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Novaes LF, Flores JM, Benfante N, Schofield E, Katz DJ, Nelson CJ, Mulhall JP. Analysis of diurnal variation in serum testosterone levels in men with symptoms of testosterone deficiency. J Sex Med 2024; 21:408-413. [PMID: 38481019 DOI: 10.1093/jsxmed/qdae026] [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: 06/06/2023] [Revised: 01/24/2024] [Accepted: 01/27/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Testosterone (T) plays a crucial role in various physiological functions in men, and understanding the variations in T levels during the day is essential for diagnosing and treating testosterone deficiency (TD). AIM We sought to evaluate the reduction in serum total T (TT) levels throughout the day in men with symptoms of testosterone deficiency and to determine the variables having an impact on the extent of this decline. METHODS The study population consisted of a group of men who within 3 months of each other had all undergone both early morning and afternoon TT level measurements. We did not include patients with a history of a prior orchiectomy, testosterone levels below 100 ng/dL or above 1000 ng/dL, a history of androgen deprivation therapy, or patients on T therapy. Statistical analyses were conducted using descriptive statistics, t-tests, chi-square tests, and correlation calculations. Liquid chromatography-tandem mass spectrometry was used to measure TT, and a change in TT levels greater than 100 ng/dL was considered significant. Using multivariable and univariable analysis, we attempted to define predictors of a decrease in afternoon TT levels. OUTCOMES The majority of men showed no significant difference in T levels between morning and afternoon. RESULTS In total, 506 men with a median age of 65 years were analyzed. The most common comorbidities were hypertension and hyperlipidemia. Levels of TT were measured in the morning and afternoon, and no significant differences in mean T levels based on the time of the test were found. Age was not significantly associated with T levels. CLINICAL IMPLICATIONS There was a weak negative correlation between age and the difference between morning and afternoon T levels, with younger men showing more significant variations in T levels. The most considerable differences in T levels were observed in men younger than 30 years. There were no predictors of the magnitude of the T decrease in the afternoon. STRENGTHS AND LIMITATIONS Strengths of the study include the number of subjects and the use of liquid chromatography-tandem mass spectrometry for T measurement. Limitations include failure to measure morning and afternoon T levels on the same day, the retrospective nature of the study, and a smaller sample size of patients younger than 30 years. CONCLUSION In this study we found no strong link between age and daily T fluctuation, but we observed a decrease in the magnitude of variation with aging. The group experiencing the most significant decline in daily T had higher morning and consistently normal afternoon T levels.
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Affiliation(s)
- Luis F Novaes
- Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, NewYork, NY 10022, United States
| | - Jose M Flores
- Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, NewYork, NY 10022, United States
| | - Nicole Benfante
- Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, NewYork, NY 10022, United States
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10017, United States
| | - Darren J Katz
- Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, NewYork, NY 10022, United States
| | - Chris J Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10017, United States
| | - John P Mulhall
- Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, NewYork, NY 10022, United States
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Androgen receptor (CAG) n repeat polymorphism contributes to risk of sudden cardiac death originated from coronary artery disease with sex discrepancy. Forensic Sci Int 2023; 343:111563. [PMID: 36630768 DOI: 10.1016/j.forsciint.2023.111563] [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: 11/09/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/09/2023]
Abstract
Sudden cardiac death (SCD) is the leading cause of natural death worldwide which is responsible for almost half of all heart disease deaths, making it a substantial public health problem. Previous epidemiological studies from different countries have demonstrated the significant SCD incident difference rate between males and females. Besides environmental and social effects, differential genetic architecture also underlines the SCD incidence discrepancy. To this end, the functional (CAG)n repeat polymorphism within Androgen Receptor (AR) gene was analyzed to evaluate its associations with SCD originated from coronary artery disease (SCD-CAD) susceptibility in Chinese populations using 182 SCD-CAD cases and 564 healthy controls. At allelic level, the (CAG)26 allele conferred a lower SCD-CAD risk in males (adjusted odds ratio [OR] = 0.428; 95% confidence interval [CI] = 0.254, 0.915; P = 0.023). On the contrary, the (CAG)26 allele was reversely associated with a higher SCD-CAD risk in females (OR = 2.581; 95% CI = 0.944, 7.056; P = 0.057). Further cutoff strategy analysis revealed that those male subjects carrying shorter allele (≤26 repeats) had significantly lower SCD-CAD risk (OR = 0.343; 95% CI = 0.221, 0.531; P = 8.1653e-7). Additionally, an allele-dependent SCD risk tendency was observed in male subjects. Specifically, compared with males carrying allele longer than 26 repeats, the SCD-CAD risk (OR value) for male subjects carrying shorter alleles (from 25 to 21) gradually increased from 0.437 to 0.533, indicating the (CAG)26 allele of the repeat polymorphism may be the watershed in male SCD etiology. Lastly, the length variations associated with multiple phenotypes were also summarized. Collectively, our results revealed for the first time that the (CAG)n repeat polymorphism within the AR gene was associated with SCD-CAD risk in Chinese populations with sex discrepancy, proposing a new candidate genetic marker for molecular diagnosis of SCD-CAD. Furthermore, a sex-dependent SCD-CAD risk stratification and prevention approach was encouraged. Further studies with more female samples were warranted to validate our findings.
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Ashraf M, Kazmi SU, Tariq H, Munır A, Rehman R. Association of trinucleotide repeat polymorphisms CAG and GGC in exon 1 of the androgen receptor gene with male infertility: a cross-sectional study. Turk J Med Sci 2022; 52:1793-1801. [PMID: 36945970 PMCID: PMC10390128 DOI: 10.55730/1300-0144.5525] [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: 05/06/2020] [Accepted: 09/10/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND : Infertility is a global problem that brings about serious sexual and social consequences that strain the health sector and society. The expansion of CAG and GGC repeats in androgen receptor (AR) gene (Ensembl number ENSG00000169083) may lead to reduced fertility. Our objective was to determine the association of CAG and GGC repeats with altered sperm parameters in male infertile subjects. METHODS This was a cross-sectional study conducted at Aga Khan University, Karachi, Pakistan. A total of 376 males were recruited, out of which group A (N = 208) and group B (N = 168) were comprised of subjects with normal and altered sperm parameters, respectively, from 18 to 60 years. The numbers of CAG and GGC repeats were determined by using PCR amplification and sequence analysis using the Molecular Evolutionary Genetic Analysis (MEGA) software version 6.0. Statistical analysis was performed using the SPSS version 20 and the P-value of <0.05 was considered significant. RESULTS The mean androgen receptor gene CAG repeats were significantly longer in males with altered sperm parameters as compared to male subjects with normal sperm parameters (P < 0.001). There was no significant difference found for GGC repeats for subjects with altered sperm parameters. DISCUSSION Longer CAG length corresponded to greater severity of spermatogenic defect and may lead to subfertility recommendations.
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Affiliation(s)
- Mussarat Ashraf
- Department of Biological and Biomedical Sciences, Medical College, Aga Khan University, Karachi, Pakistan
| | - Shahana Urooj Kazmi
- Department of Clinical Microbiology and Immunology, Faculty of Science, Dadabhoy Institute of Higher Education, Karachi, Pakistan
| | - Hemaila Tariq
- Department of Biological and Biomedical Sciences, Medical College, Aga Khan University, Karachi, Pakistan
| | - Adnan Munır
- Department of Urology, Medical College, Liaquat National Hospital, Karachi, Pakistan
| | - Rehana Rehman
- Department of Biological and Biomedical Sciences, Medical College, Aga Khan University, Karachi, Pakistan
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Metin Mahmutoglu A, Hurre Dirie S, Hekim N, Gunes S, Asci R, Henkel R. Polymorphisms of androgens-related genes and idiopathic male infertility in Turkish men. Andrologia 2021; 54:e14270. [PMID: 34632603 DOI: 10.1111/and.14270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 09/24/2021] [Indexed: 01/01/2023] Open
Abstract
Androgens, testosterone and dihydrotestosterone (DHT) are endocrine regulators of spermatogenesis and act via androgen receptor (AR). The aim of this study was to investigate the association(s) of AR (CAG repeat length), SRD5A2 (rs523349, V89L) and TNF-α (rs1800629, -308G/A) polymorphisms with idiopathic male infertility in Turkish men. This case-control study consisted of 312 men with idiopathic infertility and 113 fertile men. Polyacrylamide gel electrophoresis (PAGE) or PCR-restriction fragment length polymorphism methods were used for genotyping. The mean AR CAG repeat length was significantly longer in infertile men than in fertile men (p = 0.015). However, there was no significant association between the SRD5A2 genotypes (VV, VL and LL) and the risk of infertility (p = 0.516). The genotype frequency and allele distribution of TNF-α -308G/A polymorphism (GG, GA, AA genotypes and G, A alleles) were not associated with male infertility (p = 0.779 and p = 0.743 respectively). AR CAG repeat expansion might be one of the risk factors for idiopathic male infertility in Turkish men. Further studies investigating the association of male infertility with AR CAG, V89L and -308G/A polymorphisms are warranted to understand the possible associations among them.
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Affiliation(s)
- Asli Metin Mahmutoglu
- Faculty of Medicine, Department of Medical Biology, Ondokuz Mayis University, Samsun, Turkey
| | - Saadiq Hurre Dirie
- Faculty of Medicine, Department of Medical Biology, Ondokuz Mayis University, Samsun, Turkey
| | - Neslihan Hekim
- Faculty of Medicine, Department of Medical Biology, Ondokuz Mayis University, Samsun, Turkey
| | - Sezgin Gunes
- Faculty of Medicine, Department of Medical Biology, Ondokuz Mayis University, Samsun, Turkey.,Health Sciences Institute, Department of Multidisciplinary Molecular Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Ramazan Asci
- Health Sciences Institute, Department of Multidisciplinary Molecular Medicine, Ondokuz Mayis University, Samsun, Turkey.,Faculty of Medicine, Department of Urology, Ondokuz Mayis University, Samsun, Turkey
| | - Ralf Henkel
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa.,American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, Ohio, USA.,Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
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Melikyan LP, Bliznetz EA, Polyakov AV, Mironovich OL, Kuznetsova IA, Sorokina TM, Shtaut MI, Sedova AO, Kurilo LF, Solovova OA, Chernykh VB. Polymorphism of CAG Repeats in Exon 1 of the Androgen Receptor Gene in Russian Men with Various Forms of Pathozoospermia. RUSS J GENET+ 2020. [DOI: 10.1134/s1022795420080104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Al Zoubi MS, Bataineh H, Rashed M, Al-Trad B, Aljabali AAA, Al-Zoubi RM, Al Hamad M, Issam AbuAlArjah M, Batiha O, Al-Batayneh KM. CAG Repeats in the androgen receptor gene is associated with oligozoospermia and teratozoospermia in infertile men in Jordan. Andrologia 2020; 52:e13728. [PMID: 32583490 DOI: 10.1111/and.13728] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/09/2020] [Accepted: 05/28/2020] [Indexed: 01/06/2023] Open
Abstract
CAG trinucleotide repeats are coded for the polyglutamine tract in the N-terminal of the androgen receptor (AR) gene which varies in normal individuals from 6 to 36 residues. In this study, we inspected the impact of the CAG repeats on the spermatogenic defects by measuring the size of AR-CAG repeats length in a cohort of 260infertile and 169 fertile Jordanian men. The infertile group included three subgroups of a zoospermic, oligozoospermic and teratozoospermia men. The CAG allele size was determined by direct sequencing. The results showed a significant association between the length of the AR-CAG repeats and men's infertility (p = .001). In particular, the current cohort demonstrated a significant association between the AR-CAG length polymorphism and oligozoospermia (p < .001) and teratozoospermia (p < .001) but not azoospermia. According to distributions of allele frequency, the risk of oligozoospermia was 5.5-fold greater than normal when alleles frequency > 20 repeats, while the risk of teratozoospermia was > 10.6 folds greater than normal when allele frequency > 22 repeats. In conclusion, our results underscored that the long repeats of the AR-CAG polymorphism within the normal range might be associated with abnormal spermatogenesis such as teratozoospermia and oligozoospermia and contributing to infertility in Jordanian men.
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Affiliation(s)
- Mazhar Salim Al Zoubi
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Hamzah Bataineh
- Department of Biological Sciences, Faculty of Science, Yarmouk University, Irbid, Jordan
| | - Mitri Rashed
- King Hussein Medical Centre, Royal Medical Services, Amman, Jordan
| | - Bahaa Al-Trad
- Department of Biological Sciences, Faculty of Science, Yarmouk University, Irbid, Jordan
| | - Alaa A A Aljabali
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Raed M Al-Zoubi
- Department of Chemistry, Jordan University of Science & Technology, Irbid, Jordan
| | - Mohammad Al Hamad
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Manal Issam AbuAlArjah
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Osamah Batiha
- Department of applied biological sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid M Al-Batayneh
- Department of Biological Sciences, Faculty of Science, Yarmouk University, Irbid, Jordan
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Mobasseri N, Babaei F, Karimian M, Nikzad H. Androgen receptor ( AR)-CAG trinucleotide repeat length and idiopathic male infertility: a case-control trial and a meta-analysis. EXCLI JOURNAL 2018; 17:1167-1179. [PMID: 30713477 PMCID: PMC6341423 DOI: 10.17179/excli2018-1744] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 11/15/2018] [Indexed: 01/22/2023]
Abstract
CAG trinucleotide repeats in androgen receptor (AR) gene encode a polyglutamine tract in AR N-terminal transactivation domain. Studies have been conducted to evaluate the effect of CAG repeat length on male infertility, which have yielded contradictory results. This study aimed to explore the number of AR-CAG repeats in 150 fertile controls and 150 idiopathic infertile men, divided into four azoospermia, oligozoospermia, asthenozoospermia, and teratozoospermia subgroups. In addition, a meta-analysis was conducted based on previous studies to assess the association of the mentioned variation with male infertility in recent years. Polymerase chain reaction (PCR) targeting followed by an electrophoresis on polyacrylamide gel was used for AR-CAG genotype detecting. Moreover, a systematic search was performed in PubMed, Web of Science, Science Direct, and Google Scholar databases to collect eligible studies for meta-analysis purpose. According to the results, a significant association was observed between increased length of AR-CAG polymorphism and male infertility (p< 0.0001). Furthermore, there were similar significant associations in the azoospermia (p= 0.048), asthenozoospermia (p= 0.013) and teratozoospermia (p= 0.002) subgroups. In addition, meta-analysis on forty studies showed a significant association between AR-CAG polymorphism in the overall analysis (SMD= 0.199, 95 % CI= 0.112-0.287, p<0.001) and the Caucasian subgroup (SMD= 0.151, 95 % CI= 0.040-0.263, p= 0.008). Our results elucidated that long stretches of CAG repeat might lead to AR dysfunction, contributing to male infertility especially in the Caucasian population.
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Affiliation(s)
- Narges Mobasseri
- Gametogenesis Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Faezeh Babaei
- Gametogenesis Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Karimian
- Gametogenesis Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Hossein Nikzad
- Gametogenesis Research Center, Kashan University of Medical Sciences, Kashan, Iran
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Sha Y, Zheng L, Ji Z, Mei L, Ding L, Lin S, Wang X, Yang X, Li P. A novel TEX11 mutation induces azoospermia: a case report of infertile brothers and literature review. BMC MEDICAL GENETICS 2018; 19:63. [PMID: 29661171 PMCID: PMC5902858 DOI: 10.1186/s12881-018-0570-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 03/23/2018] [Indexed: 12/13/2022]
Abstract
Background Testis-expressed gene 11 (TEX11) is an X-linked gene and essential for meiotic recombination and chromosomal synapsis. TEX11 deficiency causes meiotic arrest and male infertility, and many TEX11 mutations have been found in azoospermic and infertile men. Case presentation This study reported one novel TEX11 mutation (2653G → T, in exon 29, GenBank accession number, NM_031276) in two brothers with azoospermia. This mutation was firstly screened out by whole-exome sequencing (WES) and further verified by amplifying and sequencing the specific exon 29. Surprisingly, the same exonic missense mutation (W856C) was observed in two brothers but not in their mother. Histological analysis of testicular biopsy from both brothers revealed meiotic arrest and no post-meiotic round spermatids and mature spermatozoa were observed in the seminiferous tubules. TEX11 expression was observed strongly in spermatogonia and weakly in spermatocytes, but not in Sertoli cells and interstitial cells. Conclusions We identified one novel TEX11 mutation in two brothers and summarized the literature regarding TEX11 mutations and male infertility. This study and previous literature indicate that TEX11 mutations are closely associated with male infertility, especially azoospermia, although auxiliary clinical analyses are needed to figure out the causes of male infertility.
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Affiliation(s)
- Yanwei Sha
- Reproductive Medicine Center, Xiamen Women's and Children's Health Hospital, Xiamen, 361003, Fujian Province, China
| | - Liangkai Zheng
- Reproductive Medicine Center, Xiamen Women's and Children's Health Hospital, Xiamen, 361003, Fujian Province, China
| | - Zhiyong Ji
- Reproductive Medicine Center, Xiamen Women's and Children's Health Hospital, Xiamen, 361003, Fujian Province, China
| | - Libin Mei
- Reproductive Medicine Center, Xiamen Women's and Children's Health Hospital, Xiamen, 361003, Fujian Province, China
| | - Lu Ding
- Reproductive Medicine Center, Xiamen Women's and Children's Health Hospital, Xiamen, 361003, Fujian Province, China
| | - Shaobin Lin
- Reproductive Medicine Center, Xiamen Women's and Children's Health Hospital, Xiamen, 361003, Fujian Province, China
| | - Xu Wang
- Reproductive Medicine Center, Xiamen Women's and Children's Health Hospital, Xiamen, 361003, Fujian Province, China
| | - Xiaoyu Yang
- Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu Province, China.
| | - Ping Li
- Reproductive Medicine Center, Xiamen Women's and Children's Health Hospital, Xiamen, 361003, Fujian Province, China.
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Trost LW, Mulhall JP. Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials. J Sex Med 2016; 13:1029-46. [PMID: 27209182 PMCID: PMC5516925 DOI: 10.1016/j.jsxm.2016.04.068] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 04/14/2016] [Accepted: 04/17/2016] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Male hypogonadism is a common condition, with an increasing body of literature on diagnosis, implications, and management. Given the significant variability in testosterone (T) from a physiologic and assay perspective, a thorough understanding of factors affecting T values and study methodology is essential to interpret reported study outcomes appropriately. However, despite the large number of publications on T, there are no reference materials consolidating all relevant and potentially confounding factors necessary to interpret T studies appropriately. AIMS To create a resource document that reviews sources of T variability, free vs total T, assay techniques and questionnaires, and study methodology relevant to interpreting outcomes. METHODS A PubMed search was performed of all the T literature published on T variability, assay techniques, and T-specific questionnaires. Results were summarized in the context of their impact on interpreting T literature outcomes and methodology. MAIN OUTCOME MEASURES Effect of various factors on T variability and their relevance to study methodology and outcomes. RESULTS Several factors affect measured T levels, including aging, circadian rhythms, geography, genetics, lifestyle choices, comorbid conditions, and intraindividual daily variability. The utility of free T over total T is debatable and must be compared using appropriate threshold levels. Among various assay techniques, mass spectrometry and equilibrium dialysis are gold standards. Calculated empirical estimates of free T also are commonly used and accepted. Hypogonadism-specific questionnaires have limited utility in screening for hypogonadism, and their role as objective end points for quantifying symptoms remains unclear. Numerous aspects of study methodology can directly or indirectly affect reported outcomes, including design (randomized, prospective, retrospective), duration, populations studied (age, comorbid conditions), low T threshold, therapeutic agent used, objective measurements and end points selected, and statistical interpretation. CONCLUSION Critical appraisal of the T literature requires an understanding of numerous factors resulting in T variability, study design and methodology, and limitations of assay techniques and objective measurement scales.
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Affiliation(s)
- Landon W Trost
- Department of Urology, Mayo Clinic, Rochester, MN, USA; Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - John P Mulhall
- Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
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Xiao F, Lan A, Lin Z, Song J, Zhang Y, Li J, Gu K, Lv B, Zhao D, Zeng S, Zhang R, Zhao W, Pan Z, Deng X, Yang X. Impact of CAG repeat length in the androgen receptor gene on male infertility - a meta-analysis. Reprod Biomed Online 2016; 33:39-49. [PMID: 27157932 DOI: 10.1016/j.rbmo.2016.03.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 03/31/2016] [Accepted: 03/31/2016] [Indexed: 12/18/2022]
Abstract
CAG repeats are polymorphic nucleotide repeats present in the androgen receptor gene. Many studies have estimated the association between CAG repeat length and male infertility, but the conclusions are controversial. Previous meta-analyses have come to different conclusions; however, new studies have been published. An updated meta-analysis was conducted. PubMed, CBM, CNKI and Web of Science databases were systematically searched for studies published from 1 January 2000 to 1 October 2015. Case-control studies on the association between CAG repeat length and male infertility using appropriate methodology were included. Forty studies were selected, including 3858 cases and 3161 controls. Results showed statistically significantly longer CAG repeat length among cases compared with controls (SMD = 0.14; 95% CI, 0.02-0.26). Shorter repeat length was associated with a lower risk of male infertility compared with a longer repeat length in the overall analysis (OR = 0.79, 95% CI: 0.66-0.95). Moreover, CAG repeat length was associated with male infertility in Caucasian populations, but not Asian or Egyptian populations. Subgroup analysis revealed no significant difference in German populations, but CAG repeat length was associated with male infertility in China and the USA. There were no significant differences between cases and controls in azoospermia and severe oligozoospermia.
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Affiliation(s)
- Feifan Xiao
- The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China; Medical Scientific Research Center, Guangxi Medical University, Nanning, Guangxi, China
| | - Aihua Lan
- Medical Scientific Research Center, Guangxi Medical University, Nanning, Guangxi, China
| | - Zhidi Lin
- Medical Scientific Research Center, Guangxi Medical University, Nanning, Guangxi, China; Department of Urology, Affiliated Hospital of Youjiang Medical College for Nationalities, Baise, Guangxi, China
| | - Jianfei Song
- The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
| | - Yuening Zhang
- Medical Scientific Research Center, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiatong Li
- Medical Scientific Research Center, Guangxi Medical University, Nanning, Guangxi, China
| | - Kailong Gu
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Baihao Lv
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Dong Zhao
- Medical Scientific Research Center, Guangxi Medical University, Nanning, Guangxi, China
| | - Siping Zeng
- Urology Medical Research Center, Department of Guangxi Medical University Affiliated Hospital, Nanning, Guangxi, China
| | - Ruoheng Zhang
- Medical Scientific Research Center, Guangxi Medical University, Nanning, Guangxi, China
| | - Wei Zhao
- First Clinical Academy, Guangxi Medical University, Nanning, Guangxi, China
| | - Zhengyan Pan
- First Clinical Academy, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaozhen Deng
- First Clinical Academy, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaoli Yang
- Medical Scientific Research Center, Guangxi Medical University, Nanning, Guangxi, China.
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Zare-Karizi S, Amin-Beidokhti M, Rahimi M, Mirfakhraie R. Analysis of the androgen receptor CAG repeats length in Iranian patients with idiopathic non-obstructive azoospermia. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2016. [DOI: 10.1016/j.apjr.2015.12.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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12
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Pan B, Li R, Chen Y, Tang Q, Wu W, Chen L, Lu C, Pan F, Ding H, Xia Y, Hu L, Chen D, Sha J, Wang X. Genetic Association Between Androgen Receptor Gene CAG Repeat Length Polymorphism and Male Infertility: A Meta-Analysis. Medicine (Baltimore) 2016; 95:e2878. [PMID: 26962784 PMCID: PMC4998865 DOI: 10.1097/md.0000000000002878] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The association between polymorphism of androgen receptor gene CAG (AR-CAG) and male infertility in several studies was controversial. Based on studies on association between AR-CAG repeat length and male infertility in recent years, an updated meta-analysis is needed. We aimed to evaluate the association between AR-CAG repeat length and male infertility in advantage of the data in all published reports.We searched for reports published before August 2015 using PubMed, CNKI, VIP, and WanFang. Data on sample size, mean, and standard deviation (SD) of AR-CAG repeat length were extracted independently by 3 investigators.Forty-four reports were selected based on criteria. The overall infertile patients and azoospermic patients were found to have longer AR-CAG repeat length (standard mean difference (SMD) = 0.19, 95% confidence interval (CI): 0.10-0.28, P < 0.01; SMD = 0.36, 95% CI: 0.10-0.61, P < 0.01). AR-CAG repeat length was longer in infertile men in Asian, Caucasian, and mixed races (SMD = 0.25, 95% CI: 0.08-0.43, P <0.01; SMD = 0.13, 95% CI: 0.02-0.25, P <0.05; SMD = 0.39, 95% CI: 0.15-0.63, P <0.01). The overall study shows that increased AR-CAG repeat length was associated with male infertility. The subgroup study on races shows that increased AR-CAG repeat length was associated with male infertility in Asian, Caucasian, and mixed races. Increased AR-CAG repeat length was also associated with azoospermia.This meta-analysis supports that increased androgen receptor CAG length is capable of causing male infertility susceptibility.
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Affiliation(s)
- Bihui Pan
- From the State Key Laboratory of Reproductive Medicine (BP, RL, YC, WW, CL, YX, XW), Institute of Toxicology, School of Public Health; Key Laboratory of Modern Toxicology of Ministry of Education (BP, RL, YC, WW, CL, YX, XW), Nanjing Medical University; State Key Laboratory of Reproductive Medicine (QT, HD), Department of Obstetrics, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing; State Key Laboratory of Reproductive Medicine (WW, LH, DC), Wuxi Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University, Wuxi; Department of Gynecology and Obstetrics (LC), The Second Affiliated Hospital of Nantong University, Nantong; State Key Laboratory of Reproductive Medicine (FP), Department of Andrology, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University; and State Key Laboratory of Reproductive Medicine (JS), Nanjing Medical University, Nanjing, China
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13
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Moura-Massari VO, Cunha FS, Garcia Gomes L, Bugano Diniz Gomes D, Marcondes JAM, Madureira G, de Mendonca BB, Bachega TASS. The Presence of Clitoromegaly in the Nonclassical Form of 21-Hydroxylase Deficiency Could Be Partially Modulated by the CAG Polymorphic Tract of the Androgen Receptor Gene. PLoS One 2016; 11:e0148548. [PMID: 26848581 PMCID: PMC4744051 DOI: 10.1371/journal.pone.0148548] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 01/19/2016] [Indexed: 11/25/2022] Open
Abstract
Background In the nonclassical form (NC), good correlation has been observed between genotypes and 17OH-progesterone (17-OHP) levels. However, this correlation was not identified with regard to the severity of hyperandrogenic manifestations, which could depend on interindividual variability in peripheral androgen sensitivity. Androgen action is modulated by the polymorphic CAG tract (nCAG) of the androgen receptor (AR) gene and by polymorphisms in 5α-reductase type 2 (SRD5A2) enzyme, both of which are involved in the severity of hyperandrogenic disorders. Objectives To analyze whether nCAG-AR and SRD5A2 polymorphisms influence the severity of the nonclassical phenotype. Patients NC patients (n = 114) diagnosed by stimulated-17OHP ≥10 ng/mL were divided into groups according to the beginning of hyperandrogenic manifestations (pediatric and adolescent/adult) and CYP21A2 genotypes (C/C: homozygosis for mild mutations; A/C: compound heterozygosis for severe/mild mutations). Methods CYP21A2 mutations were screened by allelic-specific PCR, MLPA and/or sequencing. HpaII-digested and HpaII-undigested DNA samples underwent GeneScan analysis to study nCAG, and the SRD5A2 polymorphisms were screened by RLFP. Results Mean nCAG did not differ among pediatric, adolescent/adult and asymptomatic subjects. In the C/C genotype, we observed a significantly lower frequency of longer CAG alleles in pediatric patients than in adolescent/adults (p = 0.01). In patients carrying the A/C genotype, the frequencies of shorter and longer CAG alleles did not differ between pediatric patients and adolescent/adults (p>0.05). Patients with clitoromegaly had significantly lower weighted CAG biallelic mean than those without it: 19.1±2.7 and 21.6±2.5, respectively (p = 0.007), independent of the CYP21A2 genotype's severity. The SRD5A2 polymorphisms were not associated with the variability of hyperandrogenic NC phenotypes. Conclusions In this series, we observed a modulatory effect of the CAG-AR tract on clinical manifestations of the NC form. Although the NC form is a monogenic disorder, our preliminary data suggested that the interindividual variability of the hyperandrogenic phenotype could arise from polygenic interactions.
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Affiliation(s)
- Vivian Oliveira Moura-Massari
- Unidade de Suprarrenal, Laboratório de Hormônios e Genética Molecular LIM 42, Disciplina de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Flávia Siqueira Cunha
- Unidade de Suprarrenal, Laboratório de Hormônios e Genética Molecular LIM 42, Disciplina de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
- * E-mail: (FSC); (TASSB)
| | - Larissa Garcia Gomes
- Unidade de Suprarrenal, Laboratório de Hormônios e Genética Molecular LIM 42, Disciplina de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Diogo Bugano Diniz Gomes
- Departamento de Clínica Médica, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - José Antônio Miguel Marcondes
- Unidade de Suprarrenal, Laboratório de Hormônios e Genética Molecular LIM 42, Disciplina de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Guiomar Madureira
- Unidade de Suprarrenal, Laboratório de Hormônios e Genética Molecular LIM 42, Disciplina de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Berenice Bilharinho de Mendonca
- Unidade de Suprarrenal, Laboratório de Hormônios e Genética Molecular LIM 42, Disciplina de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Tânia A. Sartori Sanchez Bachega
- Unidade de Suprarrenal, Laboratório de Hormônios e Genética Molecular LIM 42, Disciplina de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
- * E-mail: (FSC); (TASSB)
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Prentice MB, Bowman J, Wilson PJ. A test of somatic mosaicism in the androgen receptor gene of Canada lynx (Lynx canadensis). BMC Genet 2015; 16:125. [PMID: 26503624 PMCID: PMC4623281 DOI: 10.1186/s12863-015-0284-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 10/19/2015] [Indexed: 11/11/2022] Open
Abstract
Background The androgen receptor, an X-linked gene, has been widely studied in human populations because it contains highly polymorphic trinucleotide repeat motifs that have been associated with a number of adverse human health and behavioral effects. A previous study on the androgen receptor gene in carnivores reported somatic mosaicism in the tissues of a number of species including Eurasian lynx (Lynx lynx). We investigated this claim in a closely related species, Canada lynx (Lynx canadensis). The presence of somatic mosaicism in lynx tissues could have implications for the future study of exonic trinucleotide repeats in landscape genomic studies, in which the accurate reporting of genotypes would be highly problematic. Methods To determine whether mosaicism occurs in Canada lynx, two lynx individuals were sampled for a variety of tissue types (lynx 1) and tissue locations (lynx 1 and 2), and 1,672 individuals of known sex were genotyped to further rule out mosaicism. Results We found no evidence of mosaicism in tissues from the two necropsied individuals, or any of our genotyped samples. Conclusions Our results indicate that mosaicism does not manifest in Canada lynx. Therefore, the use of hide samples for further work involving trinucleotide repeat polymorphisms in Canada lynx is warranted. Electronic supplementary material The online version of this article (doi:10.1186/s12863-015-0284-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Melanie B Prentice
- Department of Environmental & Life Sciences, Trent University, 1600 West Bank Drive, Peterborough, K9J 7B8, ON, Canada.
| | - Jeff Bowman
- Wildlife Research and Monitoring Section, Ontario Ministry of Natural Resources and Forestry, 2140 East Bank Drive, Peterborough, K9J 7B8, ON, Canada.
| | - Paul J Wilson
- Biology Department, Trent University, 1600 West Bank Drive, Peterborough, K9J 7B8, ON, Canada.
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Dabaja AA, Wosnitzer MS, Mielnik A, Bolyakov A, Schlegel PN, Paduch DA. Bulbocavernosus muscle area measurement: a novel method to assess androgenic activity. Asian J Androl 2015; 16:618-22. [PMID: 24589463 PMCID: PMC4104093 DOI: 10.4103/1008-682x.123681] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Serum testosterone does not correlate with androgen tissue activity, and it is critical to optimize tools to evaluate such activity in males. Ultrasound measurement of bulbocavernosus muscle (BCM) was used to assess the relationship between the number of CAG repeats (CAGn) in the androgen receptor (AR) and the BCM size; the changes in the number of CAGn over age were also evaluated. Transperineal ultrasound measurement of the BCM was also performed. AR CAGn were determined by high performance liquid chromatography, and morning hormone levels were determined using immunoassays. Forty-eight men had CAG repeat analysis. Twenty-five were <30 years of age, mean 23.7 years (s.d. = 3.24) and 23 were >45 years of age, mean 53 years (s.d. = 5.58). The median CAGn was 21 (13-29). BCM area was greater when the number of CAGn were <18 as compared to the number of CAGn >24 (P = 0.04). There was a linear correlation between the number of CAGn and the BCM area R 2 = 16% (P = 0.01). In the 45 to 65-years-old group, a much stronger negative correlation (R 2 = 29%, P = 0.01) was noticed. In the 19 to 29-years-old group, no such correlation was found (R 2 = 4%, P = 0.36). In older men, the number of CAGn increased with age (R 2 = 32%, P = 0.01). The number of CAGn in the AR correlates with the area of the BCM. Ultrasound assessment of the BCM is an effective surrogate to evaluate end-organ activity of androgens. The number of CAGn may increase with age.
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Affiliation(s)
| | | | | | | | | | - Darius A Paduch
- Department of Urology and Reproductive Medicine, Weill Cornell Medical College, New York, USA
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16
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Khatami SR, Galehdari H, Rasekh A, Mombeini H, Konar E. Assessment of Correlation between Androgen Receptor CAG Repeat Length and Infertility in Infertile Men Living in Khuzestan, Iran. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2015; 9:189-96. [PMID: 26246877 PMCID: PMC4518487 DOI: 10.22074/ijfs.2015.4239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 11/26/2014] [Indexed: 11/28/2022]
Abstract
Background The androgen receptor (AR) gene contains a polymorphic trinucleotide
repeat that encodes a polyglutamine tract in its N-terminal transactivation domain (N-
TAD). We aimed to find a correlation between the length of this polymorphic tract and
azoospermia or oligozoospermia in infertile men living in Khuzestan, Iran. Materials and Methods In this case-control study during two years till 2010, we
searched for microdeletions in the Y chromosome in 84 infertile male patients with
normal karyotype who lived in Khuzestan Province, Southwest of Iran. All cases
(n=12) of azoospermia or oligozoospermia resulting from Y chromosome microdele-
tions were excluded from our study. The number of CAG repeats in exon 1 of the AR
gene was determined in 72 patients with azoospermia or oligozoospermia and in 72
fertile controls, using the polymerase chain reaction (PCR) and polyacrylamide gel
electrophoresis. Results Microdeletions were detected in 14.3% (n=12) patients suffering severe
oligozoospermia. The mean CAG repeat length was 18.99 ± 0.35 (range, 11-26) and
19.96 ± 0.54 (range, 12-25) in infertile males and controls, respectively. Also in the
infertile group, the most common allele was 19 (26.38%), while in controls, it was
25 (22.22%). Conclusion Y chromosome microdeletions could be one of the main reasons of
male infertility living in Khuzestan Province, while there was no correlation between
CAG length in AR gene with azoospermia or oligozoospermia in infertile men living
in Khuzestan, Iran.
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Affiliation(s)
- Saeid Reza Khatami
- Department of Genetics, Faculty of Sciences, Shahid Chamran University, Ahvaz, Iran
| | - Hamid Galehdari
- Department of Genetics, Faculty of Sciences, Shahid Chamran University, Ahvaz, Iran
| | - Abdorrahman Rasekh
- Department of Statistics, Faculty of Mathematical Sciences, Shahid Chamran University, Ahvaz, Iran
| | - Hayat Mombeini
- Department of Urology, Golestan Hospital, Ahvaz University of Medical Sciences, Ahvaz, Iran
| | - Elham Konar
- Department of Genetics, Faculty of Sciences, Shahid Chamran University, Ahvaz, Iran
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Tirabassi G, Cignarelli A, Perrini S, delli Muti N, Furlani G, Gallo M, Pallotti F, Paoli D, Giorgino F, Lombardo F, Gandini L, Lenzi A, Balercia G. Influence of CAG Repeat Polymorphism on the Targets of Testosterone Action. Int J Endocrinol 2015; 2015:298107. [PMID: 26421011 PMCID: PMC4572434 DOI: 10.1155/2015/298107] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 08/09/2015] [Indexed: 01/11/2023] Open
Abstract
In the last decade, ample evidence has demonstrated the growing importance of androgen receptor (AR) CAG repeat polymorphism in andrology. This genetic parameter is able to condition the peripheral effects of testosterone and therefore to influence male sexual function and fertility, cardiovascular risk, body composition, bone metabolism, the risk of prostate and testicular cancer, the psychiatric status, and the onset of neurodegenerative disorders. In this review, we extensively discuss the literature data and identify a role for AR CAG repeat polymorphism in conditioning the systemic testosterone effects. In particular, our main purpose was to provide an updated text able to shed light on the many and often contradictory findings reporting an influence of CAG repeat polymorphism on the targets of testosterone action.
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Affiliation(s)
- Giacomo Tirabassi
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Via Conca 71, 60126 Ancona, Italy
| | - Angelo Cignarelli
- Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology, and Metabolic Diseases, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Sebastio Perrini
- Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology, and Metabolic Diseases, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Nicola delli Muti
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Via Conca 71, 60126 Ancona, Italy
| | - Giorgio Furlani
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Via Conca 71, 60126 Ancona, Italy
| | - Mariagrazia Gallo
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome “La Sapienza”, Viale del Policlinico 155, 00161 Rome, Italy
| | - Francesco Pallotti
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome “La Sapienza”, Viale del Policlinico 155, 00161 Rome, Italy
| | - Donatella Paoli
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome “La Sapienza”, Viale del Policlinico 155, 00161 Rome, Italy
| | - Francesco Giorgino
- Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology, and Metabolic Diseases, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Francesco Lombardo
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome “La Sapienza”, Viale del Policlinico 155, 00161 Rome, Italy
| | - Loredana Gandini
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome “La Sapienza”, Viale del Policlinico 155, 00161 Rome, Italy
| | - Andrea Lenzi
- Laboratory of Seminology-Sperm Bank, Department of Experimental Medicine, University of Rome “La Sapienza”, Viale del Policlinico 155, 00161 Rome, Italy
| | - Giancarlo Balercia
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Via Conca 71, 60126 Ancona, Italy
- *Giancarlo Balercia:
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18
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Tahmasbpour E, Balasubramanian D, Agarwal A. A multi-faceted approach to understanding male infertility: gene mutations, molecular defects and assisted reproductive techniques (ART). J Assist Reprod Genet 2014; 31:1115-37. [PMID: 25117645 PMCID: PMC4156950 DOI: 10.1007/s10815-014-0280-6] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 06/16/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The assisted reproductive techniques aimed to assist infertile couples have their own offspring carry significant risks of passing on molecular defects to next generations. RESULTS Novel breakthroughs in gene and protein interactions have been achieved in the field of male infertility using genome-wide proteomics and transcriptomics technologies. CONCLUSION Male Infertility is a complex and multifactorial disorder. SIGNIFICANCE This review provides a comprehensive, up-to-date evaluation of the multifactorial factors involved in male infertility. These factors need to be first assessed and understood before we can successfully treat male infertility.
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Affiliation(s)
| | | | - Ashok Agarwal
- />Center for Reproductive Medicine, Cleveland Clinic, 44195 Cleveland, OH USA
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19
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Stanworth RD, Akhtar S, Channer KS, Jones TH. The role of androgen receptor CAG repeat polymorphism and other factors which affect the clinical response to testosterone replacement in metabolic syndrome and type 2 diabetes: TIMES2 sub-study. Eur J Endocrinol 2014; 170:193-200. [PMID: 24165020 DOI: 10.1530/eje-13-0703] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
CONTEXT The TIMES2 (testosterone replacement in hypogonadal men with either metabolic syndrome or type 2 diabetes) study reported beneficial effects of testosterone replacement therapy (TRT) on insulin resistance and other variables in men with diabetes or metabolic syndrome. The androgen receptor CAG repeat polymorphism (AR CAG) is known to affect stimulated AR activity and has been linked to various clinically relevant variables. OBJECTIVE To assess the role of AR CAG in the alteration of clinical response to TRT in the TIMES2 study. DESIGN Subgroup analysis from a multicentre, randomised, double-blind, placebo-controlled and parallel group study. SETTING Outpatient study recruiting from secondary and primary care. PATIENTS A total of 139 men with hypogonadism and type 2 diabetes or metabolic syndrome, of which 73 received testosterone during the TIMES2 study. INTERVENTION Testosterone 2% transdermal gel vs placebo. MAIN OUTCOME MEASURE Regression coefficient of AR CAG from linear regression models for each variable. RESULTS AR CAG was independently positively associated with change in fasting insulin, triglycerides and diastolic blood pressure during TRT with a trend to association with HOMA-IR - the primary outcome variable. There was a trend to negative association between AR CAG and change in PSA. There was no association of AR CAG with change in other glycaemic variables, other lipid variables or obesity. CONCLUSION AR CAG affected the response of some variables to TRT in the TIMES2 study, although the association with HOMA-IR did not reach significance. Various factors may have limited the power of our study to detect the significant associations between AR CAG, testosterone levels and change in variables with testosterone treatment. Analysis of similar data sets from other clinical trials is warranted.
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Affiliation(s)
- R D Stanworth
- Department of Diabetes and Endocrinology, Derby Hospitals NHS Foundation Trust, Derby, UK
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Francomano D, Greco EA, Lenzi A, Aversa A. CAG repeat testing of androgen receptor polymorphism: is this necessary for the best clinical management of hypogonadism? J Sex Med 2013; 10:2373-81. [PMID: 23844628 DOI: 10.1111/jsm.12268] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION It is controversial whether or not testing the length of the androgen receptor polymorphism in clinical practice is useful for correct diagnosis and treatment of hypogonadism. AIM To describe the molecular and clinical implications of testing the length of the androgen receptor polymorphism for treatment of hypogonadism in both male and female subjects. METHODS A systematic Medline search was conducted using several terms related to and including the terms "androgen receptor," "CAG-repeat polymorphism," "male hypogonadism," "female hypogonadism," and "neurodegenerative disease." MAIN OUTCOME MEASURES Clinical evidence that demonstrates the importance of CAG repeat number investigation in male and female hypogonadism. RESULTS A thorough review of the clinical utility of CAG repeat polymorphism investigation in men and women with hypogonadism is presented. CONCLUSIONS The role of AR CAG repeat number investigation in hypogonadism (male and female) is not yet established in the clinical practice. In both sexes, a role during clinical management of hormonal replacement therapies may be hypothesized, but the CAG repeat number's relationship with the presence or absence of hypogonadal symptoms remains unclear. Pharmacogenomic investigations of the AR polymorphism may be a future option to tailor testosterone titration individually and to better identify subjects as potentially more or less responsive to treatments; also, investigation may be important to individually predict beneficial and side effects in special subpopulations, specifically, obese men and postmenopausal women.
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Affiliation(s)
- Davide Francomano
- Department of Experimental Medicine, Endocrinology and Food and Science Section, Sapienza University of Rome, Rome, Italy
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Brokken LJS, Rylander L, Jönsson BA, Spanò M, Pedersen HS, Ludwicki JK, Zviezdai V, Bizzaro D, Manicardi GC, Toft G, Bonde JP, Giwercman A, Lundberg Giwercman Y. Non-linear association between androgen receptor CAG and GGN repeat lengths and reproductive parameters in fertile European and Inuit men. Mol Cell Endocrinol 2013; 370:163-71. [PMID: 23510718 DOI: 10.1016/j.mce.2013.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 03/01/2013] [Accepted: 03/06/2013] [Indexed: 11/21/2022]
Abstract
Recently the dogma that there is an inverse linear association between androgen receptor (AR) CAG and GGN polymorphisms and receptor activity has been challenged. We analysed the pattern of association between 21 male reproductive phenotypes and AR CAG/GGN repeat lengths in 557 proven-fertile men. A linear association was only found between sperm DNA fragmentation index (DFI) and CAG length, and between inhibin B and GGN length. Men with longer CAG then the reference (22-24), had higher oestradiol levels, whereas men with shorter CAG stretches had a higher DFI and a higher proportion of Fas-positive germ cells. Subjects with either short or long CAG had increased seminal levels of prostate-specific antigen and neutral α-glucosidase activity. Compared to men with the median GGN length of 23, those with shorter GGN repeats had higher levels of inhibin B, higher proportions of normal and progressive sperm, and a higher fraction of Fas-positive sperm, while men with longer GGN had higher oestradiol levels. These data indicate that at least for some markers of male reproductive function the association with CAG or GGN repeat length is curvilinear.
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Affiliation(s)
- L J S Brokken
- Department of Reproductive Molecular Medicine, Lund University, SE-20502 Malmö, Sweden.
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Eisenberg ML, Hsieh TC, Pastuszak AW, McIntyre MG, Walters RC, Lamb DJ, Lipshultz LI. The relationship between anogenital distance and the androgen receptor CAG repeat length. Asian J Androl 2013; 15:286-9. [PMID: 23334200 DOI: 10.1038/aja.2012.126] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Anogenital distance (AGD) is used to define degree of virilization of genital development, with shorter length being associated with feminization and male infertility. The first exon of the androgen receptor (AR) consists of a polymorphic sequence of cytosine-adenine-guanine (CAG) repeats, with longer CAG repeat lengths being associated with decreased receptor function. We sought to determine if there is an association between AGD and AR CAG repeat length. A cross-sectional, prospective cohort of men evaluated at a urology clinic at a single institution was recruited. AGD (the distance from the posterior scrotum to the anal verge) and penile length (PL) were measured. Sanger DNA sequence analysis was used to define CAG repeat length. AGD and CAG repeat lengths in 195 men were determined. On unadjusted analysis, there was no linear relationship between CAG repeat length and PL (P=0.17) or AGD (P=0.31). However, on sub-population analyses, those men with longer CAG repeat lengths (>26) had significantly shorter AGDs compared to men with shorter CAG repeat lengths. For example, the mean AGD was 41.9 vs. 32.4 mm with a CAG repeat length ≤26 vs. >26 (P=0.01). In addition, when stratifying the cohort based on AGD, those with AGD less than the median (i.e. 40 mm) had a longer CAG repeat length compared to men with an AGD >40 mm (P=0.02). In summary, no linear relationship was found between AGD and AR CAG repeat length overall.
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Affiliation(s)
- Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA 94305, USA.
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Tirabassi G, delli Muti N, Corona G, Maggi M, Balercia G. Androgen Receptor Gene CAG Repeat Polymorphism Regulates the Metabolic Effects of Testosterone Replacement Therapy in Male Postsurgical Hypogonadotropic Hypogonadism. Int J Endocrinol 2013; 2013:816740. [PMID: 24454369 PMCID: PMC3876679 DOI: 10.1155/2013/816740] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 11/04/2013] [Indexed: 11/26/2022] Open
Abstract
Aim. To evaluate the independent role of androgen receptor (AR) gene CAG repeat polymorphism on metabolic effects of testosterone replacement therapy (TRT) in male postsurgical hypogonadotropic hypogonadism, a condition frequently associated with hypopituitarism and in which the TRT-related metabolic effects are combined with those deriving from concomitant administration of metabolically active pituitary-function replacement therapies. Methods. 15 men affected by postsurgical hypogonadotropic hypogonadism were evaluated before and after TRT. Cardiovascular risk factors (CVRFs), pituitary-dependent hormones, and AR gene CAG repeat polymorphism were considered. Results. Testosterone, insulin-like growth factor 1 (IGF-1), and estradiol were the only hormones, which varied significantly between the two phases. All CVRFs significantly improved after TRT. The number of CAG triplets was positively and significantly correlated with all the variations (Δ-) of CVRFs (except for a significant negative correlation with Δ-high-density lipoprotein); the opposite occurred between the latter and Δ-testosterone. No correlation between Δ-IGF-1 or estradiol and Δ-CVRFs was found. At multiple linear regression, after correction for Δ-testosterone, nearly all the associations between the number of CAG triplets and Δ-CVRFs were confirmed. Conclusions. In male postsurgical hypogonadotropic hypogonadism, shorter AR gene CAG tract length seems to yield greater metabolic improvement after TRT, independently of the effects of concomitant pituitary-function replacement therapies.
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Affiliation(s)
- Giacomo Tirabassi
- Andrology Unit, Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Nicola delli Muti
- Andrology Unit, Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Giovanni Corona
- Endocrinology Unit, Azienda Usl di Bologna, Maggiore-Bellaria Hospital, Bologna, Italy
- Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy
| | - Mario Maggi
- Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy
| | - Giancarlo Balercia
- Andrology Unit, Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, 60126 Ancona, Italy
- *Giancarlo Balercia:
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Giannetta E, Gianfrilli D, Barbagallo F, Isidori AM, Lenzi A. Subclinical male hypogonadism. Best Pract Res Clin Endocrinol Metab 2012; 26:539-50. [PMID: 22863395 DOI: 10.1016/j.beem.2011.12.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Male hypogonadism is traditionally defined as the inadequate production of testosterone and impaired spermatozoa generation in the presence of elevated or reduced levels of gonadotropins. A more frequent measurement of testosterone levels and the development of highly sensitive and specific assays have led to the detection of less clinically evident gonadal dysfunction, in which small biochemical alterations may or may not be accompanied by signs and symptoms. This condition is called "compensated" or "subclinical" hypogonadism. To determine whether subclinical hypogonadism is a paraphysiological state, a clinical condition in itself, or a precursor to overt hypogonadism, we carried out a literature review with the aim of establishing a practical approach to subclinical hypogonadism.
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Affiliation(s)
- Elisa Giannetta
- Sapienza University of Rome, Dept. of Experimental Medicine, Viale del Policlinico 155, 00161 Rome, Italy
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25
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Mitra A, Chakraborty B, Mukhopadhay D, Pal M, Mukherjee S, Banerjee S, Chaudhuri K. Effect of smoking on semen quality, FSH, testosterone level, and CAG repeat length in androgen receptor gene of infertile men in an Indian city. Syst Biol Reprod Med 2012; 58:255-62. [DOI: 10.3109/19396368.2012.684195] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kim WB, Jeong JY, Doo SW, Yang WJ, Song YS, Lee SR, Park JW, Kim DW. Myotonic dystrophy type 1 presenting as male infertility. Korean J Urol 2012; 53:134-6. [PMID: 22379595 PMCID: PMC3285710 DOI: 10.4111/kju.2012.53.2.134] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 08/17/2011] [Indexed: 11/18/2022] Open
Abstract
Myotonic dystrophy 1 (DM1) is a multi-system disorder characterized by endocrine defects that include testicular and tubular atrophy, oligospermia and azoospermia, and increased follicle-stimulating hormone levels. We describe a rare case of DM1 presenting as infertility in a 29-year-old man.
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Affiliation(s)
- Woong Bin Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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27
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Evaluation of CAG repeat length of androgen receptor expressing cells in human testes showing different pictures of spermatogenic impairment. Histochem Cell Biol 2011; 136:689-97. [DOI: 10.1007/s00418-011-0871-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2011] [Indexed: 12/11/2022]
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Mostafa T, El-Shahid LH, El Azeem AA, Shaker O, Gomaa H, Abd El Hamid HM. Androgen receptor-CAG repeats in infertile Egyptian men. Andrologia 2011; 44:147-51. [PMID: 21714804 DOI: 10.1111/j.1439-0272.2010.01125.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This study aimed to assess the androgen receptor (AR) codon amino acids glutamine (CAG) repeats in 185 Egyptian men divided into fertile controls (n = 30), oligoasthenoteratozoospermic (OAT) men (n = 35), nonobstructive azoospermic (NOA) men (n = 120; 18 successful testicular sperm extraction (TESE) and 102 unsuccessful TESE cases). They were subjected to history taking, genital examination, semen analysis, testicular biopsies for NOA cases, serum hormones and CAG repeats by PCR. The mean AR-CAG repeats showed significant difference between NOA group compared with fertile controls or OAT groups. Nonsignificant difference was elicited between OAT group and fertile controls. In NOA cases, CAG repeats demonstrated nonsignificant difference between unsuccessful and successful TESE. AR-CAG repeats elicited significant negative correlation with sperm count, significant positive correlation with sperm normal forms percentage and nonsignificant correlations with sperm motility per cent, tested serum hormones or testicular volume. It is concluded that AR-CAG repeats in Egyptian infertile men are in the range of other international or regional studies. AR-CAG repeats have demonstrated nonsignificant difference regarding TESE outcome in NOA cases.
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Affiliation(s)
- T Mostafa
- Department of Andrology & Sexology, Faculty of Medicine, Cairo University, Egypt.
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Mosaad YM, Shahin D, Elkholy AAM, Mosbah A, Badawy W. CAG repeat length in androgen receptor gene and male infertility in Egyptian patients. Andrologia 2011; 44:26-33. [PMID: 21486420 DOI: 10.1111/j.1439-0272.2010.01100.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The CAG repeat and its association with infertility has been debatable. Therefore, this study was planned to assess the distribution of CAG repeat expansion in Egyptian patients and to investigate its association with male infertility. Forty-five infertile men were eligible for the study in addition to 20 aged-matched fertile males as control. Semen analysis, scrotal sonography, assay of serum testosterone, follicle-stimulating hormone (FSH) and luteinising hormone (LH), and determination of the CAG repeat number within exon 1 of the androgen receptor (AR) gene were carried out. Statistically significant difference was found between infertile and control groups regarding sperm count, sperm motility, serum FSH level and CAG repeats (P < 0.05); statistically insignificant difference for the CAG repeats (P = 1.0) was found between oligozoospermic and asthenospermic groups; negative correlation was found between CAG repeat length and sperm count, and a positive correlation was found between CAG repeat length and serum FSH (P < 0.05). Our results validate the concept that long stretches of CAG repeat may be associated with lower AR function with derangement of sperm production, and this may contribute to male infertility in Egyptian men.
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Affiliation(s)
- Y M Mosaad
- Clinical Pathology Department, Mansoura University, Mansoura, Egypt.
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Dhiman P, Bhansali A, Prasad R, Dutta P, Walia R, Ravikiran M. Predictors of pilosebaceous unit responsiveness to testosterone therapy in patients with hypogonadotrophic hypogonadism. Andrologia 2011; 43:422-7. [PMID: 21486418 DOI: 10.1111/j.1439-0272.2010.01093.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Testosterone replacement therapy is the mainstay of treatment in male patients with isolated hypogonadotrophic hypogonadism (HH) to achieve virilisation. However, responsiveness of pilosebaceous unit (PSU) to testosterone replacement therapy in these patients is quite variable. Androgen action is inversely proportional to the number of CAG repeats in exon 1 of androgen receptor gene; therefore, we hypothesised that CAG repeat length contributes to testosterone responsiveness in patients with HH. The CAG repeat length in 21 well-virilised men (hair score > 30, responders) and 25 poorly virilised men (hair score ≤ 30, non-responders) with HH on optimal testosterone replacement therapy at least for a period of 1 year was analysed. Serum LH, FSH, testosterone and 17 β oestradiol were estimated. Polymerase chain reaction (PCR) amplification of exon 1 of androgen receptor gene was performed from genomic DNA, and these PCR-amplified products were sequenced for the number of CAG repeats. The difference between number of CAG repeats in responders and non-responders was statistically significant (19.19 ± 3.25 and 22.24 ± 2.65, P = 0.001) and showed a strong negative correlation with total body hair score (r = -0.538 and P = 0.0001). In conclusion, these results suggest that the number of CAG repeats influences the responsiveness of PSU to testosterone treatment in patients with HH.
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Affiliation(s)
- P Dhiman
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Abstract
Androgens and the androgen receptor (AR) are indispensable for expression of the male phenotype. The two most important androgens are testosterone and 5α-dihydrotestosterone. The elucidation of the mechanism of androgen action has a long history starting in the 19th century with the classical experiments by Brown-Séquard. In the 1960s the steroid hormone receptor concept was established and the AR was identified as a protein entity with a high affinity and specificity for testosterone and 5α-dihydrotestosterone. In addition, the enzyme 5α-reductase type 2 was discovered and found to catalyze the conversion of testosterone to the more active metabolite 5α-dihydrotestosterone. In the second half of the 1980s, the cDNA cloning of all steroid hormone receptors, including that of the AR, has been another milestone in the whole field of steroid hormone action. Despite two different ligands (testosterone and 5α-dihydrotestosterone), only one AR cDNA has been identified and cloned. The AR (NR3C4) is a ligand-dependent transcription factor and belongs to the family of nuclear hormone receptors which has 48 members in human. The current model for androgen action involves a multistep mechanism. Studies have provided insight into AR association with co-regulators involved in transcription initiation and on intramolecular interactions of the AR protein during activation. Knowledge about androgen action in the normal physiology and in disease states has increased tremendously after cloning of the AR cDNA. Several diseases, such as androgen insensitivity syndrome (AIS), prostate cancer and spinal bulbar muscular atrophy (SBMA), have been shown to be associated with alterations in AR function due to mutations in the AR gene or dysregulation of androgen signalling. A historical overview of androgen action and salient features of AR function in normal and disease states are provided herein.
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Affiliation(s)
- Albert O Brinkmann
- Department of Reproduction and Development, Erasmus MC, Rotterdam, The Netherlands.
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O'Flynn O'Brien KL, Varghese AC, Agarwal A. The genetic causes of male factor infertility: a review. Fertil Steril 2010; 93:1-12. [PMID: 20103481 DOI: 10.1016/j.fertnstert.2009.10.045] [Citation(s) in RCA: 280] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Revised: 10/27/2009] [Accepted: 10/27/2009] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To illustrate the necessity for an enhanced understanding of the genetic basis of male factor infertility, to present a comprehensive synopsis of these genetic elements, and to review techniques being utilized to produce new insights in fertility research. BACKGROUND Male factor infertility is a complex disorder that affects a large sector of the population; however, many of its etiologies are unknown. By elucidating the underlying genetic basis of infertile phenotypes, it may be possible to discover the causes of infertility and determine effective treatments for patients. METHOD(S) The PubMed database was consulted for the most relevant papers published in the last 3 years pertaining to male factor infertility using the keywords "genetics" and "male infertility." RESULT(S) Advances have been made in the characterization of the roles of specific genes, but further research is necessary before these results can be used as guidelines for diagnosing and treating male factor infertility. The accurate transmission of epigenetic information also has considerable influence on fertility in males and on the fertility of their offspring. CONCLUSION(S) Analysis of the genetic factors that impact male factor infertility will provide valuable insights into the creation of targeted treatments for patients and the determination of the causes of idiopathic infertility. Novel technologies that analyze the influence of genetics from a global perspective may lead to further developments in the understanding of the etiology of male factor infertility through the identification of specific infertile phenotype signatures.
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Affiliation(s)
- Katherine L O'Flynn O'Brien
- Center for Reproductive Medicine, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA
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Manuck SB, Marsland AL, Flory JD, Gorka A, Ferrell RE, Hariri AR. Salivary testosterone and a trinucleotide (CAG) length polymorphism in the androgen receptor gene predict amygdala reactivity in men. Psychoneuroendocrinology 2010; 35:94-104. [PMID: 19493626 PMCID: PMC2825741 DOI: 10.1016/j.psyneuen.2009.04.013] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2008] [Revised: 03/05/2009] [Accepted: 04/22/2009] [Indexed: 01/21/2023]
Abstract
In studies employing functional magnetic resonance imaging (fMRI), reactivity of the amygdala to threat-related sensory cues (viz., facial displays of negative emotion) has been found to correlate positively with interindividual variability in testosterone levels of women and young men and to increase on acute administration of exogenous testosterone. Many of the biological actions of testosterone are mediated by intracellular androgen receptors (ARs), which exert transcriptional control of androgen-dependent genes and are expressed in various regions of the brain, including the amygdala. Transactivation potential of the AR decreases (yielding relative androgen insensitivity) with expansion a polyglutamine stretch in the N-terminal domain of the AR protein, as encoded by a trinucleotide (CAG) repeat polymorphism in exon 1 of the X-chromosome AR gene. Here we examined whether amygdala reactivity to threat-related facial expressions (fear, anger) differs as a function of AR CAG length variation and endogenous (salivary) testosterone in a mid-life sample of 41 healthy men (mean age=45.6 years, range: 34-54 years; CAG repeats, range: 19-29). Testosterone correlated inversely with participant age (r=-0.39, p=0.012) and positively with number of CAG repeats (r=0.45, p=0.003). In partial correlations adjusted for testosterone level, reactivity in the ventral amygdala was lowest among men with largest number of CAG repeats. This inverse association was seen in both the right (r(p)=-0.34, p<0.05) and left (r(p)=-0.32, p<0.05) hemisphere. Activation of dorsal amygdala, correlated positively with individual differences in salivary testosterone, also in right (r=0.40, p<0.02) and left (r=0.32, p<0.05) hemisphere, but was not affected by number of CAG repeats. Hence, androgenic influences on threat-related reactivity in the ventral amygdala may be moderated partially by CAG length variation in the AR gene. Because individual differences in salivary testosterone also predicted dorsal amygdala reactivity and did so independently of CAG repeats, it is suggested that androgenic influences within this anatomically distinct region may be mediated, in part, by non-genomic or AR-independent mechanisms.
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Affiliation(s)
- Stephen B Manuck
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, United States.
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Rodríguez-González G, Ramírez-Moreno R, Pérez P, Bilbao C, López-Ríos L, Díaz-Chico JC, Lara PC, Serra-Majem L, Chirino R, Díaz-Chico BN. The GGN and CAG repeat polymorphisms in the exon-1 of the androgen receptor gene are, respectively, associated with insulin resistance in men and with dyslipidemia in women. J Steroid Biochem Mol Biol 2009; 113:202-8. [PMID: 19159685 DOI: 10.1016/j.jsbmb.2008.12.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2008] [Revised: 11/18/2008] [Accepted: 12/22/2008] [Indexed: 11/18/2022]
Abstract
The human androgen receptor (AR) gene possesses two trinucleotide repeats of CAG and GGN in exon-1. The GGN repeat affects the amount of AR protein translated, while the CAG repeat affects the efficiency of AR transcriptionaly. In this study, we have genotyped these polymorphic tracts in a representative sample of 557 Caucasian adult individuals (314 women and 243 men) from the Canary Islands, Spain (the ENCA Study), and investigated their association with fasting serum levels of lipids, glucose and insulin. The number of CAG repeats in women (expressed as the average length of the two alleles) was inversely correlated with serum levels of LDL-cholesterol (Spearman rho=-0.179; P<0.01). Women with an average number of CAG repeats in the upper tertile showed significantly lower levels of LDL-cholesterol than those grouped in the lower and middle tertile, after adjusting for age, body mass index, waist-to-hip ratio, smoking and alcohol drinking. The number of GGN repeats in men was correlated with fasting insulin levels (Spearman rho=-0.206; P<0.01), the homeostasis model assessment of insulin resistance (HOMA-IR; Spearman rho=-0.230; P<0.01) and the McAuley index of insulin sensitivity (Spearman rho=0.194; P<0.01). Men with a number of GGN repeats in the upper tertile showed lower levels of insulin and HOMA and a higher level of the McAuley index than those grouped in the lower and middle tertile, after adjusting for the variables listed above. These results support the hypothesis that the longer alleles of the CAG and GGN polymorphisms in the exon-1 of the AR gene, indicative of lower androgenic signaling, respectively protect women from developing dyslipemia and men from developing insulin resistance.
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35
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Huhtaniemi IT, Pye SR, Limer KL, Thomson W, O'Neill TW, Platt H, Payne D, John SL, Jiang M, Boonen S, Borghs H, Vanderschueren D, Adams JE, Ward KA, Bartfai G, Casanueva F, Finn JD, Forti G, Giwercman A, Han TS, Kula K, Lean MEJ, Pendleton N, Punab M, Silman AJ, Wu FCW. Increased estrogen rather than decreased androgen action is associated with longer androgen receptor CAG repeats. J Clin Endocrinol Metab 2009; 94:277-84. [PMID: 18840639 DOI: 10.1210/jc.2008-0848] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The individual variability in the waning androgenic-anabolic functions of aging men may be influenced by the CAG repeat polymorphism in exon 1 of the androgen receptor (AR), affecting androgen sensitivity. However, findings on its phenotypic effects are inconclusive. OBJECTIVE The aim was to investigate the relationships between health status, various reproductive hormones, and the AR CAG repeat length. DESIGN We conducted a multinational prospective cohort observational study with cross-sectional baseline data. SETTING This was a population survey of community-dwelling men. PARTICIPANTS Men (40-79 yr old; n = 3369) were randomly recruited from centers in eight European countries; CAG repeat analysis was performed in 2878 men. MAIN OUTCOME MEASURES We measured the correlations of the CAG repeat length with selected endocrine, metabolic, and phenotypic parameters related to aging and sex hormone action. RESULTS Only minor differences were found in CAG repeat lengths between the eight European countries. They showed significant positive association with total, free, and bioavailable levels of testosterone (T) and estradiol. FSH but not LH correlated inversely with CAG repeat length. Significant associations were found with bone ultrasound parameters at the calcaneus. Negative correlation was found with triglycerides, but not with other blood lipids or with anthropometry, blood pressure, hemoglobin, insulin sensitivity, or sexual and prostatic functions. CONCLUSIONS The AR CAG repeat length correlates significantly with serum T and estradiol of aging men. Weaker transcriptional activity of the AR with longer CAG-encoded polyglutamine repeats appears to be totally or nearly totally compensated for by higher T levels. The residual phenotypic correlations may reflect differences in estrogen levels/actions after aromatization of the higher T levels.
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Affiliation(s)
- Ilpo T Huhtaniemi
- Department of Reproductive Biology, Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0NN, United Kingdom.
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Erenpreiss J, Tsarev I, Giwercman A, Giwercman Y. The impact of androgen receptor polymorphism and parental ethnicity on semen quality in young men from Latvia. ACTA ACUST UNITED AC 2008; 31:477-82. [DOI: 10.1111/j.1365-2605.2007.00791.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Saare M, Belousova A, Punab M, Peters M, Haller K, Ausmees K, Poolamets O, Karro H, Metspalu A, Salumets A. Androgen receptor gene haplotype is associated with male infertility. ACTA ACUST UNITED AC 2008; 31:395-402. [PMID: 17651405 DOI: 10.1111/j.1365-2605.2007.00782.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The purpose of the current study was to evaluate the importance of androgen receptor (AR) gene haplotypes and polymorphic CAG/GGN microsatellites in the aetiology of male infertility. We genotyped six haplotype-tagging single nucleotide polymorphisms and CAG/GGN microsatellites of the AR gene in 112 infertile and 212 control Estonian men. A total of 13 AR haplotypes (HAP1-13) were identified, among which HAP4 was found to confer increased risk for male infertility (OR = 5.15, 95% CI = 1.75-15.15, p = 0.003). However, infertile patients and controls had similar lengths and distributions of both AR CAG (mean +/- SD number of repeats 21.1 +/- 2.5 vs. 21.2 +/- 2.3, respectively) and GGN (mean +/- SD number of repeats 22.5 +/- 1.5 vs. 22.4 +/- 1.9, respectively) repeats. In addition, HAP2 was associated with more CAG repeats (r = 1.17, p = 0.033) and HAP3 with fewer CAG repeats (r = -2.93, p < 0.001) than the major haplotype HAP1. HAP3 and HAP4 were associated with more GGN repeats (r = 1.35, p = 0.001 and r = 1.36, p = 0.002, respectively) than HAP1. In conclusion, our results implicated the AR-HAP4 gene haplotype in increased risk for male infertility, while no association was found between AR CAG/GGN microsatellites and impaired spermatogenesis.
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Affiliation(s)
- M Saare
- Department of Obstetrics and Gynaecology, University of Tartu, Tartu, Estonia
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Lazaros L, Xita N, Kaponis A, Zikopoulos K, Sofikitis N, Georgiou I. Evidence for association of sex hormone-binding globulin and androgen receptor genes with semen quality. Andrologia 2008; 40:186-91. [PMID: 18477206 DOI: 10.1111/j.1439-0272.2008.00835.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The roles of androgen receptor AR(CAG)n gene polymorphisms and sex hormone-binding globulin SHBG(TAAAA)n gene polymorphisms on semen quality were studied. One hundred fourteen men were included in the study: 85 with normal sperm count and 29 oligospermic. The genotype analysis, on DNA extracted from spermatozoa, revealed five SHBG(TAAAA)n alleles with 6-10 repeats and 18 AR(CAG)n alleles with 12-32 repeats. The SHBG allelic distribution showed that in men with normal sperm count and motility, those with short SHBG alleles had higher sperm concentration than men with long SHBG alleles (P = 0.039). As concerns AR(CAG)n polymorphisms, men with short AR alleles had lower sperm motility compared to those with long AR alleles (P < 0.001) in both total study population and normal sperm count men. The synergistic effect analysis of the two polymorphisms revealed an association between sperm motility (P = 0.036), because of the effect of AR(CAG)n polymorphism on sperm motility. In conclusion, long AR alleles were found to be associated with higher sperm motility, while short SHBG alleles were associated with higher sperm concentration, supporting the significance of these genes in spermatogenesis and semen quality.
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Affiliation(s)
- L Lazaros
- Genetics and IVF Unit, Department of Obstetrics and Gynaecology, Medical School, University of Ioannina, Ioannina, Greece
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Monks DA, Rao P, Mo K, Johansen JA, Lewis G, Kemp MQ. Androgen receptor and Kennedy disease/spinal bulbar muscular atrophy. Horm Behav 2008; 53:729-40. [PMID: 18321505 PMCID: PMC2883265 DOI: 10.1016/j.yhbeh.2007.12.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Revised: 12/13/2007] [Accepted: 12/13/2007] [Indexed: 02/06/2023]
Abstract
Kennedy Disease/Spinal Bulbar Muscular Atrophy (KD/SBMA) is a progressive neurodegenerative disease caused by genetic polyglutamine expansion of the androgen receptor. We have recently found that overexpression of wildtype androgen receptor in skeletal muscle of transgenic mice results in a KD/SBMA phenotype. This surprising result challenges the orthodox view that KD/SBMA requires expression of polyglutamine expanded androgen receptor within motoneurons. Theories relating to the etiology of this disease drawn from studies of human patients, cellular and mouse models are considered with a special emphasis on potential myogenic contributions to as well as the molecular etiology of KD/SBMA.
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Affiliation(s)
- Douglas Ashley Monks
- Department of Psychology, University of Toronto at Mississauga, 3359 Mississauga Road, Mississauga, Ontario, Canada L5L 1C6.
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40
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Abstract
Our understanding about genetics is rapidly changing. The goal of this article is to provide an overview of the basics of and new developments in medical genetics--a Genetics 101 primer for 2008. In this article we review the structure and function of the genes, how genes are packaged, gene replication, gene mutations, and the different modes of inheritance.
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Affiliation(s)
- Keith Jarvi
- Division of Urology, Department of Surgery, Murray Koffler Urologic Wellness Centre, Mount Sinai Hospital, University of Toronto, Joseph & Wolf Lebovic Building, 60 Murray Street, 6th Floor, Toronto, Ontario, M5T 3L9.
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Westerveld H, Visser L, Tanck M, van der Veen F, Repping S. CAG repeat length variation in the Androgen Receptor gene is not associated with spermatogenic failure. Fertil Steril 2008; 89:253-9. [PMID: 17889867 DOI: 10.1016/j.fertnstert.2007.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2006] [Revised: 02/02/2007] [Accepted: 02/02/2007] [Indexed: 11/19/2022]
Abstract
Previous association studies that described the effect of an enlarged CAG repeat length in the Androgen Receptor (AR) gene on spermatogenesis could not prove or refute a true association because of methodological weaknesses. Here, we clearly show that there is no association between CAG repeat length variation and semen quality.
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Affiliation(s)
- Henrike Westerveld
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, the Netherlands.
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42
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Davis-Dao CA, Tuazon ED, Sokol RZ, Cortessis VK. Male infertility and variation in CAG repeat length in the androgen receptor gene: a meta-analysis. J Clin Endocrinol Metab 2007; 92:4319-26. [PMID: 17684052 DOI: 10.1210/jc.2007-1110] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
CONTEXT Many studies have investigated the association between male infertility and trinucleotide repeat polymorphisms in the androgen receptor (AR) gene, but no comprehensive meta-analysis of all published studies has been conducted. OBJECTIVE Our goals were to summarize published data on associations between AR CAG and GGC repeat lengths and male infertility and investigate sources of variation between study results. DATA SOURCES We searched for reports published before October 2006 using Medline, PubMed, and Web of Science. STUDY SELECTION All selected studies included the following: a case group with infertility as measured by semen parameters, a control group of known or presumed fertile men, and measurement of CAG and/or GGC repeat lengths among cases and controls. Thirty-nine reports were selected based on these criteria, and 33 were ultimately included in the meta-analysis. DATA EXTRACTION One investigator extracted data on sample size, mean and sd of trinucleotide repeat length, and study characteristics. DATA SYNTHESIS Estimates of the standardized mean difference (95% confidence interval) were 0.19 (0.09-0.29) for the 33 studies and 0.31 (0.14-0.47) for a subset of 13 studies that used more stringent case and control selection criteria. Thus, in both groups, cases had statistically significantly longer CAG repeat length than controls. Publication date appeared to be a significant source of variation between studies. CONCLUSIONS This meta-analysis provides support for an association between increased androgen receptor CAG length and idiopathic male infertility, suggesting that even subtle disruptions in the androgen axis may compromise male fertility.
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Affiliation(s)
- Carol A Davis-Dao
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, MC-9175, Los Angeles, California 90033, USA
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Crabbe P, Bogaert V, De Bacquer D, Goemaere S, Zmierczak H, Kaufman JM. Part of the interindividual variation in serum testosterone levels in healthy men reflects differences in androgen sensitivity and feedback set point: contribution of the androgen receptor polyglutamine tract polymorphism. J Clin Endocrinol Metab 2007; 92:3604-10. [PMID: 17579205 DOI: 10.1210/jc.2007-0117] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
CONTEXT There is a large interindividual variation in serum (free) testosterone (FT) levels in men, underlain in part by genetic components. OBJECTIVE The objective of the study was to explore the hypothesis that this variability results in part from differences in androgen sensitivity and feedback loop set point and assess the role of the androgen receptor (AR) polyglutamine tract polymorphism encoded by a CAG repeat of variable length in exon 1 of the AR gene. DESIGN/SETTING/PARTICIPANTS We performed a cross-sectional analysis in two independent populations of healthy men, consisting of 2322 men aged 35-59 yr (Belstress study) and 358 men aged 25-45 yr (Siblos study), respectively. MAIN OUTCOME MEASURES Serum hormonal levels and the AR gene CAG repeat length were determined. RESULTS In the Belstress population, serum testosterone and calculated FT showed a positive linear association with LH (P < 0.001). In the 200 men with lowest FT, CAG repeat number was lower than in the 200 men with highest FT (P = 0.004). As studied in a larger subset of the population consisting of 857 men covering the whole FT range, FT increased progressively with CAG repeat length (P = 0.003). These findings of a positive relation of FT with both LH and CAG repeat length were confirmed in the Siblos study population (both P < or = 0.001). Difference in FT between extreme quartiles of CAG repeat was 10 and 14% in the Belstress and Siblos study, respectively. In both study populations, CAG repeat length was also positively associated with serum total testosterone (P < or = 0.004). CONCLUSIONS The data support the view that between-subject variability in serum FT in healthy men is underlain in part by differences in androgen sensitivity and feedback set point, with a contributory role of AR polymorphism. These findings have potential implications for the interpretation of epidemiological studies, diagnosis of hypogonadism, and pharmacogenetics of androgen treatment in men.
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Affiliation(s)
- P Crabbe
- Department of Endocrinology, 9K12 I.E., Ghent University Hospital, 9000 Ghent, Belgium
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Jeske YWA, McGown IN, Cowley DM, Oley C, Thomsett MJ, Choong CSY, Cotterill AM. Androgen receptor genotyping in a large Australasian cohort with androgen insensitivity syndrome; identification of four novel mutations. J Pediatr Endocrinol Metab 2007; 20:893-908. [PMID: 17937062 DOI: 10.1515/jpem.2007.20.8.893] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We genotyped the androgen receptor (AR) gene in 31 Australasian patients with androgen insensitivity syndrome (AIS). The entire coding region of AR was examined including analysis of polymorphic CAG and GGN repeats in all patients. AR defects were found in 66.7% (6/9) of patients with complete AIS (CAIS) and 13.6% (3/22) of patients with partial AIS (PAIS). A novel deletion (N858delG) leading to a premature stop codon was found in CAIS patient P1. CAIS patient P2 has a novel deletion (N2676delGAGT) resulting in a stop at codon 787. These mutations would result in inactivation of AR protein. A novel insertion of a cysteine residue in the first zinc finger of the AR DNA-binding domain (N2045_2047dupCTG) was found in CAIS patient P3. PAIS patient P4 has a novel amino acid substitution (Arg760Ser) in the AR ligand binding domain, which may impair ligand binding. Five patients were found to have previously reported AR mutations and no mutations were identified in the remaining patients.
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Abstract
Androgen receptor (AR) gene has been extensively studied in diverse clinical conditions. In addition to the point mutations, trinucleotide repeat (CAG and GGN) length polymorphisms have been an additional subject of interest and controversy among geneticists. The polymorphic variations in triplet repeats have been associated with a number of disorders, but at the same time contradictory findings have also been reported. Further, studies on the same disorder in different populations have generated different results. Therefore, combined analysis or review of the published studies has been of much value to extract information on the significance of variations in the gene in various clinical conditions. AR genetics has been reviewed extensively but until now review articles have focused on individual clinical categories such as androgen insensitivity, male infertility, prostate cancer, and so on. We have made the first effort to review most the aspects of AR genetics. The impact of androgens in various disorders and polymorphic variations in the AR gene is the main focus of this review. Additionally, the correlations observed in various studies have been discussed in the light of in vitro evidences available for the effect of AR gene variations on the action of androgens.
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MESH Headings
- Androgen-Insensitivity Syndrome/genetics
- Androgen-Insensitivity Syndrome/physiopathology
- Bone Diseases, Metabolic/genetics
- Bone Diseases, Metabolic/physiopathology
- Breast Neoplasms/genetics
- Breast Neoplasms/physiopathology
- Cognition Disorders/genetics
- Cognition Disorders/physiopathology
- Digestive System Diseases/genetics
- Digestive System Diseases/physiopathology
- Female
- Genital Neoplasms, Female/genetics
- Genital Neoplasms, Female/physiopathology
- Genital Neoplasms, Male/genetics
- Genital Neoplasms, Male/physiopathology
- Humans
- Infertility, Male/genetics
- Male
- Muscular Atrophy, Spinal/genetics
- Muscular Atrophy, Spinal/physiopathology
- Phenotype
- Point Mutation
- Polycystic Ovary Syndrome/genetics
- Polycystic Ovary Syndrome/physiopathology
- Polymorphism, Genetic
- Pre-Eclampsia/genetics
- Pre-Eclampsia/physiopathology
- Pregnancy
- Receptors, Androgen/genetics
- Receptors, Androgen/physiology
- Schizophrenia/genetics
- Schizophrenia/physiopathology
- Testosterone/deficiency
- Trinucleotide Repeats
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Affiliation(s)
- Singh Rajender
- Centre for Cellular and Molecular Biology, Uppal Road, Hyderabad 500007, India
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Abstract
Cag Repeat Number in Androgen Receptor Gene and Male InfertilityAndrogens are essential for male sexual development and for fertility. They exert their action through the androgen receptor (AR), a ligandactivated transcription factor. The 5' end of exon 1 of the AR gene includes a polymorphic CAG triplet repeat that varies in number between 10 to 36 in the normal population. There is controversy over an association between high CAG repeat numbers in the AR gene and male infertility. We have evaluated the possible effect of long CAG repeats in the AR on infertility in men from the Republic of Macedonia (R. Macedonia). A group of 222 infertile/subfertile males with different sperm counts and a control group of 152 proven fathers were studied. The CAG repeat number was determined by fluorescent polymerase chain reaction (PCR) amplification of exon 1 of the AR gene analyzed by capillary electrophoresis. Mean CAG length did not differ significantly between males with azoospermia (22.0 ± 3.1), mild oligozoospermia (22.4 ± 2.6), severe oligozoospermia (23.0 ± 4.2), normozoospermia (21.8 ± 2.4), or known causes of infertility (22.1 ± 2.9) and fertile controls (22.3 ± 2.9). However, we found a significantly higher percentage of CAG repeats >26 (p = 0.022), >27 (p = 0.018) and >28 (p = 0.009) in males with mild oligozoospermia. These results indicate a possible association between CAG repeat length and mild oligozoospermia. Further studies on a larger number of patients with mild oligozoospermia are warranted to confirm this association.
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Georgiou I, Syrrou M, Pardalidis N, Karakitsios K, Mantzavinos T, Giotitsas N, Loutradis D, Dimitriadis F, Saito M, Miyagawa I, Tzoumis P, Sylakos A, Kanakas N, Moustakareas T, Baltogiannis D, Touloupides S, Giannakis D, Fatouros M, Sofikitis N. Genetic and epigenetic risks of intracytoplasmic sperm injection method. Asian J Androl 2007; 8:643-73. [PMID: 17111067 DOI: 10.1111/j.1745-7262.2006.00231.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Pregnancies achieved by assisted reproduction technologies, particularly by intracytoplasmic sperm injection (ICSI) procedures, are susceptible to genetic risks inherent to the male population treated with ICSI and additional risks inherent to this innovative procedure. The documented, as well as the theoretical, risks are discussed in the present review study. These risks mainly represent that consequences of the genetic abnormalities underlying male subfertility (or infertility) and might become stimulators for the development of novel approaches and applications in the treatment of infertility. In addition, risks with a polygenic background appearing at birth as congenital anomalies and other theoretical or stochastic risks are discussed. Recent data suggest that assisted reproductive technology might also affect epigenetic characteristics of the male gamete, the female gamete, or might have an impact on early embryogenesis. It might be also associated with an increased risk for genomic imprinting abnormalities.
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Affiliation(s)
- Ioannis Georgiou
- Laboratory of Molecular Urology and Genetics of Human Reproduction, Department of Urology, Ioannina University School of Medicine, Ioannina 45110, Greece
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Dakouane-Giudicelli M, Legrand B, Bergere M, Giudicelli Y, Cussenot O, Selva J. Association between androgen receptor gene CAG trinucleotide repeat length and testicular histology in older men. Fertil Steril 2006; 86:873-7. [PMID: 17027356 DOI: 10.1016/j.fertnstert.2006.03.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2005] [Revised: 03/07/2006] [Accepted: 03/07/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To determine whether the size of CAG repeat in exon 1 of the androgen receptor (AR) gene is related to impaired spermatogenesis in older men. DESIGN Study of two groups of older men: one with preserved spermatogenesis and the other with arrested spermatogenesis. SETTING University teaching hospital. PATIENT(S) Twenty-eight men aged from 53 to 102 years. INTERVENTION(S) The DNA fragment encoding the AR polyglutamine tract was amplified from DNA of testis tissue. MAIN OUTCOME MEASURE(S) The size of the CAG repeat was evaluated by using fluorescent-labeled polymerase chain reaction performed on an ABI Prism 377 DNA sequencer followed by automated analysis with Genscan 3.1.2 software. RESULT(S) Mean CAG repeat length was 22.76 +/- 3 in the group of 13 aged men with preserved spermatogenesis and 21.86 +/- 2.23 in the group of 15 aged men with arrested spermatogenesis. CONCLUSION(S) Impaired spermatogenesis in elderly men does not seem to be correlated with the AR gene CAG repeat length, which therefore does not appear to be a risk factor for impaired spermatogenesis in older men.
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Werner R, Holterhus PM, Binder G, Schwarz HP, Morlot M, Struve D, Marschke C, Hiort O. The A645D mutation in the hinge region of the human androgen receptor (AR) gene modulates AR activity, depending on the context of the polymorphic glutamine and glycine repeats. J Clin Endocrinol Metab 2006; 91:3515-20. [PMID: 16804045 DOI: 10.1210/jc.2006-0372] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Sufficient androgen receptor (AR) activity is crucial for normal male sexual differentiation. Here we report on two unrelated 46, XY patients suffering from undervirilization and genital malformations. Both patients had a short polyglycine (polyG) repeat of 10 residues and a relatively long polyglutamine (polyQ) repeat of 28 and 30 residues within the transactivation domain of the AR. In addition, they also harbor a rare A645D substitution. OBJECTIVE We made a set of AR expression plasmid constructs with varying polyQ and polyG tract sizes in context with or without the A645D substitution and analyzed their in vitro transactivation capacity in transfected CHO cells. RESULTS We found that a short polyG repeat downmodulated AR activity to approximately 60-65% of the wild-type receptor. This effect was aggravated by A645D in context of a long polyQ repeat to less than 50% activity. In contrast, in the context of a short polyQ and a short polyG repeat, the A645D mutation rescues AR activity to almost wild-type levels, demonstrating a contradictory effect of this mutation, depending on the size of the polymorphic repeats. CONCLUSIONS A combination of a short polyG repeat with a long polyQ repeat and an A645D substitution might contribute to the development of virilization disorders and explain the observed phenotypes of our patients as a form of androgen insensitivity. The whole recreation of AR sequence variations including individual polymorphic repeat sizes could unravel possible interference of mutations and variations on AR activity by in vitro transfection.
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Affiliation(s)
- Ralf Werner
- Department of Pediatric and Adolescent Medicine, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
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Analysis of Korean Infertile Males by PDMS Microchip Gel Electrophoresis. B KOREAN CHEM SOC 2006. [DOI: 10.5012/bkcs.2006.27.8.1239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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