FOXA1 in prostate cancer / 亚洲男科学杂志(英文版)

Most prostate cancers initially respond to androgen deprivation therapy (ADT). With the long-term application of ADT, localized prostate cancer will progress to castration-resistant prostate cancer (CRPC), metastatic CRPC (mCRPC), and neuroendocrine prostate cancer (NEPC), and the transcriptional network shifted. Forkhead box protein A1 (FOXA1) may play a key role in this process through multiple mechanisms. To better understand the role of FOXA1 in prostate cancer, we review the interplay among FOXA1-targeted genes, modulators of FOXA1, and FOXA1 with a particular emphasis on androgen receptor (AR) function. Furthermore, we discuss the distinct role of FOXA1 mutations in prostate cancer and clinical significance of FOXA1. We summarize possible regulation pathways of FOXA1 in different stages of prostate cancer. We focus on links between FOXA1 and AR, which may play different roles in various types of prostate cancer. Finally, we discuss FOXA1 mutation and its clinical significance in prostate cancer. FOXA1 regulates the development of prostate cancer through various pathways, and it could be a biomarker for mCRPC and NEPC. Future efforts need to focus on mechanisms underlying mutation of FOXA1 in advanced prostate cancer. We believe that FOXA1 would be a prognostic marker and therapeutic target in prostate cancer.

Second-to-fourth digit ratio and seborrheic dermatitis in males: a cross-sectional study*

Abstract: Background: Seborrheic dermatitis is a common disease characterized by the erythematous plaques with oily-yellow desquamation. Increased sebaceous gland activity by androgenic hormones has played a role in the etiology of the disease. The second-to-fourth digit (2D:4D) ratio is thought to be a marker of prenatal androgen exposure. Objectives: To investigate the association between 2D:4D ratios and seborrheic dermatitis in a male population. Methods: Healthy male controls and patients with seborrheic dermatitis were included in this study. One hundred seborrheic dermatitis patients and 120 healthy controls, aged 17-59, were enrolled. A digital Vernier caliper was used to measure the finger lengths. Seborrheic dermatitis severity was assessed using the Seborrheic Dermatitis Area and Severity Index (SDASI). Results: The 2D:4D ratios of the patients (x = 0.977) were significantly lower than those of the controls (x = 1.050) for right hands (t = 6.948; p = 0.000; > 0.05). No similar relationship was found between the 2D:4D ratio for left hands (t = 0.901; p = 0.368; > 0.05). Seborrheic dermatitis severity was negatively correlated with 2D:4D ratios of right hands (r = -0.391; p = 0.000-0.05). Study limitations: One of the main limitations of this study was the small sample, which got a head of us from acquiring certain findings about the 2D:4D ratio and seborrheic dermatitis. The other limitation is that the patient selection did not reflect the general population, as a single clinic was studied. Conclusion: To the authors' knowledge, this is the first study examining the relationship between 2D:4D ratios and seborrheic dermatitis. The result of this study may indicate a line of investigation and can support the theory of prenatal androgen exposure.

Síndrome do ovário policístico: abordagem dermatológica / Polycystic ovary syndrome: a dermatologic approach

A síndrome do ovário policístico (SOP) é uma das endocrinopatias mais freqüentes nas mulheres em idade reprodutiva. Caracteriza-se por morbidade elevada devido aos aspectos estéticos e por repercussões metabólicas importantes. Embora a sua patogênese permaneça incompletamente conhecida, acredita-se numa desordem multigênica complexa, incluindo anormalidades no eixo hipotálamohipofisário, esteroidogênese e resistência insulínica. Os achados principais para o diagnóstico são: hiperandrogenismo, anovulação crônica e ovários policísticos à ultrassonografia. As manifestações dermatológicas do hiperandrogenismo incluem: hirsutismo, acne, seborréia, alopecia e, em casos mais graves, sinais de virilização. Existe considerável heterogeneidade nos achados clínicos e também pode haver variação na mesma paciente com o passar do tempo. O tratamento visa reduzir as manifestações do hiperandrogenismo, restaurar os ciclos ovulatórios regulares e corrigir a síndrome metabólica. Este artigo apresenta revisão da fisiopatologia, diagnóstico e tratamento da síndrome do ovário policístico. Enfatiza-se a importância do diagnóstico e tratamento precoces no intuito de prevenir as complicações metabólicas e a repercussão emocional que afeta a qualidade de vida das pacientes.

Polycystic ovary syndrome (POS) is one of the most common endocrine abnormalities affecting women of reproductive age. It is a cause of significant social embarrassment and emotional distress. The pathogenesis of the disease is not yet fully understood, but it is thought to be a complex multigenic disorder, including abnormalities in the hypothalamic-pituitary axis, steroidogenesis, and insulin resistance. The main diagnostic findings of the syndrome are: hyperandrogenism, chronic anovulation and polycystic ovarian morphology seen on ultrasound. Hyperandrogenism is generally manifested as hirsutism, acne, seborrhea, androgenic alopecia and, in severe cases, signs of virilization. Treatment may improve the clinical manifestations of excess androgen production, normalize menses and ameliorate metabolic syndrome and cardiovascular complications. This article reviews the diagnosis, clinical manifestations, metabolic complications, and treatment of the syndrome. Early diagnosis and the consequent early treatment may prevent metabolic complications and emotional distress that negatively impact the patients' quality of life.

El tejido graso como modulador endocrino: Cambios hormonales asociados a la obesidad / Adipose tissue as an endocrine modulator: Hormonal changes associated with obesity

Adipose tissue not only stores fat, but secretes factors and hormones, which modify the regulation, metabolism and secretion of several other hormones. The objective of this review is to describe the hormonal disorders associated with increased adipose tissue, which acts as a modulator or disruptor of the endocrine physiology, with special reference to cortisol, androgens, growth hormone and thyroid axis, and discuss the implications for the management and treatment of these patients.

[Androgen- secreting adrenal tumors, 3 case reports]

Adrenal tumors that secrete androgens are rare; the tumor may be an adenoma or a carcinoma. This paper discusses the signs and symptoms, diagnostic methods, treatment and prognosis of these tumors, witnessed in 3 cases of androgen producing adrenal tumors. The first case was a 14 year old girl presented with hirsutism and virilism and primary amenorrhea. Testosterone and DHEAS showed very high levels while other adrenal hormones were within in normal limits. A pure androgen producing adrenal adenoma was diagnosed in this patient. The second case was a 7 year old girl with hirsutism, virilism and cushingoid facial features, acne and weight gain and a large abdominal mass. An adrenal carcinoma producing cortisol, testosterone, and DHEAS was diagnosed in this patient. The third case was a 10 month old baby with weight gain cushingoid facial features, acne and growth of pubic hair. High level of DHEAS, testosterone and cortisol due to an adrenocortical carcinoma, detected in this patient

La exposición prenatal a andrógenos como factor de reprogramación fetal / Prenatal exposure to androgens as a factor of fetal programming

Both epidemiological and clinical evidence suggest a relationship between the prenatal environment and the risk of developing diseases during adulthood. The first observations about this relationship showed that prenatal growth retardation or stress conditions during fetal life were associated to cardiovascular, metabolic and other diseases in later life. However, not only those conditions may have lasting effects after birth. Growing evidence suggests that prenatal exposure to steroids (either of fetal or maternal origin) could be another source of prenatal programming with detrimental consequences during adulthood. We have recently demonstrated that pregnant women with polycystic ovary syndrome exhibit elevated androgen levels compared to normal pregnant women, which could provide an androgen excess for both female or male fetuses. We have further tested this hypothesis in an animal model of prenatal androgenization, finding that females born from androgenized mothers have a low birth weight and high insulin resistance, that starts at an early age. On the other hand, males have low testosterone and LH secretion in response to a GnRH analogue test compared to control males and alterations in seminal parameters. We therefore propose that our efforts should be directed to modify the hyperandrogenic intrauterine environment to reduce the potential development of reproductive and metabolic diseases during adulthood.

Male contraception: expanding reproductive choice.

The development of steroid-based oral contraceptives had revolutionized the availability of contraceptive choice for women. In order to expand the contraceptive options for couples by developing an acceptable, safe and effective male contraceptive, scientists have been experimenting with various steroidal/non-steroidal regimens to suppress testicular sperm production. The non-availability of a long-acting androgen was a limiting factor in the development of a male contraceptive regimen since all currently tested anti-spermatogenic agents also concurrently decrease circulating testosterone levels. A combination regimen of long-acting progestogen and androgen would have advantage over an androgen-alone modality since the dose of androgen required would be much smaller in the combination regimen, thereby decreasing the adverse effects of high steroid load. The progestogen in the combination regimen would act as the primary anti-spermatogenic agent. Currently, a number of combination regimens using progestogen or GnRH analogues combined with androgen are undergoing trials. The side effects of long-term use of androgens and progestogens have also undergone evaluation in primate models and the results of these studies need to be kept in view, while considering steroidal regimens for contraceptive use in men. Efforts are also being made to popularize non-scalpel vasectomy and to develop condoms of greater acceptability. The development of contraceptive vaccines for men, using sperm surface epitopes not expressed in female reproductive tract as source, still requires considerable research efforts.

Ultrastructural changes in cauda epididymidal epithelial cell types of Azadirachta indica leaf treated rats.

To assess if cauda epididymis is a target for the effect of A. indica leaves, Wistar strain male albino rats were administered (po) A. indica leaves (100 mg/rat/day for 24 days). Transmission electron microscopic analysis revealed that in the cauda epididymal epithelium the nuclei of principal cells were enlarged and the number of coated micropinocytotic vesicles of the apical cytoplasm decreased. Microvilli were missing and mitochondrial cristae and Golgi complex were highly disrupted. The cytoplasm was abounding with lysosomal bodies. The clear cells increased in perimeter and their nuclei increased in size and contained lesser chromatin. The nuclear membrane bulged out. The cytoplasm was vacuolized. Further, there was decrease in size of the lipid droplets, mitochondria, Golgi complex, endoplasmic reticulum and there was accumulation of lysosomal bodies. The changes in the principal and clear cells appear to be due to the effect of the hypoandrogen status caused by treatment with A. indica leaves and a direct action on the epididymal epithelium.

Trends in male contraception

Methods that are available for male contraception, namely coitus interruptus, condoms, and vasectomy, have been used since the 19th century. With the exceptions of a few improvements of these methods, no major progress has been made with respect to introducing new male contraceptives since then. It is extremely urgent to develop new, safe, effective, and reversible male contraceptive methods. Among all male contraceptive methods that are being investigated, the hormonal approach is the closest to clinical application. Hormonal contraception provides pregnancy protection by means of spermatogenic suppression. Androgen-progestin regimens currently represent the best available hormonal combination for induction of a profound suppression of spermatogenesis. Further development of new steroids is mandatory for increasing the choices of available contraceptive formulations and to optimize long-term safety of these regimens

Relationship between Urinary Endogenous Steroid Metabolites and Lower Urinary Tract Function in Postmenopausal Women

To investigate the relationship between the endogenous steroid hormones and the lower urinary tract function in postmenopausal women. Thirty postmeopausal volunteer women who did not have lower urinary tract symptoms or hormone replacement therapy were enrolled in this study. Urodynamic studies included uroflowmetry, multi-channel cystometry, and urethral pressure profilometry were conducted. Gas Chromatography- Mass Spectroscopy (GC-MS) was used to measure the urinary endogenous steroid hormone metabolites. The relationship between the urinary profile of the endogenous steroids and the urodynamic parameters of these patients were investigated. The mean ages of the patients were 60.6 +/- 5.5 years, and the Body Mass Index (BMI) averaged 24.56 +/- 2.23 (kg/m2). Of the progesterone metabolites, pregnandiol was significantly related to the residual volume in the uroflowmetry and the functional urethral length parameters (R=0.98, p=0.000; R= -0.65, p=0.04). Pregnantriol was significantly related to the maximum flow rate, the residual volume in uroflowmetry, the maximum urethral closure pressure and the functional urethral length (R=-0.64, p=0.04; R=0.82, p=0.01; R=0.04, p=0.04; R=- 0.79, p=0.01). In the androgen metabolites, androstenedione, 5-AT, 11- keto Et, 11-betahydroxy Et, THS, and THE were significantly related to the residual volume in uroflowmetry (R=0.92, p=0.001; R=0.84, p=0.008; R=0.99, p=0.000; R=0.72, p=0.03; R=0.97, p=0.000; R=0.85, p=0.00). beta-THF/alpha-THF was significantly related to the maximum flow rate, the residual volume in uroflowmetry, the maximum urethral closure pressure and the functional urethral length (R=-0.76, p=0.02; R=0.67, p=0.04; R=0.74, p=0.02; R=-0.92, p=0.000). alpha-cortol was significantly related to the residual volume in uroflowmetry, the maximum urethral closure pressure and the functional urethral length (R=0.81, p=0.01; R=0.71, p=0.03; R=-0.87, p=0.000). Of the estrogen metabolites, estrone (E1) was significantly related to the normal desire to void (R=0.68, p=0.04) and 17 beta-estradiol/estrone was also significantly related to the normal and strong desire to void (R=-0.70, p=0.03 and R=-0.74, p=0.02, respectively). The urinary progesterone and androgen metabolite concentrations were positively related to the residual volume in uroflowmetry and positively or negatively related to MUCP and FUL. However, the urinary estrone concentration was positively related to the normal desire to void and 17 beta-estradiol/estrone was significantly related to the normal and strong desire to void.

Water temperature and pH influence olfactory sensitivity to pre-ovulatory and post-ovulatory ovarian pheromones in male Barilius bendelisis.

The attractive response and sexual activity elicited by pre-ovulatory steroid sulphate and post-ovulatory 15K-PGF pheromones are greater in wild caught tubercular males and immature males which express breeding tubercles on the snout (at 12-13 days post androgen implant) than in non-tubercular and non-androgen implanted males of freshwater fish Barilius bendelisis. This shows that circulatory androgens exert an activational effect on olfactory receptors of male fish. Wild caught tubercular males and androgen implanted juvenile males exhibit a high responsiveness to steroid sulphate at the water temperature and pH which fish experience during the pre-spawning phase. The male's sensitivity to 15K-PGF is almost equally high at the water temperature and pH which they experience in wild during the both pre-spawning and spawning periods. This suggests that the differential olfactory sensitivity to the two classes of pheromones in androgen implanted males is due to the varied temperature and pH of water, and that during the breeding season the male's olfactory sensitivity to PGF pheromone is more widespread than to the steroidal pheromone. An increased and decreased olfactory sensitivity in mature males to sex pheromones and L-alanine respectively during the breeding phase is in agreement with the hypothesis that pheromonal stimuli dominate over feeding stimuli to promote spawning success.

GnRH and / or testosterone induced changes in reproductive activities during nonbreeding season in Calotes versicolor (Daud.).

Administration of Gonadotrophin releasing hormone (GnRH) to male C versicolor during nonbreeding season increases the weight of testis;diameter of testis, seminiferous tubule, Sertoli and Leydig cell nuclei. It also activates the spermatogenic process. Increase in the weight of epididymis and lowered cholesterol level of testis indicate androgen production. Treatment of tesotsterone along with GnRH further enhances the activities of testis as a few spermatozoa appeared in the lumen of seminiferous tubule along with increase in other spermatogenic elements. It may be concluded that the exogenous GnRH can induce reproductive activities during nonbreeding season when the environmental conditions are unfavourable. Testosterone administration has the additive effect on these activities.

Implicancias de la enzima 3 beta hidroxiesteroide dehidrogenasa (3beta HSD) en la sintesis de androgenos en la adrenal humana / Role of 3 beta hydroxysteroid dehydrogenase (3 beta HSD) in human adrenal androgen synthesis

La adrenarca se caracteriza por el aumento de secreción de andrógenos adrenales. Ocurre entre los 6-8 años de edad en humanos. Con el objetivo de evaluar el posible rol regulatorio de la 3beta HSD en la síntesis de andrógenos en la adrenal humana, se analizó la abundancia del ARNm de 3beta HSD (Dot blot y RT-PCR semicuantitativa(S)) en 11 tejidos adrenales humanos normales en dos grupos (Gr) de edades, Gr1: <8 años (a) (n= 6, r: 0.1-2.5) y Gr2: si 8a (n = 5, r: 8.0-13.0); en tejido de un tumor adrenal con Síndrome de Cushing (TSC) y de 2 T virilizante (TV) y en células adrenales del TSC y 1 TV al 3er día de cultivo (basal y con ACTH e IGF-1). El ARNm de 3beta HSD fue más alto en el Gr1 que en el Gr2 (Dot blot: 4.65 + 2.70 y 0.28 + 0.27 UA, p = 0.006; RT-PCRS: 21.50 + 12.50 y 6.77 + 3.78 UA, p = 0.039 resp). Por otra parte, en el tejido TSC (8.74 + 1.74) fue más alto que en los TV (0.47 + 0.02, 0.87 + 0.08) p = 0.001. En cultivo del TSC el ARNm basal (0.82 + 0.10) disminuyó con ACTH (0.55 + 0.06), p = 0.005 y se incrementó con IGF-1 (2.36 + 0.07) p = 0.006. En el TV no hubo cambios. Al 3er día de cultivo la DHEAS y androstenediona basales fueron en TV 1170.0 + 210.0 y 335.0 + 29.0, TSC 17.1 + 3.5 y 73.7 + 11.7 pmol/10(6) células en 24 hs respectivamente y se incrementaron bajo ACTH en TV (2006.0 + 360.0 y 525.0 + 76.0) y en TSC 29.8 + 5.4 y 366.8 + 129) p<0.05 y disminuyeron con IGF-1 sólo en TSC (7.9 + 2.4 y 43.7 + 6.1) p<0.05. Estos datos sugieren que la adrenarca humana podría ser secundaria a una disminución de la abundancia del ARNm de 3beta HSD. El hecho de que bajo ACTH aumenta la secreción de andrógenos y disminuye el ARNm de 3beta HSD, mientras que el IGF-1 ejerce un efecto inverso, aporta nuevas evidencias del rol regulador ejercido por la 3beta en la síntesis de andrógenos adrenales.