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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
201

Análise de genes moduladores do fenótipo da forma não clássica da deficiência da 21-hidroxilase / Analysis of genes modulators in the nonclassical 21-hydroxylase deficiency phenotype

Vivian de Oliveira Moura 14 June 2011 (has links)
A deficiência da 21-hidroxilase é uma freqüente doença autossômica recessiva caracterizada por manifestações hiperandrogênicas, que se iniciam na infância, puberdade ou vida adulta. Observa-se existência de forte correlação do comprometimento da atividade enzimática conferido pelo genótipo com a forma clínica e com as concentrações basais e pós-estímulo da 17OH-progesterona. Entretanto, não se observa a mesma correlação com a intensidade, idade de início das manifestações e com as concentrações séricas de testosterona. Sugere-se que variações individuais na sensibilidade periférica aos andrógenos ou no metabolismo da testosterona poderiam estar implicadas na variabilidade fenotípica desta doença. Porém, os possíveis mecanismos nunca foram estudados na literatura. Os andrógenos têm sua ação mediada pelo receptor de andrógenos (AR), cujo gene apresenta um trato polimórfico de repetições CAG, o qual modula sua atividade de transativação. Em tecidos periféricos a ação androgênica pode ser ainda potencializada pela enzima 5 alfa-redutase, que transforma testosterona em dihidrotestosterona. O seu gene codificador (SRD5A2) possui vários polimorfismos que alteraram esta atividade de biotransformação nos tecidos periféricos. No clearance da testosterona, os citocromos hepáticos P4503a4, P4503a5 p4503a7 e P4502c19 são os principais envolvidos. Além disso, outro citocromo, o P450c17 representa uma enzima chave na via de produção de andrógenos. Para os citocromos P450 tipo 2, tanto da via de clearance como de síntese dos andrógenos, é necessário ainda a interação com o P450 óxido-redutase para realizar suas reações de hidroxilação. São descritos polimorfismos em todos os genes acima referidos, que alteram sua expressão ou a eficiência catalítica e, consequentemente, tem sido envolvidos na etiologia de doenças andrógeno-dependentes. Consideramos que alterações nos genes codificadores das proteínas relacionadas ao metabolismo e/ou ação periférica dos andrógenos possam atuar na modulação do fenótipo da forma não clássica. Objetivos: Correlacionar o nCAG do gene AR e os polimorfismos nos genes CYP3A5, CYP3A7, CYP3A4, CYP2C19 e CYP17A1, POR e SRD5A2 com a idade de aparecimento dos sintomas, score de Ferriman do hirsutismo ao diagnóstico, presença de virilização, com as concentrações séricas basais de testosterona, bem como com a ausência ou presença de sintomas. Casuística: Selecionamos 122 pacientes com diagnóstico de forma não clássica confirmado por 17OH-progesterona basal ou pós-estímulo com ACTH 10 ng/mL. Todos os pacientes tiveram o diagnóstico molecular, ou seja, mutações identificadas nos dois alelos do gene CYP21A2. As pacientes foram divididas de acordo com o comprometimento da atividade da 21-OH predito pelo genótipo em grupos A/C (grave) e C/C (moderado). As pacientes também foram divididas em grupos pediátrico e adulto, início das manifestações antes e após os 12 anos, respectivamente. Metodologia: O DNA foi extraído de leucócitos periféricos. As regiões de repetições CAG foram amplificadas por PCR e os produtos submetidos à eletroforese capilar e análise pelo software GeneScan. Amostras de DNA das pacientes heterozigotas para o número de repetições CAG foram digeridas com a enzima Hpa II e os produtos submetidos à amplificação da região CAG para se determinar o padrão de inativação do cromossomo X. Os genes CYP3A5, CYP3A4, CYP3A7, CYP17A1, CYP2C19, POR e SRD5A2 foram amplificados por PCR e submetidos à reação de seqüenciamento ou à reação de digestão enzimática para rastreamento das variantes alélicas. Os resultados foram comparados com as respectivas seqüências selvagens depositadas no GeneBank. Na análise estatística foram empregados os testes t de Student, ANOVA, Wilcoxon rank-sun, Kruskall Wallis rank e regressão linear. Resultados: Observamos uma frequência significativamente menor de alelos longos (> 26 repetições) do trato CAG do AR no grupo pediátrico em relação ao de adultos com genótipo 21-OH do grupo C/C (p=0,01). Adicionalmente, a média ponderada do trato CAG foi significativamente menor nas pacientes com clitoromegalia (19,1 ± 2,7) em comparação com a de pacientes sem virilização (21,6 ± 2,5), correlação que independeu do genótipo da 21-OH. A mediana das concentrações séricas de testosterona foi significativamente maior nas carreadoras da variante CYP17A1*A2 (145,7 ng/dL, 126-153) em relação às carreadoras da variante selvagem (57 ng/dL, 36-87) com genótipo 21-OH do grupo A/C. As demais variantes não se correlacionaram com os fenótipos clínico e hormonal. Conclusão: Observamos que o trato CAG apresentou efeito na modulação do fenótipo de virilização de mulheres com forma não clássica. Além disso, o trato CAG pode ter contribuído no período de início das manifestações, uma vez que o grupo pediátrico com genótipo C/C teve freqüência menor de alelos longos em relação às adultas. Dentre as variantes alélicas pesquisadas, que alteram a síntese e/ou metabolismo dos andrógenos, identificamos associação do alelo CYP17A1*A2 com concentrações maiores de testosterona. Embora tenhamos avaliado uma casuística expressiva para esta patologia, para as demais correlações com resultados negativos, não podemos afastar um efeito do tamanho da amostra. / Introduction: The 21-hydroxylase deficiency is a common autosomal recessive disease characterized by clinical hyperandrogenism, which could begin at childhood, puberty or adulthood. There is a strong correlation among impairment of enzymatic activity conferred by genotypes, clinical forms, basal and post-stimulation 17OH-progesterone (17-OHP) levels. However, we did not observe the same correlation with the intensity, age at onset of manifestations and basal testosterone levels. It is suggested that individual variations in the androgen peripheral sensitivity and/or metabolism could be implicated in the phenotypic variability of this disease. However, potential mechanisms have never been studied before. The androgen action is mediated by the androgen receptor (AR), whose gene has a polymorphic CAG repeat that modulates its transactivation activity. In the peripheral tissues, the androgen action is modified by the 5 alpha-reductase type 2 activity, which converts testosterone into a potent androgen, dihydrotestosterone. Its coding gene (SRD5A2) carries several polymorphisms altering its catalytic activity in the peripheral tissues. Regarding the testosterone clearance, hepatic cytochromes P4503a4, P4503a5 p4503a7 P4502c19 are the most important. In addition, another cytochrome, P450c17, is a key enzyme in the androgen production pathway. For the cytochrome P450 type 2 activities, involved in the androgen clearance and/or synthesis, an interaction with the P450 oxidoreductase is still necessary. Polymorphisms are described in all the aforementioned genes, which change their expression and/or catalytic efficiencies; consequently, they have been implicated in the etiology of androgen-dependent diseases. We supposed that changes in the coding genes for the aforesaid proteins could act in modulating the nonclassical phenotype. Objectives: To compare the nCAG of AR gene and polymorphisms of CYP3A5, CYP3A7, CYP3A4, CYP2C19, and CYP17A1, SRD5A2 and POR genes with the age of onset of symptoms, Ferriman score of hirsutism at diagnosis, presence of virilization, basal testosterone levels, as well as with the absence or the presence of symptoms. Patients: We selected 122 patients with basal or post-ACTH 17-OHP 10 ng/mL. All patients had confirmed nonclassical molecular diagnoses. Patients were divided according to the impairment of 21-OH activity predicted by genotype groups into A/C (severe) and C/C (moderate). Patients were also classified according to the onset of manifestations into pediatric and adult groups, younger than or older than 12 years, respectively. Methods: DNA was extracted from peripheral leukocytes. CAG repeat regions were PCR amplified, products submitted to capillary electrophoresis and analyzed by GeneScan software. DNA samples from CAG heterozygous patients were digested with the Hpa II enzyme and also submitted to PCR, in order to determine X-chromosome inactivation pattern. The CYP3A5, CYP3A4, CYP3A7, CYP17A1, CYP2C19, POR and SRD5A2 genes were PCR amplified and submitted to sequencing or enzymatic assays to screen the allelic variants. The results were compared with their wild sequences in the GenBank. Statistical comparisons employed Student\'s t tests, ANOVA, Wilcoxon rank-sun, Kruskal Wallis rank and linear regression. Results: We observed a significantly lower frequency of longer CAG alleles (> 26 repeats) of AR in the pediatric group compared to the adults carrying the 21-OH genotype from group C/C (p = 0.01). Additionally, the weighted biallelic mean of the CAG tract was considerably lower in patients with clitoromegaly (19.1 ± 2.7) in comparison to patients without it (21.6 ± 2.5), a correlation that was independent of the 21-OH genotype severity. The median of testosterone levels was significantly higher in the CYP17A1*A2 carriers (145.7 ng/dL, 126-153) compared to the ones carrying the wild allele (57 ng/dL, 36-87), from the group A/C of 21-OH genotype. The other variants did not show a correlation with clinical and hormonal phenotypes. Conclusions: We observed that the CAG tract was effective in modulating the phenotype of virilization in nonclassical women as well as influenced the period of onset of manifestations of patients carrying moderate CYP21A2 genotype. Considering the remaining allelic variants, which alter the androgen synthesis or metabolism, we identified the association of CYP17A1*A2 alleles with higher testosterone levels. Although we evaluated a significant number of patients with 21-OHD, we cannot rule out a sample size effect.
202

Aspectos comportamentais e do desenvolvimento psicossexual dos pacientes com distúrbios do desenvolvimento sexual 46,XY na idade adulta / Behavioral and psychosexual aspects of 46,XY DSD individuals at adulthood

Rafael Loch Batista 12 December 2017 (has links)
Introdução: O desenvolvimento psicossexual humano inicia no período pré-natal e é composto pelo papel de gênero (PG), pela identidade de gênero (IG) e pela orientação sexual (OS). Em indivíduos com DDS 46,XY, vários fatores podem comprometer esse desenvolvimento, levando a incongruência de identidade de gênero e à mudança de gênero. Nesses pacientes, a exposição androgênica pré-natal e o grau de virilização da genitália externa tem sido avaliados como possíveis influenciadores destes desfechos, mas seu papel ainda não foi esclarecido. Objetivos: Avaliar os desfechos psicossexuais - IG, PG e OS - e aspectos da vida sexual em uma coorte de indivíduos com DDS 46,XY na idade adulta com diagnostico etiológico caracterizado do ponto de vista clínico e molecular e investigar a influência da exposição androgênica pré-natal e do grau de virilização da genitália externa nesses desfechos e na prevalência de disforia de gênero (DG). Pacientes: 144 pacientes com diagnóstico etiológico confirmado de DDS 46,XY acompanhados do HCFMUSP com idade entre 16 e 60 anos foram incluídos neste estudo. Métodos: Os componentes do desenvolvimento psicossexual (IG, PG, OS) foram avaliados usando questionários e por teste psicológico projetivo (HTP - House-Tree-Person). O escore de Sinnecker foi utilizado para a mensuração do grau de virilização da genitália externa. A exposição androgênica pré-natal foi estimada de acordo com a etiologia do DDS 46,XY. Aspectos da vida sexual foram avaliados através de questionário específico.Todas as variáveis categóricas foram analisadas usando teste X². A força de associação foi avaliada pelo cálculo do V de Cramer. O índice kappa foi usado para avaliar concordância entre resultados dos testes. Resultados: Houve uma associação positiva entre exposição androgênica pré-natal e a maior incidência de desfechos psicossexuais masculinos em indivíduos com maior exposição. O grau de virilização da genitália externa não interferiu nos desfechos psicossexuais. Houve uma prevalência de 19% (27/144) de disforia de gênero em toda a coorte. Em 93% (25/27), a DG foi do sexo feminino para o masculino e ocorreu em 50% (16/32) de casos de deficiência de 5alfa-RD2, seguido de 33% (5/15) dos casos de deficiência da 17beta-HSD3 e se associou com exposição androgênica pré-natal (p < 001; V=0,461), mas não com a virilização da genitália externa. A mediana de idade do desejo de mudar de sexo foi de 8 anos (5 - 9) enquanto que a da idade da mudança de sexo foi 15 anos (10.5 - 20). Os desfechos psicossexuais mostraram maior concordância com o sexo social final (PG - k=0.81; IG - k=0.65 e OS - k=0.85) do que com o sexo de registro (PG - k=0.1; IG - k=0.25 e OS - k=0.15). Quanto a sexualidade, alguns parâmetros (fantasias sexuais, masturbação e parceiro sexual fixo) foram melhores no sexo masculino comparado ao feminino. No entanto, não houveram diferenças em relação aos parâmetros da vida sexual comparando indivíduos do sexo feminino com e sem atipia genital e indivíduos do sexo masculino que mantiveram o sexo social com os que mudaram para este sexo. Conclusões: A exposição androgênica pré-natal influenciou o desenvolvimento psicossexual em indivíduos com DDS 46,XY, de uma forma exposição-dependente, favorecendo desfechos masculinos, enquanto que o grau de virilização da genitália externa não influenciou estes desfechos. A DG do feminino para o masculino foi comum entre esses indivíduos e também foi influenciada pela exposição androgênica pré-natal. Os parâmetros psicossexuais nesses pacientes concorda muito mais com o sexo social final do que com o sexo de registro. A sexualidade dos indivíduos do sexo masculino tem aspectos mais satisfatórios que o feminino. Atipia genital no sexo feminino não afetou a sexualidade destas pacientes assim a sexualidade dos indivíduos que mudaram para o sexo masculino são semelhantes aos que foram registrados no sexo masculino Behavioral and Psychosexual Aspects of 46,XY DSD Individuals At Adulthood / Introduction: The human psychosexual development begins at prenatal period and is composed by gender role, gender identity and sexual orientation. In 46,XY DSD individuals a variety of factors may jeopardize an adequate psychosexual development and sometimes results in desire to change the gender. The effects of prenatal androgen exposure and the impact of atypical genitalia in the psychosexual outcomes have been suggested as influencing factors in the human psychosexual development but there is not conclusive evidence, especially in DDS 46, XY. Methods: We evaluated the psychosexual compounds - gender role (GR) at childhood gender identity (GI) and sexual orientation (SO) in individuals a large cohort of 144 46,XY DSD individuals, 86% of them raised in the female social sex, from a single tertiary medical center. The same psychologist, specialized in DSD, performed the psychosexual evaluation. We used a questionnaire and a projective psychological test (HTP test) to measure the psychosexual compounds. Prenatal androgen exposure was estimated considering the 46,XY etiology. Sinnecker\'s score was used to measure the external genitalia virilization. All ordinal variables were analyzed using Wilcoxon test. Categorical variables were analyzed using X2 test with posterior Cramer\'s V to measure the association strength. The kappa index was calculated as a concordance measure. Results: We found an association between prenatal androgen exposure and major prevalence of male psychosexual outcomes and a higher incidence of female to male gender dysphoria. There was not difference in the psychosexual outcomes according by external genitalia virilization in male and in female individuals. There was an incidence of 19% of gender dysphoria (27 out from 144). In 93% (n=25), the gender change was from female to male (F to M). The ethological diagnosis related with F to M GD were 5alpha-RD2 deficiency (5ARD2) in 16/32 (50%), followed by 5/15 (33%) in 17beta-HSD3 deficiency (17betaHSD3). Others diagnosis related with F to M GD were: partial gonadal dysgenesis (n=3/24; 12%) and 3betaHSD2 (n=1/3; 33%). Both cases of male to female (M to F) GD occurred in partial gonadal dysgenesis (8%; n=2/24). The median of GD age (desire to belong to another gender) was 8 years old (5-9), and the median of gender change itself was 15 years old (10.5 - 20). In F to M GD, gender change was associated with prenatal androgen exposure (p < 001; V=0,461). The psychosexual components showed higher concordance index with final gender (GI - k=0.81; GI - k=0.65 and SO - k=0.85) then with the assigned sex (GI - k=0.1; GI - k=0.25 and SO - k=0.15). Conclusion: Prenatal androgen exposure affects the psychosexual development, favoring more male outcomes. This influence was observed in GI, GR and SO. The degree of external genitalia virilization did not influence the psychosexual development. Female to Male GD is common in 46,XY DSD raised in female social sex, especially in 5ARD2 and 17?HSD3 deficiencies. There is a strong relationship between prenatal androgen exposure and F to M GD. On the other hand, M to F gender change was rare in 46,XY DSD and occurred only in partial gonadal dysgenesis patients
203

Ánálise de alterações no gene receptor de andrógeno em homens com infertilidade idiopática / Analysis of changes in the androgen receptor gene in men with idiopathic infertility

MESQUITA, Wyara Elanne de Jesus Castro 31 March 2009 (has links)
Made available in DSpace on 2014-07-29T15:16:33Z (GMT). No. of bitstreams: 1 dissertacao wyara biologia.pdf: 1287742 bytes, checksum: 4b2f592f2b219248664d4916820cd874 (MD5) Previous issue date: 2009-03-31 / Male idiopathic infertility is related to defects in normal spermatogenesis, due to genetic causes. The spermatogenesis is a dependent process on high levels of male sex hormones, the androgens. The androgen, in turn, perform its function when associated with the androgen receptor (AR), protein encoded by AR gene. Mutation in AR gene lead to a synthesis of non functional AR, which results in the failure of the process of spermatogenesis and, consequently, causes male infertility. This work has as its main objective the verification of the occurrence of mutation in the AR gene in patients with male idiopathic infertility who come from the HC-UFG Human Reproduction Center. Samples were analyzed from 206 patients. The result was that 95 patients were found to be normal while 111 with an altered result for the spermogram. The samples were amplified for exons 1, 4, 6, 7 and 8 of the AR gene and the results subjected to statistical analysis, Mann Whitney, logistic regression, and chi tests. The existence of the relationship between defects of sperm and AR gene mutation was verified. The analysis of the relationship between the spermogram and the AR gene mutation in five evaluated exons was significant only for exons 1 and 7. Patients with numerical unsettled spermogram had a higher frequency of mutations in exon 7, teratozoospermics in exon 1 and exon 7 in astenozoospermics patients. Exons 4, 6 and 8 showed no meaningful statistical relationship in reference to the alteration of the spermogram. Among results related to social custom, alcohol proved to be significant for mutation in the AR gene. This study has reaffirmed the relationship between the presence of mutation in AR genes as probable causes of defects in spermatogenesis. Consequently, male idiopathic infertility depends not only on the genetic factor, but also on the association between this factor and the environment where man inhabits / A infertilidade masculina idiopática está relacionada a defeitos na espermatogênese normal, devido a causas genéticas. A espermatogênese é um processo dependente de altos níveis de hormônios sexuais masculinos, os andrógenos. E os andrógenos, por sua vez, exercem sua função quando associados ao receptor androgênico (RA), proteína codificada pelo gene RA. Mutações no gene RA levam a síntese do RA não funcional, o que acarreta em falhas no processo de espermatogênese e consequentemente causam infertilidade masculina. O trabalho teve como principal objetivo verificar a ocorrência ou não de mutação no gene RA em pacientes com infertilidade masculina idiopática do Centro de Reprodução Humana do HCUFG. Foram analisadas 206 amostras de pacientes, sendo 95 normais e 111 alterados para o espermograma. As amostras foram amplificadas para os exons 1, 4, 6, 7 e 8 do gene RA e os resultados submetidos às análises estatísticas, teste U, quiquadrado e regressão logística. Foi verificada a existência de relação entre alteração no espermograma e mutação no gene RA. A análise da relação entre espermograma e mutação no gene RA dos cinco exons avaliados foi significativa somente para os exons 1 e 7. Os pacientes com alteração numérica para o espermograma apresentaram uma freqüência maior de mutações no exon 7, os pacientes teratozoospérmicos no exon 1 e os astenozoospérmicos no exon 7. Os exons 4, 6 e 8 não apresentaram relação estatística significativa para alterações no espermograma. Dentre os resultados referentes aos hábitos sociais, o etilismo mostrou-se significativo para mutações no gene RA. A realização desse estudo vem reafirmar a relação entre presença de mutações no gene RA como prováveis causas de defeitos na espermatogênese e, consequentemente, infertilidade masculina idiopática, não dependendo exclusivamente do fator gênico, mas da associação entre este fator e o meio ambiente onde o homem está inserido
204

Uloga insulinskih i IGF1 receptora u regulaciji steroidogeneze i mitohondrijallne biogenze u Leydigovim ćelijama / The role of insulin and IGF1 receptors in regulation of teroidogenesis and mitochondrial biogenesis in Leydig cells

Radović Sava 31 May 2019 (has links)
<p>Leydig-ove&nbsp; ćelije&nbsp; testisa&nbsp; su&nbsp; primarno&nbsp; mesto&nbsp; sinteze mu&scaron;kih polnih hormona. Ovi hormoni su neophodani za reproduktivno,&nbsp; ali&nbsp; i&nbsp; za&nbsp; op&scaron;te&nbsp; zdravlje&nbsp; budući&nbsp; da&nbsp; su<br />ozbiljni zdravstveni problemi često povezani sa njihovom smanjenom produkcijom.&nbsp; Insulin i insulinu sličan faktor rasta&nbsp; 1,&nbsp; IGF1&nbsp; <em>(engl.</em>&nbsp; insulin&nbsp; like&nbsp; growth&nbsp; factor&nbsp; 1),&nbsp; i<br />signalizacija koju pokreću preko svojih receptora&nbsp; (INSR i IGF1R),&nbsp; su&nbsp; jedan&nbsp; od&nbsp; ključnih&nbsp; faktora&nbsp; koji&nbsp; reguli&scaron;u specifični razvoj tkiva, pa i samih gonada. Ipak,&nbsp; uloga&nbsp; i<br />mehanizmi&nbsp; delovanja&nbsp; ovih&nbsp; receptora&nbsp; u&nbsp; steroidogenim tkivima nisu&nbsp; u potpunosti&nbsp; poznati.&nbsp; Stoga je&nbsp; istraživanje&nbsp; uokviru ove&nbsp; doktorske&nbsp; disertacije&nbsp; koncipirano sa ciljem da se,&nbsp; na&nbsp; modelu&nbsp; prepubertalnih&nbsp; (P21)&nbsp; i&nbsp; adultnih&nbsp; (P80) mužjaka mi&scaron;eva sa kondicionalnom delecijom<em> Insr </em>i <em>Igf1</em>r gena&nbsp; u&nbsp; steroidogenim&nbsp; ćelijama&nbsp; (Insr/Igf1r-DKO), defini&scaron;e uloga INSR i IGF1R u regulisanju diferencijacije i&nbsp; steroidogene&nbsp; funkcije&nbsp; Leydig-ovih&nbsp; ćelija.&nbsp; Pored&nbsp; toga, mužjaci&nbsp; i&nbsp; ženke&nbsp; P21&nbsp; mi&scaron;eva&nbsp; sa&nbsp; istom&nbsp; delecijom&nbsp; su kori&scaron;ćeni&nbsp; za&nbsp; praćenje&nbsp; ekspresije&nbsp; glavnih&nbsp; markera mitohondrijalne&nbsp; biogeneze&nbsp; i&nbsp; fuzije/arhitekture&nbsp; u&nbsp; Leydigovim&nbsp; ćelijama,&nbsp; ovarijumima&nbsp; i&nbsp;&nbsp; nadbubrežnim&nbsp; žlezdama. Rezultati&nbsp; su&nbsp; potvrdili&nbsp; da&nbsp; delecija&nbsp; Insr&nbsp; i&nbsp; Igf1r&nbsp; u<br />steroidogenim&nbsp; tkivima&nbsp; utiče&nbsp; na&nbsp; diferencijaciju&nbsp; i funkcionalne karakteristike Leydig-ovih ćelija P21 i P80 mi&scaron;eva,&nbsp; upućujući&nbsp; na&nbsp; pojavu&nbsp; tzv.&nbsp; &bdquo;feminizacije&ldquo;.&nbsp; Broj<br />Leydig-ovih&nbsp; ćelija&nbsp; izolovanih&nbsp; iz&nbsp; P21&nbsp; i&nbsp; P80&nbsp; Insr/Igf1rDKO&nbsp; mi&scaron;eva&nbsp; bio&nbsp; je&nbsp; smanjen,&nbsp; a&nbsp; morfologija&nbsp; i ultrastruktura&nbsp; ovih&nbsp; ćelija&nbsp; izmenjene&nbsp; kod&nbsp; P21&nbsp; Insr/Igf1rDKO&nbsp; mi&scaron;eva.&nbsp; Steroidogeni&nbsp; kapacitet&nbsp; i&nbsp; aktivnost,&nbsp; kao&nbsp; i ekspresija&nbsp; glavnih&nbsp; elemenata&nbsp; steroidogene&nbsp; ma&scaron;inerije <em>(Lhcgr, Star, Cyp11a1, Cyp17a1, Hsd3b1&nbsp; i&nbsp; 6, Hsd17b3,</em><br /><em>Sf</em>1)&nbsp; bili su&nbsp; smanjeni&nbsp; u Leydig-ovim ćelijama P21 i P80 <em>Insr/Igf1</em>r-DKO mi&scaron;eva,&nbsp; dok je ekspresija transkripcionih represora&nbsp; steroidogeneze&nbsp; (Arr19&nbsp; i&nbsp; Dax1)&nbsp; bila&nbsp; povećana specifično&nbsp; u&nbsp; istim&nbsp; ćelijama,&nbsp; ali&nbsp; ne&nbsp; i&nbsp; u&nbsp; ostatku&nbsp; testisa.<br />Transkripcioni&nbsp; profil&nbsp; markera&nbsp; mu&scaron;kog&nbsp; pola&nbsp; (<em>Sry,&nbsp; Sox9, Amh</em>)&nbsp; bio&nbsp; je&nbsp; izmenjen&nbsp; u Leydig-ovim ćelijama P21 i P80 <em>Insr/Igf1r</em>-DKO&nbsp; mi&scaron;eva.&nbsp; Transkripcija&nbsp; markera&nbsp; ženskog pola (<em>Rspo1, Wnt4</em>) u testisima,&nbsp; kao i ekspresija&nbsp; Cyp19a1 i&nbsp; produkcija estradiola (E2) u Leydig-ovim ćelijama,&nbsp; P21 i&nbsp; P80&nbsp;<em> Insr/Igf1r</em>-DKO&nbsp; mi&scaron;eva&nbsp; bile&nbsp; su&nbsp; povećane. Transkripcija&nbsp; markera&nbsp; mitohondrijalne&nbsp; biogenze (<em>Ppargc1a,&nbsp; Tfam</em>,&nbsp; <em>Mtnd1</em>)&nbsp; bila&nbsp; je&nbsp; smanjena&nbsp; u&nbsp; Leydigovim&nbsp; ćelijama&nbsp; P21&nbsp; <em>Insr/Igf1r</em>-DKO&nbsp; mi&scaron;eva,&nbsp; dok&nbsp; supromene&nbsp; ekspresije&nbsp; izostale&nbsp; u&nbsp; ovarijumima&nbsp; ženki&nbsp; istog&nbsp; genotipa.&nbsp; Isti&nbsp; markeri&nbsp; su&nbsp; bili&nbsp; povećani&nbsp; u&nbsp; nabdubrežnim&nbsp; žlezdama&nbsp; oba&nbsp; pola.&nbsp; Markeri&nbsp; mitohondrijalne fuzije/arhitekture&nbsp; (<em>Mfn1&nbsp; i&nbsp; Mfn2)</em>&nbsp; bili&nbsp; su&nbsp; povećani&nbsp; u Leydig-ovim ćelijama P21 <em>Insr/Igf1r</em>-DKO mi&scaron;eva, &scaron;to je&nbsp; praćeno&nbsp; i&nbsp; naru&scaron;enom&nbsp; mitohondrijalnom&nbsp; fazom steroidogeneze (produkcija progesterona), kao i brojem i&nbsp; morfologijom ovim organela.&nbsp; Ekspresija istih markera u ovarijumima&nbsp; bila&nbsp; je&nbsp; nepromenjena.&nbsp; Sumirano,&nbsp; rezultati ovog istraživanja&nbsp; su&nbsp; pokazali&nbsp; da su&nbsp; INSR i IGF1R&nbsp; važni za&nbsp; diferencijaciju&nbsp; i&nbsp; steroidogenu&nbsp; funkciju&nbsp; Leydig-ovih&nbsp; ćelija&nbsp; P21&nbsp; i&nbsp; P80&nbsp; mi&scaron;eva.&nbsp; Takođe,&nbsp; ovi&nbsp; receptori&nbsp; su&nbsp; važni regulatori&nbsp; markera&nbsp; mitohondrijalne&nbsp; biogeneze&nbsp; i fuzije/arhiteture u steroidogenim ćelijama mu&scaron;kih gonada&nbsp; P21 mi&scaron;eva, ali ne i u steroidogenim ćelijama ovarijuma.&nbsp;</p> / <p>Leydig cells of testes are the primary site of the male sex hormones&nbsp; synthesis.&nbsp; These&nbsp; hormones&nbsp; are&nbsp; indispensable for&nbsp; both&nbsp; reproductive&nbsp; and&nbsp; general&nbsp; health&nbsp; since&nbsp; serious health&nbsp; problems&nbsp; are&nbsp; often&nbsp; associated&nbsp; with&nbsp; their&nbsp; reduced production.&nbsp; Insulin&nbsp; and&nbsp; insulin-like&nbsp; growth&nbsp; factor&nbsp; 1, IGF1&nbsp; (insulin&nbsp; like&nbsp; growth&nbsp; factor&nbsp; 1),&nbsp; and&nbsp; signaling triggered through&nbsp; their receptors (INSR and IGF1R), are&nbsp; one of the key&nbsp; factors&nbsp; that regulate specific development of&nbsp; tissue&nbsp; including&nbsp; gonads.&nbsp; However,&nbsp; the&nbsp; role&nbsp; and mechanisms&nbsp; of&nbsp; these&nbsp; receptors&nbsp; action&nbsp; in&nbsp; steroidogenic tissues are not known enough. This study was designed to&nbsp; observe &nbsp; the role of INSR and IGF1R in regulating the differentiation and steroidogenic function of Leydig cells by using the model of prepubertal (P21) and adult (P80) male mice with the conditional deletion of the&nbsp; Insr&nbsp; and Igf1r&nbsp; genes&nbsp; in&nbsp; steroidogenic&nbsp; cells&nbsp; (<em>Insr/Igf1r-</em>DKO).&nbsp; In addition,&nbsp; male&nbsp; and&nbsp; female&nbsp; P21&nbsp; mice&nbsp; with&nbsp; the&nbsp; samedeletion were used to monitor the expression of the main markers&nbsp; of&nbsp; mitochondrial&nbsp; biogenesis&nbsp; and fusion/architecture&nbsp; in&nbsp; Leydig&nbsp; cells,&nbsp; ovaries&nbsp; and&nbsp; adrenal glands.&nbsp; The&nbsp; results&nbsp; confirmed&nbsp; that&nbsp; deletion&nbsp; of&nbsp;<em> Insr</em>&nbsp; and<em> Igf1r&nbsp;</em> in&nbsp; steroidogenic&nbsp; tissues&nbsp; influences&nbsp; differentiation and&nbsp; functional&nbsp; characteristics&nbsp; of&nbsp; Leydig&nbsp; cells&nbsp; isolated from&nbsp; P21&nbsp; and&nbsp; P80&nbsp; mice,&nbsp; suggesting&nbsp; an&nbsp; appearance&nbsp; of &quot;feminization&quot;.&nbsp; The&nbsp; number&nbsp; of&nbsp; Leydig&nbsp; cells&nbsp; isolated from&nbsp; both&nbsp; P21&nbsp; and&nbsp; P80&nbsp; <em>Insr/Igf1</em>r-DKO&nbsp; mice&nbsp; was reduced.&nbsp; Morphology&nbsp; and&nbsp; ultrastructure&nbsp; of&nbsp; Leydig&nbsp; cells were&nbsp; disturbed&nbsp; in&nbsp; P21&nbsp; <em>Insr/Igf1r-</em>DKO&nbsp; mice. Steroidogenic capacity and activity, as well as expression of the main elements of&nbsp; steroidogenic machinery (<em>Lhcgr, Star, Cyp11a1, Cyp17a1, Hsd3b1&nbsp; and&nbsp; 6, Hsd17b3, Sf1) </em>were&nbsp; decreased&nbsp; in&nbsp; Leydig&nbsp; cells&nbsp; from&nbsp; P21&nbsp; and&nbsp; P80 I<em>nsr/Igf1</em>r-DKO&nbsp; mice,&nbsp; while&nbsp; the&nbsp; expression&nbsp; of transcriptional&nbsp; repressors&nbsp; of&nbsp; steroidogenesis&nbsp; (<em>Arr19</em>&nbsp; and <em>Dax1) </em>was increased&nbsp; in the same cells, but not in the rest of&nbsp; the&nbsp; testes.&nbsp; Transcription&nbsp; profile&nbsp; of&nbsp; the&nbsp; male&nbsp; sex markers&nbsp; (<em>Sry,&nbsp; Sox9</em>,&nbsp; <em>Amh</em>)&nbsp; was&nbsp; altered&nbsp; in&nbsp; Leydig&nbsp; cells from&nbsp; P21&nbsp; and&nbsp; P80&nbsp; <em>Insr/Igf1</em>r-DKO&nbsp; mice.&nbsp; Transcription of the female sex markers (<em>Rspo1, Wnt4</em>) in the testes, as well&nbsp; as&nbsp; <em>Cyp19a1&nbsp; </em>expression&nbsp; and&nbsp; estradiol&nbsp; (E2) production in Leydig cells,&nbsp; from P21 and P80&nbsp; I<em>nsr/Igf1</em>rDKO&nbsp; mice&nbsp; were&nbsp; increased.&nbsp; Transcription&nbsp; of mitochondrial&nbsp; biogenesis&nbsp; markers&nbsp; (<em>Ppargc1a,&nbsp; Tfam, Mtnd1</em>)&nbsp; was&nbsp; declined&nbsp; in&nbsp; Leydig&nbsp; cells&nbsp; from&nbsp; P21<em> Insr/Igf1r-</em>DKO mice, while changes were absent in&nbsp; the ovaries of the same genotype.&nbsp; Transcription of the&nbsp; same markers&nbsp; was&nbsp; increased&nbsp; in&nbsp; the&nbsp; adrenal&nbsp; glands&nbsp; of&nbsp; both sexes.&nbsp; The&nbsp; mitochondrial&nbsp; fusion/architecture&nbsp; markers (<em>Mfn1</em>&nbsp; and&nbsp; <em>Mfn2</em>)&nbsp; were&nbsp; increased&nbsp; in&nbsp; Leydig&nbsp; cells&nbsp; from<em> Insr/Igf1r</em>-DKO&nbsp; mice&nbsp; and&nbsp; followed&nbsp; by&nbsp; disturbedmitochondrial&nbsp; phase&nbsp; of&nbsp; steroidogenesis&nbsp; (progesterone production), as well as&nbsp; decreased&nbsp; number and&nbsp; disturbed morphology&nbsp; of&nbsp; mitochondria.&nbsp;&nbsp; Expression&nbsp; of&nbsp; the&nbsp; same markers&nbsp; in&nbsp; the&nbsp; ovaries&nbsp; was&nbsp; unchanged.&nbsp; In&nbsp; summary, results&nbsp; of&nbsp; this&nbsp; study&nbsp; showed&nbsp; that&nbsp; INSR&nbsp; and&nbsp; IGF1R&nbsp; are important in differentiation and steroidogenic function of Leydig&nbsp; cells&nbsp; from&nbsp; P21&nbsp; and&nbsp; P80&nbsp; mice.&nbsp; Also,&nbsp; these receptors&nbsp; are&nbsp; important&nbsp; regulators&nbsp; of&nbsp; mitochondrial biogenesis&nbsp; and&nbsp;&nbsp; fusion/architecture&nbsp; markers&nbsp; in steroidogenic&nbsp; cells&nbsp; of&nbsp; P21&nbsp; male&nbsp; mice,&nbsp; but&nbsp; not&nbsp; in steroidogenic cells of ovaries.</p>
205

Tibia Morphology & Bone Marrow Adipose Tissue Phenotype is Controlled by Sex Steroids in C57BL/6 Mice

Sherman, Shermel B. January 2016 (has links)
No description available.
206

Transcriptomes of testis and pituitary from male Nile tilapia (O. niloticus L.) in the context of social status

Thönnes, Michelle, Prause, Rebecca, Levavi-Sivan, Berta, Pfennig, Frank 18 April 2024 (has links)
African cichlids are well established models for studying social hierarchies in teleosts and elucidating the effects social dominance has on gene expression. Ascension in the social hierarchy has been found to increase plasma levels of steroid hormones, follicle stimulating hormone (Fsh) and luteinizing hormone (Lh) as well as gonadosomatic index (GSI). Furthermore, the expression of genes related to gonadotropins and steroidogenesis and signaling along the brain-pituitary-gonad axis (BPG-axis) is affected by changes of an animal’s social status. In this study, we use RNA-sequencing to obtain an in-depth look at the transcriptomes of testes and pituitaries from dominant and subordinate male Nile tilapia living in long-term stable social hierarchies. This allows us to draw conclusions about factors along the brain-pituitary-gonad axis that are involved in maintaining dominance over weeks or even months. We identify a number of genes that are differentially regulated between dominant and subordinate males and show that in high-ranking fish this subset of genes is generally upregulated. Genes differentially expressed between the two social groups comprise growth factors, related binding proteins and receptors, components of Wnt-, Tgfβ- and retinoic acid-signaling pathway, gonadotropin signaling and steroidogenesis pathways. The latter is backed up by elevated levels of 11-ketotestosterone, testosterone and estradiol in dominant males. Luteinizing hormone (Lh) is found in higher concentration in the plasma of long-term dominant males than in subordinate animals. Our results both strengthen the existing models and propose new candidates for functional studies to expand our understanding of social phenomena in teleost fish.
207

Stem cell factor/c-Kit signalling in normal and androgenetic alopecia hair follicles

Randall, Valerie A., Jenner, Tracey J., Hibberts, Nigel A., De Oliveira, Isabel O., Vafaee, Tayyebeh January 2008 (has links)
No / Androgens stimulate many hair follicles to alter hair colour and size via the hair growth cycle; in androgenetic alopecia tiny, pale hairs gradually replace large, pigmented ones. Since stem cell factor (SCF) is important in embryonic melanocyte migration and maintaining adult rodent pigmentation, we investigated SCF/c-Kit signalling in human hair follicles to determine whether this was altered in androgenetic alopecia. Quantitative immunohistochemistry detected three melanocyte-lineage markers and c-Kit in four focus areas: the epidermis, infundibulum, hair bulb (where pigment is formed) and mid-follicle outer root sheath (ORS). Colocalisation confirmed melanocyte c-Kit expression; cultured follicular melanocytes also exhibited c-Kit. Few ORS cells expressed differentiated melanocyte markers or c-Kit, but NKI/beteb antibody, which also recognises early melanocyte-lineage antigens, identified fourfold more cells, confirmed by colocalisation. Occasional similar bulbar cells were seen. Melanocyte distribution, concentration and c-Kit expression were unaltered in balding follicles. Androgenetic alopecia cultured dermal papilla cells secreted less SCF, measured by ELISA, than normal cells. This identifies three types of melanocyte-lineage cells in human follicles. The c-Kit expression by dendritic, pigmenting, bulbar melanocytes and rounded, differentiated, non-pigmenting ORS melanocytes implicate SCF in maintaining pigmentation and migration into regenerating hair bulbs. Less differentiated, c-Kit-independent cells in the mid-follicle ORS stem cell niche and occasionally in the bulb, presumably a local reserve for long scalp hair growth, implicate other factors in activating stem cells. Androgens appear to reduce alopecia hair colour by inhibiting dermal papilla SCF production, impeding bulbar melanocyte pigmentation. These results may facilitate new treatments for hair colour changes in hirsutism, alopecia or greying.
208

Androgen secretion and cardiovascular risk factors in women with and without PCOS:studies on age-related changes and medical intervention

Puurunen, J. (Johanna) 26 May 2015 (has links)
Abstract Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. The main features of the syndrome include menstrual irregularities and hyperandrogenism. In addition to symptoms related to fertility, some women also suffer from an unfavourable metabolic profile including impaired glucose tolerance, dyslipidaemia and low-grade chronic inflammation. In the present studies we aimed to investigate the role of age on adrenal and ovarian androgen secretion in 79 women with PCOS and 98 healthy women, with special focus on the menopause. Furthermore, we studied the effects of combined hormonal contraceptives (CHCs) administered orally, transdermally and vaginally (n=42, healthy women, 9 weeks) and atorvastatin treatment (n=28, women with PCOS, 6 months) on androgen levels and metabolic factors. Androgen secretion capacity was analysed by using adrenal and ovarian stimulation tests and glucose tolerance by using oral and intravenous glucose tolerance tests. Furthermore, chronic inflammation was assessed via assay of C-reactive protein and pentraxin-3. Basal and stimulated adrenal and ovarian androgen production was elevated and levels remained higher in women with PCOS compared with healthy women even after the menopause. Furthermore, women with PCOS presented with enhanced insulin resistance and chronic inflammation, which persisted beyond menopausal transition. During CHC treatment, the route of administration was insignificant, and all treatments impaired insulin sensitivity and increased chronic inflammation. In women with PCOS, treatment with atorvastatin improved chronic inflammation and the lipid profile as expected, but worsened glucose tolerance and did not affect testosterone levels. Regardless of strict exclusion criteria, where only relatively healthy women with PCOS were recruited, the results showed that enhanced androgen secretion and unfavourable metabolic alterations associated with PCOS persist through menopausal transition. The findings emphasize the importance of monitoring glucose metabolism during the use of CHCs, especially in women with known risks of type 2 diabetes. Atorvastatin treatment exacerbates insulin resistance in women with PCOS and therefore the treatment should only be considered after individual risk assessment of cardiovascular disease and not just because of PCOS. / Tiivistelmä Monirakkulainen munasarjaoireyhtymä (PCOS) on hedelmällisessä iässä olevien naisten yleisin hormonaalinen ongelma. Tyypillisiä PCOS:n oireita ovat munarakkuloiden epäsäännöllisestä kypsymisestä johtuvat kuukautiskierron häiriöt ja miessukuhormonien eli androgeenien liikatuotanto. Hedelmällisyyttä heikentävien oireiden lisäksi PCOS:än liittyy aineenvaihdunnan ongelmia, kuten heikentynyttä sokerinsietoa sekä taipumus rasva-aineenvaihdunnan häiriöihin ja krooniseen tulehdukseen. Tutkimuksessa selvitettiin ikääntymisen ja vaihdevuosien vaikutuksia lisämunuais- ja munasarjaperäiseen androgeenieritykseen 79 PCOS-naisella ja 98 terveellä naisella. Lisäksi tutkittiin eri yhdistelmäehkäisyvalmisteiden antoreittien (suu, iho, emätin) (n=42, terveet naiset, 9 viikkoa) ja atorvastatiinihoidon (n=28, PCOS-naiset, 6 kuukautta) vaikutuksia androgeenitasoihin ja aineenvaihdunnallisiin muuttujiin. Androgeenieritystä tutkittiin lisämunuaisten ja munasarjojen stimulaatiotesteillä ja sokeriaineenvaihdunnan muutoksia suun kautta ja suonensisäisesti tehtävillä sokerirasituskokeilla. Tulehduksellista tilaa mitattiin määrittämällä C-reaktiivisen proteiinin ja pentraksiini-3:n pitoisuuksia. Lisämunuaisten ja munasarjojen androgeenieritys oli PCOS-naisilla lisääntynyt terveisiin naisiin verrattuna, ja ero säilyi vaihdevuosi-iän jälkeen. PCOS-naisilla esiintyi myös enemmän heikentynyttä sokerinsietoa ja kroonista tulehdusta vielä vaihdevuosi-iän jälkeenkin. Hormonaalinen yhdistelmäehkäisy heikensi insuliiniherkkyyttä sekä pahensi pitkäaikaista tulehdusta annostelureitistä riippumatta. Atorvastatiinihoito puolestaan paransi pitkäaikaista tulehdusta sekä rasva-aineenvaihduntaa PCOS-naisilla, mutta huononsi sokerinsietoa ja insuliiniherkkyyttä eikä sillä ollut vaikutusta testosteronitasoihin. Koska poissulkukriteerit olivat tiukat, tutkimuksiin valikoitui varsin terveitä PCOS-naisia. Siitä huolimatta osoittautui, että PCOS:än liittyvä lisääntynyt androgeenituotanto sekä epäedulliset aineenvaihdunnan muutokset jatkuvat vielä vaihdevuosi-iän jälkeen. Hormonaalisen yhdistelmäehkäisyn käytön aikana olisi hyvä seurata sokeriaineenvaihdunnan muutoksia erityisesti niillä naisilla, joilla on kohonnut riski sairastua aikuistyypin diabetekseen. Atorvastatiinihoito huonontaa PCOS-naisilla insuliiniherkkyyttä, minkä vuoksi hoito tulisi aloittaa vain yksilöllisen riskiarvion perusteella.
209

Aspectos do desenvolvimento psicológico, social e sexual em pacientes com distúrbios do desenvolvimento sexual (DDS) 46, XY expostos no período pré-natal e concentrações normais ou reduzidas de testosterona / Aspects of psychological, social and sexual development in patients with disorders of sex development (DSD) 46, XY exposed to normal or reduced levels of testosterone during prenatal period

Oliveira Junior, Ari Alves de 18 October 2013 (has links)
O objetivo deste estudo foi avaliar a influência da exposição a níveis normais ou reduzidos de testosterona durante a vida intrauterina no desenvolvimento psicológico, social e sexual dos pacientes com DDS 46, XY. Pacientes e métodos: Trata-se de um estudo retrospectivo. Os 53 participantes são pacientes portadores de DSD 46,XY devido a defeitos de produção de testosterona ou deficiência da 5alfa-RD2, todos eles com genitália ambígua que resultou na atribuição do sexo feminino ao nascimento. Os pacientes foram divididos em dois grupos: Grupo 1 (G1) - pacientes com DDS 46, XY, devido a defeito na produção de testosterona, constituído por 29 pacientes, 8 deles com deficiência de 17beta-HSD3, 7 com hipoplasia das células de Leydig, 7 com disgenesia gonadal parcial, 6 com deficiência 17alfa-hidroxilase e 1 com deficiência 3beta-HSD2; Grupo 2 (G2) - constituído por 24 pacientes com deficiência de 5alfa-RD2. Foi utilizado um questionário com 32 perguntas abrangendo aspectos do desenvolvimento psicológico, social e sexual destes pacientes. Resultados: Foi encontrada uma diferença significativa nos seguintes aspectos do desenvolvimento psicológico, social e sexual dos participantes do estudo: maior incidência de masturbação, fantasias eróticas e desejo de ter filhos em pacientes com deficiência da 5alfa-RD2 com sexo social masculino. Nas pacientes com sexo social feminino o desejo de ter filhos foi maior naquelas com DDS 46, XY por defeitos na produção de testosterona do que naquelas com deficiência da 5alfa-RD2 (p < 0,05), enquanto que o desejo de ter filhos foi maior nos homens com deficiência 5alfa-RD2 (p > 0,05). O número de indivíduos casados foi significativamente maior no grupo dos pacientes com DDS 46, XY por defeitos na produção de testosterona do que no grupo dos pacientes com DDS 46, XY por deficiência da 5alfa-RD2 (p = 0,003). Em conclusão, nossos resultados indicam uma possível influência da exposição aos andrógenos durante a vida pré-natal no desenvolvimento psicológico e social, bem como em aspectos da vida sexual dos pacientes adultos com DDS 46, XY / The aim of this study was to evaluate the influence of exposure to normal or reduced levels of testosterone during intra-uterine life in psychological, social, and sexual development of patients with DSD 46, XY. Patients and methods: This is a retrospective study. The 53 participants were patients with DSD 46, XY due to defects in production of testosterone or deficiency of 5alfa-RD2, all of them with ambiguous genitalia and female sex assignment at birth. These patients were divided into two groups: Group 1 (G1) - patients with DSD 46, XY, due to a defect in the production of testosterone, consisting of 29 people, 8 with deficiency of 17beta-HSD3, 7 with Leydig cell hypoplasia, 7 with partial gonadal dysgenesis, 6 with 17alfa-hydroxylase deficiency ,1 with 3beta-HSD2 deficiency, Group 2 (G2) - consisting of 24 patients with deficiency of 5alfa-RD2. We used a questionnaire with 32 questions covering aspects of psychological, social and sexual development of these patients. Results: A significant difference was found in the following aspects of psychological, social and sexual development of these patients: higher incidence of masturbation, erotic fantasies and desire for children in patients with deficiency of 5alfa-RD2 with male social sex. In patients with female social sex, the desire to have children was higher in those with DSD 46, XY by defects in the production of testosterone than in those with deficiency of 5alfa-RD2 (p < 0.05), while the desire to have children in men was higher in those with 5alfa-RD2 (p > 0.05). The number of married individuals was significantly higher in the group of patients with DSD 46, XY by defects in the production of testosterone than in the group of patients with DSD 46, XY by deficiency of 5alfa-RD2 (p = 0.003). In conclusion, our results indicate a possible influence of exposure to androgens during prenatal life in psychological and social development, as well as in aspects of sexual life of adult patients with DSD 46, XY
210

Aspectos do desenvolvimento psicológico, social e sexual em pacientes com distúrbios do desenvolvimento sexual (DDS) 46, XY expostos no período pré-natal e concentrações normais ou reduzidas de testosterona / Aspects of psychological, social and sexual development in patients with disorders of sex development (DSD) 46, XY exposed to normal or reduced levels of testosterone during prenatal period

Ari Alves de Oliveira Junior 18 October 2013 (has links)
O objetivo deste estudo foi avaliar a influência da exposição a níveis normais ou reduzidos de testosterona durante a vida intrauterina no desenvolvimento psicológico, social e sexual dos pacientes com DDS 46, XY. Pacientes e métodos: Trata-se de um estudo retrospectivo. Os 53 participantes são pacientes portadores de DSD 46,XY devido a defeitos de produção de testosterona ou deficiência da 5alfa-RD2, todos eles com genitália ambígua que resultou na atribuição do sexo feminino ao nascimento. Os pacientes foram divididos em dois grupos: Grupo 1 (G1) - pacientes com DDS 46, XY, devido a defeito na produção de testosterona, constituído por 29 pacientes, 8 deles com deficiência de 17beta-HSD3, 7 com hipoplasia das células de Leydig, 7 com disgenesia gonadal parcial, 6 com deficiência 17alfa-hidroxilase e 1 com deficiência 3beta-HSD2; Grupo 2 (G2) - constituído por 24 pacientes com deficiência de 5alfa-RD2. Foi utilizado um questionário com 32 perguntas abrangendo aspectos do desenvolvimento psicológico, social e sexual destes pacientes. Resultados: Foi encontrada uma diferença significativa nos seguintes aspectos do desenvolvimento psicológico, social e sexual dos participantes do estudo: maior incidência de masturbação, fantasias eróticas e desejo de ter filhos em pacientes com deficiência da 5alfa-RD2 com sexo social masculino. Nas pacientes com sexo social feminino o desejo de ter filhos foi maior naquelas com DDS 46, XY por defeitos na produção de testosterona do que naquelas com deficiência da 5alfa-RD2 (p < 0,05), enquanto que o desejo de ter filhos foi maior nos homens com deficiência 5alfa-RD2 (p > 0,05). O número de indivíduos casados foi significativamente maior no grupo dos pacientes com DDS 46, XY por defeitos na produção de testosterona do que no grupo dos pacientes com DDS 46, XY por deficiência da 5alfa-RD2 (p = 0,003). Em conclusão, nossos resultados indicam uma possível influência da exposição aos andrógenos durante a vida pré-natal no desenvolvimento psicológico e social, bem como em aspectos da vida sexual dos pacientes adultos com DDS 46, XY / The aim of this study was to evaluate the influence of exposure to normal or reduced levels of testosterone during intra-uterine life in psychological, social, and sexual development of patients with DSD 46, XY. Patients and methods: This is a retrospective study. The 53 participants were patients with DSD 46, XY due to defects in production of testosterone or deficiency of 5alfa-RD2, all of them with ambiguous genitalia and female sex assignment at birth. These patients were divided into two groups: Group 1 (G1) - patients with DSD 46, XY, due to a defect in the production of testosterone, consisting of 29 people, 8 with deficiency of 17beta-HSD3, 7 with Leydig cell hypoplasia, 7 with partial gonadal dysgenesis, 6 with 17alfa-hydroxylase deficiency ,1 with 3beta-HSD2 deficiency, Group 2 (G2) - consisting of 24 patients with deficiency of 5alfa-RD2. We used a questionnaire with 32 questions covering aspects of psychological, social and sexual development of these patients. Results: A significant difference was found in the following aspects of psychological, social and sexual development of these patients: higher incidence of masturbation, erotic fantasies and desire for children in patients with deficiency of 5alfa-RD2 with male social sex. In patients with female social sex, the desire to have children was higher in those with DSD 46, XY by defects in the production of testosterone than in those with deficiency of 5alfa-RD2 (p < 0.05), while the desire to have children in men was higher in those with 5alfa-RD2 (p > 0.05). The number of married individuals was significantly higher in the group of patients with DSD 46, XY by defects in the production of testosterone than in the group of patients with DSD 46, XY by deficiency of 5alfa-RD2 (p = 0.003). In conclusion, our results indicate a possible influence of exposure to androgens during prenatal life in psychological and social development, as well as in aspects of sexual life of adult patients with DSD 46, XY

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