Lower testosterone levels are associated with higher risk of death in men

Disease diagnosis and application analysis of molecularly imprinted polymers (MIPs) in saliva detection

Saliva has significantly evolved as a diagnostic fluid in recent years, giving a non-invasive alternative to blood analysis. A high protein concentration in saliva is delivered directly from the bloodstream, making it a "human mirror" that reflects the body's physiological state. It plays an essential role in detecting diseases in biomedical and fitness monitoring. Molecularly imprinted polymers (MIPs) are biomimetic materials with custom-designed synthetic recognition sites that imitate biological counterparts renowned for sensitive analyte detection. This paper reviews the progress made in research about MIP biosensors for detecting saliva biomarkers. Specifically, we investigate the link between saliva biomarkers and various diseases, providing detailed insights into the corresponding biosensors. Furthermore, we discuss the principles of molecular imprinting for disease diagnostics and application analysis, including recent advances in integrated MIP-sensor technologies for high-affinity analyte detection in saliva. Notably, these biosensors exhibit high discrimination, allowing for the detection of saliva biomarkers linked explicitly to chronic stress disorders, diabetes, cancer, bacterial or viral-induced illnesses, and exposure to illicit toxic substances or tobacco smoke. Our findings indicate that MIP-based biosensors match and perhaps surpass their counterparts featuring integrated natural antibodies in terms of stability, signal-to-noise ratios, and detection limits. Additionally, we highlight the design of MIP coatings, strategies for synthesizing polymers, and the integration of advanced biodevices. These tailored biodevices, designed to assess various salivary biomarkers, are emerging as promising screening or diagnostic tools for real-time monitoring and self-health management, improving quality of life.

Testosterone is positively associated with coronary artery calcium in a low cardiovascular disease risk population

Background

In industrialized populations, low male testosterone is associated with higher rates of cardiovascular mortality. However, coronary risk factors like obesity impact both testosterone and cardiovascular outcomes. Here, we assess the role of endogenous testosterone on coronary artery calcium in an active subsistence population with relatively low testosterone levels, low cardiovascular risk and low coronary artery calcium scores.

Methodology

In this cross-sectional community-based study, 719 Tsimane forager-horticulturalists in the Bolivian Amazon aged 40+ years underwent computed tomography (49.8% male, mean age 57.6 years).

Results

Coronary artery calcium levels were low; 84.5% had no coronary artery calcium. Zero-inflated negative binomial models found testosterone was positively associated with coronary artery calcium for the full sample (Incidence Rate Ratio [IRR] = 1.477, 95% Confidence Interval [CI] 1.001-2.170, P = 0.031), and in a male-only subset (IRR = 1.532, 95% CI 0.993-2.360, P = 0.053). Testosterone was also positively associated with clinically relevant coronary atherosclerosis (calcium >100 Agatston units) in the full sample (Odds Ratio [OR] = 1.984, 95% CI 1.202-3.275, P = 0.007) and when limited to male-only sample (OR = 2.032, 95% CI 1.118-4.816, P = 0.024). Individuals with coronary artery calcium >100 had 20% higher levels of testosterone than those with calcium <100 (t = -3.201, P = 0.007).

Conclusions and Implications

Among Tsimane, testosterone is positively associated with coronary artery calcium despite generally low normal testosterone levels, minimal atherosclerosis and rare cardiovascular disease (CVD) events. Associations between low testosterone and CVD events in industrialized populations are likely confounded by obesity and other lifestyle factors.

CYP19A1 mediates severe SARS-CoV-2 disease outcome in males

Male sex represents one of the major risk factors for severe COVID-19 outcome. However, underlying mechanisms that mediate sex-dependent disease outcome are as yet unknown. Here, we identify the CYP19A1 gene encoding for the testosterone-to-estradiol metabolizing enzyme CYP19A1 (also known as aromatase) as a host factor that contributes to worsened disease outcome in SARS-CoV-2-infected males. We analyzed exome sequencing data obtained from a human COVID-19 cohort (n = 2,866) using a machine-learning approach and identify a CYP19A1-activity-increasing mutation to be associated with the development of severe disease in men but not women. We further analyzed human autopsy-derived lungs (n = 86) and detect increased pulmonary CYP19A1 expression at the time point of death in men compared with women. In the golden hamster model, we show that SARS-CoV-2 infection causes increased CYP19A1 expression in the lung that is associated with dysregulated plasma sex hormone levels and reduced long-term pulmonary function in males but not females. Treatment of SARS-CoV-2-infected hamsters with a clinically approved CYP19A1 inhibitor (letrozole) improves impaired lung function and supports recovery of imbalanced sex hormones specifically in males. Our study identifies CYP19A1 as a contributor to sex-specific SARS-CoV-2 disease outcome in males. Furthermore, inhibition of CYP19A1 by the clinically approved drug letrozole may furnish a new therapeutic strategy for individualized patient management and treatment.