Spermatogenesis improved by suppressing the high level of endogenous gonadotropins in idiopathic non-obstructive azoospermia: a case control pilot study.
Spermatogenesis improved by suppressing the high level of endogenous gonadotropins in idiopathic non-obstructive azoospermia: a case control pilot study.
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DOI：
10.1186/s12958-018-0401-7
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发表时间：
2018-09-22
期刊：
影响因子：
--
通讯作者：
Yao B
中科院分区：
文献类型：
--
作者：
Hu X;Ding Z;Hong Z;Zou Z;Feng Y;Zhu R;Ma J;Ge X;Li C;Yao B
血浆促性腺激素升高与男性睾丸中支持细胞和间质细胞的脱敏有关。严重少精症患者可通过抑制高内源性促性腺激素来提高睾丸生精能力。目前尚不清楚它是否对非梗阻性无精症（NOA）患者有益。戈舍瑞林是一种促性腺激素释放激素激动剂 (GnRHα)，用于抑制 NOA 患者的内源性促性腺激素水平（促性腺激素重置），改善支持细胞和间质细胞的敏感性。然后注射人绝经期促性腺激素（hMG）和人绒毛膜促性腺激素（hCG）刺激它们改善睾丸生精能力。主要结果指标是精液中是否存在精子或睾丸精子提取（TESE）。抑制素 B 的升高和/或 ZO-1 表达模式的改善是次要目标。共有 35 名通过 TESE 未能取精的 NOA 男性入组。其中，选择 10 名未接受治疗的患者作为对照组，并在 6 个月后进行二次 TESE。在 25 名接受治疗的男性中，有 11 名患者的抑制素 B 在前 4 周内升高（反应组），而只有 5 名患者在接下来的 20 周内持续升高（反应组 2）。在 5 名男性中，2 名男性获得了精子（反应组 2B），而 3 名男性失败了（反应组 2A）。小鼠vasa同源物(MVH)和ZO-1的免疫荧光显示，反应组2中MVH阳性信号和ZO-1表达均显着增加，但仅反应组2B显示出改善的ZO-1分布。促性腺激素重置是一种新的 GnRHα 治疗方案，能够通过恢复支持细胞和 Leydig 细胞的敏感性来提高 NOA 患者睾丸生精能力，具体表现为抑制素 B 升高和 ZO-1 表达和分布改善。 ClinicalTrials.gov 标识符：NCT02544191。本文的在线版本 (10.1186/s12958-018-0401-7) 包含补充材料，可供授权用户使用。
Elevated plasma gonadotropins were associated with desensitization of Sertoli and Leydig cells in the male testis. Testis spermatogenesis ability would be improved via inhibiting high endogenous gonadotropin in patients with severe oligozoospermia. Whether it would be beneficial for non-obstructive azoospermia (NOA) patients was still unclear. Goserelin, a gonadotropin releasing hormone agonist (GnRHα) was used to suppress endogenous gonadotropin levels (gonadotropin reset) in the NOA patients, improving the sensitization of the Sertoli and Leydig cells. Then human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG) were injected to stimulate them to ameliorate the ability of testicular spermatogenesis. The main outcome measure was the existence of spermatozoa in the semen or by testicular sperm extraction (TESE). Elevation of inhibin B and/or ameliorative expression pattern of ZO-1 was the secondary objective. A total of 35 NOA men who failed to retrieve sperm via TESE were enrolled. Among these, 10 patients without treatment were selected as control group and secondary TESE was performed 6 months later. Of the 25 treated men, inhibin B was elevated in 11 patients in the first 4 weeks (Response group), while only 5 patients had constant increase in the following 20 weeks (Response group 2). Of the 5 men, 2 men acquired sperm (Response group 2B), while 3 failed (Response group 2A). Immunofluorescence of mouse vasa homologue (MVH) and ZO-1 showed that both positive MVH signals and ZO-1 expression were significantly increased in the Response group 2, but only Response group 2B showed ameliorative ZO-1 distribution. Gonadotropin reset, a new therapeutic protocol with GnRHα, was able to improve the ability of testicular spermatogenesis in the NOA patients through restoring the sensitivity of Sertoli and Leydig cells, which were reflected by elevated inhibin B and ameliorative ZO-1 expression and distribution. ClinicalTrials.gov identifier: NCT02544191. The online version of this article (10.1186/s12958-018-0401-7) contains supplementary material, which is available to authorized users.
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具有非目标化植物学的不育男性的临床管理。
影响因子：
2.9
作者：
Esteves SC
通讯作者：
Esteves SC
DOI：
10.6061/clinics/2013(sup01)05
发表时间：
2013
期刊：
Clinics (Sao Paulo, Brazil)
影响因子：
--
作者：
Aziz N
通讯作者：
Aziz N
影响因子：
6.5
作者：
Pummi, K;Malminen, M;Peltonen, S
通讯作者：
Peltonen, S
影响因子：
6.1
作者：
McLachlan, R. I.;Rajpert-De Meyts, E.;Skakkebaek, N. E.
通讯作者：
Skakkebaek, N. E.
影响因子：
2.3
作者：
Fink, Cornelia;Weigel, Roswitha;Brehm, Ralph
通讯作者：
Brehm, Ralph