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Solomon D, Cabecinha M, Gibbs J, Burns F, Sabin CA. How do we measure unmet need within sexual and reproductive health? A systematic review. Perspect Public Health 2024; 144:78-85. [PMID: 36127856 PMCID: PMC10916345 DOI: 10.1177/17579139221118778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Addressing health inequality with sexual and reproductive health requires an understanding of unmet need within a range of populations. This review examined the methods and definitions that have been used to measure unmet need, and the populations most frequently assessed. METHODS Five databases (PubMed, Web of Science, Scopus, The Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Health Management and Policy Database (HMIC)) were searched for studies that described quantitative measurement of unmet need within sexual and/or reproductive health between 2010 and 2021. A narrative synthesis was then undertaken to ascertain themes within the literature. RESULTS The database search yielded 19,747 papers; 216 papers were included after screening. 190 studies assessed unmet reproductive health need, of which 137 were analyses of trends among people living in low/lower-middle income countries; 181 used cross-sectional data, with only nine analyses being longitudinal. Eighteen studies analysed unmet sexual health need, of which 12 focused on high and upper-middle income populations. 16 papers used cross-sectional analyses. The remaining 10 studies examined unmet need for a combination of sexual and reproductive health services, eight among populations from upper-middle or high income countries. All were cross-sectional analyses. 165 studies used the Demographic and Health Surveys (DHS) definition of unmet need; no other standardised definition was used among the remaining papers. DISCUSSION There is a significant focus on unmet need for contraception among women in low income countries within the published literature, leaving considerable evidence gaps in relation to unmet need within sexual health generally and among men in particular, and unmet reproductive health need in high income settings. In addition, using an increased range of data collection methods, analyses and definitions of unmet need would enable better understanding of health inequality in this area.
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Affiliation(s)
- D Solomon
- Institute for Global Health, University College London, Gower Street, London WC1E 6BT, UK
| | - M Cabecinha
- Institute for Global Health, University College London, London, UK
| | - J Gibbs
- Institute for Global Health, University College London, London, UK
| | - F Burns
- Institute for Global Health, University College London, London, UK; Royal Free London NHS Foundation Trust, London, UK
| | - CA Sabin
- Institute for Global Health, University College London, London, UK
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Hong SH, Castro G, Wang D, Nofsinger R, Kane M, Folias A, Atkins AR, Yu RT, Napoli JL, Sassone-Corsi P, de Rooij DG, Liddle C, Downes M, Evans RM. Targeting nuclear receptor corepressors for reversible male contraception. Proc Natl Acad Sci U S A 2024; 121:e2320129121. [PMID: 38377195 PMCID: PMC10907271 DOI: 10.1073/pnas.2320129121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/06/2024] [Indexed: 02/22/2024] Open
Abstract
Despite numerous female contraceptive options, nearly half of all pregnancies are unintended. Family planning choices for men are currently limited to unreliable condoms and invasive vasectomies with questionable reversibility. Here, we report the development of an oral contraceptive approach based on transcriptional disruption of cyclical gene expression patterns during spermatogenesis. Spermatogenesis involves a continuous series of self-renewal and differentiation programs of spermatogonial stem cells (SSCs) that is regulated by retinoic acid (RA)-dependent activation of receptors (RARs), which control target gene expression through association with corepressor proteins. We have found that the interaction between RAR and the corepressor silencing mediator of retinoid and thyroid hormone receptors (SMRT) is essential for spermatogenesis. In a genetically engineered mouse model that negates SMRT-RAR binding (SMRTmRID mice), the synchronized, cyclic expression of RAR-dependent genes along the seminiferous tubules is disrupted. Notably, the presence of an RA-resistant SSC population that survives RAR de-repression suggests that the infertility attributed to the loss of SMRT-mediated repression is reversible. Supporting this notion, we show that inhibiting the action of the SMRT complex with chronic, low-dose oral administration of a histone deacetylase inhibitor reversibly blocks spermatogenesis and fertility without affecting libido. This demonstration validates pharmacologic targeting of the SMRT repressor complex for non-hormonal male contraception.
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Affiliation(s)
- Suk-Hyun Hong
- Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA92037
| | - Glenda Castro
- Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA92037
| | - Dan Wang
- Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA92037
| | - Russell Nofsinger
- Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA92037
| | - Maureen Kane
- Department of Nutritional Sciences and Toxicology, The University of California, Berkeley, CA94720
| | - Alexandra Folias
- Department of Nutritional Sciences and Toxicology, The University of California, Berkeley, CA94720
| | - Annette R. Atkins
- Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA92037
| | - Ruth T. Yu
- Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA92037
| | - Joseph L. Napoli
- Department of Nutritional Sciences and Toxicology, The University of California, Berkeley, CA94720
| | - Paolo Sassone-Corsi
- Department of Biological Chemistry, Center for Epigenetics and Metabolism, U1233 INSERM, University of California, Irvine, CA92697
| | - Dirk G. de Rooij
- Reproductive Biology Group, Division of Developmental Biology, Department of Biology, Faculty of Science, Utrecht University, 3584 CHUtrecht, The Netherlands
| | - Christopher Liddle
- Storr Liver Centre, The Westmead Institute for Medical Research and Sydney Medical School, University of Sydney, Westmead, NSW2145, Australia
| | - Michael Downes
- Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA92037
| | - Ronald M. Evans
- Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA92037
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Su Z, Diao T, McGuire H, Yao C, Yang L, Bao G, Xu X, He B, Zheng Y. Nanomaterials Solutions for Contraception: Concerns, Advances, and Prospects. ACS NANO 2023; 17:20753-20775. [PMID: 37856253 DOI: 10.1021/acsnano.3c04366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Preventing unintentional pregnancy is one of the goals of a global public health policy to minimize effects on individuals, families, and society. Various contraceptive formulations with high effectiveness and acceptance, including intrauterine devices, hormonal patches for females, and condoms and vasectomy for males, have been developed and adopted over the last decades. However, distinct breakthroughs of contraceptive techniques have not yet been achieved, while the associated long-term adverse effects are insurmountable, such as endocrine system disorder along with hormone administration, invasive ligation, and slowly restored fertility after removal of intrauterine devices. Spurred by developments of nanomaterials and bionanotechnologies, advanced contraceptives could be fulfilled via nanomaterial solutions with much safer and more controllable and effective approaches to meet various and specific needs for women and men at different reproductive stages. Nanomedicine techniques have been extended to develop contraceptive methods, such as the targeted drug delivery and controlled release of hormone using nanocarriers for females and physical stimulation assisted vasectomy using functional nanomaterials via photothermal treatment or magnetic hyperthermia for males. Nanomaterial solutions for advanced contraceptives offer significantly improved biosafety, noninvasive administration, and controllable reversibility. This review summarizes the nanomaterial solutions to female and male contraceptives including the working mechanisms, clinical concerns, and their merits and demerits. This work also reviewed the nanomaterials that have been adopted in contraceptive applications. In addition, we further discuss safety considerations and future perspectives of nanomaterials in nanostrategy development for next-generation contraceptives. We expect that nanomaterials would potentially replace conventional materials for contraception in the near future.
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Affiliation(s)
- Zhenning Su
- NHC Key Laboratory of Reproductive Health Engineering Technology Research, Department of Reproduction Physiology, National Research Institute for Family Planning, Beijing 100081, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Tian Diao
- NHC Key Laboratory of Reproductive Health Engineering Technology Research, Department of Reproduction Physiology, National Research Institute for Family Planning, Beijing 100081, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Helen McGuire
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Cancan Yao
- NHC Key Laboratory of Reproductive Health Engineering Technology Research, Department of Reproduction Physiology, National Research Institute for Family Planning, Beijing 100081, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Lijun Yang
- NHC Key Laboratory of Reproductive Health Engineering Technology Research, Department of Reproduction Physiology, National Research Institute for Family Planning, Beijing 100081, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Guo Bao
- NHC Key Laboratory of Reproductive Health Engineering Technology Research, Department of Reproduction Physiology, National Research Institute for Family Planning, Beijing 100081, China
| | - Xiaoxue Xu
- School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW 2007, Australia
- School of Science, Western Sydney University, Kumamoto NSW 2751, Australia
| | - Bin He
- NHC Key Laboratory of Reproductive Health Engineering Technology Research, Department of Reproduction Physiology, National Research Institute for Family Planning, Beijing 100081, China
| | - Yufeng Zheng
- School of Materials Science and Engineering, Peking University, Beijing 100871, China
- International Research Organization for Advanced Science and Technology, Kumamoto University, 2-39-1 Kurokami, Chuo-Ku, Kumamoto 860-8555, Japan
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4
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Gbagbo FY, Ameyaw EK. Stakeholders' perceptions of the trends in contraceptive prevalence rate and total fertility rate in Ghana. PLoS One 2023; 18:e0288924. [PMID: 37486905 PMCID: PMC10365302 DOI: 10.1371/journal.pone.0288924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 07/06/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Studies in Ghana have reported discrepancies between trends in Total Fertility Rate (TFR) and Contraceptive Prevalence Rate (CPR). Yet, there is limited empirical literature on stakeholders' perceptions on the trends in CPR and TFR in Ghana. We, therefore, examined the perceptions of key stakeholders about the documented trends in CPR and TFR in Ghana. METHODS We adopted an exploratory (qualitative) research design with a qualitative approach of data collection from stakeholders in Ghana, focusing on the trends of the TFR and CPR. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist provided additional guidance for reporting the study results. We employed the Theory of Planned Behavior (TPB) as a theoretical framework/construct to explain and predict individual changes in health behaviors resulting in trends in CPR and TFR from stakeholders' perspectives and analyzed the data using framework analysis approach. RESULTS Two main themes emerged from the data: contraceptive prevalence and total fertility ratio, with five sub-themes identified: barriers to contraception, motivations for contraception uptake, unmet need for family planning, induced abortion, and effectiveness of planning programs. Specifically, participants indicated that there is a discrepancy between the trends of CPR and TFR based on the Ghana Demographic and Health Survey, conducted between 1988 and 2014. The high unmet needs for contraceptives were attributed to CRP trends, whilst abstinence, infertility, and high demands for induced abortions were identified to impact the TFR trends significantly. CONCLUSION The findings show that an extensive quantitative enquiry into the exact relationships between Ghana's CPR and TFR as well as the contributions of abstinence, infertility, and induced abortion are worth considering.
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Affiliation(s)
- Fred Yao Gbagbo
- Department of Health Administration and Education, Faculty of Science Education, University of Education, Winneba, Ghana
| | - Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Lingnan, Hong Kong
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Jirwankar Y, Dighe V. Identification and validation of Sertoli cell homing peptides as molecular steering for testis targeted drug delivery. J Drug Target 2023; 31:390-401. [PMID: 36604336 DOI: 10.1080/1061186x.2022.2164007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The testicle, an organ privileged with immunity because of Blood-Testis Barrier (BTB), poses a major impediment to developing and delivering drugs to the testes. These problems can be prevented by targeting testicular cells using specific ligands, such as homing peptides. This is the first study to demonstrate the successful selection of Sertoli cell homing peptides using a phage display peptide library. The identification of peptides is performed with Sanger sequencing and high-throughput NGS. The Sertoli cell and testis targeting potential of the SCHP1 and SCHP2 was confirmed using confocal microscopy and flow cytometry of the FITC-labelled peptides and in vivo bio-distribution of the corresponding Cy5.5-tagged peptides. Secondary structures were predicted in the setting of different polarity by circular dichroism. The results suggest that SCHP1 and SCHP2 can effectively target Sertoli cells. In vivo bio-distribution in mouse models indicated significantly higher uptake of SCHP1 and SCHP2 by testes compared with the heart, brain, and spleen. SCHP1 and SCHP2 can be adopted as molecular steering for targeted male contraceptive delivery, treatment of testicular cancer, and male infertility. Further development of the peptides into peptidomimetics may increase their stability, and information on the molecular targets of these peptides may reveal their therapeutic potential.
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Affiliation(s)
- Yugandhara Jirwankar
- National Centre for Preclinical Reproductive and Genetic Toxicology, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Vikas Dighe
- National Centre for Preclinical Reproductive and Genetic Toxicology, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
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Service CA, Puri D, Hsieh TC, Patel DP. Emerging concepts in male contraception: a narrative review of novel, hormonal and non-hormonal options. Ther Adv Reprod Health 2023; 17:26334941221138323. [PMID: 36909934 PMCID: PMC9996746 DOI: 10.1177/26334941221138323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/20/2022] [Indexed: 03/14/2023] Open
Abstract
Access to reliable contraception is a pillar of modern society. The burden of unintended pregnancy has fallen disproportionately on the mother throughout human history; however, recent legal developments surrounding abortion have sparked a renewed interest in male factor contraceptives beyond surgical sterilization and condoms. Modern efforts to develop reversible male birth control date back nearly a century and initially focused on altering the hypothalamic-pituitary-testes axis. These hormonal contraceptives faced multiple barriers, including systemic side effects, challenging dosing regimens, unfavorable routes of delivery, and the public stigma surrounding steroid use. Novel hormonal agents are seeking to overcome these barriers by limiting the side effects and simplifying use. Non-hormonal contraceptives are agents that target various stages of spermatogenesis; such as inhibitors of retinoic acid, Sertoli cell-germ cell interactions, sperm ion channels, and other small molecular targets. The identification of reproductive tract-specific genes associated with male infertility has led to more targeted drug development, made possible by advances in CRISPR and proteolysis targeting chimeras (PROTACs). Despite multiple human trials, no male birth control agents have garnered regulatory approval in the United States or abroad. This narrative review examines current and emerging male contraceptives, including hormonal and non-hormonal agents.
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Affiliation(s)
- C Austin Service
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Dhruv Puri
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Tung-Chin Hsieh
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Darshan P Patel
- Department of Urology, University of California San Diego, 9333 Genesee Avenue, Suite 320, La Jolla, CA 92121, USA
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7
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Sheridan T, Gómez-Torres P, Vera Cruz G, Martínez-Pérez GZ. A global grounded theory exploration of investigators' perspectives on male hormonal contraceptive development and acceptability. Glob Public Health 2022; 17:3760-3772. [PMID: 35901059 DOI: 10.1080/17441692.2022.2102201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
While best practices have been proposed on how to engage men in family planning (FP), the limited options of male hormonal contraceptives (MHC) are a barrier to reaching men as clients of FP programs. The lack of alternative MHC is preventing the global health community from providing holistic reproductive healthcare. A qualitative grounded theory study was conducted in 2020 to explore MHC experts' perceptions around the development and theoretical acceptability of MHCs. Individual in-depth interviews were conducted with 15 key informants. The informants cited evidence that there is a demand for MHC. The inability to access this data by the pharmaceutical industry was acknowledged. Many informants expressed concern of the possibility for MHC to increase male power in a predominantly patriarchal world. To most informants, at least for the initial introduction of MHC, fertility sharing is something that will largely happen among couples alone rather than individually. There is proven demand among women and men for MHC, however industries may still be reluctant to invest. Effort is needed by the sexual and reproductive health and rights community to include male engagement in FP and to advocate for the development and use of MHC as a tool for women's empowerment.
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Affiliation(s)
- Taylor Sheridan
- The Barcelona Institute for Global Health Foundation (ISGlobal), Barcelona, Spain
| | - Piedad Gómez-Torres
- Department of Physiatrics and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Germano Vera Cruz
- Department of Psychology, UR 7273 CRP-CPO, University of Picardie Jules Verne, Amiens, France
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8
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Carlson EJ, Francis R, Liu Y, Li P, Lyon M, Santi CM, Hook DJ, Hawkinson JE, Georg GI. Discovery and Characterization of Multiple Classes of Human CatSper Blockers. ChemMedChem 2022; 17:e202000499. [PMID: 35644882 PMCID: PMC9378630 DOI: 10.1002/cmdc.202000499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 05/25/2022] [Indexed: 11/25/2022]
Abstract
The cation channel of sperm (CatSper) is a validated target for nonhormonal male contraception, but it lacks selective blockers, hindering studies to establish its role in both motility and capacitation. Via an innovative calcium uptake assay utilizing human sperm we discovered novel inhibitors of CatSper function from a high-throughput screening campaign of 72,000 compounds. Preliminary SAR was established for seven hit series. HTS hits or their more potent analogs blocked potassium-induced depolarization and noncompetitively inhibited progesterone-induced CatSper activation. CatSper channel blockade was confirmed by patch clamp electrophysiology and these compounds inhibited progesterone- and prostaglandin E1-induced hyperactivated sperm motility. One of the hit compounds is a potent CatSper inhibitor with high selectivity for CatSper over hCav1.2, hNav1.5, moderate selectivity over hSlo3 and hERG, and low cytotoxicity and is therefore the most promising inhibitor identified in this study. These new CatSper blockers serve as useful starting points for chemical probe development and drug discovery efforts.
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Affiliation(s)
- Erick J. Carlson
- Department of Medicinal Chemistry andInstitute for Therapeutics Discovery and DevelopmentCollege of PharmacyUniversity of Minnesota717 Delaware Street, SEMinneapolisMN 55414USA
| | - Rawle Francis
- Department of Medicinal Chemistry andInstitute for Therapeutics Discovery and DevelopmentCollege of PharmacyUniversity of Minnesota717 Delaware Street, SEMinneapolisMN 55414USA
| | - Yutong Liu
- Department of Medicinal Chemistry andInstitute for Therapeutics Discovery and DevelopmentCollege of PharmacyUniversity of Minnesota717 Delaware Street, SEMinneapolisMN 55414USA
| | - Ping Li
- Department of Obstetrics and GynecologyWashington University School of Medicine425 S. Euclid AvenueSt. LouisMO 63110USA
| | - Maximilian Lyon
- Department of Obstetrics and GynecologyWashington University School of Medicine425 S. Euclid AvenueSt. LouisMO 63110USA
| | - Celia M. Santi
- Department of Obstetrics and GynecologyWashington University School of Medicine425 S. Euclid AvenueSt. LouisMO 63110USA
| | - Derek J. Hook
- Department of Medicinal Chemistry andInstitute for Therapeutics Discovery and DevelopmentCollege of PharmacyUniversity of Minnesota717 Delaware Street, SEMinneapolisMN 55414USA
| | - Jon E. Hawkinson
- Department of Medicinal Chemistry andInstitute for Therapeutics Discovery and DevelopmentCollege of PharmacyUniversity of Minnesota717 Delaware Street, SEMinneapolisMN 55414USA
| | - Gunda I. Georg
- Department of Medicinal Chemistry andInstitute for Therapeutics Discovery and DevelopmentCollege of PharmacyUniversity of Minnesota717 Delaware Street, SEMinneapolisMN 55414USA
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Wang ZQ, Liu ZQ, Zhao CH, Zhang K, Kang ZJ, Qu TR, Zeng FS, Guo PY, Tong ZC, Wang CL, Wang KL, Wang HL, Xu YS, Wang WH, Chu ML, Wang L, Qiao ZY, Wang H, Xu W. An Ultrasound-Induced Self-Clearance Hydrogel for Male Reversible Contraception. ACS NANO 2022; 16:5515-5528. [PMID: 35352555 DOI: 10.1021/acsnano.1c09959] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Nearly half of pregnancies worldwide are unintended mainly due to failure of contraception, resulting in negative effects on women's health. Male contraception techniques, primarily condoms and vasectomy, play a crucial role in birth control, but cannot be both highly effective and reversible at the same time. Herein, an ultrasound (US)-induced self-clearance hydrogel capable of real-time monitoring is utilized for in situ injection into the vas deferens, enabling effective contraception and noninvasive recanalization whenever needed. The hydrogel is composed of (i) sodium alginate (SA) conjugated with reactive oxygen species (ROS)-cleavable thioketal (SA-tK), (ii) titanium dioxide (TiO2), which can generate a specific level of ROS after US treatment, and (iii) calcium chloride (CaCl2), which triggers the formation of the hydrogel. For contraception, the above mixture agents are one-time injected into the vas deferens, which can transform from liquid to hydrogel within 160 s, thereby significantly physically blocking the vas deferens and inhibiting movability of sperm. When fertility is needed, a noninvasive remedial ultrasound can make TiO2 generate ROS, which cleaves SA-tK to destroy the network of the hydrogel. Owing to the recanalization, the refertility rate is restored to 100%. Meanwhile, diagnostic ultrasound (D-US, 22 MHz) can monitor the occlusion and recanalization process in real-time. In summary, the proposed hydrogel contraception can be a reliable, safe, and reversible male contraceptive strategy that addresses an unmet need for men to control their fertility.
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Affiliation(s)
- Zi-Qi Wang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Zhong-Qing Liu
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Chang-Hao Zhao
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
| | - Kuo Zhang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Zhi-Jian Kang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Tian-Rui Qu
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Fan-Shu Zeng
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Peng-Yu Guo
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Zhi-Chao Tong
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Chang-Lin Wang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Ke-Liang Wang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Hong-Lei Wang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Yin-Sheng Xu
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
| | - Wan-Hui Wang
- Department of Urology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Mao-Lin Chu
- Department of Urology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Lu Wang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
| | - Zeng-Ying Qiao
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
| | - Hao Wang
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
| | - Wanhai Xu
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), Fourth Hospital of Harbin Medical University, Harbin, 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin, 150001, China
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10
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Buck KA, Stadick JL, Frazier ML. Preparing for sperm-targeted contraception: College students' perceptions and intentions related to non-hormonal intravas injectable gel. Public Health Nurs 2020; 37:639-646. [PMID: 32627239 DOI: 10.1111/phn.12761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of the study was to evaluate college students' perceptions and behavioral intentions related to a new long-acting reversible contraceptive (LARC) for people with penises: non-hormonal intravas injectable gel (NH-IVIG). DESIGN AND SAMPLE Data collection utilized predictive constructs from the theory of planned behavior. An online questionnaire surveyed undergraduates (ages 18-24 years) at a Midwestern, liberal arts college (N = 460). RESULTS Of potential NH-IVIG users, 28.6% of males and 51.4% of females reported being overall likely to use or encourage its usage. The top three hypothetical NH-IVIG promoters were low cost, reversibility, and infrequent administration. High cost, new product uncertainties, plus administration via injection for the males, were the most frequently cited NH-IVIG deterrents. A majority of potential users indicated intentions to use protective barriers or other contraceptives simultaneously with NH-IVIG; females were more likely overall. Most respondents (males, 90.4%; females, 98.5%) agreed all sexual partners should be equally responsible for contraception. Over half trusted both males and females to use contraception, but females were significantly more trusted and trusting. CONCLUSION Understanding factors influencing NH-IVIG usage can direct initiatives for sperm-targeted LARCs to mitigate risk behaviors and optimize public health promotion.
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Abstract
Unplanned pregnancies are an ongoing global burden, posing health and economic risks for women, children, and families. Advances in male contraception have been historically stymied by concerning failure rates, problematic side effects, and perceived market limitations. However, increased interest in reliable and reversible options for male contraception have resulted in resurgent efforts to introduce novel contraceptives for men. Hormonal male contraception relies on exogenous androgens and progestogens that suppress gonadotropin production, thereby suppressing testicular testosterone and sperm production. In many men, effective suppression of spermatogenesis can be achieved by androgen-progestin combination therapy. Small-scale contraceptive efficacy studies in couples have demonstrated effectiveness and reversibility with male hormonal methods, but side effects related to mood, sexual desire and cholesterol remain concerning. A number of novel androgens have reached clinical testing as potential contraceptive agents; many of these have both androgenic and progestogenic action in a single, modified steroid, thereby holding promise as single-agent contraceptives. Currently, these novel steroids hold promise as both a "male pill" and long-acting injections. Among non-hormonal methods, studies of reversible vaso-occlusive methods (polymers that block transport of sperm through the vas deferens) are ongoing, but reliable reversibility and long-term safety in men have not been established. Proteins involved in sperm maturation and motility are attractive targets, but to date both specificity and biologic redundancy have been challenges for drug development. In this review, we aim to summarize landmark studies on male contraception, highlight the most recent advances and future development in this important field of public health and medicine.
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Berardi MC, Mendes-Rodrigues C, Paro HBMDS. Contraceptive counseling lectures do not influence decision making in family planning services. CIENCIA & SAUDE COLETIVA 2018; 25:2369-2376. [PMID: 32520281 DOI: 10.1590/1413-81232020256.26472018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 11/07/2018] [Indexed: 11/22/2022] Open
Abstract
Family planning services should provide women and men with information on contraceptive methods. This study aimed to evaluate the impact of multidisciplinary contraceptive counseling lectures related to the efficacy and individual choices of contraceptive methods. Sociodemographic variables, preferred methods and opinion about the efficacy of contraceptive methods of 101 participants were analyzed. After the lecture, a lower percentage of men declared that they did not know which contraceptive method was more efficacious (24.3% versus 0.0%; p=0.006). Also, a lower percentage of women (12.7% versus 1.8%; p=0.020) and men (25.5% versus 7.7%; p=0.003) reported that they did not know which contraceptive method was less efficacious. Number of children increased the likelihood of choosing an irreversible method in a 30.87-fold (95%CI, 5.503 to 173.168, p<0.001). The choice of irreversible methods did not change after the counseling lecture (p>0.05). The lecture impacted on participants' opinions about the efficacy of contraceptive methods, making them have more informed choices. However, it did not influence their choice of contraception. Number of children was the most determining factor in choosing irreversible methods.
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Affiliation(s)
- Marília Cristina Berardi
- Diagnosis Department, Postgraduate Program in Health Science, Medical School, Federal University of Uberlandia (UFU). Av. Pará 1357/1358, Umuarama. 38405-320, Uberlândia, MG, Brazil.
| | - Clesnan Mendes-Rodrigues
- Department of Surgical Clinical Nursing, Nursing School, Medical School, UFU. Uberlândia, MG, Brazil
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Amouroux M, Mieusset R, Desbriere R, Opinel P, Karsenty G, Paci M, Fernandes S, Courbiere B, Perrin J. Are men ready to use thermal male contraception? Acceptability in two French populations: New fathers and new providers. PLoS One 2018; 13:e0195824. [PMID: 29813095 PMCID: PMC5973589 DOI: 10.1371/journal.pone.0195824] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 03/30/2018] [Indexed: 11/21/2022] Open
Abstract
Background Since the 1970s, international research has actively pursued hormonal male contraception (HMC) and, to a lesser extent, thermal male contraception (TMC). Although the efficacy of TMC has been confirmed in limited populations, its acceptability has not been studied in either potential users or potential prescribers. Methods A cross-sectional descriptive multicentre study of potential male users of TMC (new fathers) and potential prescribers of TMC (new providers) was conducted between November 2016 and February 2017.The participants completed a 3-part survey, and their responses were evaluated to i) determine their socio-demographic profiles; ii) identify personal experiences with contraception; and iii) gauge the participants’ knowledge, interest and preference for male contraception, particularly TMC. For new providers only, the survey included a fourth part to evaluate professional experience with male contraception. Results The participation rate was 51% for new fathers (305 NFs) and 34% for new providers (300 NPs, including 97 men (male new providers, MNPs) and 203 women (female new providers, FNPs)). Only 3% of NFs and 15% of NPs knew about TMC (including 26% of the MNPs and 10% of the FNPs, p<0.01). After reading information on TMC, new fathers were significantly less willing to try TMC (29%) than were new providers (40%) (p<0.01). The 3 main advantages of TMC for the new fathers included the following factors: “natural” (52%), “without side effects” (38%) and “non-hormonal” (36%). The main disadvantages were “lengthy wear time” (56%), “daily undergarment wear” (43%) and “concern about possible discomfort” (39%). Conclusions Young male and female providers have limited knowledge of male contraception, are interested in further information and would generally prescribe TMC to their patients. Successful expansion of the use of male contraception, including TMC, would require distribution of better information to potential users and providers.
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Affiliation(s)
- Marie Amouroux
- Département Universitaire de Médecine Générale Faculté de Médecine de Marseille Aix-Marseille Université, Marseille, France
| | - Roger Mieusset
- Université Toulouse III-Paul Sabatier, Groupe de Recherche en Fertilité Humaine (Human Fertility Research Group), Toulouse, France
- Andrologie-Médecine de la Reproduction, Hôpital Paule de Viguier, CHU de Toulouse, Toulouse, France
| | - Raoul Desbriere
- Service de Gynécologie-Obstétrique, Pôle Parents Enfants, Hôpital Saint-Joseph, Bd de Louvain, Marseille, France
| | - Pierre Opinel
- Centre Hospitalier Pays d'Aix, Aix-en-Provence, France
| | - Gilles Karsenty
- Service d’Urologie et Transplantation Rénale, Aix Marseille Université, CHU La Conception, Marseille, France
| | - Marine Paci
- Aix Marseille Univ, INSERM, GMGF UMR_S 910, Marseille, France
- AP-HM La Conception, Centre Clinico-Biologique d'Assistance Médicale à la Procréation -CECOS, Marseille, France
| | - Sara Fernandes
- Laboratoire de Santé Publique, bd Jean Moulin–Marseille, France
| | - Blandine Courbiere
- AP-HM La Conception, Centre Clinico-Biologique d'Assistance Médicale à la Procréation -CECOS, Marseille, France
- Aix Marseille Univ, CNRS, IRD, Avignon Univ, IMBE UMR 7263, Marseille, France
| | - Jeanne Perrin
- AP-HM La Conception, Centre Clinico-Biologique d'Assistance Médicale à la Procréation -CECOS, Marseille, France
- Aix Marseille Univ, CNRS, IRD, Avignon Univ, IMBE UMR 7263, Marseille, France
- * E-mail:
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Khourdaji I, Zillioux J, Eisenfrats K, Foley D, Smith R. The future of male contraception: a fertile ground. Transl Androl Urol 2018; 7:S220-S235. [PMID: 29928620 PMCID: PMC5989114 DOI: 10.21037/tau.2018.03.23] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The continued and rapid expansion of the Earth’s population mandates the need for safe and effective measures of contraception. While a plethora of options exist for women, methods of contraception for the male partner are limited to condoms and vasectomy. The sequela of this discrepancy has led to the family planning burden falling disproportionately on the female partner. For the past several decades, extensive research has been undertaken exploring the feasibility of hormonal male contraception. This proposed method of contraception has focused on suppressing spermatogenesis by exploiting the hypothalamic-pituitary-gonadal (HPG) axis. Beginning with proof of concept studies in the early nineties, administration of testosterone in healthy male subjects has been shown to be an efficacious method of inducing sterility. Owing to ethnic differences in spermatogenesis suppression and the comparatively low rate of azoospermia in Caucasian men with androgen-only regimens, investigators have explored the addition of progestins to further enhance the efficacy of hormonal contraception. Though studies have revealed promise with androgen-progestin regimens, the lack of long-term studies has precluded the development of a marketable product. Recently, more research has been directed towards identifying non-hormonal alternatives to male contraception. These non-hormonal options have ranged from the development of devices facilitating reversible occlusion of the vas deferens lumen to medications disrupting various pathways in the process of spermatogenesis. Underlying the development of hormonal and non-hormonal strategies is the shared enthusiasm men and women have towards these male directed methods. The willingness of couples to pursue these alternatives combined with the global need to reduce the psychological and socioeconomic implications of unintended pregnancy ensures that research will continue to bring this goal to fruition.
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Affiliation(s)
- Iyad Khourdaji
- Department of Urology, University of Virginia Healthcare System, Charlottesville, VA, USA
| | - Jacqueline Zillioux
- Department of Urology, University of Virginia Healthcare System, Charlottesville, VA, USA
| | | | - Daniel Foley
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Ryan Smith
- Department of Urology, University of Virginia Healthcare System, Charlottesville, VA, USA.,Contraline, Inc., Charlottesville, VA, USA.,University of Virginia School of Medicine, Charlottesville, VA, USA
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15
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Patel RC, Bukusi EA, Baeten JM. Current and future contraceptive options for women living with HIV. Expert Opin Pharmacother 2017; 19:1-12. [PMID: 28891343 DOI: 10.1080/14656566.2017.1378345] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Among women living with HIV, half of the pregnancies are unintended. Effective contraception can prevent unintended pregnancies and consequently reduce maternal mortality and perinatal transmission of HIV. While contraceptive options available for all women also apply to women living with HIV, specific considerations exist to the use of contraception by women living with HIV. AREAS COVERED First, general principles guiding the use of contraception among women living with HIV are discussed, such as choice, method mix, relative effectiveness, and drug-drug interactions. Second, a detailed discussion of each contraceptive method and issues surrounding the use of that method, such as drug-drug interactions, follows. Third, future contraceptive options in advanced development for use by women or men are briefly discussed. EXPERT OPINION Contraceptive methods available to all women should also be accessible to women living with HIV. When the relative effectiveness of a contraceptive method is reduced, for example due to drug-drug interactions with antiretrovirals, the method should still be made available to women living with HIV with the appropriate information sharing and counseling. Greater research on various aspects of contraceptive use by women living with HIV and more comprehensive testing of co-administration of hormonal contraceptives and common medications used by these women are warranted.
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Affiliation(s)
- Rena C Patel
- a Division of Allergy and Infectious Diseases, Department of Medicine , University of Washington , Seattle , WA , USA
| | - Elizabeth A Bukusi
- b Centre for Microbiologic Research , Kenya Medical Research Institute ; Nairobi , Kenya.,c Departments of Obstetrics and Gynecology and Global Health , University of Washington ; Seattle , WA , USA
| | - Jared M Baeten
- d Departments of Epidemiology, Global Health, and Medicine , University of Washington ; Seattle , WA , USA
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Dessauer CW, Watts VJ, Ostrom RS, Conti M, Dove S, Seifert R. International Union of Basic and Clinical Pharmacology. CI. Structures and Small Molecule Modulators of Mammalian Adenylyl Cyclases. Pharmacol Rev 2017; 69:93-139. [PMID: 28255005 PMCID: PMC5394921 DOI: 10.1124/pr.116.013078] [Citation(s) in RCA: 128] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Adenylyl cyclases (ACs) generate the second messenger cAMP from ATP. Mammalian cells express nine transmembrane AC (mAC) isoforms (AC1-9) and a soluble AC (sAC, also referred to as AC10). This review will largely focus on mACs. mACs are activated by the G-protein Gαs and regulated by multiple mechanisms. mACs are differentially expressed in tissues and regulate numerous and diverse cell functions. mACs localize in distinct membrane compartments and form signaling complexes. sAC is activated by bicarbonate with physiologic roles first described in testis. Crystal structures of the catalytic core of a hybrid mAC and sAC are available. These structures provide detailed insights into the catalytic mechanism and constitute the basis for the development of isoform-selective activators and inhibitors. Although potent competitive and noncompetitive mAC inhibitors are available, it is challenging to obtain compounds with high isoform selectivity due to the conservation of the catalytic core. Accordingly, caution must be exerted with the interpretation of intact-cell studies. The development of isoform-selective activators, the plant diterpene forskolin being the starting compound, has been equally challenging. There is no known endogenous ligand for the forskolin binding site. Recently, development of selective sAC inhibitors was reported. An emerging field is the association of AC gene polymorphisms with human diseases. For example, mutations in the AC5 gene (ADCY5) cause hyperkinetic extrapyramidal motor disorders. Overall, in contrast to the guanylyl cyclase field, our understanding of the (patho)physiology of AC isoforms and the development of clinically useful drugs targeting ACs is still in its infancy.
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Affiliation(s)
- Carmen W Dessauer
- Department of Integrative Biology and Pharmacology, McGovern Medical School, The University of Texas Health Sciences Center at Houston, Houston, Texas (C.W.D.); Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana (V.J.W.); Department of Biomedical and Pharmaceutical Sciences, Chapman University School of Pharmacy, Irvine, California (R.S.O.); Center for Reproductive Sciences, University of California San Francisco, San Francisco, California (M.C.); Institute of Pharmacy, University of Regensburg, Regensburg, Germany (S.D.); and Institute of Pharmacology, Hannover Medical School, Hannover, Germany (R.S.)
| | - Val J Watts
- Department of Integrative Biology and Pharmacology, McGovern Medical School, The University of Texas Health Sciences Center at Houston, Houston, Texas (C.W.D.); Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana (V.J.W.); Department of Biomedical and Pharmaceutical Sciences, Chapman University School of Pharmacy, Irvine, California (R.S.O.); Center for Reproductive Sciences, University of California San Francisco, San Francisco, California (M.C.); Institute of Pharmacy, University of Regensburg, Regensburg, Germany (S.D.); and Institute of Pharmacology, Hannover Medical School, Hannover, Germany (R.S.)
| | - Rennolds S Ostrom
- Department of Integrative Biology and Pharmacology, McGovern Medical School, The University of Texas Health Sciences Center at Houston, Houston, Texas (C.W.D.); Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana (V.J.W.); Department of Biomedical and Pharmaceutical Sciences, Chapman University School of Pharmacy, Irvine, California (R.S.O.); Center for Reproductive Sciences, University of California San Francisco, San Francisco, California (M.C.); Institute of Pharmacy, University of Regensburg, Regensburg, Germany (S.D.); and Institute of Pharmacology, Hannover Medical School, Hannover, Germany (R.S.)
| | - Marco Conti
- Department of Integrative Biology and Pharmacology, McGovern Medical School, The University of Texas Health Sciences Center at Houston, Houston, Texas (C.W.D.); Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana (V.J.W.); Department of Biomedical and Pharmaceutical Sciences, Chapman University School of Pharmacy, Irvine, California (R.S.O.); Center for Reproductive Sciences, University of California San Francisco, San Francisco, California (M.C.); Institute of Pharmacy, University of Regensburg, Regensburg, Germany (S.D.); and Institute of Pharmacology, Hannover Medical School, Hannover, Germany (R.S.)
| | - Stefan Dove
- Department of Integrative Biology and Pharmacology, McGovern Medical School, The University of Texas Health Sciences Center at Houston, Houston, Texas (C.W.D.); Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana (V.J.W.); Department of Biomedical and Pharmaceutical Sciences, Chapman University School of Pharmacy, Irvine, California (R.S.O.); Center for Reproductive Sciences, University of California San Francisco, San Francisco, California (M.C.); Institute of Pharmacy, University of Regensburg, Regensburg, Germany (S.D.); and Institute of Pharmacology, Hannover Medical School, Hannover, Germany (R.S.)
| | - Roland Seifert
- Department of Integrative Biology and Pharmacology, McGovern Medical School, The University of Texas Health Sciences Center at Houston, Houston, Texas (C.W.D.); Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana (V.J.W.); Department of Biomedical and Pharmaceutical Sciences, Chapman University School of Pharmacy, Irvine, California (R.S.O.); Center for Reproductive Sciences, University of California San Francisco, San Francisco, California (M.C.); Institute of Pharmacy, University of Regensburg, Regensburg, Germany (S.D.); and Institute of Pharmacology, Hannover Medical School, Hannover, Germany (R.S.)
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