Flutamide-induced testicular undescent in the rat is associated with alterations in genitofemoral nerve morphology

Journal of Pediatric Surgery-Sponsored Fred McLoed Lecture. Undescended testis: the underlying mechanisms and the effects on germ cells that cause infertility and cancer

Testicular descent is a complex morphological process that occurs in at least 2 stages, with different hormonal control. Insl3 controls the first step of gubernacular enlargement, although the abnormality long gubernacular cord in persistent Műllerian duct syndrome remains unexplained. Androgens control inguinoscrotal migration, which may be triggered by local signalling from the mammary line, and which requires the genitofemoral nerve. However, there is still much to learn about this phase, which when abnormal frequently leads to cryptorchidism. Orchidopexy is being recommended in the first year of age, because increasing research suggests that the stem cells for spermatogenesis form between 3 and 9 months, with surgery aiming to permit this normally, although this is not yet proven. Acquired cryptorchidism is now becoming accepted and is likely to be caused by inadequate elongation of the postnatal spermatic cord. It is not yet known whether orchidopexy is always needed, as this remains controversial.

The effect of flutamide on expression of androgen and estrogen receptors in the gubernaculum and surrounding structures during testicular descent

BACKGROUND/PURPOSE

Inguinoscrotal testicular descent is controlled by androgens between embryonic days E16-19, but androgen receptor (AR) and estrogen receptor (ER) locations are unknown. We aimed to find AR, ERα, and ERβ in the gubernaculum and inguinal fat pad (IFP) in normal rats and after flutamide treatment.

METHODS

Sprague-Dawley timed-mated rats were injected with flutamide (75 mg/kg body weight/5% ethanol + oil) on E16-19 or vehicle alone. Male fetuses or pups (5-10/group) were collected at E16; E19; and postnatal (P) days 0, 2, 4, 8. Sections were prepared for hematoxylin and eosin or immunohistochemistry for AR, ERα, and ERβ. Receptor labeling was quantitated as distinct nuclear labeling/100 μm(2) in gubernaculum and IFP.

RESULTS

There was minimal gubernacular AR-labeling until E19, dramatically increasing postnatally. By contrast, at E16-E19 there was significant IFP AR immunoreactivity suppressed by flutamide (P < .05). No ERα expression was observed, but ERβ was expressed in both gubernaculum and IFP, maximally at E16, but unchanged by flutamide.

CONCLUSIONS

During the androgen sensitivity window (E16-19), the gubernaculum contains ERβ but minimal ERα or AR, while the IFP, which is supplied by the genitofemoral nerve, contains abundant AR that are flutamide-sensitive. These results suggest that the IFP could be the site of androgenic action controlling gubernacular development.

Cryptorchidism: pathogenesis, diagnosis, treatment and prognosis

Cryptorchidism is a common genital anomaly diagnosed at birth or during childhood. Genetic and/or environmental factors that alter expression or function of hormones crucial for testicular descent, insulin-like 3, and testosterone, may contribute to cryptorchidism. When identified at birth, surgical treatment is indicated by 6 months of age if testes fail to descend, or at the time of diagnosis in older children. A laparoscopic approach is preferred for abdominal testes. Early surgical therapy may reduce the risk of subfertility and/or malignancy.

STRUCTURAL EVIDENCE AGAINST HORMONAL THERAPY FOR CRYPTORCHID TESTIS: ABNORMAL GUBERNACULAR ATTACHMENT

PURPOSE

Various factors are involved in testicular descent, and no single factor is elucidated as the cause of cryptorchidism. We prospectively observed the locations of gubernacular attachments in the cryptorchid testis.

MATERIALS AND METHODS

From April 1996 to June 2002, 639 boys underwent surgical correction of cryptorchid testis. Those with complete records of testicular locations and gubernacular attachments were analyzed.

RESULTS

A total of 639 boys underwent 732 surgical corrections of inguinal testis (425, 58%), high scrotal testis (165, 23%) and impalpable abdominal testis (142, 19%). Impalpable abdominal testes had gubernacular attachment to either the lateral or upper scrotum in 36 cases (25%) or around the inguinal ring in 83 (58%). The gubernaculum was attached to the bottom of the scrotum in 21 inguinal testes (5%), to the lateral or upper scrotum in 132 (31%) or around the inguinal ring in 268 (63%). In cases of high scrotal testis the gubernaculum was attached usually to the bottom of the scrotum (28, 17%), to the lateral or upper scrotum (109, 66%) or around the inguinal ring (26, 16%).

CONCLUSIONS

The locations of distal gubernacular attachments in the cryptorchid testis were usually abnormal (93%). In these cases the possible testicular descent induced by hormonal therapy may either be insufficient or unable to prevent future ascent. Thus, early surgical correction rather than hormonal therapy is warranted in boys with cryptorchid testis.

Short-time exposure to vinclozolin in utero induces testicular maldescent associated with a spinal nucleus alteration of the genitofemoral nerve in rats

BACKGROUND/PURPOSE

Vinclozolin (V), a known antiandrogen, has been used widely to protect fruits, vegetables, and turf from fungus damage. The aim of this study was to clarify the effect of V on both the development of the spinal cord nucleus and testicular descent in rats.

METHODS

Pregnant rats were administered 200 mg/kg/d of V from day 16 to 18 of gestation. At 5 days of age, the genitofemoral nerve (GFN) of male pups was identified on the psoas muscle, and diamidinophenyl indole was applied to the proximal cut end of the GFN. Forty-eight hours later, the T11 to L4 level of the spinal cord was removed, and 30-microm frozen serial sections were made. Next, the spinal nuclei labeled in a retrograde fashion by diamidinophenyl indole (DAPI) were examined with a fluorescence microscope. Additional male pups survived until 60 days of age to evaluate the position of the testes.

RESULTS

The size of the DAPI-labeled spinal nuclei were smaller in the V-treated rats than in the control rats. The average number of the DAPI-labeled spinal nuclei decreased significantly more in the V-treated rats (176+/-33) than in the controls (247+/- 21; P <.05) during the newborn period. At 60 days of age, 15 of the 26 male rats showed either unilateral or bilateral undescended testes in the V-treated rats. The incidence of cryptorchidism was also significantly higher in the V-treated rats (57.7%) than in the controls (0%; P <.05).

CONCLUSIONS

The antiandrogenic effect of the prenatal administration of V inhibited the development of the GFN nucleus in the spinal cord and induced testicular maldescent in rats. These results support the hypothesis that androgens regulate the descent of the testis through GFN development.

Chemical sympathectomy by 6-OH dopamine during fetal life results in inguinal testis through altering cremasteric contractility in rats

BACKGROUND/PURPOSE

Androgens are proposed to influence testicular descent through modulating sympathetic tone. An experimental study was undertaken to evaluate the effects of prenatal chemical sympathectomy on testicular location associated with the alterations in contractile properties of cremaster muscles in rats.

METHODS

Time-mated pregnancies were started in 10 rats. Two groups, each receiving saline or 6-hydroxydopamine from day 15 to day 19 of intrauterine life were established. At 2 months of age, localization of testes were evaluated, cremaster muscles were removed, and contractile properties were studied. Twitch and tetanic contractions were recorded isometrically at 37 degrees C. Effects of verapamil, isoprenaline, and L-NNA were investigated. Results were compared through analysis of variance (ANOVA), and P values less than.05 were considered to be significant.

RESULTS

Both testes of all male offspring in the control group (n = 19) were in the scrotum. Six offspring among 17 subjected to 6-hydroxydopamine had undescended testes. Treatment with 6-hydroxydopamine had no effect on force-frequency relationship of cremaster muscle strips. Cremaster muscles of rats exposed to 6-hydroxydopamine had lower sensitivity to voltage-sensitive Ca++ channel blockade by verapamil (3 x 10(4) mol/L; P <.05). These muscles displayed greater contractile response to isoprenaline (10(-5) mol/L; P <.05) but not to nitric oxide synthase inhibition by N(omega)-nitro-L-arginine. Alterations in contractile properties of the muscles did not differ according to localization of testes among rats subjected to 6-hydroxydopamine.

CONCLUSIONS

Administration of 6-hydroxydopamine resulted in suprascrotally located testes. This localization has been associated with less exposure at sympathetic tonus. These findings support that sympathetic activity plays an important role in localization of testis.

Ultrastructural deficiency in autonomic innervation in cremasteric muscle of boys with undescended testis

BACKGROUND/PURPOSE

The cremaster muscles (CM) associated with undescended testis reveal neurogenic alterations that mainly affect type 2 fibers. The ultrastructure of CM has been evaluated to define if further evidence to explain the alterations could be identified.

METHODS

CM of 8 boys with inguinal hernia and 8 boys with undescended testis at similar ages were biopsied. Samples were processed for electron microscopic evaluations. Semithin and thin sections were examined under an electron microscope.

RESULTS

The CM associated with inguinal hernia showed normal ultrastructure. However, some alterations were encountered in CM associated with undescended testis. Unmyelinated fibers were diminished in number, and myelinated fibers were outnumbering the unmyelinated fibers. Marked disorientation of myofibers, redundant sarcolemma, empty sleeves of basal lamina, disarray of myofibrils, densely packed myofilaments, Z disk streaming, dilated sarcoplasmic reticulum, and dense-irregularly shaped mitochondria were repeatedly encountered. Satellite cells appeared inactive. Most of the fibers were contracted.

CONCLUSIONS

The decrease in number of unmyelinated fibers appears to represent a decrease in autonomic nerve fibers. The alterations within muscle fibers may reflect a deficiency in autonomic innervation. Autonomic nervous system is highly responsive to circulating androgens. Factors decreasing the vulnerability of autonomic nervous system against androgenic effects may result in a CM with neurogenic alterations, thus inhibiting testicular descent. J Pediatr Surg 36:573-578.

Effect of vasectomy on the seminiferous tubule boundary zone in the Albino Swiss rat

The boundary zone of a seminiferous tubule consists of the basement membrane of the seminiferous epithelium, its myoid cells, and their basal laminae. This study examines the boundary zones of seminiferous tubules in healthy and degenerated testes following long-term, left-sided vasectomy in the rat and compares them to those of sham-operated controls and adult rats exposed in utero to the antiandrogen, flutamide. Degenerated tubular profiles showed similar changes, irrespective of whether the degeneration was ipsilateral or bilateral. In transverse tubular profiles, the basal laminae of the seminiferous epithelium and the myoid cells became more undulating, that of seminiferous epithelium showing complex folding. The collagen layer of the boundary zone, which lies between the basal laminae of the seminiferous epithelium and the myoid cells, thickened and its fibers became irregularly orientated. Rather than being flattened as in controls, the region of the myoid cell near the nucleus and the nucleus itself developed triangular profiles in the transversely sectioned tubules. Similar features were also seen in the degenerated tubules of rats exposed to flutamide. The changes in the boundary zone are not specific for vasectomy and probably reflect reduction in the cross-sectional area of tubular profiles and possibly in their length. We also noted occasional leukocytes infiltrating the boundary zone; they may have increased in number in those tubules that showed degeneration following vasectomy.

Does the sensory nucleus of the genitofemoral nerve have a role in testicular descent?

BACKGROUND/PURPOSE

A role for the genitofemoral nerve (GFN) and its neurotransmitter, CGRP, in testicular descent has been well established. The exact mechanism, however, by which circulating androgens act on the GFN is not yet known. The authors studied the sensory nucleus of the GFN (L1-L2 dorsal root ganglia [DRG]) to determine whether it is sexually dimorphic and able to be influenced by intrauterine antiandrogen treatment.

METHODS

Sprague-Dawley rats were injected daily with 100 mg/kg/d of the antiandrogen flutamide on day 16 to 19 of pregnancy. Control animals were treated with vehicle only. At the age of 2 to 3 days the newborn rats underwent unilateral dissection of the GFN. The proximal end was labelled with fluorescent dye, diamidinophenyl indole. The rats were killed 48 hours later, and the relevant ganglia (L1,L2) were removed. Cryostat frozen serial sections were cut, and retrogradely labelled fluorescent cells were counted under an epifluorescence microscope. In 32 animals, the cells were double fluorescent labelled with antibody to CGRP and FITC.

RESULTS

Of 75 rats evaluated, the mean number of the DAPI-positive, retrogradely labelled cells in the control groups was 266 +/- 55 in the male, and 230 +/- 67 in the female as opposed to 186 +/- 45 and 161 +/- 35 in the flutamide-treated male and female groups, respectively. In 32 animals the DRG sections were double labelled for CGRP. The number of CGRP plus DAPI-positive cells were as follows: control males, 60 +/-12; control females, 50 +/- 9; flutamide males, 36 +/- 8; flutamide females, 40 +/- 10.

CONCLUSIONS

These findings show a sexual dimorphism in the number of GFN cell bodies in the DRG. Flutamide decreases the number of GFN cell bodies in the DRG of both males and females. Our results are consistent with a role for circulating androgens acting on the sensory nucleus of the GFN (DRG) instead of the motor nucleus as previously thought. The release of CGRP from the nerve endings may occur via the sensory branch of the GFN.

Capsaicin restores gubernacular contractility in TS rats

BACKGROUND/PURPOSE

Calcitonin gene-related peptide (CGRP) may stimulate gubernacular migration during testicular descent by release from the genitofemoral nerve (GFN). The origin of CGRP within the nerve, however, is controversial. This study examines whether sensory nerve destruction alters gubernacular contractility in vitro in Sprague-Dawley (SD) and congenitally cryptochid (TS) rats.

METHODS

Part 1: Twenty-four SD and 16 TS rats (day 0) had either both GFNs transected or sham operation. Gubernacula were removed on day 2 and cultured with or without CGRP (714 nmol/L). Contractility was recorded by video. Part 2: Twenty-two SD and 17 TS rats (day 0) were injected with either capsaicin or vehicle. Gubernacula were removed (day 2) and cultured as above.

RESULTS

Part 1: In sham-operated SD rats gubernacular contracility increased from 8% to 83% with added CGRP. After GFN transection contractility was not affected by CGRP (21% without and 86% with CGRP; not significant). TS rat gubernacula had no endogenous contractions, but after GFN transection, the contractile response to CGRP increased from 6% to 44% (P = .04). Part 2: In vehicle-treated SD rats, rhythmic contractions increased from 10% to 86% with CGRP, which was unchanged by capsaicin treatment (82%; not significant). In vehicle-treated TS rats, gubernacular contractions were 6% after CGRP. After capsaicin pretreatment, contractions increased to 59% with CGRP (P = .002).

CONCLUSIONS

Results of this study show that chemical destruction of sensory nerves restores gubernacular contractility in mutant cryptorchid TS rats. Release of CGRP appears to occur through sensory nerves.

Lack of carbachol response indicates the absence of cholinergic receptors in sacs associated with undescended testis

BACKGROUND/PURPOSE

The mechanism of testicular descent remains controversial. The processus vaginalis (PV) contains smooth muscle and should have contractile activity that may contribute to descent. This study was designed to evaluate the smooth muscle of PVs associated with incomplete obliteration for spontaneous activities and responses to various stimuli, to determine if differences exist according to sex, diagnostic source, or location of the testis.

MATERIALS

Peritoneal samples (n = 4); sacs from girls (n = 8) and boys with inguinal hernia (n = 12); and sacs from boys with hydrocele (n = 3), hydrocele of the cord (n = 2), or undescended testis (n = 7) were used for the current study. Tissues were attached to the isometric force displacement transducer in an organ bath containing mammalian Ringer's solution at 37 degrees C. Spontaneous mechanical activity and contractile responses of tissues to the electrical field stimulation, phenylephrine, carbachol, and serotonin were recorded. The values obtained from boys and girls with inguinal hernia and from boys with either undescended or descended testis were compared through Fisher's Exact test.

RESULTS

There were no statistically significant differences in patient age between groups. Among the parameters studied, only the carbachol response of the sacs associated with undescended testis showed a significant difference compared with the others (P = .001). None of the sacs associated with undescended testis responded to carbachol, whereas all of the sacs from boys and girls with inguinal hernia responded to carbachol.

CONCLUSIONS

Lack of carbachol response suggests the absence of cholinergic receptors within the sacs associated with undescended testis. The lack of cholinergic receptors may play a role in the failure of the process of testicular descent by hindering either PV elongation into the scrotum or a possible propulsive activity of the PV on the testis.

Técnica para produção de criptorquia experimental em ratos

Foram utilizados 18 ratos machos albinos Wistar, divididos em dois grupos de acordo com a idade e a época do sacrifício. Todos foram submetidos ao fechamento do ânulo inguinal superficial esquerdo para a produção de criptorquia experimental. Os animais de ambos os grupos sobreviveram ao procedimento e foram sacrificados no 30º. e no 60º. dias de pós-operatório. Todos apresentavam o testículo esquerdo retido.

The effects of pre- and postnatal exposure to the nonsteroidal antiandrogen flutamide on testis descent and morphology in the Albino Swiss rat

Exposure of male Albino Swiss rats to the nonsteroidal antiandrogen flutamide during the period from gestational day (d) 10 to birth resulted in feminisation of the external genitalia and the suppression of growth of the male reproductive tract. In adulthood, testes were found to be located in diverse positions. True cryptorchidism occurred in 10% of cases, whereas 50% of testes descended to the scrotum and 40% were located in a suprainguinal ectopic region. Varying degrees of tubule abnormality were seen in the testes of flutamide-treated animals, ranging from completely normal tubules with full spermatogenesis (and the expected frequency of the stages of spermatogenesis) to severely abnormal tubules lined with Sertoli cells only. For each individual testis, the overall severity of tubule damage was strongly correlated with its adult location, with intra-abdominal testes worst affected and scrotally-located testes least; only the latter contained normal tubules. Similarly, intra-abdominal testes were the smallest in weight and contained the least testosterone. By contrast, postnatal treatment of male rats with flutamide from birth to postnatal d 14 did not impair development of the external genitalia, the process of testicular descent or adult spermatogenesis. These findings confirm that androgen blockade during embryonic development interferes with testicular descent but also demonstrate that (1) prenatal flutamide treatment per se has a detrimental effect on adult testis morphology but (2) the degree of abnormality of the testes is strongly influenced by location.

Avaliação dos efeitos da ciclofosfamida nos testículos escrotal e retido em ratos jovens submetidos à criptorquia unilateral

Foi produzida criptorquia unilateral experimental em ratos pré-puberais. Tanto no testículo retido quanto no contralateral escrotal, foram encontradas alterações similares às observadas cm seres humanos. Essas alterações correspondem a um desenvolvimento testicular prejudicado, com degeneração da gônada. A administração crônica da droga imunossupressora ciclofosfamida, em doses baixas, evitou a deterioração do testículo tópico, a despeito de sua reconhecida ação deletéria para a espermatogênese. Tendo em vista que as lesões observadas atingem também o testículo escrotal e podem ser prevenidas pela ciclofosfamida, e discutida a possibilidade de que sejam causadas por reação auto-imune.

Scanning electron microscopy shows inhibited gubernacular development in relation to undescended testes in oestrogen-treated mice

The morphological relationship between transabdominal testicular descent and the 'swelling reaction' of the gubernaculum was investigated in oestrogen-treated fetal mice by using scanning electron microscopy (scanning EM). In addition, flutamide was also administered to pregnant mice to determine whether androgens cause gubernacular growth and transabdominal testicular descent in offspring. In oestrogen-treated fetal mice, scanning EM showed that both the gubernacular 'swelling reaction' and transabdominal testicular descent were inhibited, in addition to inhibition of Müllerian duct regression. The gubernaculum showed a flat, thin bulb (widest diameter 0.25 +/- 0.04 mm) and an elongated cord (1.28 +/- 0.41 mm) after oestrogen treatment in utero, which was significantly different in appearance from that in normal control mice (width 0.44 mm +/- 0.06 mm, p < 0.001; length 0.27 +/- 0.19 mm, p < 0.0001). However, flutamide-treated mice showed much more normal gubernacular enlargement and transabdominal testicular descent. The width of the gubernacular bulb after flutamide exposure was 0.44 +/- 0.05 mm, which was comparable to that in control animals; the length of the intra-abdominal gubernaculum (0.44 +/- 0.15 mm) was slightly longer than in controls (p < 0.02). These results suggest that both the swelling reaction of the gubernaculum and transabdominal testicular migration are blocked by prenatal exposure to oestrogen. However, oestrogen exposure of the fetus does not block the swelling reaction of the gubernaculum by acting as an antiandrogen.

Lack of feminization of the cremaster nucleus by prenatal flutamide administration in the rat and pig

PURPOSE

The sexually dimorphic cremaster nucleus contains motoneurons that project via the genitofemoral nerve and theoretically direct androgen dependent testicular descent. The effects of flutamide on descent and masculinization of the cremaster nucleus were studied in the rat and pig.

MATERIALS AND METHODS

Flutamide was given to pregnant rats and pigs on days 16 to 22 and 65 to 113 of gestation, respectively. Tissues were perfused and examined at birth (pigs) or at age 30 days (rats). Spinal cords were removed, sectioned and immunohistochemically stained for serotonin (rats) or substance P (pigs) to demarcate the position of the cremaster nucleus and allow the determination of cremaster motoneuron number.

RESULTS

After exposure to flutamide testes were undescended in 6 of 9 rats and 7 of 10 pigs. Cremaster motoneuron number per nucleus were 288 +/- 22 in control versus 250 +/- 27 in flutamide treated rats, and 165 +/- 28 in control versus 148 +/- 24 in flutamide treated pigs. The decrease in motoneuron number by flutamide was significant in both species (p < 0.02) but it did not approach the levels in female rats (93 +/- 11) and pigs (57 +/- 12). Cremaster motoneuron number did not correlate with testicular position. Porcine undescended testes were associated with a significant increase in mean gubernacular volume.

CONCLUSIONS

Unlike other sexually dimorphic spinal cord nuclei masculinization of the cremaster nucleus appears to be largely androgen independent and it does not correlate with ipsilateral testicular descent. These data suggest that androgens do not mediate descent of the testes via the efferent limb of the genitofemoral nerve.

Current concepts in the pathophysiology of testicular undescent

At present, we believe that descent of the testes within the human is a complex event mediated by both hormonal and mechanical factors. We hypothesize that descent of the testes occurs as a result of the secretion of an androgen-independent factor from a normal testis (descendin). This paracrine factor is responsible for the rapid proliferation (outgrowth) of the ipsilateral gubernaculum. The development of the gubernaculum results in creating a dilated inguinal canal, the width of which matches the testicular width. Descent of the testes through the inguinal canal is an interplay between abdominal pressure, a patent processus vaginalis, and androgen-induced gubernacular regression. We hypothesize that androgens (under control of an intact hypothalamic pituitary axis) alter the viscoelastic properties of the gubernaculum, reducing the turgidity of the gubernaculum and allowing intra-abdominal pressure to push the testis into the scrotum. Cryptorchidism can therefore result when any one or more of the involved factors malfunction.

The role of the genitofemoral nerve and calcitonin gene-related peptide in congenitally cryptorchid mutant TS rats

We investigated whether previous gubernacular denervation in TS rats changes the gubernacular contractile response to or binding capacity of calcitonin gene-related peptide receptors. In TS rats there is excessive calcitonin gene-related peptide in the genitofemoral nerve and 85% of the male rats have cryptorchidism. TS rats and controls underwent genitofemoral nerve transection or sham operation at day 0. On day 3 gubernacula were cultured with or without calcitonin gene-related peptide to observe contractions. Gubernacular frozen sections were incubated with 125iodine calcitonin gene-related peptide with or without unlabeled calcitonin gene-related peptide. Exposed x-ray films were quantified by computerized densitometry. In the sham operated controls contractility increased from 15 to 55% by adding calcitonin gene-related peptide compared with 5% and 10%, respectively, in the TS rats. After genitofemoral nerve denervation exogenous calcitonin gene-related peptide increased contractility to 90% in controls and 75% in TS rats. Previous genitofemoral nerve transection increased specific 125iodine calcitonin gene-related peptide binding 21% in controls and about 100% in TS rats. Genitofemoral nerve transection in TS rats restored gubernacular contractile response to calcitonin gene-related peptide in vitro and doubled the binding capacity of calcitonin gene-related peptide receptors.

Antiandrogen induced cryptorchidism in the pig is associated with failed gubernacular regression and epididymal malformations

PURPOSE

Can antiandrogens cause cryptorchidism in an animal model with a strip-like gubernaculum? If so, what anatomical abnormalities are associated with cryptorchidism?

MATERIALS AND METHODS

Timed pregnant sows received the antiandrogen flutamide during defined gestational intervals. Fetal pigs were evaluated for the presence of testicular undescent and for morphological paratesticular abnormalities at 110 days of gestation (birth).

RESULTS

Of 180 testes 84 (47%) were undescended and 9 (5%) were in the abdominal cavity. No undescended testis (0 of 200 testes) were found in control animals (p < 0.001). Epididymal anomalies were found in all intra-abdominal testes, which was significant when compared to the epididymal abnormalities found with inguinal undescended testes (0%) or descended testes (1%) (p < 0.001). Alterations in gubernacular morphology, in particular failure of gubernacular regression, were also directly associated with cryptochidism (p < 0.001).

CONCLUSIONS

Androgens partially control transabdominal and transinguinal descent of the porcine testis. In addition, antiandrogen induced cryptorchidism is associated with epididymal malformation and failure of gubernacular regression. It remains to be determined if these latter findings are only associated with or the cause of testicular undescent.

Lack of feminization of the cremaster nucleus in cryptorchid androgen insensitive rats

Androgens may control rat testicular descent via effects on the genitofemoral nerve or cranial gonadal ligaments. Androgen-mediated release of calcitonin gene-related peptide from the genito-femoral nerve (whose motoneuron cell bodies reside in the sexually dimorphic cremaster nucleus) may stimulate cremaster sac formation and testicular descent. Alternatively, androgens may cause regression of cranial gonadal ligaments and thereby allow the testes to descend. To evaluate these theories testicular position, and the cremaster sac and nucleus were studied in Tfm (androgen insensitive) rats. Testes were abdominal, inguinal and scrotal in 20%, 67% and 13% of Tfm male rats, respectively, and cranial ligaments were present in all cases. Mean cremaster nucleus motoneuron number was lower in female rats (70 +/- 14) but not significantly different between normal male (256 +/- 44) and Tfm male (231 +/- 42) rats, and it correlated poorly with testicular position. Calcitonin gene-related peptide immunoreactivity was rarely observed in cremaster motoneurons. These data suggest that the cremaster nucleus is not androgen-dependent, calcitonin gene-related peptide release from cremaster motoneurons is not the likely mechanism of testicular descent and persistent cranial ligaments may cause cryptorchidism in the Tfm rat.

Expression of androgen receptor protein within the lumbar spinal cord during ontologic development and following antiandrogen induced cryptorchidism

One of the leading hypotheses regarding androgenic regulation of testicular descent is that the lumbar genitofemoral nucleus is morphologically altered by testosterone during a specific prenatal period. This hypothesis is based on the unproved assumption that androgen receptor is present in the fetal spinal cord. Using immunohistochemistry we identified androgen receptor in the rat lumbar spinal cord on gestational day 15, a day before the onset of maximal androgenic action for testicular descent. Experiments were performed to determine whether alterations in the morphology of the genitofemoral nucleus are associated with flutamide induced cryptorchidism. Studies revealed a reduction of motoneuron number in rats with flutamide induced cryptorchidism (124.2 +/- 18.9) compared to rats exposed to flutamide without cryptorchidism (269.3 +/- 20.2) and/or male controls (291.0 +/- 14.5, p < 0.01). These findings support the hypothesis that androgens can directly regulate development and morphology of the genitofemoral nucleus.

Epidermal growth factor reverses antiandrogen induced cryptorchidism and epididymal development

Epidermal growth factor, an androgen responsive paracrine factor, administered to pregnant mice has been reported to result in persistent wolffian ducts in female offspring. This fact led us to investigate whether epidermal growth factor can reverse the undescended testes and epididymal abnormalities associated with time specific flutamide administration. Timed pregnant Sprague-Dawley rats were treated with flutamide (undescended testes 74% and epididymal anomalies 53%) or flutamide plus epidermal growth factor (undescended testes 24% and epididymal anomalies 9%). The decrease in undescended testes and epididymal abnormalities following epidermal growth factor treatment was significant at p < 0.01. We performed immunohistological studies to evaluate whether flutamide alters epidermal growth factor expression in the paratesticular tissues during the time of maximal androgenic activity. These investigations revealed that antiandrogens did not alter epidermal growth factor expression in the fetal testes or epididymides. This finding suggests that epidermal growth factor does not reverse epididymal abnormalities or undescended testes by direct stimulation of the wolffian ducts or fetal testis.