair
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Division of Pediatric Urology, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, USA
| | - Yi Li
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Division of Pediatric Urology, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, USA
| | - Maya Overland
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Division of Pediatric Urology, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, USA
| | - Dylan Isaacson
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Division of Pediatric Urology, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, USA
| | - Gerald R Cunha
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Division of Pediatric Urology, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, USA
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Balaji DR, Reddy G, Babu R, Paramaswamy B, Ramasundaram M, Agarwal P, Joseph LD, D'Cruze L, Sundaram S. Androgen Receptor Expression in Hypospadias. J Indian Assoc Pediatr Surg 2019; 25:6-9. [PMID: 31896892 PMCID: PMC6910049 DOI: 10.4103/jiaps.jiaps_166_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 01/31/2019] [Accepted: 02/02/2019] [Indexed: 12/13/2022] Open
Abstract
Introduction: The exact mechanism behind the development of hypospadias is unclear. Research studies on androgen receptor (AR) expression are controversial with results stating all possible outcomes – AR elevated, similar, or reduced when compared to normal. Aims: The aim is to study the AR expression and hormone levels in hypospadias patients and compare them with children having normal genitalia. Methods: Group 1 (controls) involved patients who underwent circumcision for phimosis while Group 2 involved hypospadias patients who did not receive any preoperative testosterone. Preoperative hormonal assay included luteinizing hormone, follicle-stimulating hormone, and free testosterone levels in all the patients. The foreskin specimen was analyzed for AR expression using immunohistochemistry (anti-AR antibody PathnSitu, clone R441, 1/100 dilution). AR staining was expressed as H score. The H score was calculated by multiplying the intensity of staining and the percentage of stained cells showing cytoplasmic positivity at high power (×40). Results: There were 27 patients in Group 1 while 16 in Group 2 (distal 10; proximal 6).There was no significant difference in the age distribution. The mean H score was significantly higher (189.5) in hypospadias patients compared to controls (97.5) and was significantly higher in proximal (220) compared to distal (159) hypospadias. There was no significant difference in hormone levels between groups. Conclusion: AR expression was significantly elevated in hypospadias patients. It was higher in proximal compared to distal hypospadias, probably due to end-organ overexpression. Further larger trials are likely to through light into this controversial subject.
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Affiliation(s)
- Dhanvanth Rajesh Balaji
- Department of Pediatric Urology, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
| | - Goutham Reddy
- Department of Pediatric Urology, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
| | - Ramesh Babu
- Department of Pediatric Urology, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
| | | | - Madhu Ramasundaram
- Department of Pediatric Surgery, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
| | - Prakash Agarwal
- Department of Pediatric Surgery, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
| | - Leena Dennis Joseph
- Department of Pathology, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
| | - Lawrence D'Cruze
- Department of Pathology, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
| | - Sandhya Sundaram
- Department of Pathology, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
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Lin D, Liu P, Wang G, Zhang W, Sun N. The distribution of Preputial vessels in different severity of rat congenital hypospadias model: imaging study using micro-computerized tomography. BMC Urol 2019; 19:111. [PMID: 31703582 PMCID: PMC6842185 DOI: 10.1186/s12894-019-0547-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Micro-computerized tomography (micro-CT) is considered as an innovative non-invasive and high-resolution imaging technology. The current research aims to reconstruct the distribution of preputial vessels in different severity of rat congenital hypospadias model by micro-CT, and to provide an anatomic basis for the selection of preputial vessel pedicle flaps in surgery. METHODS Pregnant rats were exposed to finasteride from gestational day 12 to 17. Depending on the position of the urethral meatus, the pups were divided into normal, mild hypospadias and severe hypospadias groups. Six months after birth, the preputial blood vessels were observed in vascular perfusion with Microfil (a silicone-based polymer) and scanned by micro-CT. CTvox and NRecon were utilized to reconstruct 3-dimentional (3D) images. A pathological analysis of the specimen was taken in order to determine the position of Microfil. RESULTS The normal group and the mild hypospadias group had similar preputial image characteristics. At the junction of the inner and outer prepuce, the deep layer vessels of the superficial fascia were transversely distributed and formed a vascular ring-like structure. Among the severe hypospadias group, five had sufficient blood circulation while six had insufficient blood circulation. In sufficient blood circulation type, the ring-like vessels were found at the junction of the inner and outer prepuce similar to that of the normal and mild hypospadias group. However, only a small amount of capillary supply to this area in the insufficient type. CONCLUSION The junction of the inner and outer prepuce with abundant blood circulation was suitable to be a vascular pedicle flap. The tubularized preputial island flaps were consistent with the ring-like vessels area, and the original blood supply was retained to the greatest extent.
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Affiliation(s)
- Defu Lin
- National Center for Children's Health, Beijing, China.,Department of Urology, Beijing Children's Hospital affiliated to Capital Medical University, No.56 Nanlishilu Rd, West District, Beijing, China
| | - Pei Liu
- National Center for Children's Health, Beijing, China.,Department of Urology, Beijing Children's Hospital affiliated to Capital Medical University, No.56 Nanlishilu Rd, West District, Beijing, China
| | - Guannan Wang
- National Center for Children's Health, Beijing, China.,Department of Urology, Beijing Children's Hospital affiliated to Capital Medical University, No.56 Nanlishilu Rd, West District, Beijing, China
| | - Weiping Zhang
- National Center for Children's Health, Beijing, China.,Department of Urology, Beijing Children's Hospital affiliated to Capital Medical University, No.56 Nanlishilu Rd, West District, Beijing, China
| | - Ning Sun
- National Center for Children's Health, Beijing, China. .,Department of Urology, Beijing Children's Hospital affiliated to Capital Medical University, No.56 Nanlishilu Rd, West District, Beijing, China.
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14
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Chen Y, Yu H, Pask AJ, Fujiyama A, Suzuki Y, Sugano S, Shaw G, Renfree MB. Hormone-responsive genes in the SHH and WNT/β-catenin signaling pathways influence urethral closure and phallus growth. Biol Reprod 2019; 99:806-816. [PMID: 29767687 DOI: 10.1093/biolre/ioy117] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 05/13/2018] [Indexed: 11/14/2022] Open
Abstract
Environmental endocrine disruptors (EEDs) that affect androgen or estrogen activity may disrupt gene regulation during phallus development to cause hypospadias or a masculinized clitoris. We treated developing male tammar wallabies with estrogen and females with androgen from day 20-40 postpartum (pp) during the androgen imprinting window of sensitivity. Estrogen inhibited phallus elongation but had no effect on urethral closure and did not significantly depress testicular androgen synthesis. Androgen treatment in females did not promote phallus elongation but initiated urethral closure. Phalluses were collected for transcriptome sequencing at day 50 pp when they first become sexually dimorphic to examine changes in two signaling pathways, sonic hedgehog (SHH) and wingless-type MMTV integration site family (WNT)/β-catenin. SHH mRNA and β-catenin were predominantly expressed in the urethral epithelium in the tammar phallus, as in eutherian mammals. Estrogen treatment and castration of males induced an upregulation of SHH, while androgen treatment downregulated SHH. These effects appear to be direct since we detected putative estrogen receptor α (ERα) and androgen receptor (AR) binding sites near SHH. WNT5A, like SHH, was downregulated by androgen, while WNT4 was upregulated in female phalluses after androgen treatment. After estrogen treatment, WIF1 and WNT7A were both downregulated in male phalluses. After castration, WNT9A was upregulated. These results suggest that SHH and WNT pathways are regulated by both estrogen and androgen to direct the proliferation and elongation of the phallus during differentiation. Their response to exogenous hormones makes these genes potential targets of EEDs in the etiology of abnormal phallus development including hypospadias.
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Affiliation(s)
- Yu Chen
- School of BioSciences, The University of Melbourne, Victoria, Australia
| | - Hongshi Yu
- School of BioSciences, The University of Melbourne, Victoria, Australia
| | - Andrew J Pask
- School of BioSciences, The University of Melbourne, Victoria, Australia
| | - Asao Fujiyama
- Advanced Genomics Center, National Institute of Genetics, Mishima, Shizuoka, Japan
| | - Yutaka Suzuki
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Sumio Sugano
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Geoff Shaw
- School of BioSciences, The University of Melbourne, Victoria, Australia
| | - Marilyn B Renfree
- School of BioSciences, The University of Melbourne, Victoria, Australia
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15
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Cripps SM, Mattiske DM, Black JR, Risbridger GP, Govers LC, Phillips TR, Pask AJ. A loss of estrogen signaling in the aromatase deficient mouse penis results in mild hypospadias. Differentiation 2019; 109:42-52. [PMID: 31520742 DOI: 10.1016/j.diff.2019.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/02/2019] [Accepted: 09/04/2019] [Indexed: 11/18/2022]
Abstract
Hypospadias is the abnormal opening of the urethra on the underside of the penis and occurs in approximately 1/125 live male births worldwide. The incidence rate of hypospadias has dramatically increased over the past few decades. This is now attributed, at least in part, to our exposure to endocrine-disrupting chemicals (EDCs) which alter the hormonal signals required for development of the penis. In humans androgens are the main drivers of fusion of the urethral folds to form the urethra within the shaft of the penis, a process required for termination of the urethra in its normal location at the tip of the penis. However, recent research has suggested that estrogen also plays a role in this process. To better understand how EDCs impact urethral development it is essential that we understand the normal function of hormones during development of the penis. To define the role of estrogen in urethral development we examined development of the penis in the aromatase (Cyp19a1) Knockout (ArKO) mouse strain in which endogenous estrogen production is completely ablated. We found that the ArKO penis had a mild hypospadias phenotype. The developing ArKO postnatal penis displayed an early disruption in preputial development, which likely causes the mild hypospadias observed in adults. Using qPCR, we found altered expression of keratin genes and key urethral patterning genes in response to the disrupted estrogen signaling. The hypospadias phenotype was almost identical to that reported for the estrogen receptor α (ERα) knockout confirming that ERα is the predominant receptor for mediating estrogen action during development of the mouse penis. Our results show that estrogen is required for normal prepucial development and placement of the mature urethral opening at the distal aspect of the penis. We also identified several genes which are potential downstream targets of estrogen during normal urethral closure. With this knowledge, we can now better understand how anti-estrogenic as well as estrogenic EDCs disrupt urethral closure to cause mild hypospadias in both mice and humans.
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Affiliation(s)
- Samuel M Cripps
- School of BioSciences, The University of Melbourne, Victoria, Australia
| | - Deidre M Mattiske
- School of BioSciences, The University of Melbourne, Victoria, Australia
| | - Jay R Black
- School of Earth Sciences, The University of Melbourne, Victoria, Australia
| | - Gail P Risbridger
- Monash Biomedicine Discovery Institute, Monash University, Victoria, Australia; Department of Anatomy and Developmental Biology, Monash University, Victoria, Australia
| | - Luke C Govers
- School of BioSciences, The University of Melbourne, Victoria, Australia
| | | | - Andrew J Pask
- School of BioSciences, The University of Melbourne, Victoria, Australia.
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16
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Buur LE, Laurberg VR, Ernst A, Arendt LH, Nybo Andersen AM, Olsen J, Ramlau-Hansen CH. Oral contraceptive use and genital anomalies in sons. A Danish cohort study. Reprod Toxicol 2019; 89:67-73. [PMID: 31299209 DOI: 10.1016/j.reprotox.2019.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 06/30/2019] [Accepted: 07/08/2019] [Indexed: 11/18/2022]
Abstract
Exposure to exogenous sex hormones with estrogenic or anti-androgen properties may influence intrauterine development of male genitals. This population-based cohort study based on data from 44,408 live-born singleton sons in the Danish National Birth Cohort (DNBC) aimed to investigate whether maternal use of oral contraceptives prior to or during early pregnancy increase the risk of cryptorchidism or hypospadias. We found no consistent association between use of oral contraceptives and cryptorchidism or hypospadias, neither in those exposed any time four months prior to conception [cryptorchidism: adjusted Odds Ratio (aOR): 1.06 (95% CI: 0.91; 1.23), hypospadias: 0.74 (95% CI: 0.53; 1.03)] nor in those exposed any time during the first trimester of pregnancy [cryptorchidism: aOR: 0.93 (95% CI: 0.53; 1.62), hypospadias: 1.02 (95% CI: 0.32; 3.23)]. Despite relatively strong exposure levels from oral contraceptive use in pregnancy, this study revealed no evidence of an increased risk of either two genital malformations.
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Affiliation(s)
- L E Buur
- Department of Public Health, Aarhus University, Aarhus, Denmark.
| | - V R Laurberg
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - A Ernst
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - L H Arendt
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - A-M Nybo Andersen
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - J Olsen
- Department of Public Health, Aarhus University, Aarhus, Denmark; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
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Risk Factors for hypospadias in Northwest Russia: A Murmansk County Birth Registry Study. PLoS One 2019; 14:e0214213. [PMID: 30946760 PMCID: PMC6448815 DOI: 10.1371/journal.pone.0214213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 03/10/2019] [Indexed: 11/19/2022] Open
Abstract
Background Hypospadias is the most common congenital anomaly of the penis, but its causes are mainly unknown. Of the risk factors identified, the most plausible are hormonal and genetic. The aim of this study was to identify risk factors for hypospadias in Northwest Russia based on registry data. Methods The study population included male infants registered in the Murmansk County Birth Registry between 1 January 2006 and 31 December 2011 (n = 25 475). These infants were followed-up for 2 years using the Murmansk Regional Congenital Defects Registry to identify cases of hypospadias not diagnosed at birth. We used logistic regression analysis to examine the contributions of hypospadias risk factors. Results Out of 25 475 male infants born during the study period, 148 had isolated hypospadias. The overall prevalence rate was 54.2 (95% CI 53.6–54.8) per 10 000 male infants. Those born to mothers with preeclampsia (OR = 1.65; 95% CI 1.03–2.66) or infant birthweight < 2500 g (OR = 2.06; 95% CI 1.18–3.60) exhibited increased risk for hypospadias. Maternal age, smoking during pregnancy, folic acid intake during pregnancy or hepatitis B surface antigen positivity did not associate with increased risk of hypospadias. Conclusions Combining data from a birth registry with those from a congenital defects registry provided optimal information about the prevalence of hypospadias and its association with low infant birthweight and preeclampsia. These factors have in common changes in hormone levels during pregnancy, which in turn may have contributed to hypospadias development.
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18
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Michikawa T, Yamazaki S, Ono M, Kuroda T, Nakayama SF, Suda E, Isobe T, Iwai-Shimada M, Kobayashi Y, Yonemoto J, Tamura K, Kawamoto T, Nitta H. Isoflavone Intake in Early Pregnancy and Hypospadias in the Japan Environment and Children's Study. Urology 2018; 124:229-236. [PMID: 30447265 DOI: 10.1016/j.urology.2018.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 08/15/2018] [Accepted: 11/03/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To explore the association between isoflavone intake in early pregnancy (the critical window of masculinisation) and hypospadias. Since oestrogen is likely to contribute to the differentiation of male external genitalia, dietary intake of isoflavone, which has a similar structure to human oestrogen, may be associated with the occurrence of hypospadias. However, there has been little evidence of this association. MATERIALS AND METHODS We used data of a nationwide birth cohort study, which recruited women as early in pregnancy as possible throughout Japan between 2011 and 2014. From the response to a self-administered food-frequency questionnaire, the daily intake of genistein (as a representative for isoflavone) was estimated. Information on hypospadias cases that were diagnosed until the first month after birth was obtained from medical records. Odds ratios (ORs) of hypospadias were estimated using a logistic regression model. RESULTS Among 41,578 mothers, who delivered singleton live male births, the median genistein intake was 15.3 mg/day, and a total of 51 cases of hypospadias were identified. Compared with mothers in the reference group (genistein intake 11th-89th percentiles), those in the low intake group (≤10th percentile) had an elevated risk of their sons having hypospadias (multivariable-adjusted OR = 2.8, 95% confidence interval = 1.4-5.8). Adverse or beneficial effects of genistein on hypospadias were not observed in the high intake group (≥90th percentile) (OR = 0.9, 95% confidence interval = 0.4-2.4). CONCLUSION Low maternal intake of isoflavone in early pregnancy was associated with an elevated risk of hypospadias.
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Affiliation(s)
- Takehiro Michikawa
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan.
| | - Shin Yamazaki
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Masaji Ono
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Tatsuo Kuroda
- Department of Paediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shoji F Nakayama
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Eiko Suda
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Tomohiko Isobe
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Miyuki Iwai-Shimada
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Yayoi Kobayashi
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Junzo Yonemoto
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Kenji Tamura
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Toshihiro Kawamoto
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan; Department of Environmental Health, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroshi Nitta
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
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19
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Expression of androgen, estrogen, and progesterone hormone receptors in the penile tissues of children with different types of hypospadias. North Clin Istanb 2018; 6:110-116. [PMID: 31297475 PMCID: PMC6593914 DOI: 10.14744/nci.2018.47108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 02/09/2018] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE: Androgen (AR), Estrogen (ER) and Progesterone (PR) hormones play an important role in the prenatal and postnatal development of urogenital tract and especially the penis. The expressions of AR, ER and PR receptors in penile tissues in children with hypospadiases had also been shown previously. In this leading study, to demonstrate of the sex hormone receptor expression in cases with different types of hypospadias were aimed. METHODS: This study was designed in children operated due to hypospadiases without DSD. Biopsy samples of 3 mm’s were obtained from three different sytes as the lateral parameatal tissue and the anterior corner of the prepuce, and inner layer of posterior prepuce. The presence of AR, ER and PR receptors was investigated immunehistochemically. RESULTS: Mean age was 5.4 years in 18 children with hypospadiases; in totally 33 specimens were taken in 5 subcoronal as 5 specimens, and 7 penile as 15 specimens, and 6 penoscrotal as 13 specimens. According to sytes of samples; 13 samples were from lateral para-meatal tissues, and 13 were from anterior corners of prepuces, and 7 were from inner layers of posterior prepuces. In regard to receptor expression; ER and AR receptors were positive in 29 (87.8%) and 12 (36.4%) respectively; PR receptors were negative. CONCLUSION: This study emphasized the dominant expression of estrogen receptors in penile tissues of children with hypospadias. Although there was not a manifest correlation of androgen receptors absence in regard to the severity of hypospadias patients, there was a marked estrogen receptors presence in penile tissues. These findings suggest that the disrupted androgen and estrogen receptor interaction and/or balance could play a role during the development of external genitalia in hypospadias patients. Progesterone receptor was not present and therefore the active role in the postnatal development of hypospadias is still debatable.
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Shen J, Isaacson D, Cao M, Sinclair A, Cunha GR, Baskin L. Immunohistochemical expression analysis of the human fetal lower urogenital tract. Differentiation 2018; 103:100-119. [PMID: 30287094 PMCID: PMC6589035 DOI: 10.1016/j.diff.2018.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 09/16/2018] [Accepted: 09/18/2018] [Indexed: 12/15/2022]
Abstract
We have studied the ontogeny of the developing human male and female urogenital tracts from 9 weeks (indifferent stage) to 16 weeks (advanced sex differentiation) of gestation by immunohistochemistry on mid-sagittal sections. Sixteen human fetal pelvises were serial sectioned in the sagittal plane and stained with antibodies to epithelial, muscle, nerve, proliferation and hormone receptor markers. Key findings are: (1) The corpus cavernosum in males and females extends into the glans penis and clitoris, respectively, during the ambisexual stage (9 weeks) and thus appears to be an androgen-independent event. (2) The entire human male (and female) urethra is endodermal in origin based on the presence of FOXA1, KRT 7, uroplakin, and the absence of KRT10 staining. The endoderm of the urethra interfaces with ectodermal epidermis at the site of the urethral meatus. (3) The surface epithelium of the verumontanum is endodermal in origin (FOXA1-positive) with a possible contribution of Pax2-positive epithelial cells implying additional input from the Wolffian duct epithelium. (4) Prostatic ducts arise from the endodermal (FOXA1-positive) urogenital sinus epithelium near the verumontanum. (5) Immunohistochemical staining of mid-sagittal and para-sagittal sections revealed the external anal sphincter, levator ani, bulbospongiosus muscle and the anatomic relationships between these developing skeletal muscles and organs of the male and female reproductive tracts. Future studies of normal human developmental anatomy will lay the foundation for understanding congenital anomalies of the lower urogenital tract.
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Affiliation(s)
- Joel Shen
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States; Division of Pediatric Urology, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, United States
| | - Dylan Isaacson
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States; Division of Pediatric Urology, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, United States
| | - Mei Cao
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States; Division of Pediatric Urology, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, United States
| | - Adriane Sinclair
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States; Division of Pediatric Urology, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, United States
| | - Gerald R Cunha
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States; Division of Pediatric Urology, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, United States
| | - Laurence Baskin
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States; Division of Pediatric Urology, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, United States.
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Stewart MK, Mattiske DM, Pask AJ. In utero exposure to both high- and low-dose diethylstilbestrol disrupts mouse genital tubercle development†. Biol Reprod 2018; 99:1184-1193. [DOI: 10.1093/biolre/ioy142] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 06/19/2018] [Indexed: 02/04/2023] Open
Affiliation(s)
- Melanie K Stewart
- School of BioSciences, The University of Melbourne, Victoria, Australia
| | - Deidre M Mattiske
- School of BioSciences, The University of Melbourne, Victoria, Australia
| | - Andrew J Pask
- School of BioSciences, The University of Melbourne, Victoria, Australia
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22
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Liu G, Liu X, Shen J, Sinclair A, Baskin L, Cunha GR. Contrasting mechanisms of penile urethral formation in mouse and human. Differentiation 2018; 101:46-64. [PMID: 29859371 DOI: 10.1016/j.diff.2018.05.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 11/27/2022]
Abstract
This paper addresses the developmental mechanisms of formation of the mouse and human penile urethra and the possibility that two disparate mechanisms are at play. It has been suggested that the entire penile urethra of the mouse forms via direct canalization of the endodermal urethral plate. While this mechanism surely accounts for development of the proximal portion of the mouse penile urethra, we suggest that the distal portion of the mouse penile urethra forms via a series of epithelial fusion events. Through review of the recent literature in combination with new data, it is unlikely that the entire mouse urethra is formed from the endodermal urethral plate due in part to the fact that from E14 onward the urethral plate is not present in the distal aspect of the genital tubercle. Formation of the distal portion of the mouse urethra receives substantial contribution from the preputial swellings that form the preputial-urethral groove and subsequently the preputial-urethral canal, the later of which is subdivided by a fusion event to form the distal portion of the mouse penile urethra. Examination of human penile development also reveals comparable dual morphogenetic mechanisms. However, in the case of human, direct canalization of the urethral plate occurs in the glans, while fusion events are involved in formation of the urethra within the penile shaft, a pattern exactly opposite to that of the mouse. The highest incidence of hypospadias in humans occurs at the junction of these two different developmental mechanisms. The relevance of the mouse as a model of human hypospadias is discussed.
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Affiliation(s)
- Ge Liu
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Department of Urology, University of California, San Francisco, CA, United States
| | - Xin Liu
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Department of Urology, University of California, San Francisco, CA, United States
| | - Joel Shen
- Department of Urology, University of California, San Francisco, CA, United States
| | - Adriane Sinclair
- Department of Urology, University of California, San Francisco, CA, United States
| | - Laurence Baskin
- Department of Urology, University of California, San Francisco, CA, United States
| | - Gerald R Cunha
- Department of Urology, University of California, San Francisco, CA, United States.
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Isaacson D, Shen J, Cao M, Sinclair A, Yue X, Cunha G, Baskin L. Renal Subcapsular xenografing of human fetal external genital tissue - A new model for investigating urethral development. Differentiation 2017; 98:1-13. [PMID: 29031189 DOI: 10.1016/j.diff.2017.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/26/2017] [Accepted: 09/11/2017] [Indexed: 12/01/2022]
Abstract
In this paper, we introduce our novel renal subcapsular xenograft model for the study of human penile urethral and clitoral development. We grafted fifteen intact fetal penes and clitorides 8-11 weeks fetal age under the renal capsules of gonadectomized athymic mice. The mice were treated with a subcutaneous pellet of dihydrotestosterone (DHT), diethylstilbestrol (DES) or untreated with hormones. Xenografts were harvested after fourteen days of growth and analyzed via serial histologic sectioning and immunostaining for Ki-67, cytokeratins 6, 7 and 10, uroplakin and the androgen receptor. Non-grafted specimens of similar fetal age were sectioned and immunostained for the same antigenic markers. 14/15 (93.3%) grafts were successfully propagated and harvested. The developing urethral plate, urethral groove, tubular urethra, corporal bodies and preputial lamina were easily identifiable. These structures demonstrated robust cellularity, appropriate architecture and abundant Ki-67 expression. Expression patterns of cytokeratins 6, 7 and 10, uroplakin and the androgen receptor in xenografted specimens demonstrated characteristic male/female differences analogous to non-grafted specimens. DHT treatment reliably produced tubularization of nascent urethral and vestibular structures and male patterns of androgen receptor expression in grafts of both genetic sexes while estrogenic or hormonally absent conditions reliably resulted in a persistent open urethral/vestibular groove and female patterns of androgen receptor expression. This model's success enables further study into causal pathways by which endocrine-disrupting and endocrine-mimicking substances may directly cause disruption of normal human urethral development or hypospadias.
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Affiliation(s)
- Dylan Isaacson
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Joel Shen
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA
| | - Mei Cao
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA
| | - Adriane Sinclair
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA
| | - Xuan Yue
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA
| | - Gerald Cunha
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA
| | - Laurence Baskin
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Division of Pediatric Urology, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, USA.
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Amato CM, McCoy KA. A validated protocol to quantify severity of male urogenital feminization using the MOUSE (Mouse objective urethral severity evaluation). Pediatr Res 2016; 80:880-885. [PMID: 27490742 DOI: 10.1038/pr.2016.157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 06/09/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND Congenital abnormalities vary in presentation, yet studies using model organisms tend to focus on occurrence rather than severity of the defect. Scoring severity of abnormalities in model systems allows explicit hypothesis testing during basic, translational, and reverse translational studies. We developed and validated a protocol to quantify severity of male urogenital feminization (hypospadias) in the mouse model. Hypospadias is one of the most common birth defects in the world. METHODS To induce genital feminization, pregnant mice were exposed to different concentrations of the antiandrogen vinclozolin. Genitalia were photographed at gestational age 18.5. A dichotomous scoring system to evaluate genital feminization was developed, and validated against histological measurements of urethral length. A training protocol was developed for novice scorers, and criteria were defined to evaluate precision and accuracy of scores. RESULTS Vinclozolin induced variation in hypospadias severity. Severity scores were tightly correlated with histologically determined urethral length and both techniques showed similar dose-response relationships. Novice observers were trained to precisely and accurately score hypospadias severity. CONCLUSION This standardized scoring system advances the mouse as a model to study urogenital development, and will facilitate research on the mechanisms driving genital feminization in males, and aid translational hypospadias research.
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Affiliation(s)
- Ciro M Amato
- Department of Biology, East Carolina University, Greenville, North Carolina
| | - Krista A McCoy
- Department of Biology, East Carolina University, Greenville, North Carolina
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Sinclair AW, Cao M, Shen J, Cooke P, Risbridger G, Baskin L, Cunha GR. Mouse hypospadias: A critical examination and definition. Differentiation 2016; 92:306-317. [PMID: 27068029 DOI: 10.1016/j.diff.2016.03.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/24/2016] [Accepted: 03/29/2016] [Indexed: 11/27/2022]
Abstract
Hypospadias is a common malformation whose etiology is based upon perturbation of normal penile development. The mouse has been previously used as a model of hypospadias, despite an unacceptably wide range of definitions for this malformation. The current paper presents objective criteria and a definition of mouse hypospadias. Accordingly, diethylstilbestrol (DES) induced penile malformations were examined at 60 days postnatal (P60) in mice treated with DES over the age range of 12 days embryonic to 20 days postnatal (E12-P20). DES-induced hypospadias involves malformation of the urethral meatus, which is most severe in DES E12-P10, DES P0-P10 and DES P5-P15 groups, and less so or absent in the other treatment groups. A frenulum-like ventral tether between the penis and the prepuce was seen in the most severely affected DES-treated mice. Internal penile morphology was also altered in the DES E12-P10, DES P0-P10 and DES P5-P15 groups (with little effect in the other DES treatment groups). Thus, adverse effects of DES are a function of the period of DES treatment and most severe in the P0-P10 period. In "estrogen mutant mice" (NERKI, βERKO, αERKO and AROM+) hypospadias was only seen in AROM+ male mice having genetically-engineered elevation is serum estrogen. Significantly, mouse hypospadias was only seen distally at and near the urethral meatus where epithelial fusion events are known to take place and never in the penile midshaft, where urethral formation occurs via an entirely different morphogenetic process.
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Affiliation(s)
- Adriane Watkins Sinclair
- Department of Urology, University of California San Francisco, 400 Parnassus Avenue, Box A610, San Francisco, CA 94143, United States
| | - Mei Cao
- Department of Urology, University of California San Francisco, 400 Parnassus Avenue, Box A610, San Francisco, CA 94143, United States
| | - Joel Shen
- Department of Urology, University of California San Francisco, 400 Parnassus Avenue, Box A610, San Francisco, CA 94143, United States
| | - Paul Cooke
- Department of Physiological Sciences, University of Florida, Gainsville, FL 32610, United States
| | - Gail Risbridger
- Monash Institute of Reproduction and Development, Monash University, Monash Medical Centre, Clayton, Victoria, Australia
| | - Laurence Baskin
- Department of Urology, University of California San Francisco, 400 Parnassus Avenue, Box A610, San Francisco, CA 94143, United States
| | - Gerald R Cunha
- Department of Urology, University of California San Francisco, 400 Parnassus Avenue, Box A610, San Francisco, CA 94143, United States.
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Investigation of sexual dimorphisms through mouse models and hormone/hormone-disruptor treatments. Differentiation 2016; 91:78-89. [DOI: 10.1016/j.diff.2015.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 11/11/2015] [Indexed: 01/23/2023]
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Abstract
Introduction Endocrine disruptors or environmental agents, disrupt the endocrine system, leading to various adverse effects in humans and animals. Although the phenomenon has been noted historically in the cases of diethylstilbestrol (DES) and dichlorodiphenyltrichloroethane (DDT), the term “endocrine disruptor” is relatively new. Endocrine disruptors can have a variety of hormonal activities such as estrogenicity or anti-androgenicity. The focus of this review concerns on the induction of hypospadias by exogenous estrogenic endocrine disruptors. This has been a particular clinical concern secondary to reported increased incidence of hypospadias. Herein, the recent literature is reviewed as to whether endocrine disruptors cause hypospadias. Methods A literature search was performed for studies involving both humans and animals. Studies within the past 5 years were reviewed and categorized into basic science, clinical science, epidemiologic, or review studies. Results Forty-three scientific articles were identified. Relevant sentinel articles were also reviewed. Additional pertinent studies were extracted from the reference of the articles that obtained from initial search results. Each article was reviewed and results presented. Overall, there were no studies which definitely stated that endocrine disruptors caused hypospadias. However, there were multiple studies which implicated endocrine disruptors as one component of a multifactorial model for hypospadias. Conclusions Endocrine disruption may be one of the many critical steps in aberrant development that manifests as hypospadias.
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Affiliation(s)
- Sisir Botta
- Department of Urology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Gerald R Cunha
- Department of Urology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Laurence S Baskin
- Department of Urology, University of California San Francisco, San Francisco, CA 94143, USA
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Sinclair AW, Cao M, Baskin L, Cunha GR. Diethylstilbestrol-induced mouse hypospadias: "window of susceptibility". Differentiation 2016; 91:1-18. [PMID: 26810244 DOI: 10.1016/j.diff.2016.01.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 01/07/2016] [Indexed: 11/26/2022]
Abstract
This review presents published and novel results that define the programming window for diethylstilbestrol (DES)-induced abnormal development of the mouse penis. These data indicate that DES has its greatest effect during the period of most intense penile morphogenesis, namely postnatal days 0-15 (P0-P15). Pregnant mice and their neonatal pups were injected subcutaneously with 200 ng/gbw DES every other day from embryonic day 12-18 (DES E12-E18), postnatal day 0-10 (DES P0-P10), embryonic day 12 to postnatal day 10 (DES E12-P10), postnatal day 5-15 (DES P5-P15), and postnatal day 10-20 (DES P10-P20). Aged-matched controls received sesame oil vehicle. After euthanasia at 10, 15, 20 and 60 days, penises were analyzed by gross morphology, histology and morphometry. Penises of all 5 groups of DES-treated mice were reduced in size, which was confirmed by morphometric analysis of internal penile structures. The most profound effects were seen in the DES E12-P10, DES P0-P10, and DES P5-P15 groups, thus defining a DES "programming window". For all parameters, DES treatment from P10 to P20 showed the most mild of effects. Adverse effects of DES on the MUMP cartilage and erectile bodies observed shortly after the last DES injection reverted to normality in the DES P5-P15, but not in the E12-P10 and P0-P10 groups, in which MUMP cartilage and erectile body malformations persisted into adulthood, again emphasizing a "window of susceptibility" in the early neonatal period.
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Affiliation(s)
- Adriane Watkins Sinclair
- Department of Urology, University of California San Francisco, 400 Parnassus Avenue, Box A610, San Francisco, CA 94143, United States
| | - Mei Cao
- Department of Urology, University of California San Francisco, 400 Parnassus Avenue, Box A610, San Francisco, CA 94143, United States
| | - Laurence Baskin
- Department of Urology, University of California San Francisco, 400 Parnassus Avenue, Box A610, San Francisco, CA 94143, United States
| | - Gerald R Cunha
- Department of Urology, University of California San Francisco, 400 Parnassus Avenue, Box A610, San Francisco, CA 94143, United States.
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Expression Analysis of DGKK during External Genitalia Formation. J Urol 2015; 194:1728-36. [DOI: 10.1016/j.juro.2015.06.098] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2015] [Indexed: 01/23/2023]
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Troncoso B, Mushtaq I, Muneer A. Environmental Exposure to Endocrine Disruptors: Can We Identify the Link with Genital Disorders? Eur Urol 2015; 68:1031-2. [DOI: 10.1016/j.eururo.2015.08.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 08/12/2015] [Indexed: 11/16/2022]
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Timing of androgen receptor disruption and estrogen exposure underlies a spectrum of congenital penile anomalies. Proc Natl Acad Sci U S A 2015; 112:E7194-203. [PMID: 26598695 DOI: 10.1073/pnas.1515981112] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Congenital penile anomalies (CPAs) are among the most common human birth defects. Reports of CPAs, which include hypospadias, chordee, micropenis, and ambiguous genitalia, have risen sharply in recent decades, but the causes of these malformations are rarely identified. Both genetic anomalies and environmental factors, such as antiandrogenic and estrogenic endocrine disrupting chemicals (EDCs), are suspected to cause CPAs; however, little is known about the temporal window(s) of sensitivity to EDCs, or the tissue-specific roles and downstream targets of the androgen receptor (AR) in external genitalia. Here, we show that the full spectrum of CPAs can be produced by disrupting AR at different developmental stages and in specific cell types in the mouse genital tubercle. Inactivation of AR during a narrow window of prenatal development results in hypospadias and chordee, whereas earlier disruptions cause ambiguous genitalia and later disruptions cause micropenis. The neonatal phase of penile development is controlled by the balance of AR to estrogen receptor α (ERα) activity; either inhibition of androgen or augmentation of estrogen signaling can induce micropenis. AR and ERα have opposite effects on cell division, apoptosis, and regulation of Hedgehog, fibroblast growth factor, bone morphogenetic protein, and Wnt signaling in the genital tubercle. We identify Indian hedgehog (Ihh) as a novel downstream target of AR in external genitalia and show that conditional deletion of Ihh inhibits penile masculinization. These studies reveal previously unidentified cellular and molecular mechanisms by which antiandrogenic and estrogenic signals induce penile malformations and demonstrate that the timing of endocrine disruption can determine the type of CPA.
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Cunha GR, Sinclair A, Risbridger G, Hutson J, Baskin LS. Current understanding of hypospadias: relevance of animal models. Nat Rev Urol 2015; 12:271-80. [DOI: 10.1038/nrurol.2015.57] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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33
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Choudhry S, Baskin LS, Lammer EJ, Witte JS, Dasgupta S, Ma C, Surampalli A, Shen J, Shaw GM, Carmichael SL. Genetic polymorphisms in ESR1 and ESR2 genes, and risk of hypospadias in a multiethnic study population. J Urol 2014; 193:1625-31. [PMID: 25463985 DOI: 10.1016/j.juro.2014.11.087] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE Estrogenic endocrine disruptors acting via estrogen receptors α (ESR1) and β (ESR2) have been implicated in the etiology of hypospadias, a common congenital malformation of the male external genitalia. We determined the association of single nucleotide polymorphisms in ESR1 and ESR2 genes with hypospadias in a racially/ethnically diverse study population of California births. MATERIALS AND METHODS We investigated the relationship between hypospadias and 108 ESR1 and 36 ESR2 single nucleotide polymorphisms in 647 cases and 877 population based nonmalformed controls among infants born in selected California counties from 1990 to 2003. Subgroup analyses were performed by race/ethnicity (nonHispanic white and Hispanic subjects) and by hypospadias severity (mild to moderate and severe). RESULTS Odds ratios for 33 of the 108 ESR1 single nucleotide polymorphisms had p values less than 0.05 (p = 0.05 to 0.007) for risk of hypospadias. However, none of the 36 ESR2 single nucleotide polymorphisms was significantly associated. In stratified analyses the association results were consistent by disease severity but different sets of single nucleotide polymorphisms were significantly associated with hypospadias in nonHispanic white and Hispanic subjects. Due to high linkage disequilibrium across the single nucleotide polymorphisms, haplotype analyses were conducted and identified 6 haplotype blocks in ESR1 gene that had haplotypes significantly associated with an increased risk of hypospadias (OR 1.3 to 1.8, p = 0.04 to 0.00001). Similar to single nucleotide polymorphism analysis, different ESR1 haplotypes were associated with risk of hypospadias in nonHispanic white and Hispanic subjects. No significant haplotype association was observed for ESR2. CONCLUSIONS The data provide evidence that ESR1 single nucleotide polymorphisms and haplotypes influence the risk of hypospadias in white and Hispanic subjects, and warrant further examination in other study populations.
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Affiliation(s)
- Shweta Choudhry
- Department of Urology, University of California, San Francisco, California.
| | - Laurence S Baskin
- Department of Urology, University of California, San Francisco, California
| | - Edward J Lammer
- Children's Hospital Oakland Research Institute, Oakland, California
| | - John S Witte
- Department of Epidemiology and Biostatistics, and Institute of Human Genetics, University of California, San Francisco, California
| | - Sudeshna Dasgupta
- Department of Urology, University of California, San Francisco, California
| | - Chen Ma
- Department of Pediatrics, Division of Neonatology, Stanford University School of Medicine, Stanford, California
| | | | - Joel Shen
- Department of Urology, University of California, San Francisco, California
| | - Gary M Shaw
- Department of Pediatrics, Division of Neonatology, Stanford University School of Medicine, Stanford, California
| | - Suzan L Carmichael
- Department of Pediatrics, Division of Neonatology, Stanford University School of Medicine, Stanford, California
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Sexually dimorphic expression of Mafb regulates masculinization of the embryonic urethral formation. Proc Natl Acad Sci U S A 2014; 111:16407-12. [PMID: 25362053 DOI: 10.1073/pnas.1413273111] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Masculinization of external genitalia is an essential process in the formation of the male reproductive system. Prominent characteristics of this masculinization are the organ size and the sexual differentiation of the urethra. Although androgen is a pivotal inducer of the masculinization, the regulatory mechanism under the control of androgen is still unknown. Here, we address this longstanding question about how androgen induces masculinization of the embryonic external genitalia through the identification of the v-maf avian musculoaponeurotic fibrosarcoma oncogene homolog B (Mafb) gene. Mafb is expressed prominently in the mesenchyme of male genital tubercle (GT), the anlage of external genitalia. MAFB expression is rarely detected in the mesenchyme of female GTs. However, exposure to exogenous androgen induces its mesenchymal expression in female GTs. Furthermore, MAFB expression is prominently down-regulated in male GTs of androgen receptor (Ar) KO mice, indicating that AR signaling is necessary for its expression. It is revealed that Mafb KO male GTs exhibit defective embryonic urethral formation, giving insight into the common human congenital anomaly hypospadias. However, the size of Mafb KO male GTs is similar with that of wild-type males. Moreover, androgen treatment fails to induce urethral masculinization of the GTs in Mafb KO mice. The current results provide evidence that Mafb is an androgen-inducible, sexually dimorphic regulator of embryonic urethral masculinization.
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Mahawong P, Sinclair A, Li Y, Schlomer B, Rodriguez E, Ferretti MM, Liu B, Baskin LS, Cunha GR. Prenatal diethylstilbestrol induces malformation of the external genitalia of male and female mice and persistent second-generation developmental abnormalities of the external genitalia in two mouse strains. Differentiation 2014; 88:51-69. [PMID: 25449352 PMCID: PMC4254634 DOI: 10.1016/j.diff.2014.09.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 09/04/2014] [Accepted: 09/19/2014] [Indexed: 11/28/2022]
Abstract
Potential trans-generational influence of diethylstilbestrol (DES) exposure emerged with reports of effects in grandchildren of DES-treated pregnant women and of reproductive tract tumors in offspring of mice exposed in utero to DES. Accordingly, we examined the trans-generational influence of DES on development of external genitalia (ExG) and compared effects of in utero DES exposure in CD-1 and C57BL/6 mice injected with oil or DES every other day from gestational days 12 to 18. Mice were examined at birth, and on 5-120 days postnatal to evaluate ExG malformations. Of 23 adult (>60 days) prenatally DES-exposed males, features indicative of urethral meatal hypospadias (see text for definitions) ranged from 18% to 100% in prenatally DES-exposed CD-1 males and 31% to 100% in prenatally DES-exposed C57BL/6 males. Thus, the strains differed only slightly in the incidence of male urethral hypospadias. Ninety-one percent of DES-exposed CD-1 females and 100% of DES-exposed C57BL/6 females had urethral-vaginal fistula. All DES-exposed CD-1 and C57BL/6 females lacked an os clitoris. None of the prenatally oil-treated CD-1 and C57BL/6 male and female mice had ExG malformations. For the second-generation study, 10 adult CD-1 males and females, from oil- and DES-exposed groups, respectively, were paired with untreated CD-1 mice for 30 days, and their offspring evaluated for ExG malformations. None of the F1 DES-treated females were fertile. Nine of 10 prenatally DES-exposed CD-1 males sired offspring with untreated females, producing 55 male and 42 female pups. Of the F2 DES-lineage adult males, 20% had exposed urethral flaps, a criterion of urethral meatal hypospadias. Five of 42 (11.9%) F2 DES lineage females had urethral-vaginal fistula. In contrast, all F2 oil-lineage males and all oil-lineage females were normal. Thus, prenatal DES exposure induces malformations of ExG in both sexes and strains of mice, and certain malformations are transmitted to the second-generation.
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Affiliation(s)
- Phitsanu Mahawong
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, United States
| | - Adriane Sinclair
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, United States
| | - Yi Li
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, United States
| | - Bruce Schlomer
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, United States
| | - Esequiel Rodriguez
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, United States
| | - Max M Ferretti
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, United States
| | - Baomei Liu
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, United States
| | - Laurence S Baskin
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, United States
| | - Gerald R Cunha
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, United States.
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Mahawong P, Sinclair A, Li Y, Schlomer B, Rodriguez E, Ferretti MM, Liu B, Baskin LS, Cunha GR. Comparative effects of neonatal diethylstilbestrol on external genitalia development in adult males of two mouse strains with differential estrogen sensitivity. Differentiation 2014; 88:70-83. [PMID: 25449353 PMCID: PMC4254630 DOI: 10.1016/j.diff.2014.09.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 08/27/2014] [Accepted: 09/19/2014] [Indexed: 11/28/2022]
Abstract
The effect of neonatal exposure to diethylstilbestrol (DES), a potent synthetic estrogen, was examined to evaluate whether the CD-1 (estrogen insensitive, outbred) and C57 (estrogen sensitive, inbred) mouse strains differ in their response to estrogen disruption of male ExG differentiation. CD-1 and C57BL/6 litters were injected with sesame oil or DES (200 ng/g/5 μl in sesame oil vehicle) every other day from birth to day 10. Animals were sacrificed at the following time points: birth, 5, 10 and 60 days postnatal. Neonatally DES-treated mice from both strains had many ExG abnormalities that included the following: (a) severe truncation of the prepuce and glans penis, (b) an abnormal urethral meatus, (c) ventral tethering of the penis, (d) reduced os penis length and glans width, (e) impaired differentiation of cartilage, (f) absence of urethral flaps, and (g) impaired differentiation of erectile bodies. Adverse effects of DES correlated with the expression of estrogen receptors within the affected tissues. While the effects of DES were similar in the more estrogen-sensitive C57BL/6 mice versus the less estrogen-sensitive CD-1 mice, the severity of DES effects was consistently greater in C57BL/6 mice. We suggest that many of the effects of DES, including the induction of hypospadias, are due to impaired growth and tissue fusion events during development.
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Affiliation(s)
- Phitsanu Mahawong
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, USA
| | - Adriane Sinclair
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, USA
| | - Yi Li
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, USA
| | - Bruce Schlomer
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, USA
| | - Esequiel Rodriguez
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, USA
| | - Max M Ferretti
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, USA
| | - Baomai Liu
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, USA
| | - Laurence S Baskin
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, USA
| | - Gerald R Cunha
- Division of Pediatric Urology, University of California, San Francisco, CA 94143, USA.
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Mavrogenis S, Urban R, Czeizel AE, Acs N. Maternal risk factors in the origin of isolated hypospadias: a population-based case-control study. Congenit Anom (Kyoto) 2014; 54:110-5. [PMID: 24279371 DOI: 10.1111/cga.12041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 11/12/2013] [Indexed: 11/30/2022]
Abstract
The birth prevalence of hypospadias increased in Hungary during the last decades, thus the aim of this study was to analyze the possible role of maternal risk factors in the origin of isolated hypospadias (IHS). The incidence/prevalence of acute and chronic maternal diseases with related drug treatments were compared in the mothers of cases with IHS, population controls without defect and malformed controls affected with other isolated abnormalities in the population-based Hungarian Case-Control Surveillance of Congenital Abnormalities including 3038 cases with IHS, 24 814 population male controls without any defects and 11 096 malformed male controls with other isolated defect. Among exposures, prospective medically recorded chronic diseases and medically recorded or retrospective maternal information regarding acute diseases and drug treatments were evaluated in the study groups. Maternal epilepsy due to the treatment of valproate (odds ratio [OR] with 95% confidence interval [CI]: 1.97, 1.07-3.61) and cervical erosion (4.09, 1.84-9.12) were associated with a higher risk of IHS. In addition, there was an association of oral nystatin (1.94, 1.22-3.09), lynestrenol (26.66, 8.69-81.80) and ethynilestradiol (3.51, 1.61-7.67) treatments in the mothers of cases with a higher risk for IHS. In conclusion, maternal cervical erosion, valproate, nystatin, lynestrenol and ethynilestradiol associated with a higher risk for IHS.
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Affiliation(s)
- Stelios Mavrogenis
- Department of Uro-oncology, National Institute of Oncology, Budapest, Hungary
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van Gelder MM, van Rooij IA, de Jong-van den Berg LT, Roeleveld N. Teratogenic Mechanisms Associated with Prenatal Medication Exposure. Therapie 2014; 69:13-24. [DOI: 10.2515/therapie/2014003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 10/18/2013] [Indexed: 12/31/2022]
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Carmichael SL, Witte JS, Ma C, Lammer EJ, Shaw GM. Hypospadias and variants in genes related to sex hormone biosynthesis and metabolism. Andrology 2013; 2:130-7. [PMID: 24281767 DOI: 10.1111/j.2047-2927.2013.00165.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 10/24/2013] [Accepted: 10/29/2013] [Indexed: 11/29/2022]
Abstract
We examined whether variants in genes related to sex hormone biosynthesis and metabolism were associated with hypospadias in humans. We examined 332 relatively common tag single-nucleotide polymorphisms (tagSNPs) in 20 genes. Analyses included 633 cases (84 mild, 322 moderate, 212 severe and 15 undetermined severity) and 855 population-based non-malformed male controls born in California from 1990 to 2003. We used logistic regression models to estimate odds ratios (OR) and 95% confidence intervals (CI) for each SNP. Several of the 332 studied SNPs had p < 0.01: one in CYP3A4, four in HSD17B3, one in HSD3B1, two in STARD3, 10 in SRD5A2 and seven in STS. In addition, haplotype analyses gave several associations with p < 0.01. For HSD17B3, 14-SNP and 5-SNP blocks had ORs of 1.5 (95% CI 1.1, 2.0, p < 0.001) and 2.8 (95% CI 1.6, 4.8, p < 0.001) respectively. For SRD5A2, 9-SNP, 3-SNP and 8-SNP blocks had ORs of 1.7 (95% CI 1.3, 2.2, p < 0.001), 1.4 (95% CI 1.1, 1.8, p = 0.008) and 1.5 (95% CI 1.2, 1.9, p = 0.002) respectively. Our study indicates that several genes that contribute to sex hormone biosynthesis and metabolism are associated with hypospadias risk.
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Affiliation(s)
- S L Carmichael
- Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
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Carmichael SL, Yang W, Roberts EM, Kegley SE, Wolff C, Guo L, Lammer EJ, English P, Shaw GM. Hypospadias and residential proximity to pesticide applications. Pediatrics 2013; 132:e1216-26. [PMID: 24167181 PMCID: PMC3813401 DOI: 10.1542/peds.2013-1429] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Experimental evidence suggests pesticides may be associated with hypospadias. OBJECTIVE Examine the association of hypospadias with residential proximity to commercial agricultural pesticide applications. METHODS The study population included male infants born from 1991 to 2004 to mothers residing in 8 California counties. Cases (n = 690) were ascertained by the California Birth Defects Monitoring Program; controls were selected randomly from the birth population (n = 2195). We determined early pregnancy exposure to pesticide applications within a 500-m radius of mother's residential address, using detailed data on applications and land use. Associations with exposures to physicochemical groups of pesticides and specific chemicals were assessed using logistic regression adjusted for maternal race or ethnicity and age and infant birth year. RESULTS Forty-one percent of cases and controls were classified as exposed to 57 chemical groups and 292 chemicals. Despite >500 statistical comparisons, there were few elevated odds ratios with confidence intervals that excluded 1 for chemical groups or specific chemicals. Those that did were for monochlorophenoxy acid or ester herbicides; the insecticides aldicarb, dimethoate, phorate, and petroleum oils; and adjuvant polyoxyethylene sorbitol among all cases; 2,6-dinitroaniline herbicides, the herbicide oxyfluorfen, and the fungicide copper sulfate among mild cases; and chloroacetanilide herbicides, polyalkyloxy compounds used as adjuvants, the insecticides aldicarb and acephate, and the adjuvant nonyl-phenoxy-poly(ethylene oxy)ethanol among moderate and severe cases. Odds ratios ranged from 1.9 to 2.9. CONCLUSIONS Most pesticides were not associated with elevated hypospadias risk. For the few that were associated, results should be interpreted with caution until replicated in other study populations.
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Affiliation(s)
- Suzan L. Carmichael
- Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Wei Yang
- Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | | | | | | | - Liang Guo
- Public Health Institute, Oakland, California
| | - Edward J. Lammer
- Children's Hospital Oakland Research Institute, Oakland, California; and
| | - Paul English
- California Department of Public Health, Richmond, California
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Carmichael SL, Cogswell ME, Ma C, Gonzalez-Feliciano A, Olney RS, Correa A, Shaw GM. Hypospadias and maternal intake of phytoestrogens. Am J Epidemiol 2013; 178:434-40. [PMID: 23752918 DOI: 10.1093/aje/kws591] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Experimental data indicate that gestational exposures to estrogenic compounds impact risk of hypospadias. We examined whether risk of hypospadias (i.e., a congenital malformation in which the opening of the penile urethra occurs on the ventral side of the penis) was associated with maternal intake of phytoestrogens, given their potential impact on estrogen metabolism. The analysis included data on mothers of 1,250 hypospadias cases and 3,118 controls who delivered their infants from 1997 to 2005 and participated in the National Birth Defects Prevention Study, a multistate, population-based, case-control study. After adjustment for several covariates, high intakes of daidzein, genistein, glycetin, secoisolariciresinol, total isoflavones, total lignans, and total phytoestrogens were associated with reduced risks; odds ratios comparing intakes ≥90th percentile with intakes between the 11th and 89th percentiles ranged from 0.6 to 0.8. For example, the odds ratio for total phytoestrogen intake was 0.7 (95% confidence interval: 0.5, 1.0). This study represents the first large-scale analysis of phytoestrogen intake and hypospadias. The observed associations merit investigation in additional populations before firm conclusions can be reached.
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Affiliation(s)
- Suzan L Carmichael
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, California 94305, USA.
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Schlomer BJ, Feretti M, Rodriguez E, Blaschko S, Cunha G, Baskin L. Sexual differentiation in the male and female mouse from days 0 to 21: a detailed and novel morphometric description. J Urol 2013; 190:1610-7. [PMID: 23473905 DOI: 10.1016/j.juro.2013.02.3198] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE We hypothesized that a significant portion of sexual differentiation of mouse external genitalia occurs postnatally. To establish a baseline of normal development to which genital abnormalities could be compared, we determined morphometric measurements and morphological descriptions of the postnatal period of sexual differentiation in mice from birth to 21 days postnatally. MATERIALS AND METHODS The external genitalia of male and female CD-1® mice were serially sectioned for histological staining. Mice were studied by age group, including ages 0 to 1, 2 to 3, 4 to 5, 10 and 21 days. Three-dimensional reconstructions were created to visually compare differences. Morphometric measurements were made of the distal mouse external genitalia and compared across age groups, and between males and females. RESULTS The morphology of male and female mouse external genitalia is similar at 0 to 1 days but undergoes dramatic changes during 21 days. The changes include the development of mesenchymal extensions, which in males form the male urogenital mating protuberance and erectile bodies, as well as comparable structures in females. Differences in morphometric measurements in homologous males and females became pronounced during 0 to 21 days, serving as a baseline for recognizing the genesis of malformations of the mouse external genitalia. CONCLUSIONS Male and female mouse external genitalia are similar morphologically and morphometrically at birth but achieve dramatic differences by age 21 days, suggesting that a significant portion of sexual differentiation in the mouse occurs after birth. We described these changes using novel, accurate morphometric measurements and 3-dimensional reconstruction. These results will be useful for studying abnormal sexual development of the mouse external genitalia.
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Affiliation(s)
- Bruce J Schlomer
- Department of Urology, University of California-San Francisco, San Francisco, California
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Rodriguez E, Weiss DA, Ferretti M, Wang H, Menshenia J, Risbridger G, Handelsman D, Cunha G, Baskin L. Specific morphogenetic events in mouse external genitalia sex differentiation are responsive/dependent upon androgens and/or estrogens. Differentiation 2012; 84:269-79. [PMID: 22925506 PMCID: PMC3715656 DOI: 10.1016/j.diff.2012.07.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 07/16/2012] [Indexed: 11/26/2022]
Abstract
The objective of this study was to perform a comprehensive morphologic analysis of developing mouse external genitalia (ExG) and to determine specific sexual differentiation features that are responsive to androgens or estrogens. To eliminate sex steroid signaling postnatally, male and female mice were gonadectomized on the day of birth, and then injected intraperitoneally every other day with DES (200 ng/g), DHT (1 μg/g), or oil. On day-10 postnatal male and female ExG were dissected, fixed, embedded, serially sectioned and analyzed. We identified 10 sexually dimorphic anatomical features indicative of normal penile and clitoral differentiation in intact mice. Several (but not all) penile features were impaired or abolished as a result of neonatal castration. Those penile features remaining after neonatal castration were completely abolished with attendant clitoral development in androgen receptor (AR) mutant male mice (X(Tfm)/Y and X/Y AR-null) in which AR signaling is absent both pre- and postnatally. Administration of DHT to neonatally castrated males restored development of all 10 masculine features to almost normal levels. Neonatal ovariectomy of female mice had little effect on clitoral development, whereas treatment of ovariectomized female mice with DHT induced partial masculinization of the clitoris. Administration of DES to neonatally gonadectomized male and female mice elicited a spectrum of development abnormalities. These studies demonstrate that the presence or absence of androgen prenatally specifies penile versus clitoral identity. Differentiated penile features emerge postnatally and are sensitive to and dependent upon prenatal or pre- and postnatal androgen. Emergence of differentiated clitoral features occurs postnatally in either intact or ovariectomized females. It is likely that each penile and clitoral feature has a unique time-course of hormonal dependency/sensitivity.
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Affiliation(s)
- Esequiel Rodriguez
- Division of Pediatric Urology, University of California, San Francisco, California 94143, United States
| | - Dana A. Weiss
- Division of Pediatric Urology, University of California, San Francisco, California 94143, United States
| | - Max Ferretti
- Division of Pediatric Urology, University of California, San Francisco, California 94143, United States
| | - Hong Wang
- Department of Anatomy & Developmental Biology, Monash University Clayton Campus, Building 76 Level 3, Wellington Road, Clayton, Victoria 3800, Australia
| | - Julia Menshenia
- Division of Pediatric Urology, University of California, San Francisco, California 94143, United States
| | - Gail Risbridger
- Department of Anatomy & Developmental Biology, Monash University Clayton Campus, Building 76 Level 3, Wellington Road, Clayton, Victoria 3800, Australia
| | - David Handelsman
- ANZAC Research Institute, Sydney, New South Wales 2139, Australia
| | - Gerald Cunha
- Division of Pediatric Urology, University of California, San Francisco, California 94143, United States
| | - Laurence Baskin
- Division of Pediatric Urology, University of California, San Francisco, California 94143, United States
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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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A pilot study of the association between genetic polymorphisms involved in estrogen signaling and infant male genital phenotypes. Asian J Androl 2012; 14:766-72. [PMID: 22580635 DOI: 10.1038/aja.2012.27] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Single nucleotide polymorphisms (SNPs) in genes that influence development of the male reproductive tract have been associated with male genitourinary abnormalities. However, no studies have tested the relationship between SNPs and intermediate phenotypes such as anogenital distance (AGD), anoscrotal distance (ASD) and penile width (PW). We tested whether 24 common SNPs in eight genes that influence male genital development were associated with intermediate phenotypes in 106 healthy male infants from the Study for Future Families. We used DNA from buccal smears and linear regression models to assess the relationship between anogenital measurements and SNP genotypes with adjustment for covariates. We found that the rs2077647 G allele, located in the coding region of estrogen receptor alpha (ESR1), was associated with a shorter AGD (P=0.02; -7.3 mm, 95% confidence interval (CI): -11.6 to -3.1), and the rs10475 T allele, located in the 3' untranslated region of activating transcription factor 3 (ATF3), was associated with a shorter ASD (-4.3 mm, 95% CI: -7.2 to -1.4), although this result was not significant (P=0.07) after controlling for multiple comparisons. We observed no association between PW and the SNPs tested. Minor alleles for two SNPs in genes that regulate estrogen signaling during male genital development were associated with AGD and ASD, although the significance of the association was marginal. Our findings suggest that AGD and ASD are influenced by heritable factors in genes known to be associated with frank male genital abnormalities such as hypospadias and cryptorchidism.
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Androgen receptor is overexpressed in boys with severe hypospadias, and ZEB1 regulates androgen receptor expression in human foreskin cells. Pediatr Res 2012; 71:393-8. [PMID: 22391641 PMCID: PMC3423458 DOI: 10.1038/pr.2011.49] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION ZEB1 is overexpressed in patients with severe hypospadias. We examined the interaction between ZEB1 and the androgen receptor (AR) in vitro and the expression of AR in boys with hypospadias. RESULTS ZEB1 and AR colocalize to the nucleus. Estrogen upregulated ZEB1 and AR expression. Chromatin immunoprecipitation (ChIP) demonstrated that ZEB1 binds to an E-box sequence in the AR gene promoter. AR expression is higher in subjects with severe hypospadias than those with mild hypospadias and control subjects (P < 0.05). ZEB1 physically interacts with AR in human foreskin cells. DISCUSSION AR is overexpressed in patients with severe hypospadias. Environmental estrogenic compounds may increase the risk of hypospadias by facilitating the interaction between ZEB1 and AR. METHODS Hs68 cells, a fibroblast cell line derived from neonatal human foreskin, were exposed to 0, 10, and 100 nmol/l of estrogen, after which the cellular localization of ZEB1 and AR was assessed using immunocytochemistry. To determine if ZEB1 interacted with the AR gene, ChIP was performed using ZEB1 antibody and polymerase chain reaction (PCR) for AR. Second, AR expression was quantified using real-time PCR and western blot in normal subjects (n = 32), and subjects with mild (n = 16) and severe hypospadia (n = 16).
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van der Zanden LFM, van Rooij IALM, Feitz WFJ, Franke B, Knoers NVAM, Roeleveld N. Aetiology of hypospadias: a systematic review of genes and environment. Hum Reprod Update 2012; 18:260-83. [PMID: 22371315 DOI: 10.1093/humupd/dms002] [Citation(s) in RCA: 182] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Hypospadias is a common congenital malformation of the male external genitalia. Most cases have an unknown aetiology, which is probably a mix of monogenic and multifactorial forms, implicating both genes and environmental factors. This review summarizes current knowledge about the aetiology of hypospadias. METHODS Pubmed was used to identify studies on hypospadias aetiology published between January 1995 and February 2011. Reference lists of the selected manuscripts were also searched to identify additional studies, including those published before 1995. RESULTS The search provided 922 articles and 169 articles were selected for this review. Studies screening groups of patients with hypospadias for single gene defects found mutations in WT1, SF1, BMP4, BMP7, HOXA4, HOXB6, FGF8, FGFR2, AR, HSD3B2, SRD5A2, ATF3, MAMLD1, MID1 and BNC2. However, most investigators are convinced that single mutations do not cause the majority of isolated hypospadias cases. Indeed, associations were found with polymorphisms in FGF8, FGFR2, AR, HSD17B3, SRD5A2, ESR1, ESR2, ATF3, MAMLD1, DGKK, MID1, CYP1A1, GSTM1 and GSTT1. In addition, gene expression studies indentified CTGF, CYR61 and EGF as candidate genes. Environmental factors consistently implicated in hypospadias are low birthweight, maternal hypertension and pre-eclampsia, suggesting that placental insufficiency may play an important role in hypospadias aetiology. Exogenous endocrine-disrupting chemicals have the potential to induce hypospadias but it is unclear whether human exposure is high enough to exert this effect. Other environmental factors have also been associated with hypospadias but, for most, the results are inconsistent. CONCLUSIONS Although a number of contributors to the aetiology of hypospadias have been identified, the majority of risk factors remain unknown.
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Affiliation(s)
- L F M van der Zanden
- Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands.
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Hsieh MH, Alonzo DG, Gonzales ET, Jones EA, Cisek LJ, Roth DR. Ex-premature infant boys with hypospadias are similar in size to age-matched, ex-premature infant boys without hypospadias. J Pediatr Urol 2011; 7:543-7. [PMID: 20833109 PMCID: PMC3010437 DOI: 10.1016/j.jpurol.2010.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 08/03/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Studies have postulated that hypospadias, prematurity, and low birth weight are linked by defects in androgen signaling. To determine whether premature, hypospadiac boys are small and remain so, we compared their size at birth and at hypospadias repair to premature boys who underwent post-neonatal circumcision. METHODS We identified premature boys admitted to Texas Children's Hospital who underwent either hypospadias repair or circumcision after 4 months of age. Age, weight, and height at birth and surgery were recorded. RESULTS Fifty-four boys had hypospadias and 34 did not. For hypospadiac boys, the mean birth weight and age, height, and weight at surgery were lower than for boys without hypospadias. More importantly, length-for-age and weight-for-age percentiles were also lower for hypospadiac boys. When subset analysis was performed on boys younger than 2 years at surgery, however, there were no significant differences in height or weight between hypospadiac and non-hypospadiac boys. CONCLUSION Our series suggests that premature, hypospadiac boys are born smaller than age-matched, non-hypospadiac controls. However, there were no age-corrected size differences between hypospadiac and non-hypospadiac boys at surgery. This implies that hypospadiac boys exhibit post-neonatal 'rebound' growth. Global growth deficits, if any, do not persist in hypospadiac boys.
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Affiliation(s)
- Michael H Hsieh
- Department of Urology, Stanford School of Medicine, Stanford, CA 94305, USA.
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Miyagawa S, Sato M, Iguchi T. Molecular mechanisms of induction of persistent changes by estrogenic chemicals on female reproductive tracts and external genitalia. J Steroid Biochem Mol Biol 2011; 127:51-7. [PMID: 21397691 DOI: 10.1016/j.jsbmb.2011.03.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 02/25/2011] [Accepted: 03/04/2011] [Indexed: 12/27/2022]
Abstract
The effects of environmental endocrine-disrupting chemicals (EDCs) are a great and growing concern for human and animal development and life. The reproductive organs are considered as a primary target of EDCs, yet the effects on reproductive organs can extend to other body systems. Perinatal diethylstilbestrol (DES)-exposed mice exhibit various reproductive organ abnormalities. The perinatal DES-exposure model has allowed insight into our understanding of the mechanisms of persistent reproductive organ abnormalities elicited by exposure to estrogens and/or estrogenic EDCs. The persistent changes in the vagina of neonatally DES-exposed mice result from sustained expression of growth factors by ligand-independent transcriptional activation of the estrogen receptor. Developmental regulatory genes, such as Wnt and Hox genes, are also targets of DES during fetal stages and altered gene expression can induce malformations of the reproductive organs. In this review, we focus on the development of female reproductive tracts and external genitalia, and discuss the recent progress in understanding the disruptive effects of estrogens and EDCs on these organs.
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Affiliation(s)
- Shinichi Miyagawa
- Okazaki Institute for Integrative Bioscience, National Institute for Basic Biology, National Institutes of Natural Sciences, Okazaki, Aichi, Japan
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Kalfa N, Philibert P, Baskin LS, Sultan C. Hypospadias: interactions between environment and genetics. Mol Cell Endocrinol 2011; 335:89-95. [PMID: 21256920 DOI: 10.1016/j.mce.2011.01.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 01/03/2011] [Accepted: 01/07/2011] [Indexed: 10/18/2022]
Abstract
Hypospadias is one of the most common congenital malformations. It is considered to be a mild form of the 46,XY disorders of sex development (DSD), but its precise etiology remains to be elucidated. Compromised androgen synthesis or effects can cause this frequent malformation, although the mutational analyses of the genes involved in androgen actions have identified abnormalities in only a very small portion of patients. The overwhelming majority of cases remain unexplained and hypospadias may be a highly heterogeneous condition subject to multiple genetic and environmental factors. We here review the recent advances in this field and discuss the potential interactions between the environment and genetics.
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Affiliation(s)
- N Kalfa
- Service d'Hormonologie, Hôpital Lapeyronie, CHU de Montpellier et UM1, Montpellier, France
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