隐睾患儿术后性激素和抗精子抗体的检测

目的探讨隐睾患儿抗精子抗体(AsAb)与手术、绒毛膜促性腺激素(HCG)应用的相关性及术后血清雌二醇(E2)、睾酮(T)水平的变化。方法随机抽取隐睾患儿40例,分为应用HCG组(12例)及未用HCG组(28例)取腹股沟手术和正常同龄儿各20例作为对照组,检测各组血清AsAb、E2、T水平。结果各组患儿血清E2、T水平结果比较差异无统计学意义(P>0.05);在40例隐睾患儿组中IgG阳性率为53.57%,腹股沟手术组中IgG阳性率为15.00%,正常对照组无一例AsAb阳性;HCG治疗组与未用HCG治疗组AsAb阳性率比较差异无统计学意义(P>0.05)。结论隐睾患儿AsAb产生的机制可能与血睾屏障的破坏、内分泌紊乱等因素有关;应用HCG对AsAb的产生无影响。     

睾酮凝胶剂的处方研究

目的:探讨睾酮凝胶剂的最佳处方.方法:以卡波姆940为基质设计不同的处方,探讨最佳制备方法,并在单室扩散池上测定睾酮通过小鼠腹部皮肤的透过量,研究不同的促吸收剂对经皮透过的影响.结果:1.0%卡波姆940,67%的乙醇为最佳基质;卡波姆940均匀撒入无水乙醇中,加热回流,使其溶胀完全再加中和剂形成凝胶;氮酮、肉豆蔻酸异丙酯、油酸等促渗剂均能显著提高睾酮凝胶的经皮透过速率,其中以肉豆蔻酸异丙酯的促渗透效果最好.结论:以1.0%卡波姆940,67%的乙醇和肉豆蔻酸异丙酯为基质的处方最佳.     

In Vitro and In Vivo Evaluations of Dihydroquinoline- and Dihydroisoquinoline-based Targetor Moieties for Brain-specific Chemical Delivery Systems

Brain-targeted delivery of various drugs can be successfully achieved by chemical delivery systems (CDS) that contain a 1,4-dihydropyridine-based redox targetor moiety and undergo a sequential metabolism. However, the susceptibility of this moiety toward hydration in acidic media may limit the shelf-life of such compounds in aqueous formulation. Here, a systematic investigation of the chemical stability toward oxidation and hydration of ester and amide derivatives of 3-substituted 1,4-dihydropyridine, 1,4-dihydroquinoline, and 4-substituted 1,2-dihydroisoquinoline is reported, together with the in vitro stability and in vivo (rat) distribution of isoquinoline-based testosterone and hydrocortisone chemical delivery systems, which were selected as having the most suitable acid-resistant targetor moieties.     

Testosterone Deficiency Causes Endothelial Dysfunction via Elevation of Asymmetric Dimethylarginine and Oxidative Stress in Castrated Rats

BackgroundTestosterone is believed to mediate the penile erectile response by producing adequate nitric oxide; therefore, testosterone deficiency results in erectile dysfunction through decreased nitric oxide bioavailability. However, the mechanisms underlying endothelial dysfunction in testosterone deficiency remain unclear.AimTo investigate the mechanism of endothelial dysfunction in a rat model of testosterone deficiency.MethodsRats were distributed into 3 groups: castrated (Cast), castrated and supplemented with testosterone (Cast + T), and sham (Sham). In the Cast + T group, castrated rats were treated daily with subcutaneous testosterone (3 mg/kg daily) for 4 weeks; Sham and Cast rats received only the vehicle.OutcomesErectile function using intracavernosal pressure and mean arterial pressure measurements after electrical stimulation of the cavernous nerve, endothelial function using isometric tension, asymmetric dimethylarginine (ADMA) levels using ultra-performance liquid chromatography and tandem mass spectrometry, and inflammatory biomarker expression were performed 4 weeks after the operation.ResultsIn the Cast group, the ratio of intracavernosal pressure to mean arterial pressure significantly decreased, acetylcholine-induced relaxation was lower, and serum ADMA, oxidative stress, and inflammation biomarker levels were significantly increased (P < .01). Testosterone injection significantly improved each of these parameters (P < .01).Clinical TranslationThe present results provide scientific evidence of the effect of testosterone deficiency on erectile function and the effect of testosterone replacement therapy.Strengths and LimitationsThis study provides evidence of the influence of testosterone deficiency on endothelial function by investigating ADMA and oxidative stress. A major limitation of this study is the lack of a direct link of increased ADMA by oxidative stress to inflammation.ConclusionTestosterone deficiency increased not only ADMA levels but also oxidative stress and inflammation in castrated rats, which can cause damage to the corpus cavernosum, resulting in erectile dysfunction.Kataoka T, Hotta Y, Maeda Y, Kimura K. Testosterone Deficiency Causes Endothelial Dysfunction via Elevation of Asymmetric Dimethylarginine and Oxidative Stress in Castrated Rats. J Sex Med 2017;14:1540–1548.     

An update on heart disease risk associated with testosterone boosting medications

Introduction: The cardiovascular (CV) safety of testosterone replacement therapy (TRT) remains a crucial issue in the management of subjects with late-onset hypogonadism. The authors systematically reviewed and discussed the available evidence focusing our analysis on heart-related issues.

Areas covered: All the available data from prospective observational studies evaluating the role endogenous T levels on the risk of acute myocardial infarction (AMI) were collected and analyzed. In addition, the impact of TRT on heart-related diseases, as derived from pharmaco-epidemiological studies as well as from randomized placebo-controlled trials (RCTs), was also investigated.

Expert opinion: Available evidence indicates that endogenous low T represents a risk factor of AMI incidence and its related mortality. TRT in hypogonadal patients is able to improve angina symptoms in subjects with ischemic heart diseases and exercise ability in patients with heart failure (HF). In addition, when prescribed according to the recommended dosage, TRT does not increase the risk of heart-related events.     

Hormonal and Psychogenic Risk Factors for Erectile Dysfunction in Men with HTLV-1

IntroductionErectile dysfunction (ED) is associated with neurological damage due to human T-lymphotropic virus 1 (HTLV-1) infection, but hormonal and psychogenic factors also cause ED.AimTo evaluate the association of psychogenic and hormonal factors with ED in men infected with HTLV-1.MethodsIn this cross-sectional study, we compared total testosterone, follicle stimulating hormone, luteinizing hormone, prolactin, anxiety symptoms, depressive symptoms, and neurologic manifestations in HTLV-1-infected men with or without ED. The International Index of Erectile Function was used to determine the degree of ED. Participants were grouped according to Osame’s Motor Disability Scale and the Expanded Disability Status Scale: HTLV-1-associated myelopathy or tropical spastic paraparesis (HAM/TSP), probable HAM/TSP, or HTLV-1 carrier. Chi-square and Fisher’s exact tests were used to compare the groups, and regression analyses were used to show predictors of ED.Main Outcome MeasureSexual hormonal levels, psychogenic factors, and neurologic disabilities were found to be associated with ED.ResultsED was associated with age older than 60 years (P < .001), degree of neurologic involvement (P < .001), depression (P = .009), and anxiety (P = .008). In the multivariate analyses, only age and degree of neurological injury remained as risk factors for ED.Clinical ImplicationsNeurological manifestations are a stronger predictor of ED than hormonal and psychogenic factors in HTLV-1-infected men.Strengths & LimitationsThe statistical power of the study was limited due to the low number of participants, but neurologic manifestations were clearly associated with ED. There was no strong association between hormonal and psychogenic factors and ED.ConclusionHormonal and psychogenic factors did not show a strong association with ED in individuals with HTLV-1, but neurological manifestations were strongly associated with ED in these individuals.de Oliveira CJV, Neto, JAC, Andrade RCP, et al. Hormonal and Psychogenic Risk Factors for Erectile Dysfunction in Men with HTLV–1. J Sex Med 2019; 16:1763–1768.     

An association between diet,metabolic syndrome and lower urinary tract symptoms

Diet is a key factor in the aetiology of many diseases, including metabolic syndrome and lower urinary tract disorders. Metabolic syndrome is a growing and increasingly expensive health problem in both the developed and the developing world, with an associated rise in morbidity and mortality. On the other hand, lower urinary tract symptoms affect millions of individuals worldwide, lowering their quality of life. Associations have been established between both conditions in existing literature and the various components of the metabolic syndrome have been linked with the onset and aggravation of symptoms in various forms of LUTS. This current review explores the relationships between these in detail, focusing on their inter-relationships particularly vis-a-vis dietary macronutrient and micronutrient intake.