Suppression of testosterone stimulates recovery of spermatogenesis after cancer treatment.
Suppression of testosterone stimulates recovery of spermatogenesis after cancer treatment.
复制标题
睾丸激素的抑制可刺激癌症治疗后精子发生的恢复。
DOI：
10.1046/j.1365-2605.2003.00400.x
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发表时间：
2003
影响因子：
--
通讯作者：
Shetty,Gunapala
中科院分区：
文献类型：
--
作者：
Meistrich,MarvinL;Shetty,Gunapala
重要的是开发方法来预防或逆转男性癌症化疗或放疗引起的不育。放射和一些化疗药物会杀死精原干细胞，但我们已经证明这些细胞在大鼠体内存活，尽管它们无法分化。有证据表明，这种现象也发生在男性身上。大鼠精原细胞分化受阻是由于睾丸精原细胞或睾丸体细胞发生了一些未知的变化，如睾酮抑制精原细胞分化。在大鼠中，在细胞毒性损伤之前或之后，通过用促性腺激素释放激素（GnRH）激动剂或拮抗剂抑制睾酮，可以恢复用辐射或某些化疗剂治疗后丧失的精子发生和生育能力。这个程序对人类的适用性仍然是未知的。一些抗癌方案可能会杀死所有的干细胞，在这种情况下，唯一的选择将是精原细胞移植。然而，在某些情况下，干细胞存活，并且有一份关于激素治疗刺激精子发生恢复的报告。临床试验应侧重于在抗癌治疗期间或之后不久使用激素治疗患者。激素治疗方案应包括抑制睾酮的产生，同时补充最少的雄激素以改善性欲下降。
It is important to develop methods to prevent or reverse the infertility caused by chemotherapy or radiation therapy for cancer in men. Radiation and some chemotherapeutic agents kill spermatogonial stem cells, but we have shown that these cells survive in rats, although they are unable to differentiate. There is evidence that this phenomenon also occurs in men. The block to spermatogonial differentiation in rats is caused by some unknown change, either in the spermatogonia or the somatic elements of the testis, such that testosterone inhibits spermatogonial differentiation. In the rat, the spermatogenesis and fertility lost following treatment with radiation or some chemotherapeutic agents can be restored by suppressing testosterone with gonadotropin releasing hormone (GnRH) agonists or antagonists, either before or after the cytotoxic insult. The applicability of this procedure to humans is still unknown. Some anticancer regimens may kill all the stem cells, in which case the only option would be spermatogonial transplantation. However, in some cases stem cells survive and there is one report of stimulation of recovery of spermatogenesis with hormonal treatment. Clinical trials should focus on treating patients with hormones during or soon after anticancer treatment. The hormone regimen should involve suppression of testosterone production with minimum androgen supplementation used to improve the diminished libido.