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Rajmil O, Moreno-Sepulveda J. Recovery of spermatogenesis after androgenic anabolic steroids abuse in men. A systematic review of the literature. Actas Urol Esp 2024; 48:116-124. [PMID: 37567343 DOI: 10.1016/j.acuroe.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/10/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVE This systematic review aims to evaluate the optimal treatment for male infertility resulting from Anabolic Androgenic Steroids (AAS) abuse. METHODS A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies that compared different protocols for the recovery of spermatogenesis in patients after AAS use were included. RESULTS 13 studies investigating different protocols to restore spermatogenesis in patients with AAS abuse met the inclusion criteria. The available agents that showed restoration of spermatogenesis include injectable gonadotropins, selective estrogen receptor modulators, and aromatase inhibitors, but their use is still poorly described in the literature. CONCLUSIONS Clinicians need to be aware of the detrimental effects of AAS on spermatogenesis. AAS-associated infertility may be reversible, but sperm production may take over a year to normalize. Both conservative and aggressive treatment can boost spermatogenesis with positive results. Further understanding of male reproductive endocrinology and high-quality data on the field of restoration of spermatogenesis after AAS abuse are warranted.
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Affiliation(s)
- O Rajmil
- Servicio de Andrología, Fundació Puigvert, Barcelona, Spain; Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - J Moreno-Sepulveda
- Departmento de Obstetricia y Ginecología, Universitat Autònoma de Barcelona, Campus Universitario UAB, Barcelona, Spain; Clínica de la Mujer y Medicina Reproductiva, Viña del Mar, Chile.
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Mohammadzadeh M, Montazeri F, Poodineh J, Vatanparast M, Rahmanian Koshkaki E, Ghasemi Esmailabad S, Mohseni F, Talebi AR. Therapeutic potential of testosterone on sperm parameters and chromatin status in fresh and thawed normo and asthenozoospermic samples. Rev Int Androl 2023; 21:100352. [PMID: 37244225 DOI: 10.1016/j.androl.2023.100352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/02/2022] [Accepted: 03/18/2022] [Indexed: 05/29/2023]
Abstract
BACKGROUND Hormonal changes alter the physiological level of ROS and cause oxidative stress in the cell. As estimated, hormonal deficiencies, environmental and ideological factors make up about 25% of male infertility. Pathogenic reactive oxygen species (ROS) is a chief cause of unexplained infertility. Limited studies exist on the effects of testosterone on human sperm culture. Therefore, in the current study, the effect of different doses of testosterone on sperm parameters and chromatin quality was investigated. MATERIALS AND METHODS Semen samples from 15 normospermic and 15 asthenospermic patients were prepared by swim up method, and then were divided into four groups by exposing to different concentrations of testosterone (1, 10, and 100nM) for 45min. Samples without any intervention were considered as control group. All samples were washed twice. Sperm parameters and chromatin protamination were assessed in each group and the remains were frozen. After two weeks, all tests were repeated for sperm thawed. Also, the MSOM technique was used to determine the sperm morphology of class 1. RESULTS Although sperm parameters were not show any significant differences in normospermic and asthenospermic samples exposed to different concentrations of testosterone before and after freezing, chromatin protamination was significantly decreased in the normospermic samples exposed to 10nM of testosterone before freezing (p<0.006), as well as 1 and 10nM of testosterone after freezing compared to control samples (p=0.001 and p=0.0009, respectively). Similarly, chromatin protamination in the asthenospermic samples was significantly decreased at concentration of 1nM of testosterone before and after freezing (p=0.0014 and p=0.0004, respectively), and at concentration of 10nM of testosterone before and after freezing (p=0.0009, p=0.0007) compared to control samples. CONCLUSION Using a low dose of testosterone in the sperm culture medium, has positive effects on chromatin quality.
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Affiliation(s)
- Masoomeh Mohammadzadeh
- Department of Reproductive Biology, Yazd Reproductive Sciences Institute, Research and Clinical Center for Infertility, and Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fateme Montazeri
- Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Jafar Poodineh
- Department of Clinical Biochemistry, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Mahboubeh Vatanparast
- Molecular Medicine Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Elham Rahmanian Koshkaki
- Anatomy and Embryology Department, Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Saeed Ghasemi Esmailabad
- Department of Reproductive Biology, Yazd Reproductive Sciences Institute, Research and Clinical Center for Infertility, and Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Mohseni
- Department of Anesthesiology, Nursing School, Gerash University of Medical Sciences, Gerash, Iran
| | - Ali Reza Talebi
- Department of Reproductive Biology, Yazd Reproductive Sciences Institute, Research and Clinical Center for Infertility, and Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Mendonça F, Souto S, Dória S, Carvalho D. Klinefelter syndrome: The characterization of the clinical and sociological features of 51 patients. Rev Int Androl 2023; 21:100349. [PMID: 37054629 DOI: 10.1016/j.androl.2023.100349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/10/2022] [Indexed: 04/15/2023]
Abstract
INTRODUCTION Klinefelter syndrome is the most frequently found aneuploidy among male patients. Its clinical presentation is very heterogeneous, and thus poses a challenge for a timely diagnosis. METHODS A retrospective study was carried out with 51 consecutively selected patients diagnosed with Klinefelter Syndrome from Jan/2010 to Dec/2019. The karyotypes were identified using high resolution GTL banding at the Genetics Department. Multiple clinical and sociological parameters were studied by collecting data from the clinical records. RESULTS 44 (86%) of the 51 patients presented a classical karyotype (47,XXY) and 7 (14%) showed evidence of mosaicism. The mean age at diagnosis was 30.2±14.3 years old. Regarding the level of education (N=44), 26 patients (59.1%) had no secondary education, with 5 (11.4%) patients having concluded university studies. Almost two thirds of the sample revealed learning difficulties (25/38) and some degree of intellectual disability was present in 13.6% (6/44). Half of the patients were either non-qualified workers (19.6%) or workers in industry, construction, and trades (30.4%), which are jobs that characteristically require a low level of education. The proportion of unemployed patients was 6.5%. The main complaints were infertility (54.2%), followed by hypogonadism-related issues (18.7%) and gynecomastia (8.3%). 10 patients (23.8%, N=42) were biological parents. With regards the question of fertility, assisted reproductive techniques were used in 39.6% of the studied subjects (N=48), with a success rate (a take home baby) of 57.9% (11/19), 2 with donor sperm and 9 with the patients' own gametes. Only 41% of the patients (17/41) were treated with testosterone. CONCLUSION This study identifies the most important clinical and sociological findings of Klinefelter syndrome patients that should be considered when deciding workout and disease management.
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Affiliation(s)
- Fernando Mendonça
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar e Universitário de S. João, Faculty of Medicine, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal; i3s - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal.
| | - Selma Souto
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar e Universitário de S. João, Faculty of Medicine, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal; i3s - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal
| | - Sofia Dória
- i3s - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal; Department of Genetics, Faculdade de Medicina da Universidade do Porto, Portugal
| | - Davide Carvalho
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar e Universitário de S. João, Faculty of Medicine, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal; i3s - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal
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Casals G, Ferrer Costa R, Urgell Rull E, Escobar-Morreale HF, Argente J, Sesmilo G, Biagetti B. Executive summary of the position statement of the Spanish Societies SEQC ML/SEEN/SEEP. Recommendations for the measurement of sex steroids in clinical practice. ENDOCRINOL DIAB NUTR 2023; 70 Suppl 1:103-109. [PMID: 36894451 DOI: 10.1016/j.endien.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 03/09/2023]
Abstract
Accurate measurement of sex steroids, particularly testosterone and estradiol, is relevant for the diagnosis and treatment of a wide range of conditions. Unfortunately, current chemiluminescent immunoassays have analytical limitations with important clinical consequences. This document reviews the current state of clinical assays for estradiol and testosterone measurements and their potential impact in different clinical situations. It also includes a series of recommendations and necessary steps to introduce steroid analysis by mass spectrometry into national health systems, a methodology recommended for more than a decade by international societies.
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Affiliation(s)
- Gregori Casals
- Servicio de Bioquímica y Genética Molecular, Hospital Clínic, IDIBAPS, CIBERHD, Universitat de Barcelona, Barcelona, Spain.
| | - Roser Ferrer Costa
- Servicio de Bioquímica, Laboratoris Clínics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eulàlia Urgell Rull
- Servicio de Bioquímica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Héctor F Escobar-Morreale
- Servicio de Endocrinología y Nutrición, Hospital Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, CIBER Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Madrid, Spain
| | - Jesús Argente
- Departamento de Pediatría y Endocrinología Pediátrica, Hospital Infantil Universitario Niño Jesús, Universidad Autónoma de Madrid, CIBEROBN, Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Sesmilo
- Servicio de Endocrinología y Nutrición, Hospital Universitari Dexeus, Barcelona, Spain
| | - Betina Biagetti
- Servicio de Endocrinología y Nutrición, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Espitia De La Hoz FJ. [Efficacy and safety of testosterone in the treatment of hypoactive sexual desire in women: what does the evidence say?]. Rev Int Androl 2023; 21:100328. [PMID: 36347772 DOI: 10.1016/j.androl.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/19/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine the efficacy and safety of testosterone in the treatment of hypoactive sexual desire in women. MATERIALS AND METHODS A systematic review of the literature was carried out in different electronic databases (CINAHL, DynaMed, EMBASE, Lilacs, Medline, Scopus, among others), between January 1990 and May 2021; through standardized search terms. The outcomes evaluated included the efficacy and safety of testosterone in increasing sexual desire, the total number of satisfactory sexual activity, the number of orgasms and the level of distress in patients with hypoactive sexual desire and the proportion of adverse reactions. RESULTS 72 articles were included. The use of testosterone, in postmenopausal women, with hypoactive sexual desire, reports a positive effect on sexual function, with significant increases in satisfactory sexual activity, as well as improvement in all domains of sexual function (desire, arousal and orgasmic response) and a decrease in personal anguish, with an increase in the Female Sexual Function Index score. In women of childbearing age, testosterone is formulated for "off-label" use, in such a way that compounds and doses designed for treatments in men or magisterial formulas are used (which are not approved by consensus groups or endorsed by research), but has not shown any effect on sexual function. The most frequent adverse reactions are usually hirsutism and acne, although in general testosterone, at physiological doses, has a favorable safety profile. CONCLUSIONS Testosterone is an effective and safe therapy in the treatment of hypoactive sexual desire disorder in women after menopause. Currently there are no studies available to support the use of testosterone therapy in women of reproductive age, therefore, its use is not approved.
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Affiliation(s)
- Franklin José Espitia De La Hoz
- Ginecología y Obstetricia, Universidad Militar Nueva Granada, Bogotá, Colombia; Sexología Clínica, Universidad de Alcalá de Henares, Madrid, España; Uroginecología, FUCS, Hospital de San José, Unicamp, Brasil; Hathor, Clínica Sexológica, Armenia, Colombia.
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Peralta-Amaro AL, Pecero-García EI, Valadez-Calderón JG, Ramírez-Ventura JC, Coria-Moctezuma LA, Hernández-Utrera JE. Low testosterone levels as an independent risk factor for mortality in male patients with COVID-19: Report of a Single-Center Cohort Study in Mexico. Rev Int Androl 2023; 21:100329. [PMID: 36266232 PMCID: PMC9576254 DOI: 10.1016/j.androl.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/06/2021] [Accepted: 11/22/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND OBJECTIVES Throughout the coronavirus disease 2019 (COVID-19) pandemic, a greater severity and lethality of the disease has been highlighted in male patients, so we set out to evaluate the prognostic role of serum testosterone levels in the clinical results of this population. METHODS In this single-center and cross-sectional design, we included male patients admitted to our hospital with COVID-19 confirmed diagnosis. The biochemical analysis included lymphocytes, lactate dehydrogenase (LDH), total testosterone (TT), dehydroepiandrosterone, follicle-stimulating hormone, and luteinizing hormone. Receiver operating characteristic curves, univariate and bivariate analysis, and binary logistic regression for multivariate analysis were performed. A p value<0.05 was consider significant. RESULTS From 86 men included, 48.8% died. TT levels were lower in non-survivor patients than in survivor patients (4.01nmol/L [0.29-14.93] vs 5.41 (0.55-25.08) nmol/L, p=0.021). The independent risk factors that increased the relative risk (RR) of dying from COVID-19 were: age>59 years (RR 3.5 [95% IC 1.0-11.6], p=0.045), TT levels<4.89nmol/L (RR 4.0 [95% IC 1.2-13.5], p=0.027) and LDH levels>597IU/L (RR 3.9 [95% IC 1.2-13.1], p=0.024). Patients who required mechanical ventilation (p=0.025), had lymphopenia (p=0.013) and LDH levels>597IU/L (p=0.034), had significantly lower TT levels compared to those who did not present these conditions. There were no differences in TT levels between patients who had or did not have comorbidities. CONCLUSIONS A TT level<4.89nmol/L increase four times the RR of death from COVID-19 in men, regardless of age or presence of comorbidities.
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Affiliation(s)
- Ana Lilia Peralta-Amaro
- M.D. Internal Medicine Department, Hospital de Especialidades Centro Médico Nacional "La Raza", Instituto Mexicano del Seguro Social, Mexico City, Mexico; Division of Postgraduate Studies, Universidad Nacional Autónoma de México, Mexico City, Mexico.
| | - Emily Itzel Pecero-García
- M.D. Internal Medicine Department, Hospital de Especialidades Centro Médico Nacional "La Raza", Instituto Mexicano del Seguro Social, Mexico City, Mexico; Division of Postgraduate Studies, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - José Guadalupe Valadez-Calderón
- M.D. Internal Medicine Department, Hospital de Especialidades Centro Médico Nacional "La Raza", Instituto Mexicano del Seguro Social, Mexico City, Mexico; Division of Postgraduate Studies, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Julio César Ramírez-Ventura
- M.D. Internal Medicine Department, Hospital de Especialidades Centro Médico Nacional "La Raza", Instituto Mexicano del Seguro Social, Mexico City, Mexico; Division of Postgraduate Studies, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Luis Alonso Coria-Moctezuma
- M.D. Diagnostic and Treatment Division, Hospital de Especialidades Centro Médico Nacional "La Raza", Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Jaime Enrique Hernández-Utrera
- M.D. Internal Medicine Department, Hospital de Especialidades Centro Médico Nacional "La Raza", Instituto Mexicano del Seguro Social, Mexico City, Mexico
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Ranjbarkohan F, Hamedi S. Chronic minocycline administration improves spermatogenesis in rats. Rev Int Androl 2022; 21:100332. [PMID: 36428214 DOI: 10.1016/j.androl.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 08/30/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Minocycline is a tetracycline with promising protective effects on different organs which are completely distinct from its antibacterial effects. METHODS To evaluate the effects of chronic administration of this agent on histological structure and sperm parameters of testes, forty adult male rats were randomly allocated into 2 equal groups I: control animals and II: treated animal that received 25mg/kg/day minocycline, orally. After 90 days of treatment, serum level of testosterone was assessed as well as sperm count, motility and morphology. Moreover, histological and histomorphometric evaluation of testes was performed including determination of height of the seminiferous germinal epithelium and perpendicular diameter of seminiferous tubules. Numbers of spermatogonia, primary spermatocytes, spermatids, Sertoli and Leydig cells were counted. Johnsen's scoring method was also performed. RESULTS Sperm parameters significantly improved in minocycline-treated animals. Moreover, number of germ cells in different stages of development significantly increased in treatment group as compared to control. This finding was associated with better Johnsen's score and thicker epithelium in seminiferous tubules. However, serum testosterone levels, Leydig and Sertoli cell count as well as tubular diameter did not show significant changes (p>0.05). DISCUSSION Chronic administration of minocycline is associated with improved spermatogenesis and sperm characteristics without affecting steroidogenesis in rats.
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Affiliation(s)
- Farshad Ranjbarkohan
- Department of Veterinary Basic Sciences, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Somayeh Hamedi
- Department of Veterinary Basic Sciences, Karaj Branch, Islamic Azad University, Karaj, Iran.
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Aslan R, Taken K, Erbin A, Alp HH, Eryilmaz R, Sarilar O, Huyut Z. The synergistic effects of testosterone and phophodiesterase-5 inhibitor combination on oxidative stress markers, matrix metalloproteinases and oxidative DNA damage: A randomized controlled experimental study. Rev Int Androl 2022; 20:73-79. [PMID: 35115255 DOI: 10.1016/j.androl.2020.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 10/17/2020] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the effects of combined tadalafil and testosterone usage on oxidative stress, DNA damage and MMPs in testosterone deficiency. METHODS Fifty rats were randomly divided into 5 groups (group-1: sham group-placebo, group-2: bilateral orchiectomy (ORX), group-3: bilateral ORX+tadalafil, group-4: bilateral ORX+testosterone, group-5: bilateral ORX+tadalafil+testosterone). Group-3 received tadalafil (5mg/kg/day, oral). Group-4 was administered testosterone undecanoate (100mg/kg i.m., single dose). Group-5 was administered a combination of tadalafil and testosterone undecanoate. All groups were compared with regard to serum nicotinamide adenine dinucleotide phosphate oxidase-4 (NOX-4), total thiol, matrix metalloproteinase-2 (MMP-2), MMP-3 and MMP-9, tissue inhibitor of metalloproteinases-1 (TIMP-1) and TIMP-2 and 8-hydroxy-2-deoxy guanosine (8-OHdG) levels. RESULTS Total thiol levels of group-2 were significantly lower than the other groups and thiol levels were higher in group-1 and group-5 than in the other groups. NOX4, MMP2 and 9 levels in group-2 were higher than in the other groups. MMP-9 levels in group-5 were lower than in groups 3 and 4 (p=.001). The level of 8-OHdG in groups 2 and 3 was higher than in the other groups (p=.001). In correlation analysis, 8-OHdG, MMP2, and 9 levels were negatively correlated with total thiol, whereas NOX4 and 8-OHdG levels were positively correlated with MMPs values. CONCLUSIONS The combination of testosterone with PDE-5 inhibitor suppresses MMP-9 levels and increases total thiol levels better than testosterone alone and tadalafil alone. Therefore, testosterone can be considered for use with PDE-5 inhibitor from the initial stage in case of testosterone deficiency.
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Affiliation(s)
- Rahmi Aslan
- Department of Urology, Faculty of Medicine, Van Yuzuncu Yıl University, Van, Turkey
| | - Kerem Taken
- Department of Urology, Faculty of Medicine, Van Yuzuncu Yıl University, Van, Turkey
| | - Akif Erbin
- Department of Urology, Haseki Training and Research Hospital, Istanbul, Turkey.
| | - Hamit Hakan Alp
- Department of Biochemistry, Faculty of Medicine, Van Yuzuncu Yıl University, Van, Turkey
| | - Recep Eryilmaz
- Department of Urology, Faculty of Medicine, Van Yuzuncu Yıl University, Van, Turkey
| | - Omer Sarilar
- Department of Urology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Zubeyir Huyut
- Department of Biochemistry, Faculty of Medicine, Van Yuzuncu Yıl University, Van, Turkey
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Peng T, Chen QK, Lun JS, Pratush A, Xiong GM, Huang TW, Hu Z. Isolation and characterization of a marine testosterone-degrading bacterium: Vibrio sp. N3. Rev Argent Microbiol 2018; 51:170-178. [PMID: 30297081 DOI: 10.1016/j.ram.2018.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 05/08/2018] [Accepted: 05/13/2018] [Indexed: 11/29/2022] Open
Abstract
Steroids, including testosterone, estrone, 17β-estradiol, estriol and 17β-ethinyl estradiol, are harmful not only to the population dynamics of aquatic life forms but also to public health. In this study, a marine testosterone-degrading bacterium (strain N3) was isolated from Nanao Island in the South China Sea. In addition, the strain could also use 17β-estradiol (E2), 17β-ethinyl estradiol (EE2), estriol (E3) or cholesterol as a sole carbon source. According to the 16S rRNA gene sequence analysis, strain N3 was identified as Vibrio sp. Further characterization showed that the strain is aerobic, gram-negative, and mobile and exhibits resistance to ampicillin, carbenicillin, penicillin and spectinomycin. For enhancing its capacity of testosterone degradation, the Plackett-Burman factorial design and the central composite design were used to optimize the culture condition. Under optimal conditions, 92% of testosterone was degraded by Vibrio sp. N3 in 48h.
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Affiliation(s)
- Tao Peng
- Department of Biology, Shantou University, Shantou, China
| | - Qing-Kun Chen
- Department of Biology, Shantou University, Shantou, China
| | - Jing-Sheng Lun
- Department of Biology, Shantou University, Shantou, China
| | - Amit Pratush
- Department of Biology, Shantou University, Shantou, China
| | - Guang-Ming Xiong
- Institute of Toxicology and Pharmacology for Natural Scientists, University Medical School Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | - Zhong Hu
- Department of Biology, Shantou University, Shantou, China.
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Font-Jordà A, Gamundí A, Nicolau Llobera MC, Aguilar-Mediavilla E. [Use of the 2D:4D digit ratio as a biological marker of specific language disorders]. An Pediatr (Barc) 2018; 89:361-368. [PMID: 29625804 DOI: 10.1016/j.anpedi.2018.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/09/2018] [Accepted: 02/14/2018] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The finding of biological markers of specific language impairment would facilitate their detection and early intervention. In this sense, the 2D:4D finger ratio is considered an indirect indicator of prenatal exposure to testosterone. Previous studies have related it to linguistic competence and aggressive behaviour, and could be a candidate for a biological marker of language impairment. The aim was to compare the value of the 2D:4D ratio in children with Specific Language Impairment (SLI) with those of children with typical language development, as well as to establish to what extent this biological index correlates with the behaviour (linguistic, cognitive, social,...) in both groups. SUBJECTS AND METHODS 2D:4D ratio, language, cognition and social behaviour were compared in a group of children with SLI (n=15), with a group of children without language difficulties (n=16) of the same age (between 5-8 years), gender (male), and socio-cultural level. RESULTS Children with SLI showed significantly higher values of 2D:4D ratio of the right hand, and a negative correlation between this ratio and their linguistic competence. Although the children with SLI showed impaired adaptive abilities, but not more aggressive behaviour, these measurements did not correlate with the 2D:4D index. Nevertheless, social behaviour correlated with language and cognition competence. CONCLUSIONS A higher value of the biological 2D:4D ration (lower intrauterine exposure to testosterone) seems to be associated with language difficulties in boys with SLI, but not with their behavioural difficulties. Their behavioural difficulties seem to be a consequence of their linguistic difficulties and their level of cognition.
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Affiliation(s)
| | - Antoni Gamundí
- Universitat de les Illes Balears, Palma de Mallorca, España
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Squarza S, Rossi UG, Torcia P, Cariati M. Association between cholesterol gallstones and testosterone replacement therapy in a patient with primary hypogonadism. Rev Gastroenterol Mex (Engl Ed) 2018; 83:205-207. [PMID: 29656844 DOI: 10.1016/j.rgmx.2017.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 08/17/2017] [Accepted: 09/07/2017] [Indexed: 06/08/2023]
Abstract
A 16-year-old boy had a past medical history of primary hypogonadism, due to bilateral anorchia. He presented with gallstones located in the gallbladder and a mild dilatation of the intrahepatic biliary tree. The histology study reported cholesterol gallstones. The patient had been treated with testosterone replacement therapy since infancy. We suggest a possible correlation between testosterone replacement therapy and the presence of cholesterol gallstones.
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Affiliation(s)
- S Squarza
- Departamento de Radiología, ASST Santi Paolo e Carlo, Hospital San Carlo Borromeo, Milán, Italia.
| | - U G Rossi
- Departamento de Radiología, ASST Santi Paolo e Carlo, Hospital San Carlo Borromeo, Milán, Italia; Unidad de Radiología Intervencionista Hospital Galliera, Mura delle Cappuccine 14, Génova
| | - P Torcia
- Departamento de Radiología, ASST Santi Paolo e Carlo, Hospital San Carlo Borromeo, Milán, Italia
| | - M Cariati
- Departamento de Radiología, ASST Santi Paolo e Carlo, Hospital San Carlo Borromeo, Milán, Italia
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Comas I, Ferrer R, Planas J, Celma A, Regis L, Morote J. A systematic review of methods for quantifying serum testosterone in patients with prostate cancer who underwent castration. Actas Urol Esp 2018; 42:86-93. [PMID: 28259362 DOI: 10.1016/j.acuro.2017.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 01/04/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND The clinical practice guidelines recommend measuring serum testosterone in patients with prostate cancer (PC) who undergo castration. The serum testosterone concentration should be <50ng/dL, a level established by using a radioimmunoassay method. The use of chemiluminescent immunoassays (IA) has become widespread, although their metrological characteristics do not seem appropriate for quantifying low testosterone concentrations. The objective of this review is to analyse the methods for quantifying testosterone and to establish whether there is scientific evidence that justifies measuring it in patients with PC who undergo castration, through liquid chromatography attached to a mass spectrometry in tandem (LC-MSMS). MATERIAL AND METHODS We performed a search in PubMed with the following MeSH terms: measurement, testosterone, androgen suppression and prostate cancer. We selected 12 studies that compared the metrological characteristics of various methods for quantifying serum testosterone compared with MS detection methods. RESULTS IAs are standard tools for measuring testosterone levels; however, there is evidence that IAs lack accuracy and precision for quantifying low concentrations. Most chemiluminescent IAs overestimate their concentration, especially below 100ng/dL. The procedures that use LC-MSMS have an adequate lower quantification limit and proper accuracy and precision. We found no specific evidence in patients with PC who underwent castration. CONCLUSIONS LC-MSMS is the appropriate method for quantifying low serum testosterone concentrations. We need to define the level of castration with this method and the optimal level related to better progression of the disease.
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Affiliation(s)
- I Comas
- Servicio de Bioquímica Clínica, Laboratoris Clínics, Hospital Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, España.
| | - R Ferrer
- Servicio de Bioquímica Clínica, Laboratoris Clínics, Hospital Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, España
| | - J Planas
- Servicio de Urología, Hospital Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, España
| | - A Celma
- Servicio de Urología, Hospital Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, España
| | - L Regis
- Servicio de Urología, Hospital Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, España
| | - J Morote
- Servicio de Urología, Hospital Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, España
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13
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Planas J, Celma A, Placer J, Maldonado X, Trilla E, Salvador C, Lorente D, Regis L, Cuadras M, Carles J, Morote J. Hormonal changes after localized prostate cancer treatment. Comparison between external beam radiation therapy and radical prostatectomy. Actas Urol Esp 2016; 40:549-55. [PMID: 27207596 DOI: 10.1016/j.acuro.2016.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 02/22/2016] [Accepted: 02/22/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the influence of radical prostatectomy (RP) and external beam radiation therapy (EBRT) on the hypothalamic pituitary axis of 120 men with clinically localized prostate cancer treated with RP or EBRT exclusively. MATERIALS AND METHODS 120 patients with localized prostate cancer were enrolled. Ninety two patients underwent RP and 28 patients EBRT exclusively. We measured serum levels of luteinizing hormone, follicle stimulating hormone (FSH), total testosterone (T), free testosterone, and estradiol at baseline and at 3 and 12 months after treatment completion. RESULTS Patients undergoing RP were younger and presented a higher prostate volume (64.3 vs. 71.1 years, p<0.0001 and 55.1 vs. 36.5 g, p<0.0001; respectively). No differences regarding serum hormonal levels were found at baseline. Luteinizing hormone and FSH levels were significantly higher in those patients treated with EBRT at three months (luteinizing hormone 8,54 vs. 4,76 U/l, FSH 22,96 vs. 8,18 U/l, p<0,0001) while T and free testosterone levels were significantly lower (T 360,3 vs. 414,83ng/dl, p 0,039; free testosterone 5,94 vs. 7,5pg/ml, p 0,018). At 12 months FSH levels remained significantly higher in patients treated with EBRT compared to patients treated with RP (21,01 vs. 8,51 U/l, p<0,001) while T levels remained significantly lower (339,89 vs. 402,39ng/dl, p 0,03). CONCLUSIONS Prostate cancer treatment influences the hypothalamic pituitary axis. This influence seems to be more important when patients with prostate cancer are treated with EBRT rather than RP. More studies are needed to elucidate the role that prostate may play as an endocrine organ.
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Morote J, Regis L, Celma A, Planas J. Measurement of serum testosterone during androgenic suppression in patients with prostate cancer: A systematic review. Actas Urol Esp 2016; 40:477-84. [PMID: 26899928 DOI: 10.1016/j.acuro.2016.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 01/14/2016] [Accepted: 01/15/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Clinical practice guidelines recommend measuring serum testosterone (ST) during androgenic suppression (AS) to assess its efficacy and define castration resistance (CR). The objectives of this systematic review were to assess the level of scientific evidence that justify checking ST levels during AS, when to perform it and for what purpose. MATERIAL AND METHODS We performed a search in PubMed with the following mesh terms: androgen suppression, testosterone, and prostate cancer. The search was narrowed to original articles published in English. RESULTS We found 8 publications that analysed the clinical impact of ST concentrations during AS. In all of the series, ST was measured using chemiluminescent assays. However, only indirect methods based on liquid or gas chromatography for its extraction and subsequent quantification using mass spectrometry are recommended, especially for measuring low levels. The endpoints were specific survival and CR-free survival. Six studies were retrospective. The series were not uniform in terms of clinical stage, types of AS and ST assessment methods. In general, low ST levels (<20ng/dL or <32ng/dL) were related to longer CR-free survival. The measurements were performed every 3 or 6 months. Four studies confirmed the beneficial effect of adding bicalutamide when detecting microelevations above 50ng/dL. CONCLUSIONS The level of scientific evidence justifying the measurement of ST during AS is low, and the methods employed for quantifying ST levels are inadequate. However, we consider it useful to check ST levels during AS, and there appears to be an association between low ST levels and better disease outcomes. In the event of microelevations above 50ng/dL, we recommend the administration of bicalutamide.
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Affiliation(s)
- J Morote
- Servicio de Urología, Hospital Vall d́Hebron, Universitat Autònoma de Barcelona, Barcelona, España
| | - L Regis
- Servicio de Urología, Hospital Vall d́Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
| | - A Celma
- Servicio de Urología, Hospital Vall d́Hebron, Universitat Autònoma de Barcelona, Barcelona, España
| | - J Planas
- Servicio de Urología, Hospital Vall d́Hebron, Universitat Autònoma de Barcelona, Barcelona, España
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Ghiciuc CM, Dima-Cozma LC, Bercea RM, Lupusoru CE, Mihaescu T, Cozma S, Patacchioli FR. Imbalance in the diurnal salivary testosterone/cortisol ratio in men with severe obstructive sleep apnea: an observational study. Braz J Otorhinolaryngol 2016; 82:529-35. [PMID: 26749455 PMCID: PMC9444622 DOI: 10.1016/j.bjorl.2015.09.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 08/23/2015] [Accepted: 09/08/2015] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION The complex relationship between sleep disorders and hormones could lead to alterations in the production of cortisol and testosterone in obstructive sleep apnea (OSA) patients. OBJECTIVE The purpose of this study was to determine the diurnal trajectories of salivary free-testosterone, free-cortisol and their ratio (T/C). METHODS Ten subjects newly diagnosed with OSA, based on nocturnal polysomnography evaluation and excessive daytime sleepiness, and seven matched controls were consecutively recruited. Cortisol and testosterone were measured in salivary samples collected upon awakening, at noon and in the evening. The psychometric evaluation of anxiety/depression and referred sexual function disturbances was performed to evaluate the presence of neuropsychological comorbidities. RESULTS AND CONCLUSION The main finding was that OSA subjects displayed hypocortisolism upon awakening and a significant reduction in testosterone concentration in the evening in comparison with the control group, which has maintained the physiological testosterone and cortisol diurnal fluctuation, with higher hormone concentrations in the morning and lower concentrations in the evening. The use of data from multiple diurnal measurements rather than a single point allowed the detection of T/C ratio changes of opposite signs at the beginning and end of the day: the OSA subjects had a higher T/C ratio than the controls in the morning, while their T/C ratio was significantly lower than that of the controls in the evening. The imbalances in the anabolic-catabolic diurnal equilibrium suggest that OSA is associated with a dysregulation of the hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes, potentially an underlying cause of some of the neuropsychological comorbidities observed in OSA patients.
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Affiliation(s)
| | - Lucia Corina Dima-Cozma
- University of Medicine and Pharmacy Grigore T. Popa, School of Medicine, Department of Internal Medicine, Iasi, Romania
| | - Raluca Mihaela Bercea
- University of Medicine and Pharmacy Grigore T. Popa, Clinic of Pulmonary Diseases, Iasi, Romania
| | - Catalina Elena Lupusoru
- University of Medicine and Pharmacy Grigore T. Popa, Department of Pharmacology, Iasi, Romania
| | - Traian Mihaescu
- University of Medicine and Pharmacy Grigore T. Popa, Clinic of Pulmonary Diseases, Iasi, Romania
| | - Sebastian Cozma
- University of Medicine and Pharmacy Grigore T. Popa, Department of Otorhinolaryngology, Iasi, Romania
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Cobo G, Gallar P, Di Gioia C, García Lacalle C, Camacho R, Rodriguez I, Ortega O, Mon C, Vigil A, Lindholm B, Carrero JJ. Hypogonadism associated with muscle atrophy, physical inactivity and ESA hyporesponsiveness in men undergoing haemodialysis. Nefrologia 2016; 37:54-60. [PMID: 27553987 DOI: 10.1016/j.nefro.2016.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 03/31/2016] [Accepted: 04/28/2016] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Testosterone deficiency (hypogonadism) is common among men undergoing haemodialysis, but its clinical implications are not well characterized. Testosterone is an anabolic hormone that induces erythrocytosis and muscle synthesis. We hypothesized that testosterone deficiency would be associated with low muscle mass, physical inactivity and higher dosages of erythropoietin-stimulating agents (ESA). METHODS Single-center cross-sectional study of 57 male haemodialysis patients. None of the patients was undergoing testosterone replacement therapy. Total testosterone was measured in serum. Body composition (by bioelectrical impedance analysis) and physical activity (by the use of pedometers) were assessed. Patients with testosterone levels below the normal range were considered hypogonadal. RESULTS Mean testosterone level was 321±146ng/dL; 20 patients (35%) were hypogonadal. Hypogonadal patients were older and had lower mean arterial blood pressure, higher interleukin-6 levels, lower lean body mass and higher fat body mass. A negative association between testosterone and normalized ESA dose was found in uni- and multivariate regression analyses. Testosterone levels directly correlated with lean body mass regardless of confounders. Hypogonadal patients had lower physical activity than their counterparts [2753±1784 vs. 4291±3225steps/day (p=0.04)]. The relationship between testosterone and physical activity was independent of age, comorbidities and inflammatory markers, but dependent on the proportion of muscle mass. CONCLUSION Hypogonadism is common in our male haemodialysis population and is associated with higher ESA doses, reduced muscle mass and lower physical activity. The link between low testosterone levels and physical inactivity may conceivably relate to reduced muscle mass due to inadequate muscle protein synthesis.
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Affiliation(s)
- Gabriela Cobo
- Department of Nephrology, Hospital Severo Ochoa, Leganes, Madrid, Spain; Divisions of Renal Medicine and Baxter Novum, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
| | - Paloma Gallar
- Department of Nephrology, Hospital Severo Ochoa, Leganes, Madrid, Spain
| | - Cristina Di Gioia
- Department of Nephrology, Hospital Severo Ochoa, Leganes, Madrid, Spain
| | | | - Rosa Camacho
- Department of Nephrology, Hospital Severo Ochoa, Leganes, Madrid, Spain
| | - Isabel Rodriguez
- Department of Nephrology, Hospital Severo Ochoa, Leganes, Madrid, Spain
| | - Olimpia Ortega
- Department of Nephrology, Hospital Severo Ochoa, Leganes, Madrid, Spain
| | - Carmen Mon
- Department of Nephrology, Hospital Severo Ochoa, Leganes, Madrid, Spain
| | - Ana Vigil
- Department of Nephrology, Hospital Severo Ochoa, Leganes, Madrid, Spain
| | - Bengt Lindholm
- Divisions of Renal Medicine and Baxter Novum, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Juan Jesús Carrero
- Divisions of Renal Medicine and Baxter Novum, CLINTEC, Karolinska Institutet, Stockholm, Sweden
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Fernández-Pérez L, de Mirecki-Garrido M, Guerra B, Díaz M, Díaz-Chico JC. Sex steroids and growth hormone interactions. ACTA ACUST UNITED AC 2016; 63:171-80. [PMID: 26775014 DOI: 10.1016/j.endonu.2015.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 11/09/2015] [Accepted: 11/10/2015] [Indexed: 01/17/2023]
Abstract
GH and sex hormones are critical regulators of body growth and composition, somatic development, intermediate metabolism, and sexual dimorphism. Deficiencies in GH- or sex hormone-dependent signaling and the influence of sex hormones on GH biology may have a dramatic impact on liver physiology during somatic development and in adulthood. Effects of sex hormones on the liver may be direct, through hepatic receptors, or indirect by modulating endocrine, metabolic, and gender-differentiated functions of GH. Sex hormones can modulate GH actions by acting centrally, regulating pituitary GH secretion, and peripherally, by modulating GH signaling pathways. The endocrine and/or metabolic consequences of long-term exposure to sex hormone-related compounds and their influence on the GH-liver axis are largely unknown. A better understanding of these interactions in physiological and pathological states will contribute to preserve health and to improve clinical management of patients with growth, developmental, and metabolic disorders.
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Affiliation(s)
- Leandro Fernández-Pérez
- Institute for Research in Biomedicine and Health (IUIBS), University of Las Palmas de Gran Canaria, Molecular and Translational Pharmacology - BioPharm Group, Las Palmas de G.C., Spain.
| | - Mercedes de Mirecki-Garrido
- Institute for Research in Biomedicine and Health (IUIBS), University of Las Palmas de Gran Canaria, Molecular and Translational Pharmacology - BioPharm Group, Las Palmas de G.C., Spain
| | - Borja Guerra
- Institute for Research in Biomedicine and Health (IUIBS), University of Las Palmas de Gran Canaria, Molecular and Translational Pharmacology - BioPharm Group, Las Palmas de G.C., Spain
| | - Mario Díaz
- Department of Animal Biology, University of La Laguna, Laboratory of Membrane Physiology and Biophysics, La Laguna, Spain
| | - Juan Carlos Díaz-Chico
- Institute for Research in Biomedicine and Health (IUIBS), University of Las Palmas de Gran Canaria, Molecular and Translational Pharmacology - BioPharm Group, Las Palmas de G.C., Spain
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Regis L, Planas J, Celma A, de Torres I, Ferrer R, Morote J. Behavior of total and free serum testosterone as a predictor for the risk of prostate cancer and its aggressiveness. Actas Urol Esp 2015; 39:573-81. [PMID: 25944770 DOI: 10.1016/j.acuro.2015.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 03/12/2015] [Accepted: 03/13/2015] [Indexed: 10/23/2022]
Abstract
CONTEXT Serum testosterone is mostly bound to the sex hormone-binding globulin and albumin. A small metabolically active part is present in the form of free testosterone (FT). The relationship between serum total testosterone (TT) levels and prostate carcinogenesis is debated. Our hypothesis is that the serum FT concentration is more closely associated with the risk of prostate cancer (PC) and its aggressiveness than TT. OBJECTIVE To analyze the scientific evidence that relates serum TT and/or FT levels with the diagnosis of PC and its aggressiveness. ACQUISITION OF EVIDENCE A systematic review was conducted in PubMed up to January 2015 using the following mesh terms: prostate cancer, sex hormone, androgen, testosterone and free testosterone. SYNTHESIS OF THE EVIDENCE We found 460 publications, 124 of which were reviewed to analyze the evidence. The relationship between serum TT levels and the diagnosis of PC and its aggressiveness is highly heterogeneous. The variability in the design of the studies, the quantification methods and other variables could explain this heterogeneity. In a number of studies that evaluated the estimated or measured FT, the evidence remains equally conflicting. CONCLUSIONS Based on the current evidence, we cannot recommend the measurement of serum TT and/or TL levels for the diagnosis of PC or for assessing its aggressiveness.
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Santos C, Reis L, Destro-Saade R, Luiza-Reis A, Fregonesi A. Tribulus terrestris versus placebo in the treatment of erectile dysfunction: A prospective, randomized, double blind study. Actas Urol Esp 2014; 38:244-8. [PMID: 24630840 DOI: 10.1016/j.acuro.2013.09.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 09/08/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the possible effects of Tribulus terrestris herbal medicine in the erectile dysfunction treatment and to quantify its potential impact on serum testosterone levels. DESIGN AND METHODS Prospective, randomized, double-blind and placebo-controlled study including thirty healthy men selected from 100 patients who presented themselves spontaneously complaining of erectile dysfunction, ≥ 40 years of age, nonsmokers, not undergoing treatment for prostate cancer or erectile dysfunction, no dyslipidemia, no phosphodiesterase inhibitor use, no hormonal manipulation and, if present hypertension and/or diabetes mellitus should be controlled. International Index of Erectile Function (IIEF-5) and serum testosterone were obtained before randomization and after 30 days of study. Patients were randomized into two groups of fifteen subjects each. The study group received 800 mg of Tribulus terrestris, divided into two doses per day for thirty days and the control group received placebo administered in the same way. RESULTS The groups were statistically equivalent in all aspects evaluated. The mean (SD) age was 60 (9.4) and 62.9 (7.9), P = .36 for intervention and placebo groups, respectively. Before treatment, the intervention group showed mean IIEF-5 of 13.2 (5-21) and mean total testosterone 417.1 ng/dl (270.7-548.4 ng/dl); the placebo group showed mean IIEF-5 of 11.6 (6-21) and mean total testosterone 442.7 ng/dl (301-609.1 ng/dl). After treatment, the intervention group showed mean IIEF-5 of 15.3 (5-21) and mean total testosterone 409.3 ng/dl (216.9-760.8 ng/dl); the placebo group showed mean IIEF-5 of 13.7 (6-21) and mean total testosterone 466.3 ng/dl (264.3-934.3 ng/dl). The time factor caused statistically significant changes in both groups for IIEF-5 only (P = .0004), however, there was no difference between the two groups (P = .7914). CONCLUSIONS At the dose and interval studied, Tribulus terrestris was not more effective than placebo on improving symptoms of erectile dysfunction or serum total testosterone.
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