Tribulus terrestris versus placebo en el tratamiento de la disfunción eréctil: un estudio aleatorizado,prospectivo y doble ciego

ObjectivesTo 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 methodsProspective, 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.ResultsThe 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).ConclusionsAt the dose and interval studied, Tribulus terrestris was not more effective than placebo on improving symptoms of erectile dysfunction or serum total testosterone.     

Regulation of male fertility by the bone-derived hormone osteocalcin

Traditionally, bone has been viewed as a relatively static tissue only fulfilling mechanical and scaffolding function. In the past decade however, this classical view of the bone has considerably evolved towards a more complex picture. It is now clear that the skeleton is not only a recipient for hormonal input but it is also an endocrine organ itself. Through the secretion of an osteoblast-derived molecule, osteocalcin, the skeleton regulates glucose homeostasis and male reproductive functions. When undercarboxylated, osteocalcin acts following its binding to a G-coupled receptor, Gprc6a, on pancreatic β cells to increase insulin secretion, on muscle and white adipose tissue to promote glucose homeostasis and on Leydig cells of the testis to favor testosterone biosynthesis. More recently, it was also shown that osteocalcin acts via a pancreas-bone-testis axis that regulates, independently of and in parallel to the hypothalamus–pituitary–testis axis, male reproductive functions by promoting testosterone biosynthesis. Lastly, in trying to expand the biological relevance of osteocalcin from mouse to human, it was shown that Gprc6a is a potential new susceptibility locus for primary testicular failure in humans. Altogether, these results shed new light on the importance of the endocrine role of the skeleton and also provide credence to the search for additional endocrine functions of this organ.     

Antireproductive effect of calcium channel blockers on male rats

Introduction  Drugs have been shown to adversely affect male fertility and recently anti-hypertensive drugs were added to the list. The anti-fertility effects of nifedipine and similar calcium channel blockers are well-illustrated in in vitro experiments but not in vivo. Purpose  The present study was designed to experimentally elucidate the sub-chronic effect of nifedipine, verapamil and diltiazem on sperm functions and reproductive hormone levels in vivo. Methods  Male rats (150–200 g) were divided into four groups of ten rats each. Group 1 (control) received distilled water; Group 2 received nifedipine 0.57 mg/kg BW; Group 3 were given verapamil 3.40 mg/kg BW and Group 4 were given diltiazem 2.57 mg/kg BW. Each drug-treated group had its own recovery group from which treatment was discontinued for 30 days before the animals were sacrificed. Blood samples were collected for hormonal assay of FSH, LH and testosterone. Semen evaluation was done and the testes, seminal vesicle, epididymis and prostate were removed, and weighed immediately. Results  Nifedipine, verapamil and diltiazem significantly decreased (P < 0.05) sperm count and motility in drug treated groups. The weight of the epididymis was significantly reduced (P < 0.05) in the drug treated rats. Semen parameters and other associated changes were restored after 30 days of drug withdrawal. Conclusion  Calcium channel blockers appear to have a reversible anti-fertility effect on male rats which does not occur through inhibition of the pituitary-gonadal axis.     

十一酸睾酮对雄性家兔髂动脉内膜损伤后的修复作用

目的观察十一酸睾酮对雄兔髂动脉内膜损伤后的修复作用。方法成熟雄性日本大耳白兔25只,随机分成5组,每组5只:假手术组(不切除睾丸和附睾)、模型组、小剂量组(手术后补充睾酮3mg/kg)、中剂量组(手术后补充睾酮6mg/kg)和大剂量组(手术后补充睾酮12mg/kg),后4组均切除双侧睾丸和附睾。所有动物手术后第14d行右侧髂动脉内皮剥脱术。手术后第7、14和第21d肌肉注射十一酸睾酮,假手术组和模型组肌注生理盐水。于不同时间测定血清总睾酮。第28d处死动物,取损伤血管段,应用扫描电镜和HE染色观察髂动脉内膜的修复情况。结果光镜下观察发现,模型组、小剂量组和中剂量组动脉内膜增生严重,大剂量组内膜增厚程度明显减低,接近假手术组。模型组、小剂量组和中剂量组的髂动脉内膜/中膜面积比值分别是1.25±0.10、0.90±0.10和0.74±0.11,明显高于假手术组(0.22±0.05;P<0.01)。大剂量组的髂动脉内膜/中膜面积比值为0.26±0.07,接近于假手术组(P>0.05)。扫描电镜观察发现,假手术组动物髂动脉内皮光滑,整齐连续,模型组几乎未见到有内皮细胞再生,小剂量组内皮有散在覆盖,中剂量组片状覆盖,大剂量组内皮细胞修复明显,排列趋于正常,偶有缺失。在手术后第28d大剂量组血清总睾酮水平接近假手术组,其它组在不同时间点均低于假手术组。结论生理水平的睾酮具有保护雄性家兔血管内皮,抑制动脉损伤后内膜增生的作用。     

Cardiovascular impact of testosterone therapy for hypogonadism

Introduction: Since 2010 some evidence supporting the possible increased cardiovascular (CV) risk related to testosterone treatment (TTh) has created much debate in the scientific community. Based on these results, the US Food and Drug Administration agency has questioned TTh for aging men recognizing its value only for classical hypogonadism due to genetic or organic causes. To better clarify this topic, we scrutinized and summarized, also by using meta-analytic methods, the data generated during the last 7 years, as derived from the analysis of randomized controlled trials (RCTs) on TTh and CV risk.

Areas covered: Analysis included 31 RCTs published between 2010 and 2018. Retrieved trials included 2675 and 2308 patients in TTh and placebo groups, respectively. The analysis documented that TTh was not associated with an increased CV mortality or morbidity either when overall or major adverse CV events were considered.

Expert commentary: Despite present evidence it is important to recognize that the duration of the available trials is short (lower that 3 years) limiting final conclusions on this topic. In particular, the available information on possible long-term effects of TTh on CV risk is limited. Long-term safety studies are advisable to better clarify these points.     

女性不同性激素水平下脑源性神经营养因子的变化

目的:观察女性不同性激素水平下脑源性神经营养因子(brain-derived neurotrophic factor,BD-NF)的变化.方法:临床纳入62例围绝经期及绝经后妇女,根据STRAW分期以及绝经年限长短进行分组,同时纳入16例健康育龄妇女作为对照组.分别采集所有入组者的血液标本,检测血清雌二醇(E2)、睾酮(T)、卵泡刺激素(FSH)以及BDNF的水平.结果:围绝经期组以及绝经后的妇女,血清BD-NF水平明显低于健康育龄妇女,BDNF水平与E2水平有明显相关性(r=0.302,P=0.016).结论:血清BDNF水平与脑源性雌激素水平有着密切的联系.     

Association between urinary biomarkers of exposure to organophosphate insecticides and serum reproductive hormones in men from NHANES 1999–2002

Exposure to organophosphate (OP) insecticides may alter reproductive hormone levels in men and increase the risk for poor reductive health and other adverse health outcomes. However, relevant epidemiology studies in men are limited. We evaluated urinary concentrations of OP metabolites (3,5,6-trichloro-2-pyridinol and six dialkyl phosphates) in relation to serum concentrations of testosterone (T) and estradiol among 356 men aged 20–55 years old from the U.S. National Health and Nutrition Examination Survey. Biomarkers were detected in greater than 50% of the samples, except for diethyldithiophosphate, dimethylphosphate, and dimethyldithiophosphate. In adjusted regression models, we observed a statistically significant inverse relationship between diethyl phosphate (DEP) and T when DEP was modeled as either a continuous or categorical variable. These findings add to the limited evidence that exposure to certain OP insecticides is linked to altered T in men, which may have important implications for male health.     

Peri-pubertal administration of 3-nitro-1,2,4-triazol-5-one (NTO) affects reproductive organ development in male but not female Sprague Dawley rats

Nitrotriazolone (3-nitro-1,2,4-triazol-5-one; NTO) is an insensitive munition that has demonstrated effects on reproductive organs in adult male rats. NTO was administered to male (0, 250, and 500 milligrams per kilogram per day (mg/kg-day)) and female (0, 500, and 1000 mg/kg-day) Sprague-Dawley rats (15/sex/group) via oral gavage from weaning through post-natal day 53/54 and 42/43, respectively. Age and body mass at vaginal opening (VO) and preputial separation (PPS), as well as all measures of estrous cyclicity were not affected by treatment with NTO. Males treated with NTO exhibited reductions in testis mass associated with tubular degeneration/atrophy. Less pronounced reductions in accessory sex organ masses were also observed in the 500 mg/kg-day group. Treatment with NTO did not affect thyroid hormone or testosterone levels. These findings suggest that NTO is not acting as an estrogen or thyroid active compound, but may indicate effects on steroidogenesis and/or direct testicular toxicity.     

妊娠高血压综合征患者血雄激素水平的观察

检测妊娠高血压综合征 (妊高征 )患者及正常孕妇血清睾酮 (T)、游离睾酮 (Tf)、硫酸脱氢表雄酮、雌二醇及性激素结合球蛋白的水平。结果显示妊高征组平均动脉压 ,T和Tf 水平明显升高 (均P <0 .0 0 1) ,雄激素 (T和Tf)可能与妊高征的发病机制有关。