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Liu L, Huang W, Luo K, Zeng Y, Shao Y, Long Z. Relationship between semen parameters, serum InhB, and INSL-3 levels, and the degree of varicocele. Clinics (Sao Paulo) 2024; 79:100339. [PMID: 38330789 PMCID: PMC10864834 DOI: 10.1016/j.clinsp.2024.100339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/12/2023] [Accepted: 01/18/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Varicocele is an abnormal expansion of the pampininias venous plexus in the scrotum, resulting in impaired sperm production and reduced sperm quality. The exact pathophysiological mechanism leading to varicocele-related infertility has not been fully elucidated. Although treatable, varicocele may lead to male infertility. OBJECTIVE To investigate the relationship between semen parameters, serum InhB and INSL-3 levels, and the degree of varicocele in male patients. METHODS Serum InhB and INSL-3 were detected. To evaluate the relationship between semen parameters and serum InhB and INSL-3 levels. To evaluate the value of semen parameters and serum InhB and INSL-3 levels in distinguishing disease severity in patients with varicocele. RESULTS Serum INSL-3 in patients with varicocele decreased with the severity of the disease. Serum INSL-3 was positively correlated with total sperm count and frequency of normal sperm morphology. There was a weak correlation between serum InhB and semen volume, concentration, and total sperm. Patients with different disease severity were similar within the groups, with partial overlap or similarity between varicocele Grade I and Grade II, and significant differences between Grade III and Grade I and II. Semen volume, concentration, total sperm, normal sperm morphology, and serum InhB and INSL-3 levels could distinguish the degree of varicocele. CONCLUSION Semen parameters and the combination of serum InhB and INSL-3 levels in patients with varicocele are closely related to the severity of the disease. Serum INSL-3 is expected to be a potential biomarker for early clinical intervention.
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Affiliation(s)
- Lei Liu
- Department of Urinary Surgery, The First people's hospital of Zunyi City (The third affiliated hospital of Zunyi Medical University), Zunyi, Guizhou Province, China
| | - WenJie Huang
- Department of Urinary Surgery, The First people's hospital of Zunyi City (The third affiliated hospital of Zunyi Medical University), Zunyi, Guizhou Province, China.
| | - KeBing Luo
- Department of Urinary Surgery, The First people's hospital of Zunyi City (The third affiliated hospital of Zunyi Medical University), Zunyi, Guizhou Province, China
| | - YiZhou Zeng
- Department of Urinary Surgery, The First people's hospital of Zunyi City (The third affiliated hospital of Zunyi Medical University), Zunyi, Guizhou Province, China
| | - YunHao Shao
- Department of Urinary Surgery, The First people's hospital of Zunyi City (The third affiliated hospital of Zunyi Medical University), Zunyi, Guizhou Province, China
| | - ZongMin Long
- Department of Urinary Surgery, The First people's hospital of Zunyi City (The third affiliated hospital of Zunyi Medical University), Zunyi, Guizhou Province, China
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Орешкина ЕМ, Болотова НВ, Пылаев ТЕ, Аверьянов АП, Райгородская НЮ. [Hormonal and genetic causes of cryptorchidism]. PROBLEMY ENDOKRINOLOGII 2023; 69:99-106. [PMID: 37968957 PMCID: PMC10680546 DOI: 10.14341/probl13242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/28/2023] [Accepted: 04/28/2023] [Indexed: 11/17/2023]
Abstract
Cryptorchidism is the most frequent congenital disorders of the reproductive system, is present in 2-3% of term newborn boys. Genes involved in embryonic testicular migration are known but their role in cryptorchidism development are not investigated enough. Genetical causes of cryptorchidism are identified in 5-7% of patients. The article contains data on the role of insulin-like peptide 3 and its receptor, anti-Müllerian hormone, gonadotropins, androgens in embryonic testicular migration. INSL3 and AMH are presented as markers of testicular dysfunction associated with cryptorchidism. Hypogonadotropic hypogonadism is also associated with cryptorchidism and can be diagnosed based on it. Results of modern investigations determine the necessary of hormonal and genetical examination of patients with isolated cryptorchidism to detect causes of cryptorchidism and manage of patients.
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Affiliation(s)
- Е. М. Орешкина
- Саратовский государственный медицинский университет им. В.И. Разумовского
| | - Н. В. Болотова
- Саратовский государственный медицинский университет им. В.И. Разумовского
| | - Т. Е. Пылаев
- Саратовский государственный медицинский университет им. В.И. Разумовского
| | - А. П. Аверьянов
- Саратовский государственный медицинский университет им. В.И. Разумовского
| | - Н. Ю. Райгородская
- Саратовский государственный медицинский университет им. В.И. Разумовского
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Lăptoiu AR, Spoială EL, Stanciu GD, Hanganu E, Lupu VV, Ciongradi CI, Gavrilovici C. New Insights into the Role of INSL-3 in the Development of Cryptorchidism. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040737. [PMID: 37189986 DOI: 10.3390/children10040737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/09/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023]
Abstract
Cryptorchidism, defined as the failure of at least one or both testicles to descend into the scrotal pouches, is the most frequent (1.6-9% at birth, 1/20 males at birth) congenital anomaly encountered in newborn males, resulting in one of the most frequent causes of non-obstructive azoospermia in men. Similar to other congenital malformations, cryptorchidism is thought to be caused by endocrine and genetic factors, combined with maternal and environmental influences. The etiology of cryptorchidism is unknown, as it involves complex mechanisms aiming to control the testicular development and descent from their initial intra-abdominal location in scrotal pouches. The implication of insulin-like 3 (INSL-3) associated with its receptor (LGR8) is critical. Genetic analysis discloses functionally deleterious mutations in INSL3 and GREAT/LGR8 genes. In this literature review, we discuss and analyze the implication of INSL3 and the INSL3/LGR8 mutation in the occurrence of cryptorchidism in both human and animal models.
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Affiliation(s)
- Alma-Raluca Lăptoiu
- Pediatrics Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena-Lia Spoială
- Pediatrics Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Gabriela Dumitrita Stanciu
- Advanced Research and Development Center for Experimental Medicine (CEMEX), "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Elena Hanganu
- Department of Biomedical Sciences, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Department of Pediatric and Orthopaedic Surgery, "Sfânta Maria" Emergency Children Hospital, 700309 Iași, Romania
| | - Vasile Valeriu Lupu
- Pediatrics Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Carmen-Iulia Ciongradi
- Department of Pediatric and Orthopaedic Surgery, "Sfânta Maria" Emergency Children Hospital, 700309 Iași, Romania
- 2nd Department of Surgery and Ortophedics, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Cristina Gavrilovici
- Pediatrics Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
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Esteban-Lopez M, Wilson KJ, Myhr C, Kaftanovskaya EM, Henderson MJ, Southall NT, Xu X, Wang A, Hu X, Barnaeva E, Ye W, George ER, Sherrill JT, Ferrer M, Morello R, Agoulnik IU, Marugan JJ, Agoulnik AI. Discovery of small molecule agonists of the Relaxin Family Peptide Receptor 2. Commun Biol 2022; 5:1183. [PMCID: PMC9636434 DOI: 10.1038/s42003-022-04143-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
The relaxin/insulin-like family peptide receptor 2 (RXFP2) belongs to the family of class A G-protein coupled receptors (GPCRs) and it is the only known target for the insulin-like factor 3 peptide (INSL3). The importance of this ligand-receptor pair in the development of the gubernacular ligament during the transabdominal phase of testicular descent is well established. More recently, RXFP2 has been implicated in maintaining healthy bone formation. In this report, we describe the discovery of a small molecule series of RXFP2 agonists. These compounds are highly potent, efficacious, and selective RXFP2 allosteric agonists that induce gubernacular invagination in mouse embryos, increase mineralization activity in human osteoblasts in vitro, and improve bone trabecular parameters in adult mice. The described RXFP2 agonists are orally bioavailable and display favorable pharmacokinetic properties, which allow for future evaluation of the therapeutic benefits of modulating RXFP2 activation in disease models. Specific small molecule RXFP2 agonists with favorable pharmacokinetic properties induce gubernacular invagination in mouse embryos, increase mineralization activity in human osteoblasts in vitro, and improve bone trabecular parameters in adult mice.
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Affiliation(s)
- Maria Esteban-Lopez
- grid.65456.340000 0001 2110 1845Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL USA
| | - Kenneth J. Wilson
- grid.94365.3d0000 0001 2297 5165Early Translation Branch, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD USA
| | - Courtney Myhr
- grid.65456.340000 0001 2110 1845Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL USA
| | - Elena M. Kaftanovskaya
- grid.65456.340000 0001 2110 1845Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL USA
| | - Mark J. Henderson
- grid.94365.3d0000 0001 2297 5165Early Translation Branch, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD USA
| | - Noel T. Southall
- grid.94365.3d0000 0001 2297 5165Early Translation Branch, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD USA
| | - Xin Xu
- grid.94365.3d0000 0001 2297 5165Early Translation Branch, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD USA
| | - Amy Wang
- grid.94365.3d0000 0001 2297 5165Early Translation Branch, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD USA
| | - Xin Hu
- grid.94365.3d0000 0001 2297 5165Early Translation Branch, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD USA
| | - Elena Barnaeva
- grid.94365.3d0000 0001 2297 5165Early Translation Branch, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD USA
| | - Wenjuan Ye
- grid.94365.3d0000 0001 2297 5165Early Translation Branch, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD USA
| | - Emmett R. George
- grid.94365.3d0000 0001 2297 5165Early Translation Branch, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD USA
| | - John T. Sherrill
- grid.241054.60000 0004 4687 1637Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Marc Ferrer
- grid.94365.3d0000 0001 2297 5165Early Translation Branch, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD USA
| | - Roy Morello
- grid.241054.60000 0004 4687 1637Department of Physiology & Cell Biology, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Irina U. Agoulnik
- grid.65456.340000 0001 2110 1845Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL USA ,grid.65456.340000 0001 2110 1845Biomolecular Sciences Institute, Florida International University, Miami, FL USA
| | - Juan J. Marugan
- grid.94365.3d0000 0001 2297 5165Early Translation Branch, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD USA
| | - Alexander I. Agoulnik
- grid.65456.340000 0001 2110 1845Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL USA ,grid.65456.340000 0001 2110 1845Biomolecular Sciences Institute, Florida International University, Miami, FL USA
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Ivell R, Mamsen LS, Andersen CY, Anand-Ivell R. Expression and Role of INSL3 in the Fetal Testis. Front Endocrinol (Lausanne) 2022; 13:868313. [PMID: 35464060 PMCID: PMC9019166 DOI: 10.3389/fendo.2022.868313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/14/2022] [Indexed: 11/16/2022] Open
Abstract
Insulin-like peptide 3 (INSL3) is a small peptide hormone of the insulin-relaxin family which is produced and secreted by the fetal Leydig cells in the testes only. It appears to be undetectable in female fetuses. In the human fetus INSL3 synthesis begins immediately following gonadal sex determination at weeks 7 to 8 post coitum and the peptide can be detected in amniotic fluid 1 to 2 weeks later. INSL3 acts through a unique G-protein-coupled receptor, called RelaXin-like Family Peptide receptor 2 (RXFP2), which is expressed by the mesenchymal cells of the gubernacular ligament linking the testes to the inguinal wall. The role of INSL3 in the male fetus is to cause a thickening of the gubernaculum which then retains the testes in the inguinal region, while the remainder of the abdominal organs grow away in an antero-dorsal direction. This represents the first phase of testis descent and is followed later in pregnancy by the second inguino-scrotal phase whereby the testes pass into the scrotum through the inguinal canal. INSL3 acts as a significant biomarker for Leydig cell differentiation in the fetus and may be reduced by maternal exposure to endocrine disrupting chemicals, such as xenoestrogens or phthalates, leading to cryptorchidism. INSL3 may have other roles within the fetus, but as a Leydig cell biomarker its reduction acts also as a surrogate for anti-androgen action.
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Affiliation(s)
- Richard Ivell
- School of Bioscience, University of Nottingham, Sutton Bonington, United Kingdom
| | - Linn Salto Mamsen
- Laboratory of Reproductive Biology, Section 5712, Juliane Marie Centre for Women, Children and Reproduction, Rigshospitalet, University Hospital of Copenhagen, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Claus Yding Andersen
- Laboratory of Reproductive Biology, Section 5712, Juliane Marie Centre for Women, Children and Reproduction, Rigshospitalet, University Hospital of Copenhagen, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ravinder Anand-Ivell
- School of Bioscience, University of Nottingham, Sutton Bonington, United Kingdom
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Swee DS, Quinton R. Current concepts surrounding neonatal hormone therapy for boys with congenital hypogonadotropic hypogonadism. Expert Rev Endocrinol Metab 2022; 17:47-61. [PMID: 34994276 DOI: 10.1080/17446651.2022.2023008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 12/22/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Congenital hypogonadotropic hypogonadism (CHH) is a genetic disorder of reproduction and development, characterized by deficient gonadotropin-releasing hormone (GnRH) secretion or action, affecting 1-in-4,000-15,000 males. Micropenis and undescended testes are cardinal features of antenatal GnRH deficiency and could indicate absent minipuberty in the first postnatal months. In this review, we outline the pathophysiology and clinical consequences of absent minipuberty and its implications for optimal approaches to the endocrine management of affected boys. AREAS COVERED Deficient GnRH activity during fetal development and neonatal-infancy phase of minipuberty accounts for the diminished mass of Sertoli cells and seminiferous tubules among CHH males, enduring impairment of reproductive function even during gonadotropin replacement in adult life. In overcoming this obstacle, several clinical studies of neonatal gonadotropin replacement have consistently shown positive results in inducing testicular development and correcting cryptorchidism. EXPERT OPINION A high index of clinical suspicion, combined with hormonal testing undertaken in the postnatal period of 1-4 months, can reliably confirm or refute the diagnosis of CHH. Timely identification of CHH in affected male infants (having characteristic "red flag' developmental anomalies) opens up the possibility for gonadotropin replacement as a targeted therapy to restore the normal hormonal milieu of minipuberty. Further work is necessary in formulating optimal gonadotropin treatment regimens to be more widely adopted in clinical practice.
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Affiliation(s)
- Du Soon Swee
- Department of Endocrinology, Singapore General Hospital, Singapore, Singapore
| | - Richard Quinton
- Department of Endocrinology, Diabetes & Metabolism Royal Victoria Infirmary, Newcastle-Upon-Tyne Hospitals, Newcastle-upon-Tyne, UK
- Translational & Clinical Research Institute, University of Newcastle-upon-Tyne, Newcastle-Upon-Tyne, UK
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Punjani N, Lamb DJ. Male infertility and genitourinary birth defects: there is more than meets the eye. Fertil Steril 2020; 114:209-218. [PMID: 32741459 PMCID: PMC10590568 DOI: 10.1016/j.fertnstert.2020.06.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/24/2020] [Accepted: 06/24/2020] [Indexed: 12/17/2022]
Abstract
Male factor infertility is a significant problem present in up to 50% of infertile couples. The relationship between male infertility and systemic disease is of significant interest, and emerging evidence suggests a relationship between male infertility and male genitourinary (GU) birth defects (cryptorchidism, hypospadias, ambiguous genitalia, and congenital anomalies of the kidney and urinary tract). Many of these birth defects are treated in isolation by busy urologists without acknowledgment that these may be related to more global syndromic conditions. Conversely, geneticists and nonurologists who treat variable systemic phenotypes may overlook GU defects, which are indeed related conditions. Many of these defects are attributed to copy number variants dosage-sensitive genes due to chromosome microdeletions or microduplications. These variants are responsible for disease phenotypes seen in the general population. The copy number variants described in this review are syndromic in some cases and responsible for both GU birth defects as well as other systemic phenotypes. This review highlights the emerging evidence between these birth defects, male infertility, and other systemic conditions.
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Affiliation(s)
- Nahid Punjani
- James Buchanan Brady Foundation Institute of Urology, Weill Cornell Medical College, New York, New York
| | - Dolores J Lamb
- James Buchanan Brady Foundation Institute of Urology, Weill Cornell Medical College, New York, New York; Englander Institute for Precision Medicine, Weill Cornell Medical College, New York, New York; Center for Reproductive Genomics, Weill Cornell Medical College, New York, New York.
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Bizzarri C, Cappa M. Ontogeny of Hypothalamus-Pituitary Gonadal Axis and Minipuberty: An Ongoing Debate? Front Endocrinol (Lausanne) 2020; 11:187. [PMID: 32318025 PMCID: PMC7154076 DOI: 10.3389/fendo.2020.00187] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/17/2020] [Indexed: 12/13/2022] Open
Abstract
The fetal hypothalamus-pituitary gonadal (HPG) axis begins to function during mid-gestation but its activity decreases during late pregnancy due to the suppressive effects of placental estrogens. Placental hormones drop immediately after birth, FSH and LH surge at around 1 week and peak between 1 and 3 months of life. The HPG axis is activated in both sexes, but a sexual dimorphism is evident with higher LH values in boys, while FSH prevails in girls. Both gonadotrophins decline in boys by around 6 months of age. In girls, LH declines at the same time as in boys, while FSH persists elevated up to 3 or 4 years of age. As a result of gonadotropin activation, testicular testosterone increases in males and ovarian estradiol rises in females. These events clinically translate into testicular and penile growth in boys, enlargement of uterus and breasts in girls. The functional impact of HPG axis activity in infancy on later reproductive function is uncertain. According to the perinatal programming theory, this period may represent an essential programming process. In boys, long-term testicular hormonal function and spermatogenesis seem to be, at least in part, regulated by minipuberty. On the contrary, the role of minipuberty in girls is still uncertain. Recently, androgen exposure during minipuberty has been correlated with later sex-typed behavior. Premature and/or SGA infants show significant differences in postnatal HPG axis activity in comparison to full-term infants and the consequences of these differences on later health and disease require further research. The sex-dimorphic HPG activation during mid-gestation is probably responsible for the body composition differences observed ad birth between boys and girls, with boys showing greater total body mass and lean mass, and a lower proportion of fat mass. Testosterone exposure during minipuberty further contributes to these differences and seems to be responsible for the significantly higher growth velocity observed in male infants. Lastly, minipuberty is a valuable "window of opportunity" for differential diagnosis of disorders of sex development and it represents the only time window before puberty when congenital hypogonadism can be diagnosed by the simple analysis of basal gonadotropin and gonadal hormone levels.
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