Magister Scientiae (Medical Bioscience) - MSc(MBS) / Introduction: Eurycoma longifolia (Tongkat Ali; TA) is a Malaysian shrub used to treat various illnesses including male infertility. Considering that TA is also used to improve male fertility and no report regarding its safety has been published, this study investigated the effects of a patented, aqueous TA extract on various sperm and testicular functions. Materials and Methods: This study encompasses two parts (part 1: on spermatozoa; part 2: on TM3-Leydig and TM4-Sertoli cells). Part 1: Semen samples of 27 patients and 13 fertile donors were divided into two groups, washed and swim-up prepared spermatozoa, and incubated with different concentrations of TA (1, 10, 20, 100, 2000 μg/ml) for 1 hour at 37°C. A sample without addition of TA served as control. After incubation with TA, the following parameters were evaluated: viability (Eosin-Nigrosin test), total and progressive motility (CASA), acrosome reaction (triple stain technique), sperm production of reactive oxygen species (ROS; dihydroethidium test; DHE), sperm DNA fragmentation (TUNEL assay) and mitochondrial membrane potential (Δψm) (Depsipher kit). Part 2: TM3-Leydig and TM4-Sertoli cells incubated with different concentrations of TA (0.4, 0.8, 1.6, 3.125, 6.25, 12.5, 25, 50 μg/ml) and control (without extract) for 48 and 96 hours. After incubation with TA, the following parameters were evaluated: viability (XTT), cell proliferation (protein assay), testosterone (testosterone ELISA test) and pyruvate (pyruvate assay). Results Part 1: For washed spermatozoa, significant dose-dependent trends were found for viability, total motility, acrosome reaction and sperm ROS production. However, these trends were only significant if the highest concentrations were included in the calculation. In the swim-up spermatozoa, ROS production of spermatozoa showed a biphasic relationship with its lowest percentage at 10 μg/ml, yet, no significance could be observed (P=0.9505). No influence of TA could be observed for sperm DNA fragmentation nor Δψm. Part 2: The viability rates and protein production of TM3-Leydig and TM4-Sertoli cells at 48-hour exposure to TA showed increases whereas at 96-hour incubation periods viability and protein production declined especially as from concentration 25 μg/ml TA. Similar results could be seen for TM4-Sertoli cells pyruvate production. The testosterone production at 48-hour exposure marginally increased (P=0.0580) at the highest (50 μg/ml) concentration of TA. However, at 96-hour exposure to TA the testosterone production significantly (P=0.0065) increased. It is also apparent that after 96 hours the concentration of testosterone has increased [12 x 10-4 ng/ml] when compared to 48-hour exposure [6 x 10-7ng/ml] of Tongkat Ali. Conclusion: Part 1: Results indicate that the Tongkat Ali extract has no deleterious effects on sperm functions at therapeutically used concentrations (<2.5 μg/ml). Part 2: The cytotoxic effect of TA are only presented at higher concentration from 25 μg/ml. TM3-Leydig cells appears to be more resilient than TM4-Sertoli cells in viability and protein production yet at prolonged periods of exposure it is detrimental. Testosterone production only increases after 96 hours exposure to TA.

Einleitung: Der Einfluss von Stress während der Schwangerschaft auf den Fetus lässt sich auch postnatal bis in das Erwachsenenalter und teilweise sogar bis in nachfolgende Generationen nachweisen. Eine Vielzahl an Störgrößen erschwert es enorm, beim Menschen konkrete Kausalitäten auszuarbeiten. Mit dem Weißbüschelaffen steht ein humanrelevanter Modellorganismus zur Verfügung, der eine dem Menschen sehr ähnliche Situation in Bezug auf die Physiologie der Trächtigkeit sowie der männlichen Reproduktion bietet, gleichzeitig jedoch einen hohen Grad der Standardisierung ermöglicht. Ziele der Untersuchungen: Im Rahmen der vorliegenden Arbeit sollten ausgewählte Faktoren des Reproduktionssystems in den Hoden adulter Weißbüschelaffen mittels qPCR und Immunhistochemie nachgewiesen und auf Zellebene lokalisiert werden. Weiterhin sollte ermittelt werden, ob die nachgewiesenen Proteine durch pränatalen Stress beeinflusst werden. Ziel des zweiten Teils der vorliegenden Arbeit war es herauszufinden, ob und in welcher Form sich ein standardisierter pränataler Stressreiz postnatal auf ausgewählte Parameter der männlichen Reproduktion des Weißbüschelaffen bis hin zur F3-Generation auswirken kann. Tiere, Material und Methoden: Trächtige Weißbüschelaffen wurden von Trächtigkeitstag 42 bis 48 (EDEX) bzw. Trächtigkeitstag 90 bis 96 (LDEX) täglich mit 5 mg Dexamethason (DEX) pro kg Körpergewicht per os behandelt. Eine Kontrollgruppe (C) erhielt während der gesamten Trächtigkeit keine Glucocorticoide. Von den adulten männlichen Nachkommen der F1-Generation wurden 9 (C), 8 (EDEX) und 9 (LDEX) jeweils tiefgefrorene Hoden auf 12 Transkripte aus den Gruppen der Enzyme der Steroidbiosynthese, der Steroidrezeptoren, des Relaxinsystems und der Proliferationsmarker mittels qPCR quantitativ untersucht. Die jeweils kontralateralen Hoden waren in Paraformaldehyd fixiert worden und wurden parallel auf Proteinebene mittels Immunhistochemie (IHC) untersucht. Für den zweiten Teil der vorliegenden Arbeit wurden die jeweils in maternaler Linie weitergezüchteten Männchen der DEX F2 (n = 2) und DEX F3 (n = 3) auf relevante Parameter der Reproduktionsfähigkeit hin untersucht: Die Größe der Hoden wurde im Frühling, im Sommer und im Winter gemessen, Blutplasma¬proben an einem Tag im Sommer um 8 Uhr, 12 Uhr und 16 Uhr sowie an einem Tag im Winter um 8 Uhr entnommen und daraus mittels ELISA die Konzentration von Testosteron sowie teilweise von 17β Östradiol ermittelt; Ejakulate wurden durch penile Vibrostimulation (PVS) gewonnen und computergestützt untersucht. Alle Ergebnisse wurden jeweils mit mindestens elf unbehandelten männlichen Tieren derselben Kolonie verglichen. Ergebnisse: Alle untersuchten für die männliche Reproduktion relevanten Proteine konnten in den Hoden der F1 nachgewiesen werden. In den Hoden der EDEX F1 und der LDEX F1 war auf Proteinebene jeweils einzig die Steroid-5α-Reduktase 1 (SRD5A1) gegenüber C erhöht. Auf Genebene waren von den untersuchten Transkripten nur in den Hoden der EDEX F1 die SRD5A1, SRD5A2 und Ki 67 jeweils signifikant gegenüber C aufreguliert. Die Hodengröße änderte sich nicht signifikant im Jahresverlauf. Im Tagesverlauf konnte ein signifikanter Anstieg der Testosteronkonzentration im Blutplasma zwischen 8 Uhr und 12 Uhr ermittelt werden. Jedoch konnte kein signifikanter Unterschied zwischen Testosteronkonzentration im weiteren Tageszeitenvergleich, im Sommer und Winter und in Relation zum Alter festgestellt werden. Darüber hinaus bestand keine Korrelation zwischen Testosteron- und 17β Östradiol¬konzentration aus denselben Blutproben. Der Vergleich aller im Zusammenhang mit der PVS erhobenen Parameter zwischen DEX F2/F3 und C ergab, dass einzig die Erfolgsrate der PVS in DEX F2/F3 niedriger lag als in C. Der versuchsgruppen-übergreifende Vergleich aller Ejakulate zwischen den Altersgruppen ergab bei jung adulten Tieren einen signifikant höheren Anteil an motilen Spermien sowie eine signifikant schlechtere Erfolgsrate der PVS gegenüber adulten Tieren. Schlussfolgerungen: Die Ergebnisse der vorliegenden Arbeit geben Hinweise darauf, wie sich Stress während der Trächtigkeit beim Weißbüschelaffen auf die Nachkommen auswirken könnte: In DEX F1 sind wichtige Voraussetzungen für eine funktionierende Testosteron-Biosynthese sowie die Vermittlung von Testosteron- und Östrogen-mediierten Signalen im Hoden gegeben, möglicherweise sogar in verstärkter Weise. Darüber hinaus bestätigen diese Ergebnisse die Humanrelevanz des Weißbüschelaffen als Modell¬organismus zum männlichen Reproduktionssystem. In DEX F2/F3 könnte die niedrige Erfolgsrate der PVS ein Hinweis auf verminderte Konzentrationsfähigkeit in den auf intra¬uterinen Stress folgenden Generationen sein. Jedoch unterscheiden sich die meisten erhobenen reproduktions-physiologisch bedeutsamen Parameter nicht zwischen DEX F2/F3 und C.:1 EINLEITUNG 2 LITERATURÜBERSICHT 2.1 Glucocorticoide und Stress während der Trächtigkeit 2.2 Relevante Hormone der Reproduktion und ihre Biosynthese 2.2.1 3β-Hydroxysteroid-Dehydrogenase 2 2.2.2 Testosteron und Androgenrezeptor 2.2.3 Steroid-5α-Reduktasen 2.2.4 Aromatase 2.2.5 17β-Hydroxysteroid-Dehydrogenase 7 2.2.6 Östradiol und Östrogenrezeptoren 2.2.7 Relaxinsystem 2.2.8 Proliferationsfaktoren 2.3 Weißbüschelaffen 2.3.1 Allgemeines zu Weißbüschelaffen 2.3.2 Reproduktionsbiologie der männlichen Weißbüschelaffen 3 TIERE, MATERIAL UND METHODEN 3.1 Versuchsteil I – ex vivo Hoden DEX F1 3.1.1 Versuchsaufbau (DEX) im DPZ 3.1.2 qPCR an DEX F1 Hoden 3.1.3 Immunhistochemie an Hoden der DEX F1 3.2 Versuchsteil II – in vivo DEX F2/DEX F3 3.2.1 Herkunft der Weißbüschelaffen 3.2.2 Haltung der Weißbüschelaffen 3.2.3 Bestimmung der Hodengrößen und des Körpergewichtes 3.2.4 Blutentnahmen und Hormonbestimmungen mittels ELISA 3.2.5 Penile Vibrostimulation 3.3 Statistische Auswertung 4 ERGEBNISSE 4.1 Versuchsteil I – ex vivo Hoden DEX F1 4.1.1 qPCR der Hoden der F1 4.1.2 Immunhistochemie der Hoden der DEX F1 4.1.2.1 Enzyme der Steroidbiosynthese 4.1.2.2 Steroidrezeptoren 4.1.2.3 Relaxinsystem 4.1.2.4 Proliferationsmarker 4.1.3 Zusammenfassung der Ergebnisse des Versuchsteils I – ex vivo DEX F1 4.2 Versuchsteil II – in vivo DEX F2/F3 4.2.1 Hodengrößen 4.2.2 Testosteron 4.2.3 Ejakulatanalyse 4.2.4 Zusammenfassung der Ergebnisse des Versuchsteils II – in vivo DEX F2/F3 5 DISKUSSION 5.1 Versuchsteil I – ex vivo Hoden DEX F1 5.1.1 Vergleichende Diskussion der Ergebnisse auf Gen- und Proteinebene in den Hoden der F1 5.1.1.1 Relevante Enzyme der Testosteronbiosynthese 5.1.1.2 Steroidrezeptoren 5.1.1.3 Das Relaxinsystem 5.1.1.4 Proliferationsfaktoren 5.2 Versuchsteil II – in vivo DEX F2/F3 5.2.1 Hodengrößen 5.2.2 Testosteron 5.2.3 Ejakulatanalyse 5.3 Schlussbetrachtung 6 ZUSAMMENFASSUNG 7 SUMMARY 8 Literaturverzeichnis 9 ANHANG 10 DANKSAGUNG / Introduction: The impact of prenatal stress can also be detected in the grown-up offspring and partly even in following generations. There are many interfering variables that make it nearly impossible to establish precise correlations in humans. However, the common marmoset is a model organism very similar to humans with respect to the physiology of pregnancy as well as to male reproduction. In addition to that, the possibility of a high-grade standardisation is extremely advantageous. Objective: The first part of this work aimed at detecting selected factors of the reproductive system in testes of adult common marmosets by qPCR and immunohistochemistry, and localising them at the cellular level; both were directed at clarifying whether or not the target proteins respond to prenatal stress. The second part aimed at determining in which form and to what extent standardised prenatal stress affects selected parameters of male reproduction up to the F3-generation in the common marmoset. Animals, materials and methods: Pregnant common marmosets were treated daily with a dose of 5 mg dexamethasone (DEX) per kg body weight per os on gestational days 42 to 48 (EDEX) and gestational days 90 to 96 (LDEX). A control group (C) received no glucocorticoid treatment during pregnancy at all. By qPCR, 12 transcripts from the groups of steroidogenic enzymes, steroid receptors, the relaxin system and the proliferation markers were quantitatively analysed in 9 (C), 8 (EDEX) und 9 (LDEX) frozen testes of F1 generation adult male offspring. Respective contralateral testes had been fixed in paraformaldehyde and were analysed on protein level by immunohistochemistry (IHC). In the second part of this work, males of DEX F2 (n = 2) and DEX F3 (n = 3), each bred in the maternal line, were analysed for relevant parameters of reproduction ability: testes were measured in spring, summer, and winter; blood plasma samples were taken on one day in summer at 8 a.m., 12 noon and 4 p.m. as well as on a day in winter at 8 a.m. and subsequently analysed by ELISA for testosterone and partly 17β oestradiol; ejaculates have been gathered by penile vibrostimulation (PVS) and were tested by computer-assisted sperm analysis. All results were compared with those on at least 11 untreated male common marmosets of the same colony. Results: Each of the targeted proteins relevant for male reproduction was detected in testes of F1. At the protein level only steroid 5α-reductase 1 (SRD5A1) was enhanced expressed in testes of EDEX F1, and LDEX F1 compared to C. At the gene level, SRD5A1, SRD5A2 and Ki 67 were each enhanced expressed compared to C, but in testes of EDEX F1 only. Testis size did not vary significantly during the course of the year. During the course of the day there was a significant rise of the testosterone concentration in blood plasma between 8 a.m. and 12 noon. However, there was no significant difference in the testosterone concentration during other times of the day, nor between summer and winter or in relation to the age of the monkeys. Furthermore there was no correlation between the testosterone and the 17β oestradiol concentrations in the same blood samples. Comparisons of all measured PVS parameters between DEX F2/F3 and C gave a lower success rate of PVS in DEX F2/F3 as the only difference. Comparisons of the ejaculates between age groups irrespective of the DEX classification revealed that young adult common marmosets possess a significantly higher percentage of motile sperms as well as a significantly lower success rate of PVS compared to adult monkeys. Conclusions: The results of this study suggest how stress during pregnancy could influence subsequent generations in the common marmoset: in DEX F1, important requirements of active testosterone biosynthesis as well as of mediation of testosterone and oestrogen signals in testis are met, possibly even enhanced. In addition, these results confirm the relevance of the common marmoset as a model organism for human male reproduction. In DEX F2/F3, the low success rate of PVS might indicate a reduced capability to concentrate in generations following intrauterine stress on F1. Yet, most of the tested parameters pertinent to reproduction physiology do not differ between DEX F2/F3 and C.:1 EINLEITUNG 2 LITERATURÜBERSICHT 2.1 Glucocorticoide und Stress während der Trächtigkeit 2.2 Relevante Hormone der Reproduktion und ihre Biosynthese 2.2.1 3β-Hydroxysteroid-Dehydrogenase 2 2.2.2 Testosteron und Androgenrezeptor 2.2.3 Steroid-5α-Reduktasen 2.2.4 Aromatase 2.2.5 17β-Hydroxysteroid-Dehydrogenase 7 2.2.6 Östradiol und Östrogenrezeptoren 2.2.7 Relaxinsystem 2.2.8 Proliferationsfaktoren 2.3 Weißbüschelaffen 2.3.1 Allgemeines zu Weißbüschelaffen 2.3.2 Reproduktionsbiologie der männlichen Weißbüschelaffen 3 TIERE, MATERIAL UND METHODEN 3.1 Versuchsteil I – ex vivo Hoden DEX F1 3.1.1 Versuchsaufbau (DEX) im DPZ 3.1.2 qPCR an DEX F1 Hoden 3.1.3 Immunhistochemie an Hoden der DEX F1 3.2 Versuchsteil II – in vivo DEX F2/DEX F3 3.2.1 Herkunft der Weißbüschelaffen 3.2.2 Haltung der Weißbüschelaffen 3.2.3 Bestimmung der Hodengrößen und des Körpergewichtes 3.2.4 Blutentnahmen und Hormonbestimmungen mittels ELISA 3.2.5 Penile Vibrostimulation 3.3 Statistische Auswertung 4 ERGEBNISSE 4.1 Versuchsteil I – ex vivo Hoden DEX F1 4.1.1 qPCR der Hoden der F1 4.1.2 Immunhistochemie der Hoden der DEX F1 4.1.2.1 Enzyme der Steroidbiosynthese 4.1.2.2 Steroidrezeptoren 4.1.2.3 Relaxinsystem 4.1.2.4 Proliferationsmarker 4.1.3 Zusammenfassung der Ergebnisse des Versuchsteils I – ex vivo DEX F1 4.2 Versuchsteil II – in vivo DEX F2/F3 4.2.1 Hodengrößen 4.2.2 Testosteron 4.2.3 Ejakulatanalyse 4.2.4 Zusammenfassung der Ergebnisse des Versuchsteils II – in vivo DEX F2/F3 5 DISKUSSION 5.1 Versuchsteil I – ex vivo Hoden DEX F1 5.1.1 Vergleichende Diskussion der Ergebnisse auf Gen- und Proteinebene in den Hoden der F1 5.1.1.1 Relevante Enzyme der Testosteronbiosynthese 5.1.1.2 Steroidrezeptoren 5.1.1.3 Das Relaxinsystem 5.1.1.4 Proliferationsfaktoren 5.2 Versuchsteil II – in vivo DEX F2/F3 5.2.1 Hodengrößen 5.2.2 Testosteron 5.2.3 Ejakulatanalyse 5.3 Schlussbetrachtung 6 ZUSAMMENFASSUNG 7 SUMMARY 8 Literaturverzeichnis 9 ANHANG 10 DANKSAGUNG

This dissertation presents the results of a study that I undertook to better understand the breeding biology of Eastern Kingbirds (hereafter, kingbirds) at Malheur National Wildlife Refuge in southeastern Oregon from 2003 to 2009. Kingbirds are long-distance migratory songbirds that breed across much of North America. This species is socially monogamous but, via frequent extra-pair copulations, is genetically polygamous. Kingbirds exhibit relatively high breeding site fidelity, often returning to the same tree to nest in subsequent years. Both members of a pair provide parental care, but there are often specific duties performed by both male and female kingbirds. For example, males typically perform much of the vigilant nest defense that this species is well known for and contribute, to an extent, to the feeding of nestlings. Females, on the other hand, are entirely responsible for incubating and brooding. Beginning in 2002, most adults within the population of kingbirds at Malheur had been banded with a unique combination of three colored plastic leg bands and an aluminum USFWS band. Also, as many nests were located in each year as possible, and any young that survived to fledging age were banded with a unique combination of leg bands. Considerable effort was then spent each year to locate as many banded individuals as possible, which allowed me to document adult and juvenile survival. Annual survival rates of adult male and female kingbirds in the population at Malheur did not differ and were relatively high at approximately 0.65. Juvenile survival rate was approximately 0.29, indicating that slightly less than one-third of nestlings survive the interval between fledging and their first potential breeding season. Resighting probability was high for both sexes, although higher for adult males (0.94) than for adult female (0.84). The latter finding is consistent with the higher site fidelity of males than of females. Resighting probabilities for juveniles were much lower at 0.68 and 0.40 for males and females, respectively. Again, this was expected because natal site fidelity is typically much lower than breeding site fidelity. Compared to most other reports, resighting probability and return rates of juvenile kingbirds was high, presumably because the riparian habitats where kingbirds breed at Malheur function as an ecological island surrounded by, for kingbirds, unsuitable high desert habitat. Thus, unless they disperse very long distances, the only option for juvenile kingbirds is to begin nesting on the refuge. The collection of blood samples from birds has become an increasingly common practice in ornithology. The data that can be gained from these samples allow a number of interesting questions to be asked such as understanding the genetic mating system of a species, patterns of hormone secretion, and discerning migratory pathways via stable isotope analysis. The volume of blood collected is usually small and was assumed to cause no long-term negative effects on sampled individuals. However, few studies have rigorously examined the effect of blood sampling on survival. I used a multistate mark-recapture analysis to assess the effect blood sampling on annual survival of kingbirds by combining the annual survival data described above with whether or not individuals were subjected to blood sample collection. The results of this analysis indicated that blood sampling had no effect on annual survival rates of kingbirds. Whether or not this is the case for other species remains to be seen. However, my results support the assumption that when done correctly, blood sampling has little to no long-term negative effects on birds. Comparative analyses of many bird species show that testosterone secretion exhibits fairly predictable patterns among breeding birds of different mating systems. Monogamous species reach a peak during mate attraction and the period of female fertility which is then followed by a sharp decline when young are in the nest. By contrast, males of polygynous species tend to maintain higher levels of testosterone throughout the breeding season to, presumably, maximize opportunities for acquiring additional mates. Kingbirds are socially monogamous but cryptically polygamous. However, because of high rates of extra-pair paternity, variation in reproductive success among males is much higher than what is expected for a monogamous species, and, instead, is similar to what has been reported for polygynous species. Therefore from 2005 to 2009 I measured testosterone concentrations from the blood samples collected from male kingbirds to determine the breeding season profile of testosterone secretion in kingbirds and to understand the factors that influence testosterone variation among individuals. Contrary to expected for a monogamous species, the testosterone profile of kingbirds did not exhibit the brief peak in testosterone followed by a precipitous decline. Testosterone peaked early in the season, but declined very slowly as the nest cycle progressed. I attributed this gradual decline in testosterone to the cryptically polygynous nature of the kingbird extra-pair mating system. I also found substantial variation in testosterone concentration among male kingbirds and was able to identify several factors contributing to this variation. As expected, testosterone declined as the breeding season progressed (independent of stage in nest cycle) and nest density increased, while increases in testosterone were correlated with the number of fertile females within the population. This suggests that male kingbirds were capable of modulating testosterone concentrations to both cope with an increase in conspecific density, but also to ready themselves for times when extra-pair copulations were more likely.

The goal of this long-term study was to better understand the reproductive biology of the female bottlenose dolphin (Tursiops truncatus) and provide a hypothesis for how dolphins may communicate reproductive readiness to one another. Utilizing conditioned dolphins in aquaria, this dissertation examined several previously unknown aspects of dolphin reproduction, including ovarian follicular dynamics during the luteinizing hormone surge, urinary prolactin levels, estrus behavior, vaginal fluid arboriform arrangement, in-situ vaginal and cervical anatomy during estrus, reversed-phase high-performance liquid chromatography (RP-HPLC) of urine samples to identify proteins and peptides that may be used in chemical communication, and a review and anatomical analysis of dolphin vibrassal crypts. The diffusely seasonal dolphin estrous cycle is not controlled by photoperiod and has a 10-day follicular and 20-day luteal phase. A brief ovulatory LH surge is followed by ovulation within 48 hours. An ethogram of 20 reproductive behaviors was developed, and all occurrences of reproductive behavior were analyzed during conceptive estrous cycles. A novel form of standing heat estrus, termed immobility, was observed, and estrus dolphins displayed genital nuzzling, active and passive mounting with other females, and an increase of standing heat intensity as LH levels rose. Prolactin plays a role in pregnancy maintenance, mammary development, allo-mothering behavior, lactation, and lactational anestrus. Dolphins are similar to sows where weaning causes a return to estrus, and in the boar effect, where days to ovulation are shortened in the presence of a mature male. Dolphin vaginal fluid showed crystallization arrangements with large open mesh patterns, conducive to sperm transport, during the estrogenic follicular phase, and closed mesh during the luteal phase. RP-HPLC analysis revealed that urine contained large amounts of peptides and proteins with peaks that change throughout the estrous cycle and with changes in social grouping. Remnant vibrissae from dolphin follicular crypts were sectioned, and it was hypothesized that trigeminal nerve endings could act similarly to those found in the nasal mucosa of terrestrial species and respond to chemical stimuli. This study provides new data to better understand the reproductive biology of a holaquatic mammal.

Les différences sexuelles ne se limitent pas uniquement aux organes de reproduction, elles sont aussi très marquées dans plusieurs pathologies humaines. De ce fait, les études impliquant un seul sexe ne pourraient jamais permettre d’élucider les mécanismes qui sous-tendent ces pathologies. De plus, l’exclusion des femelles/filles/femmes des protocoles de recherche a des impacts négatifs sur la qualité de vie des patients, plus spécifiquement celle des filles et femmes. Des études récentes ont suggéré que la testostérone et ses métabolites affectent le développement de l’hippocampe aux niveaux biochimique, morphologique et fonctionnel. En revanche, les données ne sont pas aussi extensives que celles de leurs rôles chez les adultes. Ainsi, une meilleure compréhension des mécanismes par lesquels l’hormone stéroïdienne influence le développement du cerveau facilitera l’identification des cibles thérapeutiques de plusieurs maladies neurodéveloppementales qui affectent le fonctionnement de l’hippocampe. Afin de se développer adéquatement, le cerveau mâle requiert une exposition aux hormones sexuelles mâles pendant une période de temps donnée. En revanche, le cerveau femelle possède une phase critique peu après la naissance au cours de laquelle une exposition aux hormones sexuelles mâles le masculinise en produisant des caractéristiques comparables à celles rencontrées chez des mâles biologiques. Ainsi, la capacité de manipuler les cerveaux femelles dans le but de les masculiniser représente un outil expérimental important pour investiguer les différences sexuelles. Du fait que les hormones sexuelles telles que la testostérone et l’estradiol représentent respectivement l’élément caractéristique de chacun des sexes, cette thèse a pour objectif de disséquer l’implication de la testostérone dans le développement et le fonctionnement du cerveau en étudiant en plus des rats mâles et femelles, des femelles traitées avec la testostérone ainsi que des mâles rendus insensibles à la testostérone. En premier lieu, nous avons investigué sur un système de neurotransmission spécifique, à savoir le système GABAergique, qui est important pour le contrôle des convulsions communément observées dans l’épilepsie. Ce système possède des particularités notables en fonction du sexe, particularités qui pourraient être l’une des causes de la prédisposition des mâles à l’épilepsie. En effet, notre étude révèle qu’au niveau basal, les femelles ainsi que les mâles insensibles à la testostérone montrent très tôt au cours de leur développement une localisation à la membrane du co-transporteur KCC2 qui régule la force de la neurotransmission inhibitrice. Par ailleurs, nous avons aussi détecté des niveaux élevés du neurotrophine BDNF qui est un puissant modulateur du fonctionnement des cellules GABAergiques, ceci, au cours de la première semaine postnatale. Par ailleurs, chez les adultes, nous avons trouvé que les femelles ainsi que les mâles insensibles à la testostérone montrent une augmentation de la transmission GABergique spontanée comparativement aux mâles et aux femelles qui ont été exposées à la testostérone. En somme, ces données démontrent que le fonctionnement de la circuiterie GABAergique est modulé par le niveau de testostérone périnatal, ce qui suggère d’un rôle des hormones sexuelles dans la régulation de l’excitabilité cellulaire. De plus, les différences sexuelles dans le cerveau sont largement déterminées par des facteurs extrinsèques. Parmi ces derniers, le stress du début de la vie est un facteur extrinsèque puissant qui altère l’habileté à contrôler la rétroaction négative des glucocorticoïdes sur l’axe hypothalamo-hypophyso-surrénalien (HHS). Le stress est également connu pour affecter différentiellement les rats mâles comparativement aux femelles. Nous démontrons alors que la corticostérone rend l’hippocampe vulnérable à une seconde insulte, telle que les épilepsies induites par l’hyperthermie. En effet, chez les rats traités à la corticostérone, la latence d’induction des épilepsies par hyperthermie est réduite, le temps de récupération plus long et le nombre d’évènements épileptiques plus nombreux. En outre, nous avons trouvé que tous ces effets sont plus proéminents chez les mâles que chez les femelles. Ces données confirment l’existence d’un lien entre le stress du début de la vie et la susceptibilité aux convulsions hyperthermiques chez les rats mâles et femelles. Une meilleure compréhension des conséquences des convulsions fébriles pourrait aider dans le pronostic et le traitement des patients souffrant d’épilepsie. Somme toute, cette thèse met en lumière le rôle complexe des hormones sexuelles dans la régulation des circuits GABAergiques, des réponses au stress et de l’hyperexcitabilité du cerveau en développement. Une meilleure compréhension des mécanismes pathologiques propres aux modèles animaux mâles et femelles résulterait en de meilleures interventions et thérapies aussi bien chez les hommes que les chez les femmes. / Sex differences extend far beyond reproductive health — there is a widespread prevalence of sex differences in many human diseases and conditions. Therefore, studies limited to a single-sex cannot fully give a comprehensive picture of the underlying disease mechanisms, and the neglect of females/girls/women in biological research negatively impacts patients' quality of life, especially women. Recent data suggest that testosterone and its metabolites affect the hippocampus during development at the biochemical, morphological, and functional levels, although the data are not nearly as extensive as what is known in adults. Therefore, a better understanding of these effects will elucidate steroid hormone-dependent mechanisms of brain development and, possibly, help identifying ways to mitigate the burden of the many neurodevelopmental disorders that involve hippocampal function. The male brain is unique in that it must be exposed to male sex hormones for a fixed period of time, which is so-called critical period. This is deemed a critical period because if androgens levels do not rise at this time in males, the brain will fail to be masculinized. The female brain, on the other hand, has a sensitive period shortly after birth, during which exposure to male sex hormones may masculinize the brain and produce features comparable to those seen in biological males. This capacity to manipulate females toward more masculinized brains represent an important experimental tool to investigate sex differences. Because sexual hormones, such as testosterone and estradiol, are a distinct point of divergence between sexes, my thesis proposes to study the implication of testosterone by using, in addition to male and female animals, females treated with testosterone as well as testosterone-insensitive male rats. First, we investigated a specific neurotransmitter system, the GABAergic system, which contributes to the control of seizures commonly observed in epilepsies. This system shows robust differences between males and females, which may be involved with the predisposition to epilepsy observed in males. Our study revealed that at baseline conditions female and testosterone-insensitive male rats show an earlier localization at the membrane of the chloride co-transporter KCC2, which regulates the strengths of inhibitory neurotransmission, and higher levels of the neurotrophin BDNF, which is a powerful modulator of GABAergic cell function, during the first postnatal week. In addition, we found that female and testosterone-insensitive male rats show enhanced spontaneous GABA synaptic transmission when compared to males and testosterone-exposed females in adults. Overall, these data show that perinatal testosterone levels modulate GABAergic circuit function, suggesting a role of sex hormones in regulating cell excitability. Second, sex differences in the brain are largely determined by extrinsic factors. Early-life stress is one such powerful extrinsic factor that impairs the ability to control glucocorticoid negative feedback on the HPA axis. Stress is also known to differentially affect male and female rats. Here, we show that corticosterone alone renders the hippocampus vulnerable to a second insult, namely hyperthermia-induced seizures, in fact in corticosterone-treated rats the latency to hyperthermia-induced seizures was shorter, the recovery time longer, and a larger number of hyperthermia-induced seizures. Further, these effects were a lot more prominent in males than in females. These findings support a link between early-life stress and hyperthermic seizure susceptibility in both male and female rats. A better understanding of the consequences of febrile seizures could help improve the prognosis and treatment of patients with epilepsy. Altogether, these findings shed light on the complex roles of sex hormones in regulating GABAergic circuits, stress responses and circuit hyper-excitability in the developing brain. A better understanding of disease-mechanisms underlying male and female animal models could lead to better interventions and therapeutics in both men and women.

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INTRODUÇÃO: A obesidade é uma das causas de hipogonadismo (HG) secundário no homem. A terapia de reposição padrão de testosterona (TRT) é associada à melhora dos parâmetros metabólicos, mas pode levar à infertilidade. Apenas recentemente indicou-se que não há novas evidências nível 1 para apoiar uma conexão definitiva entre TRT e eventos cardiovasculares (CV). OBJETIVO: Avaliar os efeitos do Citrato de Clomifeno (CC) em homens jovens com hipogonadismo associado à obesidade diagnosticado por testosterona total (TT) <= 300 ng/dL em duas ocasiões, sintomas positivos no questionário ADAM, hormônio Luteinizante (LH) baixo ou inadequadamente normal (VR: 1,7 - 8,6 UI/L). MÉTODOS: Estudo randomizado, duplo cego, controlado por placebo (PLB), longitudinal em centro único. Setenta e oito pacientes com idade entre 36,5±7,8 anos, índice de massa corporal (IMC) 46,2±8,5 kg/m2 foram randomizados (1:1) para receber CC 50 mg ou PLB durante 12 semanas. Os pacientes foram avaliados através de: 1) Parâmetros clínicos: Questionário ADAM, número de intercursos sexuais, queixa de insatisfação com a vida sexual; 2) Parâmetros hormonais: dosagem sérica de TT, testosterona livre, Estradiol (E2), LH, hormônio folículo estimulante (FSH), SHBG, relação TT:E2; 3) Parâmetros de composição corporal: IMC, circunferência abdominal (CA) e análise de bioimpedanciometria; 4) Parâmetros metabólicos: pressão arterial sistólica e diastólica, glicemia em jejum (GJ), hemoglobina glicada (HbA1c), índice HOMA-IR, colesterol total e frações, triglicérides; 5) Parâmetros de resposta CV: dilatação fluxo mediada artéria braquial (FMDAB), níveis circulantes de sICAM-1, sVCAM-1, Selectina-sE e quantificação de células endoteliais progenitoras (CEPs) por citometria de fluxo; 6) Efeitos adversos: hematócrito, antígeno prostático específico sérico (PSA), questionário internacional de sintomas prostáticos (I-PSS), dosagem sérica de alanina aminotransferase (ALT), aspartato aminotransferase (AST), e efeitos adversos autorreferidos. RESULTADOS: Na randomização os dois grupos foram semelhantes em relação à idade (CC: 35,5±7,8 anos, PLB: 35,6±7,8; p= 0,951), IMC (CC: 45,5±11,3 kg/m2; PLB: 47,2±9,6; p= 0,470), CA (CC: 137,5±17,9 cm; PLB: 140,2±19,6; p= 0,526) e testosterona total (CC: 225,8±70,0 ng/dL; PLB: 216,0±72,1; p= 0,543). Não houve diferenças nos parâmetros de resposta clínica, exceto com relação à queixa de perda de vigor nas ereções (p < 0,001). Observou-se elevação significativa (p= < 0,001) de TT, Testosterona livre, E2, LH, FSH e SHBG no grupo CC em comparação com PLB. Houve um aumento significativo (p < 0,001) na massa magra e na massa muscular; e também na massa livre de gordura (p= 0,004). O CC reduziu HDL em comparação com PLB (p < 0,001) e não mostrou efeito em outros parâmetros metabólicos. Não houve significância estatística nos parâmetros CV, indicando efeito nulo do tratamento. CC reduziu ALT (p < 0,001) e aumentou o PSA (p= 0,023) dentro dos limites da normalidade. CONCLUSÕES: CC foi efetivo para melhorar os parâmetros de resposta hormonal e afetou positivamente um parâmetro de resposta clínica (perda de vigor nas ereções). Apesar das alterações na composição corporal, não se observou melhora do perfil metabólico. No entanto, o CC não ocasionou resposta adversa nos parâmetros CV. O tratamento CC para HG parece ser uma alternativa efetiva em jovens obesos que desejam preservar sua fertilidade, mas ensaios clínicos de seguimento em longo prazo e com maior número de participantes são necessários para melhor análise do perfil metabólico e de sintomas, além de impactos CV / INTRODUCTION: Obesity can cause secondary hypogonadism in man. The standard testosterone replacement therapy (TRT) improves metabolic parameters but can lead to infertility. Only recently TRT was not clearly associated with adverse cardiovascular (CV) events, but its impacts on endothelial function are still controversial. AIM: To evaluate the effects of Clomiphene Citrate (CC) in out clinic young man with obesity related hypogonadism: total testosterone (TT) <= 300 ng/dL on two occasions, positive symptoms in ADAM questionnaire, Luteinizing Hormone (LH) low or inappropriate normal (RV: 1.7-8.6 IU/liter). METHODS: This is a randomized, double blind, placebo-controlled, parallel group, single-center study. Seventy eight patients aged 36.5±7.8 years, Body mass index (BMI) 46.2±8.5 kg/m2 were randomized (1:1) to receive CC 50 mg or Placebo (PLB) during 12 weeks. MAIN OUTCOME MEASURES: 1) Clinical symptomology: ADAM Questionnaire, number of sexual intercourses and satisfaction with sexual life; 2) Hormonal monitoring: serum TT, Free testosterone, Estradiol (E2), LH and Follicle-stimulating hormone (FSH), SHBG, TT/E2 ratio; 3) Body composition and anthropometric measurements: BMI, waist circumference (WC) and Bioelectric Impedance analysis parameters; 4) Metabolic response parameters: systolic and diastolic blood pressure, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), serum cholesterol and fractions, triglycerides; 5) CV assessment by endothelial function parameters: Flowmediated dilatation of the brachial artery (FMDAB), circulating levels of sICAM-1, sVCAM-1, E-selectin and flow cytometry endothelial progenitor cells (EPCs); 6) Adverse outcomes: Hematocrit, serum Prostate-Specific Antigen (PSA), International Prostate Symptom Score (I-PSS), Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST) and Selfreported Adverse Effects. RESULTS: Two groups were similar with regard to age (CC: 35.5±7.8 years; PLB: 35.6±7.8; P=0.951), BMI (CC: 45.5±11.3 kg/m2; PLB: 47.2±9.6; P=0.470), WC (CC: 137.5±17.9 cm; PLB: 140.2±19.6; P=0.526) and total testosterone (CC: 225.8±70.0 ng/dL; PLB: 216.0±72.1; P=0.543) in baseline data. There was an improvement in one sexual complaint (weaker erections) (P < 0.001) and there were significant improvements (P < 0.001) in TT, Free Testosterone, E2, LH, FSH and SHBG in CC group (vs. PLB). There was a gain in lean mass (P < 0.001), free fat mass (P=0.004) and muscle mass (P < 0.001). CC reduced HDL compared to PLB (P < 0.001) and showed no effect in other metabolic parameters. No statistical significance was seen in CV parameters. CC reduced ALT (P < 0.001) and increased PSA (P=0.023). CONCLUSIONS: CC was effective in increase hormonal response parametersand improved one sexual complaint (weaker erections). Despite body composition changes, CC did not improved metabolic profile and lowered LDL cholesterol. CC showed no adverse response in CV parameters. CC treatment for HG appears to be an effective alternative in young obese men wishing to preserve their fertility but long-term follow-up trials to better analyze the metabolic profile and CV outcomes are needed

<p>Premenstrual dysphoria, so severe that it affects the lives of the women afflicted, is the condition studied in this thesis. Physiological and pharmacological mechanisms of pathogenetic relevance were investigated. </p><p>Women with premenstrual dysphoria showed a stronger and less dampened response of LH to an estradiol challenge than asymptomatic women, indicating an altered neuroendocrine regulation. In women with premenstrual dysphoria, the LH response was correlated to the severity of irritability and bloating, and the early FSH response was correlated to the severity of depressed mood. </p><p>The positron-emission study showed strong, consistent correlations between worsening of mood symptoms and a decrease in brain trapping of the immediate serotonin precursor, from the mid-follicular to the late luteal phase in women with premenstrual dysphoria. The strongest correlations were seen for the cardinal mood symptoms of premenstrual dysphoria, and for their opposites. Physical symptoms showed weaker or no correlations with the exception of nociceptive symptoms from erogenous body regions which showed positive correlations to serotonin precursor trapping in the right caudate nucleus. The findings are consistent with the serotonin hypothesis of premenstrual dysphoria, and might possibly explain the observed effects of serotonin-augmenting drugs in this condition.</p><p>The partial 5-HT_1A receptor agonist buspirone was superior to placebo in the treatment of premenstrual dysphoria. The weak SRI and 5-HT₂ receptor antagonist nefazodone was not superior to placebo. For women with premenstrual dysphoria in need of medication and who do not tolerate SRIs because of the sexual sideeffects, buspirone may be an alternative drug, since it had no adverse effects on sexual function. </p><p>The prevalence of polycystic ovaries and serum levels of androgens were not higher in women with premenstrual dysphoria than in their asymptomatic counterparts. The findings are not consistent with the hypothesis that irritability in women with premenstrual dysphoria is induced by elevated testosterone levels. </p><p>Thesis results, which are in line with the serotonin hypothesis of premenstrual dysphoria, may imply that increased brain sensitivity is one of the factors underlying severe premenstrual mood symptoms, thereby further supporting a common serotonergic dysregulation in this condition.</p>

Premenstrual dysphoria, so severe that it affects the lives of the women afflicted, is the condition studied in this thesis. Physiological and pharmacological mechanisms of pathogenetic relevance were investigated. Women with premenstrual dysphoria showed a stronger and less dampened response of LH to an estradiol challenge than asymptomatic women, indicating an altered neuroendocrine regulation. In women with premenstrual dysphoria, the LH response was correlated to the severity of irritability and bloating, and the early FSH response was correlated to the severity of depressed mood. The positron-emission study showed strong, consistent correlations between worsening of mood symptoms and a decrease in brain trapping of the immediate serotonin precursor, from the mid-follicular to the late luteal phase in women with premenstrual dysphoria. The strongest correlations were seen for the cardinal mood symptoms of premenstrual dysphoria, and for their opposites. Physical symptoms showed weaker or no correlations with the exception of nociceptive symptoms from erogenous body regions which showed positive correlations to serotonin precursor trapping in the right caudate nucleus. The findings are consistent with the serotonin hypothesis of premenstrual dysphoria, and might possibly explain the observed effects of serotonin-augmenting drugs in this condition. The partial 5-HT1A receptor agonist buspirone was superior to placebo in the treatment of premenstrual dysphoria. The weak SRI and 5-HT2 receptor antagonist nefazodone was not superior to placebo. For women with premenstrual dysphoria in need of medication and who do not tolerate SRIs because of the sexual sideeffects, buspirone may be an alternative drug, since it had no adverse effects on sexual function. The prevalence of polycystic ovaries and serum levels of androgens were not higher in women with premenstrual dysphoria than in their asymptomatic counterparts. The findings are not consistent with the hypothesis that irritability in women with premenstrual dysphoria is induced by elevated testosterone levels. Thesis results, which are in line with the serotonin hypothesis of premenstrual dysphoria, may imply that increased brain sensitivity is one of the factors underlying severe premenstrual mood symptoms, thereby further supporting a common serotonergic dysregulation in this condition.