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Zhu R, Wang L, Zhao L, Liu X. Central precocious puberty secondary to postoperative craniopharyngioma: two case reports and a literature review. Childs Nerv Syst 2024:10.1007/s00381-024-06406-8. [PMID: 38635073 DOI: 10.1007/s00381-024-06406-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/12/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Craniopharyngioma is a common intracranial tumour in children. Clinical manifestations are related to hypothalamic/pituitary deficiencies, visual impairment, and increased intracranial pressure. Defects in pituitary function cause shortages of growth hormone, gonadotropin, corticotropin, thyrotropin, and vasopressin, resulting in short stature, delayed puberty, feebleness, lethargy, polyuria, etc. However, manifestations involving precocious puberty (PP) are rare. CASE REPORT In both patients, surgical resection was performed after the diagnosis of craniopharyngioma, and breast development occurred postoperatively at one month in one patient and at one year and three months in the other patient. Central precocious puberty (CPP) was diagnosed via relevant examinations. Leuprorelin was injected subcutaneously every 28 days, and changes in height, weight, bone age, gonadal ultrasound and sex hormones were recorded. During the follow-up of the two children, the sex hormone levels were significantly reduced, and significant acceleration in bone age was not observed. CONCLUSIONS CPP was induced by craniopharyngioma surgery, and treatment with gonadotropin-releasing hormone analogues (GnRHa) inhibited sexual development and bone age progression. More attention should be given to monitoring for CPP during long-term follow-up of craniopharyngiomas in the clinic.
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Affiliation(s)
- Ruyuan Zhu
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui Province, China
| | - Luyao Wang
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui Province, China
| | - Ling Zhao
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui Province, China
| | - Xiaojing Liu
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui Province, China.
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Park JH, Noh ES, Hwang IT. α-Klotho levels in girls with central precocious puberty: potential as a diagnostic and monitoring marker. Front Endocrinol (Lausanne) 2024; 15:1383812. [PMID: 38650713 PMCID: PMC11033302 DOI: 10.3389/fendo.2024.1383812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/25/2024] [Indexed: 04/25/2024] Open
Abstract
Background Recent studies suggest a link between the Klotho protein, sex hormones, and insulin-like growth factor-1 (IGF-1), indicating that α-Klotho levels may rise during puberty, including in central precocious puberty (CPP) cases. This study aimed to explore α-Klotho levels in girls with CPP to assess its potential as a diagnostic and monitoring tool for this condition. Methods In total, 139 girls, comprising 82 patients diagnosed with CPP and 57 healthy prepubertal controls, were enrolled in this study. From March 2020 to May 2023, we assessed both α-Klotho levels and clinical parameters. α-Klotho concentrations were measured using an α-Klotho ELISA kit. For the girls with CPP, we additionally analyzed samples taken 6 months after GnRH agonist treatment. Results α-Klotho levels were higher in the CPP group compared with the control (CPP group: 2529 ± 999 ng/mL; control group: 1802 ± 675 pg/mL) (P < 0.001), and its level modest decreased after 6 months of GnRH agonist treatment (2147± 789 pg/mL) (P < 0.001). The association between α-Klotho and IGF-1 SDS, follicular stimulating hormone and baseline luteinizing hormone was assessed by partial correlation after adjusting for age, BMI SDS (r= 0.416, p= <0.001; r= 0.261, p= 0.005; r= 0.278, p= 0.002), respectively. Receiver operating characteristic curve analysis identified an α-Klotho cut-off differentiating CPP from controls, with a cut-off of 1914 pg/mL distinguishing girls with CPP from controls with a sensitivity of 69.5% and specificity of 70.2%; the area under the curve was 0.723. Conclusion The findings of our study are the first step towards deciphering the role of α-Klotho in puberty induction. With additional data and further research, α-Klotho could potentially be utilized as a significant diagnostic and monitoring tool for CPP.
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Affiliation(s)
- Jun-Hong Park
- Department of Pediatrics, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Eu-Seon Noh
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Il Tae Hwang
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
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Boogers LS, Wiepjes CM, Staphorsius AS, Klink DT, Ciancia S, Romani A, Stolk THR, van den Boogaard E, Steensma TD, de Vries ALC, van Trotsenburg ASP, den Heijer M, Fisher AD, Cools M, Hannema SE. A European Network for the Investigation of Gender Incongruence in adolescents. J Sex Med 2024; 21:350-356. [PMID: 38427555 DOI: 10.1093/jsxmed/qdae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Knowledge regarding the effects and side effects of gender-affirming hormone therapy (GAHT) in adults is rapidly growing, partly through international research networks such as the European Network for the Investigation of Gender Incongruence (ENIGI). However, data on the effects of puberty suppression (PS) and GAHT in transgender and gender diverse (TGD) youth are limited, although these data are of crucial importance, given the controversies surrounding this treatment. AIM We sought to present a detailed overview of the design of the ENIGI Adolescents study protocol, including the first baseline data. METHODS The ENIGI Adolescents study is an ongoing multicenter prospective cohort study. This study protocol was developed by 3 European centers that provide endocrine care for TGD adolescents and were already part of the ENIGI collaboration: Amsterdam, Ghent, and Florence. OUTCOMES Study outcomes include physical effects and side effects, laboratory parameters, bone mineral density, anthropometric characteristics, attitudes toward fertility and fertility preservation, and psychological well-being, which are measured in the study participants during PS and GAHT, up to 3 years after the start of GAHT. RESULTS Between November 2021 and May 2023, 172 TGD adolescents were included in the ENIGI Adolescents protocol, of whom 51 were assigned male at birth (AMAB) and 121 were assigned female at birth (AFAB); 3 AFAB participants reported a nonbinary gender identification. A total of 76 participants were included at the start of PS, at a median (IQR) age of 13.7 (12.9-16.5) years in AMAB and 13.5 (12.4-16.1) years in AFAB individuals. The remaining 96 participants were included at start of GAHT, at a median (IQR) age of 15.9 (15.1-17.4) years in AFAB and 16.0 (15.1-16.8) years in AMAB individuals. At the time of this report the study was open for inclusion and follow-up measurements were ongoing. CLINICAL IMPLICATIONS In response to the rising demand for gender-affirming treatment among TGD youth, this ongoing study is fulfilling the need for prospective data on the effects and safety of PS and GAHT, thus providing a foundation for evidence-based healthcare decisions. STRENGTHS AND LIMITATIONS This study has a strong multicenter, prospective design that allows for systematic data collection. The use of clinical and self-reported data offers a broad range of outcomes to evaluate. Nevertheless, the burden of additional measurements and questionnaires may lead to withdrawal or lower response rates. Few participants with a non-binary gender identity have been included. CONCLUSION With the ENIGI Adolescents study we aim to create a comprehensive dataset that we can use for a wide range of studies to address current controversies and uncertainties and to improve healthcare for TGD adolescents.
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Affiliation(s)
- Lidewij S Boogers
- Department of Endocrinology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
- Department of Pediatric Endocrinology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, 1081 HZ, Amsterdam, The Netherlands
| | - Chantal M Wiepjes
- Department of Endocrinology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, 1081 HZ, Amsterdam, The Netherlands
| | - Annemieke S Staphorsius
- Department of Endocrinology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
| | - Daniel T Klink
- Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital, 9000, Ghent, Belgium
| | - Silvia Ciancia
- Department of Internal Medicine and Pediatrics, Ghent University, 9000, Ghent, Belgium
| | - Alessia Romani
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, 50139, Florence, Italy
| | - Tessa H R Stolk
- Department of Obstetrics & Gynaecology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
| | - Emmy van den Boogaard
- Department of Obstetrics & Gynaecology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
| | - Thomas D Steensma
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
| | - Annelou L C de Vries
- Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
| | - A S Paul van Trotsenburg
- Department of Pediatric Endocrinology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, 1081 HZ, Amsterdam, The Netherlands
| | - Martin den Heijer
- Department of Endocrinology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, 1081 HZ, Amsterdam, The Netherlands
| | - Alessandra D Fisher
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, 50139, Florence, Italy
| | - Martine Cools
- Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital, 9000, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, 9000, Ghent, Belgium
| | - Sabine E Hannema
- Department of Pediatric Endocrinology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, 1081 HZ, Amsterdam, The Netherlands
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Guo N, Zhou F, Jiang X, Yang L, Ma H. The effect of gonadotropin-releasing hormone analog treatment on the endocrine system in central precocious puberty patients: a meta-analysis. J Pediatr Endocrinol Metab 2024; 37:197-208. [PMID: 38235550 DOI: 10.1515/jpem-2023-0480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/04/2024] [Indexed: 01/19/2024]
Abstract
OBJECTIVES Gonadotropin-releasing hormone (GnRHa) is the first choice for the treatment of patients with central precocious puberty (CPP). However, the effects of GnRHa on the endocrine system of CPP patients, including insulin sensitivity, lipid level, thyroid function, bone mineral density (BMD), and testosterone (T) level, are currently contradictory. Therefore, the long-term safety of GnRHa therapy remains controversial. CONTENT A systematic literature search was performed using PubMed, Embase, Cochrane Library, and CNKI databases. The changes in HOMA-IR, TG, LDL-C, HDL-C, TSH, FT3, FT4, T, and BMD in CPP patients before and after GnRHa treatment were compared by meta-analysis. As the heterogeneity between studies, we estimated standard deviation mean differences (SMDs) and 95 % confidence intervals (CIs) using a random-effects model. Egger's test was used to assess publication bias. SUMMARY A total of 22 studies were included in our meta-analysis. Compared with before GnRHa treatment, there were no statistically significant differences in endocrine indicators including HOMA-IR, TG, LDL-C, HDL-C, TSH, FT4, FT3, T, and BMD of CPP patients treated with GnRHa. OUTLOOK Treatment with GnRHa for central precocious puberty will not increase the adverse effect on the endocrine system.
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Affiliation(s)
- Na Guo
- Graduate School of Hebei North University, Zhangjiakou, Hebei, P.R. China
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, P.R. China
| | - Fei Zhou
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, P.R. China
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Xiaolan Jiang
- Graduate School of Hebei North University, Zhangjiakou, Hebei, P.R. China
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, P.R. China
| | - Linlin Yang
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, P.R. China
- Data Center, The First Hospital of Hebei Medical University, Hebei, 050031, P.R. China
| | - Huijuan Ma
- Department of Endocrinology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
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Ventriglia G, Fakriadis I, Papadaki M, Zupa R, Pousis C, Mandalakis M, Corriero A, Mylonas CC. Effects of different hormonal treatments on spermatogenesis advancement in hatchery-produced greater amberjack Seriola dumerili (Risso 1810). Gen Comp Endocrinol 2024; 348:114447. [PMID: 38216096 DOI: 10.1016/j.ygcen.2024.114447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/14/2023] [Accepted: 01/05/2024] [Indexed: 01/14/2024]
Abstract
In earlier studies, wild-caught greater amberjack Seriola dumerili (Risso, 1810) males reared in sea cages showed gametogenesis impairment and low sperm production and quality. Here, we (a) examined if F1 hatchery-produced males reared in sea cages also exhibit reproductive dysfunctions and (b) evaluated the effects of gonadotropin releasing hormone agonist (GnRHa) administration through injections (GnRHainj) or sustained-release implants (GnRHaimpl), and human chorionic gonadotropin (hGC) injections on spermatogenesis/spermiation enhancement. Fish were given a hormone treatment just prior to the spawning season, and were transferred to land-based tanks, according to an established spawning induction protocol. Blood samples (n = 6) were obtained on Days 0, 7 and 13 after treatment. Testis samples were obtained on Days 0 (n = 4) and 13 (n = 2 per treatment). The fish prior to their transfer from the sea cages to the land-based tanks, exhibited a low gonadosomatic index, altered sex steroid hormone profile and high density of testicular apoptotic cells. After transfer to tanks, there was a general depression of sex steroid plasma levels parallel to an increase in cortisol concentrations. Despite the negative effect on steroidogenesis by the transfer from the sea, the hormonal treatments increased the number of fish from where sperm could be obtained, as well as testis growth, and reduced testicular apoptosis. Treatment with hCG resulted in the most significant changes in spermatogenesis, while GnRHaimpl appeared to induce less intense, but likely longer-lasting effects. The study indicated that F1 hatchery-produced males also exhibited reproductive dysfunctions as wild-caught captive-reared greater amberjack, and that the observed positive effects of the hormone treatments on spermiation/spermatogenesis were likely mediated by factors other than sex steroid hormones.
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Affiliation(s)
- G Ventriglia
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Valenzano (Bari), Italy
| | - I Fakriadis
- Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Centre for Marine Research, 71003 Heraklion, Crete, Greece
| | - M Papadaki
- Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Centre for Marine Research, 71003 Heraklion, Crete, Greece
| | - R Zupa
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Valenzano (Bari), Italy
| | - C Pousis
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Valenzano (Bari), Italy
| | - M Mandalakis
- Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Centre for Marine Research, 71003 Heraklion, Crete, Greece
| | - A Corriero
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Valenzano (Bari), Italy.
| | - C C Mylonas
- Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Centre for Marine Research, 71003 Heraklion, Crete, Greece
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Lancerotto S, Fakriadis I, Papadaki M, Mandalakis M, Sigelaki I, Mylonas CC. Timing of puberty in F1-generation hatchery-produced greater amberjack (Seriola dumerili). Gen Comp Endocrinol 2024; 347:114414. [PMID: 38008343 DOI: 10.1016/j.ygcen.2023.114414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/11/2023] [Accepted: 11/19/2023] [Indexed: 11/28/2023]
Abstract
We evaluated the onset of puberty of first-generation (F1) hatchery-produced greater amberjack (Seriola dumerili) reared in sea cages for 5 years. Fish were sampled every year in June, at the expected peak of the spawning period in the Mediterranean Sea. No sexual dimorphism in body weight was observed in the study. The ovaries of 1 and 2-year-old (yo) females consisted of primary oocytes only, while at the age of 3-yo early vitellogenic (Vg) oocytes were also identified, but with extensive follicular atresia. At the age of 4-yo, late Vg oocytes were observed, but again extensive follicular atresia characterized the ovaries of 50 % of females. At the age of 5-yo, follicular atresia of Vg oocytes was very limited. In males, gametogenesis was evident already in 1- and 2-yo fish, and 100 % of sampled 3-yo males produced collectable viable sperm. Plasma testosterone (T), 17β-estradiol (E2), and 17,20β-dihydroxy-4-pregnen-3-one (17,20β-P) remained similar in 3 - 5-yo females, with T and E2 levels being highest in females in advanced vitellogenesis or with significant follicular atresia, compared to immature females. In males, plasma T declined over the years, while 11-ketotestosterone (11-KT) and 17,20β-P were highest in 4 and 5-yo males, with spermatozoa motility characteristics being improved from the 4th year onwards. The administration of GnRHa implants to 5-yo fish induced only two spawns, albeit no fertilized eggs were obtained. The results indicate that hatchery-produced greater amberjack males mature well and within the same age observed in the wild, however with smaller gonad size. On the contrary, females mature later than in the wild, also with a smaller gonad size. Spawning in response to GnRHa treatment was not effective, suggesting that Mediterranean hatchery-produced broodstocks may be dysfunctional, and further research is needed to document any improvement as the fish get older, or to determine if the results may be related to the specific stock of fish.
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Affiliation(s)
- Stefano Lancerotto
- Institute of Marine Biology, Biotechnology, and Aquaculture, Hellenic Centre for Marine Research, P.O. Box 2214, Heraklion 71003 Crete, Greece; Biology Department, University of Crete, PO Box 2208, 71409 Heraklion, Crete, Greece
| | - Ioannis Fakriadis
- Institute of Marine Biology, Biotechnology, and Aquaculture, Hellenic Centre for Marine Research, P.O. Box 2214, Heraklion 71003 Crete, Greece
| | - Maria Papadaki
- Institute of Marine Biology, Biotechnology, and Aquaculture, Hellenic Centre for Marine Research, P.O. Box 2214, Heraklion 71003 Crete, Greece
| | - Manolis Mandalakis
- Institute of Marine Biology, Biotechnology, and Aquaculture, Hellenic Centre for Marine Research, P.O. Box 2214, Heraklion 71003 Crete, Greece
| | - Irini Sigelaki
- Institute of Marine Biology, Biotechnology, and Aquaculture, Hellenic Centre for Marine Research, P.O. Box 2214, Heraklion 71003 Crete, Greece
| | - Constantinos C Mylonas
- Institute of Marine Biology, Biotechnology, and Aquaculture, Hellenic Centre for Marine Research, P.O. Box 2214, Heraklion 71003 Crete, Greece.
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Huang S, Zhang L, Gao C, Ou H, Hou L, Liu Z, Wang D, Xu Y, Liang L, Meng Z. Efficacy and safety of leuprorelin 3-month depot (11.25 mg) for idiopathic central precocious puberty treatment of Chinese girls: a single-center retrospective study. J Pediatr Endocrinol Metab 2024; 37:15-20. [PMID: 37975727 DOI: 10.1515/jpem-2023-0410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES This study aimed to evaluate the efficacy and safety of 3-month leuprorelin acetate (3-month LA, 11.25 mg) for the treatment of idiopathic central precocious puberty (ICPP) in Chinese girls. METHODS We conducted a single-center retrospective study in China on 28 girls with ICPP who received at least one year of 3-month LA treatment. Data from anthropometry, biochemistry, bone age (BA), and pelvic ultrasonography were assessed before and every 6 months during medication. RESULTS At CPP diagnosis, the mean chronological age (CA) was 7.8±0.8 years, with bone age advancement (BA-CA) of 1.5±0.8 years. After treatment initiation, growth velocity decreased significantly from 8.5±1.6 cm/year to 5.8±1.1 cm/year at month 12 (p<0.001). GnRH-stimulated peak LH ≤3IU/L, the primary efficacy criterion, was observed in 27 out of 28 (96.4 %) children at month 3. Basal estradiol <20 pg/mL was achieved by all 28 girls (100 %) at month 6 and remained stable at month 12. Basal follicle-stimulating hormone (FSH) decreased from 4.1±3.5 to 1.7±0.9 (p<0.001), and basal LH was also significantly reduced from 3.3±6.5 to 0.7±0.8 (p=0.035) at month 12. The mean predicted adult height (PAH) at treatment initiation was 152.7±5.8 cm, it increased significantly to 157.5±5.5 cm (p=0.007) after one-year treatment. Pubertal development was slowed in most patients, and in some cases, it was even reversed. Only one patient (3.6 %) reported local intolerance. CONCLUSIONS Three-month leuprorelin acetate is a safe and effective treatment for suppressing the pituitary-gonadal axis and restoring impaired adult height in Chinese girls.
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Affiliation(s)
- Siqi Huang
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lina Zhang
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chenchen Gao
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hui Ou
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lele Hou
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zulin Liu
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dilong Wang
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yingying Xu
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Liyang Liang
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhe Meng
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Rodriguez-Wallberg KA, Kieler H, Foukakis T, Li J, Gissler M, Oberg AS, Bergh J, Lundberg FE. Gonadotropin Releasing Hormone agonist ( GnRHa) during chemotherapy and post-cancer childbirths - a Nationwide population-based cohort study of 24,922 women diagnosed with cancer in Sweden. EClinicalMedicine 2024; 67:102335. [PMID: 38314058 PMCID: PMC10837528 DOI: 10.1016/j.eclinm.2023.102335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 02/06/2024] Open
Abstract
Background Worldwide, an increasing number of women with cancer are receiving Gonadotropin Releasing Hormone agonist (GnRHa) co-treatment during chemotherapy aiming at ovarian protection. There is divergence among guidelines, and some have recommended GnRHa co-treatment for women with breast cancer, however, the effect of GnRHa on future fertility is uncertain. Methods In this population-based cohort study we included all women diagnosed with cancer at ages 15-45 between July 2005 and March 2017 in Sweden, identified in the Swedish Cancer Register. Exposure to GnRHa co-treatment was captured using the Prescribed Drug Register. Post-cancer childbirth, extracted from the Medical Birth Register, was the main outcome. Secondary outcomes included childbirths achieved through natural conception (NC), infertility diagnosis and cancer mortality. For each outcome, adjusted hazard ratios (aHR) and 95% confidence intervals (CI) were estimated using delayed-entry Cox models, stratified by age and cancer site. Findings Among 24,922 women diagnosed with cancer, 1.5% had GnRHa co-treatment. Breast cancer diagnoses were found in 80.2% of GnRHa exposed women and the GnRHa exposure was not associated with higher rates of childbirth (aHR 1.23, 95% CI 0.80-1.89), or NC childbirth (aHR 1.02, 95% CI 0.62-1.67), whereas the rate of infertility was significantly higher (aHR 2.42, 95% CI 1.44-4.08). In women with lymphoma and other cancers, GnRHa exposure was not associated with higher rates of childbirth, NC childbirth or infertility. GnRHa exposure was not associated with higher cancer mortality for any cancer type. Interpretation We did not find evidence of improved or maintained fertility, estimated as childbirth rates post-cancer, in women who received GnRHa during cancer treatment. Funding This study was financed by research grants from The Swedish Cancer Society (CAN 2017/704; 190249Pj, 200170F), The Swedish Research Council (Dnr 2019-00446), the Nordic Cancer Union NCU (Grant 2017), The Swedish Childhood Cancer Fund (KP2016-0031), Radiumhemmets Forskningsfonder (Dnr: 201313), Stockholm County Council (FoUI-953912) and Karolinska Institutet (Dnr 2020-01963).
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Affiliation(s)
- Kenny A. Rodriguez-Wallberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Division of Gynecology and Reproduction, Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
- Laboratory of Translational Fertility Preservation, BioClinicum, New Karolinska University Hospital, Stockholm, Sweden
| | - Helle Kieler
- Department of Medicine, Centre for Pharmacoepidemiology (CPE), Karolinska Institutet, Stockholm, Sweden
| | - Theodoros Foukakis
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Breast Cancer Center, Theme Cancer, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden
| | - Jiong Li
- Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Mika Gissler
- Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland
- Region Stockholm, Academic Primary Health Care Centre, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Anna Sara Oberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jonas Bergh
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Breast Cancer Center, Theme Cancer, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden
| | - Frida E. Lundberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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9
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Boogers LS, Reijtenbagh SJP, Wiepjes CM, van Trotsenburg ASP, den Heijer M, Hannema SE. Time course of body composition changes in transgender adolescents during puberty suppression and sex hormone treatment. J Clin Endocrinol Metab 2023:dgad750. [PMID: 38128064 DOI: 10.1210/clinem/dgad750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 12/23/2023]
Abstract
CONTEXT Transgender adolescents can undergo puberty suppression (PS) and subsequent gender-affirming hormone therapy (GAHT) but little information is available on the expected rate of physical changes. OBJECTIVE To investigate the time course of body composition changes during PS and GAHT. DESIGN Retrospective cohort study. SETTING Gender identity clinic. PARTICIPANTS 380 trans boys and 168 trans girls treated with PS prior to GAHT. MAIN OUTCOME MEASURES Total lean- and fat mass Z-scores using birth-assigned sex as reference determined using dual energy X-ray absorptiometry. RESULTS In trans boys, lean mass Z-scores decreased (-0.32, 95%CI -0.41; -0.23) and fat mass Z-scores increased (0.31, 95%CI 0.21; 0.41) in the first year of PS and remained stable thereafter. Only during the first year of testosterone, lean mass Z-scores increased (0.92, 95%CI 0.81; 1.04) and fat mass Z-scores decreased (-0.43, 95%CI -0.57; -0.29). In trans girls, both lean and fat mass Z-scores gradually changed over three years of PS (respectively -1.13, 95%CI -1.29; -0.98 and 1.06, 95%CI 0.90; 1.23). Only in the first year of GAHT, lean mass Z-scores decreased (-0.19, 95%CI -0.36; -0.03) while fat mass Z-scores remained unchanged after three years (-0.02, 95%CI -0.20; 0.16). CONCLUSIONS Compared to peers, trans girls experienced ongoing lean mass decrease and fat mass increase during 3 years of PS while in trans boys smaller changes were observed that stabilized after one year. A large increase in lean mass Z-scores occurred only during the first year of testosterone treatment. In trans girls, body composition changed only slightly during GAHT. This information can improve counseling about treatment effects.
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Affiliation(s)
- Lidewij Sophia Boogers
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC, Amsterdam, the Netherlands
- Department of Endocrinology and Metabolism, and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC, Amsterdam, the Netherlands
| | | | - Chantal Maria Wiepjes
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC, Amsterdam, the Netherlands
- Department of Endocrinology and Metabolism, and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC, Amsterdam, the Netherlands
| | - Adrianus Sarinus Paulus van Trotsenburg
- Department of Endocrinology and Metabolism, and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC, Amsterdam, the Netherlands
- Department of Pediatric Endocrinology, Amsterdam University Medical Center location AMC, Amsterdam, the Netherlands
| | - Martin den Heijer
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC, Amsterdam, the Netherlands
- Department of Endocrinology and Metabolism, and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC, Amsterdam, the Netherlands
| | - Sabine Elisabeth Hannema
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC, Amsterdam, the Netherlands
- Department of Endocrinology and Metabolism, and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC, Amsterdam, the Netherlands
- Department of Pediatric Endocrinology, Amsterdam University Medical Center location AMC, Amsterdam, the Netherlands
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10
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Hadziselimovic F, Verkauskas G, Stadler MB. Epigenetics, cryptorchidism, and infertility. Basic Clin Androl 2023; 33:24. [PMID: 37730534 PMCID: PMC10512650 DOI: 10.1186/s12610-023-00199-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/02/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Cryptorchid boys with defective mini-puberty and impaired differentiation of Ad spermatogonia (high infertility risk) have altered expression of several genes encoding histone methyltransferases compared to patients with intact differentiation of gonocytes into Ad spermatogonia (low infertility risk). RESULTS High infertility risk cryptorchid boys display hypogonadotropic hypogonadism, which, together with the diminished expression of histone deacetylases and increased expression of HDAC8 decrotonylase, indicates altered histone marks and, thus, a perturbed histone code. Curative GnRHa treatment induces normalization of histone methyltransferase, chromatin remodeling, and histone deacetylase gene expression. As a result, histone changes induce differentiation of Ad spermatogonia from their precursors and, thus, fertility. In this short report, we describe key functions of histone lysine methyltransferases, chromatin remodeling proteins, and long-noncoding RNAs, and discuss their potential roles in processes leading to infertility. CONCLUSION Our findings suggest that epigenetic mechanisms are critical to better understanding the root causes underlying male infertility related to cryptorchidism and its possible transgenerational transmission.
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Affiliation(s)
- Faruk Hadziselimovic
- Cryptorchidism Research Institute, Children’s Day Care Center, 4410 Liestal, Switzerland
| | - Gilvydas Verkauskas
- Children’s Surgery Centre, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania
| | - Michael B. Stadler
- Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
- Swiss Institute of Bioinformatics, Basel, Switzerland
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11
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Yang J, Wen Y, Li D, Hou X, Peng B, Wang Z. Retrospective analysis of the endometrial preparation protocols for frozen-thawed embryo transfer cycles in women with endometriosis. Reprod Biol Endocrinol 2023; 21:83. [PMID: 37670354 PMCID: PMC10478394 DOI: 10.1186/s12958-023-01132-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 08/24/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND There was inconsistency in optimal endometrial preparation protocol for frozen-thawed embryo transfer (FET) in patients with endometriosis. We conducted this study to investigate the effect of different endometrial preparation protocols on the pregnancy outcomes in patients with endometriosis undergoing FET cycles, and determine the optimal number of GnRHa injections in GnRHa-HRT protocols. METHOD(S) This was a retrospective cohort analysis of women with endometriosis who underwent FET cycles at a single university-based center. This study retrospectively analyzed 2048 FET cycles in our center from 2011 to 2020. According to the endometrial preparation protocols, patients were divided into 4 groups: gonadotropin releasing hormone agonist-hormone replacement therapy(GnRHa-HRT), hormone replacement therapy(HRT), ovulation induction(OI), and natural cycle(NC). In the GnRHa-HRT group, patients were further divided into 3 groups: one injection of GnRHa, two injections of GnRHa, and three or more injections of GnRHa. The primary outcome was the clinical pregnancy rate. Propensity score matching was used to adjust for potential non-similarities among the groups. Multivariate logistic regression analysis was performed to figure out the risk factors for pregnancy outcomes. RESULT(S) There were no statistical differences in pregnancy outcomes among the four endometrial preparation protocols in FET cycles with endometriosis patients, the results retained after propensity score matching(PSM). And in endometriosis patients complicated with adenomyosis, the results remained similar. In patients with GnRHa-HRT protocol, there were no differences in clinical pregnancy rate and live birth rate with different numbers of GnRHa injections, the early miscarriage rate were 18% in the two injections of GnRHa group and 6.5% in the one injection of GnRHa group(P = 0.017). Multifactorial logistic regression analysis showed that two injections of GnRHa before FET was associated with increased early miscarriage rate compared with one injection of GnRHa[adjusted OR (95% CI): 3.116(1.079-8.998),p = 0.036]. CONCLUSION(S) The four kinds of endometrial preparation protocols for FET, GnRHa-HRT, HRT, OI and NC had similar pregnancy outcomes in patients with endometriosis. In endometriosis patients complicated with adenomyosis, the results remained similar. In patients with endometriosis undergoing GnRHa-HRT protocol for FET, more injections of GnRHa had no more advantages in pregnancy outcomes, on the contrary, it might increase the early miscarriage rate.
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Affiliation(s)
- Jingdi Yang
- Reproductive Center, Guangdong Key Laboratory of Reproductive Medicine, The First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Er Road, 510080, Guangzhou, China
| | - Yangxing Wen
- Reproductive Center, Guangdong Key Laboratory of Reproductive Medicine, The First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Er Road, 510080, Guangzhou, China
| | - Danping Li
- Reproductive Center, Guangdong Key Laboratory of Reproductive Medicine, The First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Er Road, 510080, Guangzhou, China
| | - Xuerong Hou
- Reproductive Center, Guangdong Key Laboratory of Reproductive Medicine, The First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Er Road, 510080, Guangzhou, China
| | - Bo Peng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zengyan Wang
- Reproductive Center, Guangdong Key Laboratory of Reproductive Medicine, The First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Er Road, 510080, Guangzhou, China.
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12
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Fisch-Shvalb N, Alfandary-Harani H, Lazar L, Davidovits M, Shvalb N, Demol-Eliaz S, Yackobovitch-Gavan M, de Vries L. Blood pressure in girls with central precocious puberty receiving GnRH analogue therapy. J Pediatr Endocrinol Metab 2023; 36:726-731. [PMID: 37392130 DOI: 10.1515/jpem-2023-0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/16/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVES Case reports show hypertension in children treated with GnRH analogues for central precocious puberty (CPP). However, relevant data on blood pressure are scarce. We aimed to evaluate blood pressure (BP) among girls with idiopathic CPP and early-onset puberty before and during GnRH analogue therapy; and to examine associations of blood pressure with clinical parameters. METHODS For this retrospective longitudinal cohort study, demographic, anthropometric, clinical, and laboratory data were collected from electronic files. The study group included 112 girls with idiopathic CPP or early-onset puberty followed in a tertiary pediatric endocrinology institute, and a control group of 37 healthy pre-pubertal girls. The main outcome measures were BP percentile, before, and during treatment with GnRH analogue. RESULTS At baseline, similar proportions of the study and control groups had BP values>90th percentile: 64 (53 %) and 17 (46 %), respectively (p=0.57). The mean systolic and diastolic BP percentiles measured under treatment remained unchanged. In the study group, baseline BP>90th percentile compared to normal baseline BP was associated with lower birthweight and a higher body mass index-standard deviation score: 2,821 ± 622 vs. 3,108 ± 485 g and 1.0 ± 0.7 vs. 0.70 ± 0.8, respectively, p=0.01 for both. CONCLUSIONS GnRH analogue therapy for precocious or early puberty was not associated with increased blood pressure. The stability of mean blood pressure percentile during treatment is reassuring.
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Affiliation(s)
- Naama Fisch-Shvalb
- National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, The Jesse Z. and Lea Shafer Institute of Endocrinology and Diabetes, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hadas Alfandary-Harani
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Schneider Children's Medical Center of Israel, Institute of Nephrology, Petach Tikva, Israel
| | - Liora Lazar
- National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, The Jesse Z. and Lea Shafer Institute of Endocrinology and Diabetes, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Nir Shvalb
- Faculty of Engineering, Ariel University, Ariel, Israel
| | - Sharon Demol-Eliaz
- National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, The Jesse Z. and Lea Shafer Institute of Endocrinology and Diabetes, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Yackobovitch-Gavan
- National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, The Jesse Z. and Lea Shafer Institute of Endocrinology and Diabetes, Petach Tikva, Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liat de Vries
- National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, The Jesse Z. and Lea Shafer Institute of Endocrinology and Diabetes, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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13
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Ciancia S, Iughetti L. How do Italian pediatric endocrinologists approach gender incongruence? Ital J Pediatr 2023; 49:70. [PMID: 37316939 DOI: 10.1186/s13052-023-01471-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/09/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Gender incongruence (GI) is a term used to describe a marked and persistent incompatibility between the sex assigned at birth (SAAB) and the experienced gender. Some persons presenting with GI experience a severe psychological distress defined as gender dysphoria (GD).. Although the prevalence of GI is probably underestimated, recently a great increase in numbers of transgender and gender diverse (TGD) youths presenting at the gender clinics has been registered. After a careful multidisciplinary evaluation and upon acquisition of informed consent from the youth and the legal guardian(s), puberty suppression can be started in TGD youths, followed by the addition of gender affirming hormones (GAH) by the age of 16 years. Although Italian specific guidelines are available, their application is often complex because of (among other reasons) lack of specialized centers and healthcare professional with experience in the field and the regional differences within the Italian healthcare system. MAIN BODY To investigate the care offered to TGD youths across Italy, we proposed a survey of 20 questions to the directors of the 32 Italian Centers of pediatric endocrinology participating to the Study Group on Growth and Puberty of the Italian Society of Pediatric Endocrinology (ISPED). Eighteen pediatric endocrinologists representative of 16 different centers belonging to 11 different regions responded to the survey. In the large majority of centers TGD youths are taken in charge between the age of 12 and 18 years and at least three healthcare professional are involved. Most of Italian pediatric endocrinologists follow only a very limited number of TGD youths and reference centers for TGD youths are lacking. CONCLUSION There is an urgent need for gender clinics (homogeneously distributed on the national territory) where TGD youths can access high standard care.
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Affiliation(s)
- Silvia Ciancia
- Pediatric Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Largo del Pozzo 71, Modena, 41124, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Largo del Pozzo 71, Modena, 41124, Italy.
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14
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Valenzise M, Nasso C, Scarfone A, Rottura M, Cafarella G, Pallio G, Visalli G, Di Prima E, Nasso E, Squadrito V, Wasniewska M, Irrera P, Arcoraci V, Squadrito F. Leuprolide and triptorelin treatment in children with idiopathic central precocious puberty: an efficacy/tolerability comparison study. Front Pediatr 2023; 11:1170025. [PMID: 37266535 PMCID: PMC10229807 DOI: 10.3389/fped.2023.1170025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/25/2023] [Indexed: 06/03/2023] Open
Abstract
Introduction Central precocious puberty (CPP) results from premature activation of hypothalamic-pituitary-gonadal axis, with the consequent increase of gonadotropin-releasing hormone (GnRH); GnRH agonists (GnRHa) represent the gold-standard therapy in children with CPP although their use might be responsible for pituitary GnRH receptors down-regulation, that in turn suppresses luteinizing hormone (LH) and follicle stimulating hormone (FSH) and blocks of gonadal sex hormones release. The most prescribed GnRHa in the clinical practice are leuprolide and triptorelin, whose use is generally safe and well tolerated; however, mild menopausal-like side effects could appear. The aim of the present study was to investigate and compare the efficacy and tolerability profile of leuprolide and triptorelin in CPP patients. Methods 110 girls affected by CPP were enrolled in this retrospective study, carried out from 2018 to 2020. The enrolled patients received leuprolide (n = 48) or triptorelin (n = 62). Efficacy was investigated by the means of clinical parameters and radiological changes and side effects were also recorded to evaluate the possible relationship between the two GnRHa treatments and side effects appearance. Results At baseline triptorelin patients had significantly higher LH and LH peak levels than leuprolide patients, whereas no significant difference in other patient characteristics was observed between the two groups. The leuprolide treatment lasted 971 days [790-1,171 days] while the duration of triptorelin administration was 792 days [760-1,003 days] (p < 0.001). Overall 46 (41.8%) of the studied patients reported mild menopausal-like symptoms: among these 27 were treated with triptorelin and 19 with leuprolide (p = 0.558). Patients treated with triptorelin, or leuprolide showed headache (27.4% vs. 16.7%), mood swings (12.9% vs. 16.7%), increased appetite (12.9% vs. 18.8%) and nausea (1.6% vs. 10.4%) respectively. Moreover, the onset of side effects appearance related to GnRHa therapy significantly reduces with the increase of the initial bone age (p = 0.038). Conclusion Leuprolide and triptorelin treatment appear to be effective and safe without significant difference between the two drugs in term of efficacy and tolerability, making both good options for treating CPP.
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Affiliation(s)
- M. Valenzise
- Department of Human Pathology and Evolutive Age “Gaetano Barresi”, University of Messina, Messina, Italy
| | - C. Nasso
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - A. Scarfone
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - M. Rottura
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - G. Cafarella
- Department of Human Pathology and Evolutive Age “Gaetano Barresi”, University of Messina, Messina, Italy
| | - G. Pallio
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - G. Visalli
- Department of Human Pathology and Evolutive Age “Gaetano Barresi”, University of Messina, Messina, Italy
| | - E. Di Prima
- Department of Human Pathology and Evolutive Age “Gaetano Barresi”, University of Messina, Messina, Italy
| | - E. Nasso
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - V. Squadrito
- Department of Human Pathology and Evolutive Age “Gaetano Barresi”, University of Messina, Messina, Italy
| | - M. Wasniewska
- Department of Human Pathology and Evolutive Age “Gaetano Barresi”, University of Messina, Messina, Italy
| | - P. Irrera
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - V. Arcoraci
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - F. Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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15
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Willemsen LA, Boogers LS, Wiepjes CM, Klink DT, van Trotsenburg ASP, den Heijer M, Hannema SE. Just as Tall on Testosterone; a Neutral to Positive Effect on Adult Height of GnRHa and Testosterone in Trans Boys. J Clin Endocrinol Metab 2023; 108:414-421. [PMID: 36190924 PMCID: PMC9844962 DOI: 10.1210/clinem/dgac571] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/15/2022] [Indexed: 01/22/2023]
Abstract
CONTEXT Growth is an important topic for many transgender boys. However, few studies have investigated the impact of puberty suppression (PS) and gender-affirming hormone treatment (GAHT) on growth and adult height. OBJECTIVE To evaluate the effect of PS and GAHT on growth and adult height. DESIGN Retrospective cohort study. SETTING Specialized gender identity clinic. PARTICIPANTS A total of 146 transgender boys treated with GnRH analogues and testosterone who reached adult height. MAIN OUTCOME MEASURES Growth, bone age (BA), adult height, and difference between adult height and predicted adult height (PAH) and midparental height. RESULTS In those with BA ≤14 years at start (n = 61), a decrease in growth velocity and bone maturation during PS was followed by an increase during GAHT. Adult height was 172.0 ± 6.9 cm; height SD score was similar to baseline (0.1; 95% CI, -0.2 to 0.4). Adult height was 3.9 ± 6.0 cm above midparental height and 3.0 ± 3.6 cm above PAH at start of PS. A younger BA at start PS was associated with an adult height significantly further above PAH. CONCLUSION During PS, growth decelerated followed by an acceleration during GAHT. Although adult height SD score was similar to baseline, adult height was taller than predicted based on BA at baseline, especially in those who started treatment at a younger BA. It is reassuring that PS and GAHT do not have a negative impact on adult height in transgender boys and might even lead to a slightly taller adult height, especially in those who start at a younger age.
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Affiliation(s)
| | | | - Chantal Maria Wiepjes
- Center of Expertise on Gender Dysphoria, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
- Department of Endocrinology, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, 1105 BK Amsterdam, the Netherlands
| | - Daniel Tatting Klink
- Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital, Ghent, Oost-Vlaanderen 9000, Belgium
| | - Adrianus Sarinus Paulus van Trotsenburg
- Department of Pediatric Endocrinology, Amsterdam UMC location University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, 1105 BK Amsterdam, the Netherlands
| | - Martin den Heijer
- Center of Expertise on Gender Dysphoria, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
- Department of Endocrinology, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, 1105 BK Amsterdam, the Netherlands
| | - Sabine Elisabeth Hannema
- Correspondence: Sabine Elisabeth Hannema, MD PhD, Department of Pediatrics, Section Endocrinology, Amsterdam University Medical Centers, Amsterdam, the Netherlands, PO Box 7057, 1007 MB Amsterdam.
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Abstract
Pubertal children with significant growth retardation represent a considerable therapeutic challenge. In growth hormone (GH) deficiency, and in those without identifiable pathologies (idiopathic short stature), the impact of using GH is significantly hindered by the relentless tempo of bone age acceleration caused by sex steroids, limiting time available for growth. Estrogen principally modulates epiphyseal fusion in females and males. GH production rates and growth velocity more than double during puberty, and high-dose GH use has shown dose-dependent increases in linear growth, but also can raise insulin-like growth factor I concentrations supraphysiologically, and increase treatment costs. Gonadotropin-releasing hormone analogs (GnRHas) suppress physiologic puberty, and when used in combination with GH can meaningfully increase height potential in males and females while rendering adolescents temporarily hypogonadal at a critical time in development. Aromatase inhibitors (AIs) block androgen to estrogen conversion, slowing down growth plate fusion, while allowing normal virilization in males and stimulating longitudinal bone growth via androgen receptor effects on the growth plate. Here, we review the physiology of pubertal growth, estrogen and androgen action on the epiphyses, and the therapeutic impact of GH, alone and in combination with GnRHa and with AIs. The pharmacology of potent oral AIs, and pivotal work on their efficacy and safety in children is also reviewed. Time-limited use of AIs is a viable alternative to promote growth in pubertal males, particularly combined with GH. Use of targeted growth-promoting therapies in adolescence must consider the impact of sex steroids on growth plate fusion, and treatment should be individualized.
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Affiliation(s)
| | - Judith Ross
- Nemours Children's Health Wilmington, DE, USA
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Gong C, Lin Z, Deng Y, Yang B, Zhang L. Successful pregnancies in women with diffuse uterine leiomyomatosis after high-intensity focused ultrasound ablation: report of three cases. Int J Hyperthermia 2023; 40:2234674. [PMID: 37437896 DOI: 10.1080/02656736.2023.2234674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/25/2023] [Accepted: 07/04/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVE To describe the reproductive outcomes of patients with diffuse uterine leiomyomatosis (DUL) treated with high-intensity focused ultrasound (HIFU) ablation. MATERIALS AND METHODS Three patients of reproductive age with DUL who underwent HIFU treatment were enrolled, all of whom had a strong desire to become pregnant. All patients underwent routine laboratory tests, electrocardiography (ECG), chest X-ray radiography, ultrasound, and magnetic resonance imaging (MRI) examinations after routine medical history collection and physical examination. The treatment time, treatment power, sonication time, and adverse events were recorded. One day after HIFU, MRI was performed to evaluate treatment efficacy. The patients were scheduled for follow-up at 3-, 6-, 12-, and 24-month after HIFU treatment. RESULTS All the three patients completed HIFU treatment successfully without any major complication. Uterine size and menstrual volume significantly decreased with the combination of medical and HIFU treatments. The shrinkage rate of uterine volume was 31-44% and the menstrual volume reduced by 1/2 or returned to normal at 3 months post-HIFU. Three patients had successful conceptions between 3 and 11 months after HIFU with healthy deliveries. No uterine rupture occurred during pregnancy and delivery. CONCLUSION HIFU ablation may help achieve a successful pregnancy in patients with DUL.
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Affiliation(s)
- Chunmei Gong
- Department of Gynecology, Chongqing Haifu Hospital, Chongqing, P.R. China
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
| | - Zhenjiang Lin
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Department of Gynaecology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizou, P.R. China
| | - Yongbin Deng
- Department of Gynecology, Chongqing Haifu Hospital, Chongqing, P.R. China
| | - Bing Yang
- Department of Gynaecology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizou, P.R. China
| | - Lian Zhang
- Department of Gynecology, Chongqing Haifu Hospital, Chongqing, P.R. China
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
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Cozzolino M, Pellicer N, Galliano D, Pellicer A. Pituitary suppression with GnRH agonists before ART may be insufficient to treat women with severe adenomyosis. Reprod Biomed Online 2023; 46:150-5. [PMID: 36402667 DOI: 10.1016/j.rbmo.2022.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/26/2022] [Accepted: 09/13/2022] [Indexed: 01/31/2023]
Abstract
RESEARCH QUESTION Does aromatase inhibitor improve IVF outcomes by reducing local oestrogen production in patients with adenomyosis undergoing long-term gonadotrophin-releasing hormone agonist (GnRHa) treatment? DESIGN Four patients with severe adenomyosis who failed to improve after long-term treatment (≥3 months) with depot GnRHa received treatment with an aromatase inhibitor for 21 days. Blood oestradiol concentrations were monitored after GnRHa treatment both before and after treatment with an aromatase inhibitor. Women received a transfer of IVF autologous or donor oocytes. Pregnancy and ongoing pregnancy rates were the primary outcomes. Blood oestradiol concentration after treatment with an aromatase inhibitor was a secondary outcome. RESULTS Patients with severe adenomyosis presented with hyperestrogenism due to local production from the lesions even after long-term treatment with GnRHa. Treatment with an aromatase inhibitor reduced hyperestrogenism and improved clinical outcomes in adenomyosis patients who have experienced previous embryo transfer failures. CONCLUSION Women with severe adenomyosis would benefit from letrozole or a combination of GnRHa plus letrozole before receipt of treatment with assisted reproductive technology. For women with severe adenomyosis, GnRHa treatment alone may be insufficient to suppress oestrogen production by adenomyotic lesions. Thus, it should be mandatory to test for oestradiol concentrations in patients with severe adenomyosis who have received long-term GnRHa treatment. Also, GnRHa may not always be the sole strategy for medical management of adenomyotic lesions. Letrozole is safe and can improve IVF outcomes for patients with adenomyosis.
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19
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Nyuji M, Hamaguchi M, Shimizu A, Isu S, Yoneda M, Matsuyama M. Development of sandwich enzyme-linked immunosorbent assays for chub mackerel Scomber japonicus gonadotropins and regulation of their secretion in female reproduction. Gen Comp Endocrinol 2022; 328:114103. [PMID: 35940318 DOI: 10.1016/j.ygcen.2022.114103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/25/2022] [Accepted: 08/03/2022] [Indexed: 11/18/2022]
Abstract
The pituitary gonadotropins (Gths), follicle-stimulating hormone (Fsh) and luteinizing hormone (Lh), play critical roles in regulating gonadal development and sexual maturation in vertebrates. We developed non-competitive enzyme-linked immunosorbent assays (ELISAs) to measure Fsh and Lh in chub mackerel Scomber japonicus, which is a commercially important scombrid species. Mouse monoclonal antibodies specific for Fsh and Lh, and a rabbit polyclonal antibody against both Gths were produced by immunization with hormones purified from chub mackerel pituitaries. These monoclonal and polyclonal antibodies were used as capture and detection antibodies in the developed sandwich ELISAs. The ELISAs were reproducible, sensitive, and specific for chub mackerel Fsh and Lh. Parallelism between the standard curve and serial dilutions of chub mackerel serum and pituitary extract was observed for both Fsh and Lh ELISAs. Comparison between vitellogenic and immature females revealed that Fsh is secreted during vitellogenesis and Lh is barely released during immaturity. After gonadotropin-releasing hormone analog (GnRHa) injection, vitellogenic females showed increases in serum Lh, whereas serum levels of Fsh did not vary. Moreover, the serum steroid profiles revealed that estradiol-17β was continuously produced after GnRHa treatment, whereas 17,20β-dihydroxy-4-pregnen-3-one secretion was transiently induced. These results indicate that, in vitellogenic females, GnRHa stimulates the release of Lh, but not Fsh, which results in acceleration of vitellogenesis and induction of oocyte maturation via steroid production.
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Affiliation(s)
- Mitsuo Nyuji
- Fisheries Technology Institute, Japan Fisheries Research and Education Agency, Nagasaki 851-2213, Japan.
| | - Masami Hamaguchi
- Fisheries Technology Institute, Hatsukaichi Field Station, Japan Fisheries Research and Education Agency, Hiroshima 739-0452, Japan
| | - Akio Shimizu
- Fisheries Resources Institute, Japan Fisheries Research and Education Agency, Yokohama 236-8648, Japan
| | - Sayoko Isu
- Fisheries Resources Institute, Japan Fisheries Research and Education Agency, Yokohama 236-8648, Japan
| | - Michio Yoneda
- Fisheries Technology Institute, Hakatajima Field Station, Japan Fisheries Research and Education Agency, Imabari 794-2305, Japan
| | - Michiya Matsuyama
- Aqua-Bioresource Innovation Center, Faculty of Agriculture, Kyushu University, Fukuoka 819-0395, Japan
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20
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Hadziselimovic F, Verkauskas G, Stadler M. A novel role for CFTR interaction with LH and FGF in azoospermia and epididymal maldevelopment caused by cryptorchidism. Basic Clin Androl 2022; 32:10. [PMID: 35725394 PMCID: PMC9210799 DOI: 10.1186/s12610-022-00160-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/16/2022] [Indexed: 11/21/2022] Open
Abstract
Cryptorchidism occurs frequently in children with cystic fibrosis. Among boys with cryptorchidism and abrogated mini-puberty, the development of the epididymis and the vas deferens is frequently impaired. This finding suggests that a common cause underlies the abnormal development of Ad spermatogonia and the epididymis. The cystic fibrosis transmembrane conductance regulator (CFTR) is an ATP-binding cassette transporter protein that acts as a chloride channel. The CFTR gene has been associated with spermatogenesis and male fertility. In boys with cryptorchidism, prepubertal hypogonadotropic hypogonadism induces suboptimal expression of the ankyrin-like protein gene, ASZ1, the P-element induced wimpy testis-like gene, PIWIL, and CFTR. The abrogated expression of these gene leads to transposon reactivation, and ultimately, infertility. Curative gonadotropin-releasing hormone agonist (GnRHa) treatment stimulates the expression of CFTR and PIWIL3, which play important roles in the development of Ad spermatogonia and fertility. Furthermore, GnRHa stimulates the expression of the epididymal androgen-sensitive genes, CRISP1, WFDC8, SPINK13, and PAX2, which thereby promotes epididymal development. This review focuses on molecular evidence that favors a role for CFTR in cryptorchidism-induced infertility. Based on information available in the literature, we interpreted our RNA-Seq expression data obtained from samples before and after randomized GnRHa treatment in boys with bilateral cryptorchidism. We propose that, in boys with cryptorchidism, CFTR expression is controlled by luteinizing hormone and testosterone. Moreover, CFTR regulates the activities of genes that are important for fertility and Wolffian duct differentiation.
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Affiliation(s)
- Faruk Hadziselimovic
- Cryptorchidism Research Institute, Children's Day Care Center Liestal, 4410, Liestal, Schweiz, Switzerland.
| | - Gilvydas Verkauskas
- Children's Surgery Centre, Faculty of Medicine, Vilnius University, 01513, Vilnius, Lithuania
| | - Michael Stadler
- Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland.,Swiss Institute of Bioinformatics, Basel, Switzerland.,Faculty of Science, University of Basel, Basel, Switzerland
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21
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Aapkes SE, Bernts LHP, van den Berg AP, van den Berg M, Blokzijl H, Cantineau AEP, van Gastel MDA, de Haas RJ, Kappert P, Müller RU, Nevens F, Torra R, Visser A, Drenth JPH, Gansevoort RT. Protocol for a randomized controlled multicenter trial assessing the efficacy of leuprorelin for severe polycystic liver disease: the AGAINST-PLD study. BMC Gastroenterol 2022; 22:82. [PMID: 35216547 PMCID: PMC8876117 DOI: 10.1186/s12876-022-02142-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/06/2022] [Indexed: 11/11/2022] Open
Abstract
Background In patients with severe polycystic liver disease (PLD), there is a need for new treatments. Estrogens and possibly other female sex hormones stimulate growth in PLD. In some patients, liver volume decreases after menopause. Female sex hormones could therefore be a target for therapy. The AGAINST-PLD study will examine the efficacy of the GnRH agonist leuprorelin, which blocks the production of estrogen and other sex hormones, to reduce liver growth in PLD.
Methods The AGAINST-PLD study is an investigator-driven, multicenter, randomized controlled trial. Institutional review board (IRB) approval was received at the University Medical Center of Groningen and will be collected in other sites before opening these sites. Thirty-six female, pre-menopausal patients, with a very large liver volume for age (upper 10% of the PLD population) and ongoing liver growth despite current treatment options will be randomized to direct start of leuprorelin or to 18 months standard of care and delayed start of leuprorelin. Leuprorelin is given as 3.75 mg subcutaneously (s.c.) monthly for the first 3 months followed by 3-monthly depots of 11.25 mg s.c. The trial duration is 36 months. MRI scans to measure liver volume will be performed at screening, 6 months, 18 months, 24 months and 36 months. In addition, blood will be drawn, DEXA-scans will be performed and questionnaires will be collected. This design enables comparison between patients on study treatment and standard of care (first 18 months) and within patients before and during treatment (whole trial). Main outcome is annualized liver growth rate compared between standard of care and study treatment. Secondary outcomes are PLD disease severity, change in liver growth within individuals and (serious) adverse events. The study is designed as a prospective open-label study with blinded endpoint assessment (PROBE). Discussion In this trial, we combined the expertise of hepatologist, nephrologists and gynecologists to study the effect of leuprorelin on liver growth in PLD. In this way, we hope to stop liver growth, reduce symptoms and reduce the need for liver transplantation in severe PLD. Trial registration Eudra CT number 2020-005949-16, registered at 15 Dec 2020. https://www.clinicaltrialsregister.eu/ctr-search/search?query=2020-005949-16.
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Affiliation(s)
- S E Aapkes
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - L H P Bernts
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A P van den Berg
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M van den Berg
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - H Blokzijl
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A E P Cantineau
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M D A van Gastel
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - R J de Haas
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - P Kappert
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - R U Müller
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - F Nevens
- Department of Gastroenterology and Hepatology, Universiteitsziekenhuis Leuven, Leuven, Belgium
| | - R Torra
- Department of Nephrology, Fundacio Puigvert, Barcelona, Spain
| | - A Visser
- Department of Applied Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J P H Drenth
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R T Gansevoort
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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22
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Cozzolino M, Tartaglia S, Pellegrini L, Troiano G, Rizzo G, Petraglia F. The Effect of Uterine Adenomyosis on IVF Outcomes: a Systematic Review and Meta-analysis. Reprod Sci 2022; 29:3177-3193. [PMID: 34981458 DOI: 10.1007/s43032-021-00818-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 12/01/2021] [Indexed: 11/28/2022]
Abstract
To investigate the impact of uterine adenomyosis on in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) clinical outcomes and also to evaluate the impact of gonadotropin-releasing hormone agonist (GnRHa) and surgical treatments. Infertile women with adenomyosis undergoing conventional IVF or ICSI were compared with women without adenomyosis. Fertility outcomes were evaluated in two patients with adenomyosis untreated and treated surgically or medically therapy. The review protocol was registered in PROSPERO (CRD42020214586). We consider the live birth rate (LBR) as the primary outcome. The analysis showed that women with adenomyosis had lower LBR (OR 0.59, 95% CI 0.37-0.92, p = 0.02), clinical pregnancy rate (OR 0.66, 95% CI 0.48-0.90), and ongoing pregnancy rate (OR 0.43, 95% CI 0.21-0.88) compared to those without adenomyosis, and miscarriage rate was higher in women with adenomyosis (OR 2.11, 95% CI 1.33-3.33). Surgical treatment increases natural conception in women with adenomyosis although the paucity of data (only two studies), and conversely, treatment with GnRHa does not increase the IVF outcomes. Women with adenomyosis have decreased IVF clinical outcomes. Pretreatment with the use of long-term GnRHa could not be beneficial, even though only three studies were included in the meta-analysis. The major part of the studies has not divided focal and diffuse adenomyosis, and this represents a relevant source of bias: studies conducted with standardized diagnostic criteria for adenomyosis are still needed to determine if the different clinical presentations of such condition could compromise IVF outcomes.
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Affiliation(s)
- Mauro Cozzolino
- IVIRMA Rome, Largo Ildebrando Pizzetti 1, 00197, Rome, Italy.
- Universidad Rey Juan Carlos, Calle Tulipán, 28933, Móstoles, Madrid, Spain.
- Department of Obstetrics, Gynaecology and Reproductive Sciences, Yale School of Medicine, 310 Cedar St, New Haven, CT, 06510, USA.
| | - Silvio Tartaglia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Montpellier 1, 00133, Rome, Italy
- U.O.C. Di Ostetricia E Patologia Ostetrica, Dipartimento Di Scienza Della Salute Della Donna E del Bambino E Di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
| | | | | | - Giuseppe Rizzo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Montpellier 1, 00133, Rome, Italy
- Department of Obstetrics and Gynaecology, Fondazione Policlinico Tor Vergata, Rome, Italy
- Department of Obstetrics and Gynecology, The First IM Sechenov, Moscow State University, Moscow, Russian Federation
| | - Felice Petraglia
- Department of Experimental and Clinical Biomedical Sciences "M. Serio", The University of Florence, Florence, Italy
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23
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Peng J, Zhong F, Zhu Y, Zhang M, Zhang M, Lu C, Wang Y, Qi X, Wang C, Li G. Clinical analysis of uterine intravenous leiomyomatosis: A retrospective study of 260 cases. J Obstet Gynaecol Res 2021; 47:4357-4364. [PMID: 34525488 PMCID: PMC9293182 DOI: 10.1111/jog.15013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/31/2021] [Accepted: 08/29/2021] [Indexed: 11/30/2022]
Abstract
Methods We collected the clinical data of 260 patients admitted to the hospital from April 2003 to September 2019 with pathologically confirmed intravenous leiomyomatosis (IVL) and followed up with these patients regularly. Univariate and multivariate logistic regression analyses were carried out on the relevant recurrence factors. Results A total of 166 patients were regularly followed up, the median follow‐up time was 36 (range 2–168) months, 14 (5.4%) patients eventually relapsed, and the median recurrence time was 8.5 (range 2–42) months. The univariate analysis showed that age (p = 0.003) and surgical type (p < 0.001) were associated with recurrence, and multivariate regression analysis demonstrated that surgical type was the only factor associated with recurrence (p < 0.001, OR 20.01). Conclusions The use of gonadotrophin releasing hormone agonist (GnRHa) cannot reduce the postsurgical recurrence rate of patients with UIVL. Compared to total hysterectomy and bilateral salpingo‐oophorectomy (TH‐BSO), total hysterectomy (TH) does not increase the odds of recurrence, but the chance of recurrence with tumorectomy (TE) is 20 times higher than that of TH‐BSO.
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Affiliation(s)
- Jing Peng
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.,Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China
| | - Fangfang Zhong
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.,Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China
| | - Yuemeng Zhu
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.,Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China
| | - Mingxing Zhang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.,Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China
| | - Meng Zhang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.,Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China
| | - Chong Lu
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.,Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China
| | - Yumeng Wang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.,Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China
| | - Xingling Qi
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.,Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China
| | - Congwen Wang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.,Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China
| | - Guiling Li
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.,Department of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China
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24
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Chen DY, Su PJ, See LC, Liu JR, Chuang CK, Pang ST, Tseng CN, Chen SW, Hsieh IC, Chu PH, Lin YC, Hsu CL, Chang JWC, Lin MS, Pang JHS, Hsieh MJ, Huang WK. Gonadotropin-releasing hormone antagonist associated with lower cardiovascular risk compared with gonadotropin-releasing hormone agonist in prostate cancer: A nationwide cohort and in vitro study. Prostate 2021; 81:902-912. [PMID: 34196430 DOI: 10.1002/pros.24187] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/29/2021] [Accepted: 06/07/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND We aimed to determine whether cardiovascular (CV) risk in patients with prostate cancer (PCa) differs between those who receive gonadotropin-releasing hormone (GnRH) agonist (GnRHa) therapy and those who receive GnRH antagonist therapy. METHODS Using the Taiwan National Health Insurance Research Database, we analyzed data by comparing 666 participants receiving GnRH antagonists and 1332 propensity score-matched participants treated with GnRHa in a 1:2 fashion during the period from May 1, 2015, to September 30, 2018. Cox proportional-hazards models were used to estimate the treatment effect on CV outcomes. Furthermore, we conducted an in vitro study to investigate the effect of a GnRHa (leuprolide) or a GnRH antagonist (degarelix) on matrix metalloproteinase-9 (MMP-9) expression and invasion ability in THP-1 differentiated macrophages. RESULTS GnRH antagonist therapy was associated with a lower risk of composite CV events of myocardial infarction, ischemic stroke, or CV death (hazard ratio [HR], 0.48; 95% confidence interval [CI], 0.25-0.90) than GnRHa therapy, with a mean follow-up period of 1.21 years. Significantly lower risks of CV death (HR, 0.21; 95% CI, 0.06-0.70) and all-cause mortality (HR, 0.77; 95% CI, 0.61-0.97) were observed in the GnRH antagonist group. In the in vitro study, leuprolide, but not degarelix, significantly increased the expression of MMP-9 activity and the invasive ability of THP-1 differentiated macrophages through gelatin zymography and the matrix invasion assay, respectively. CONCLUSION GnRH antagonists were associated with reduced risk CV events compared with the GnRHa among patients with PCa, which may be through effects on macrophages.
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Affiliation(s)
- Dong-Yi Chen
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Po-Jung Su
- Division of Hematology/Oncology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Lai-Chu See
- Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Jia-Rou Liu
- Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Keng Chuang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - See-Tong Pang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chi-Nan Tseng
- Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Shao-Wei Chen
- Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - I-Chang Hsieh
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Pao-Hsien Chu
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yung-Chang Lin
- Division of Hematology/Oncology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Cheng-Lung Hsu
- Division of Hematology/Oncology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - John Wen-Cheng Chang
- Division of Hematology/Oncology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Miao-Sui Lin
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jong-Hwei S Pang
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital Linkou, Taiwan
| | - Ming-Jer Hsieh
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Wen-Kuan Huang
- Division of Hematology/Oncology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
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25
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Albeitawi S, Marar EA, Reshoud FA, Hamadneh J, Hamza R, Alhasan G, Omeish H, Vigano P. Dual trigger with gonadotropin-releasing hormone agonist and human chorionic gonadotropin significantly improves oocyte yield in normal responders on GnRH-antagonist cycles. JBRA Assist Reprod 2021; 26:28-32. [PMID: 34463444 PMCID: PMC8769195 DOI: 10.5935/1518-0557.20210039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective During in vitro fertilization (IVF) cycles, final oocyte maturation is usually triggered by human Chorionic Gonadotropin (hCG) for its known effect in mimicking Luteinizing Hormone (LH) surge; however, with the widespread use of the ‘antagonist protocol’, Gonadotropin Releasing Hormone agonist (GnRHa) is being more commonly employed as a trigger in order to minimize or eliminate the risk of ovarian hyper-stimulation syndrome (OHSS). Many studies proved its efficacy in inducing oocyte maturation and its safety in preventing OHSS in high-risk groups. Moreover, some studies showed that GnRHa trigger may improve oocyte yield. This study aimed to further explore any beneficial effect of adding GnRHa to hCG (dual trigger) on oocyte yield and fertilization rate in normal responder women. Methods We retrospectively reviewed and analyzed the data from 127 patients on antagonist protocol (67 dual trigger and 60 HCG trigger). Results The number of total oocytes, the number of MII oocytes and the number of fertilized oocytes were all significantly higher with the dual trigger protocol compared to hCG-only trigger. However, there is no significant difference in clinical pregnancy rate. Conclusions Using the dual trigger improved the number and quality of oocytes, and the fertilization rate in normal responders.
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Affiliation(s)
- Soha Albeitawi
- Yarmouk University, Faculty of Medicine, Obstetrics and Gynecology Division, Clinical Science Department, Irbid, Jordan
| | - Ehab Abu Marar
- Yarmouk University, Faculty of Medicine, Obstetrics and Gynecology Division, Clinical Science Department, Irbid, Jordan
| | - Firas Al Reshoud
- The Hashemite University, Faculty of Medicine, Obstetrics and gynecology department, Al Zarqa, Jordan
| | - Jehan Hamadneh
- Jordan University of Science & Technology, Faculty of Medicine, Obstetrics and gynecology department, Al Ramtha, Jordan
| | | | | | - Haya Omeish
- Yarmouk University, Faculty of Medicine, Obstetrics and Gynecology Division, Clinical Science Department, Irbid, Jordan
| | - Paola Vigano
- IRCCS Ospedale San Raffaele, Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, Milan
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26
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Abdel-Latif HMR, Shukry M, Saad MF, Mohamed NA, Nowosad J, Kucharczyk D. Effects of GnRHa and hCG with or without dopamine receptor antagonists on the spawning efficiency of African catfish (Clarias gariepinus) reared in hatchery conditions. Anim Reprod Sci 2021; 231:106798. [PMID: 34225238 DOI: 10.1016/j.anireprosci.2021.106798] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 10/21/2022]
Abstract
Optimization of artificial reproduction is essential for minimizing genetic diversity, especially when fish are captured from their natural habitats and spawned in controlled conditions. In the present study, there was evaluation of the effects of gonadotropin-releasing hormone analogue (GnRHa) and human chorionic gonadotropin (hCG) with or without dopamine receptor antagonists such as domperidone (DOM) and metoclopramide (MET) on the spawning efficiency of African catfish (Clarias gariepinus) reared in captivity. The control group was intramuscularly (IM) injected with 1 mL of sterile saline solution. The fish specimens of the other six groups were injected IM with GnRHa or hCG, or in combination with either DOM or MET. None of the specimens had ovulations in the control group. There was the longest latency period in specimens treated with only GnRHa or hCG. There were the largest egg mass weight, fecundity, and hatchability (%) in specimens of the GnRHa + MET group. These findings indicate that GnRHa or hCG combined with dopamine receptor antagonists such as DOM and MET resulted in a marked enhancement of ovulation rate and increased the egg mass, fecundity, and hatchability of the treated C. gariepinus, and the values when there was inclusion of the MET treatment exceeded those when there was treatment with DOM.
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Affiliation(s)
- Hany M R Abdel-Latif
- Department of Poultry and Fish Diseases, Faculty of Veterinary Medicine, Alexandria University, Alexandria 22758, Egypt.
| | - Mustafa Shukry
- Department of Physiology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh 33516, Egypt
| | - Michel F Saad
- Department of Physiology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh 33516, Egypt
| | - Nesreen A Mohamed
- Department of Biochemistry, Nutritional Deficiency Diseases and Toxicology, Animal Health Institute, Kafrelsheikh, Egypt
| | - Joanna Nowosad
- Department of Ichthyology and Aquaculture, Faculty of Animal Bioengineering, Warmia and Mazury University in Olsztyn, Poland
| | - Dariusz Kucharczyk
- Department of Ichthyology and Aquaculture, Faculty of Animal Bioengineering, Warmia and Mazury University in Olsztyn, Poland
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27
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Lai ZZ, Yang HL, Shi JW, Shen HH, Wang Y, Chang KK, Zhang T, Ye JF, Sun JS, Qiu XM, Li MQ. Protopanaxadiol improves endometriosis associated infertility and miscarriage in sex hormones receptors-dependent and independent manners. Int J Biol Sci 2021; 17:1878-1894. [PMID: 34131393 PMCID: PMC8193274 DOI: 10.7150/ijbs.58657] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/23/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Patients with endometriosis (EMs) have high risks of infertility and spontaneous abortion. How to remodel the fertility of patients with EMs has always been the hot spot and difficulty in the field of reproductive medicine. As an aglycone of ginsenosides, protopanaxadiol (PPD) possesses pleiotropic biological functions and has high medicinal values. We aimed to investigate the effect and potential mechanism of PPD in the treatment of EMs-associated infertility and spontaneous abortion. Methods: The EMs mice models were constructed by allotransplantation. The pregnancy rates, embryo implantation numbers and embryo resorption rates of control and EMs were counted. RNA sequencing, qRT-PCR, enzyme linked immunosorbent assay (ELISA) and FCM analysis were performed to screen and confirm the expression of endometrial receptivity/decidualization-related molecules, inflammation cytokines and NK cell function-related molecules in vitro and/or in vivo. The SWISS Target Prediction, STRING and Cytoscape were carried out to predict the potential cellular sensory proteins, the protein-protein interaction (PPI) network between sensory proteins and fertility-related molecules, respectively. Micro-CT detection, liver and kidney function tests were used to evaluate the safety. Results: Here, we observe that PPD significantly up-regulates endometrial receptivity-related molecules (e.g., Lif, Igfbp1, Mmps, collagens) and restricts pelvic inflammatory response (low levels of IL-12 and IFN-γ) of macrophage, and further remodel and improve the fertility of EMs mice. Additionally, PPD increases the expression of decidualization-related genes and Collagens, and promotes the proliferation, residence, immune tolerance and anagogic functions of decidual NK cells (low levels of CD16 and NKp30, high levels of Ki67, VEGF, TGF-β) in pregnant EMs mice, and further triggers decidualization, decidual NK cell-mediated maternal-fetal immune tolerance and angiogenesis, preventing pregnant EMs mice from miscarriage. Mechanically, these effects should be dependent on ESRs, PGR and other sensory proteins (e.g., AR). Compared with GnRHa (the clinic first-line drug for EMs), PPD does not lead to the decline of serum estrogen and bone loss. Conclusion: These data suggest that PPD prevents EMs-associated infertility and miscarriage in sex hormones receptors-dependent and independent manners possibly, and provides a potential therapeutic strategy with high efficiency and low side effects to remodels the fertility of patients with EMs.
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Affiliation(s)
- Zhen-Zhen Lai
- NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai 200080, People's Republic of China.,Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai 200080, People's Republic of China
| | - Hui-Li Yang
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai 200080, People's Republic of China
| | - Jia-Wei Shi
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai 200080, People's Republic of China
| | - Hui-Hui Shen
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai 200080, People's Republic of China
| | - Yan Wang
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai 200080, People's Republic of China
| | - Kai-Kai Chang
- Department of Gynecology, Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai 200011, People's Republic of China
| | - Tao Zhang
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Jiang-Feng Ye
- Division of Obstetrics and Gynecology, KK Women's and Children's Hospital, 229899, Singapore
| | - Jian-Song Sun
- National Research Centre for Carbohydrate Synthesis, Jiangxi Normal University, 330022 Jiangxi, Nanchang, China
| | - Xue-Min Qiu
- NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai 200080, People's Republic of China.,Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai 200080, People's Republic of China
| | - Ming-Qing Li
- NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai 200080, People's Republic of China.,Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai 200080, People's Republic of China.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, 200080, People's Republic of China
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28
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Alexopoulou E, Stormlund S, Løssl K, Prætorius L, Sopa N, Bogstad JW, Mikkelsen AL, Forman J, la Cour Freiesleben N, Vikkelsø Jeppesen J, Bergh C, Al Humaidan PSH, Grøndahl ML, Zedeler A, Pinborg AB. Embryo Morphokinetics and Blastocyst Development After GnRH Agonist versus hCG Triggering in Normo-ovulatory Women: a Secondary Analysis of a Multicenter Randomized Controlled Trial. Reprod Sci 2021; 28:2972-2981. [PMID: 33847977 DOI: 10.1007/s43032-021-00564-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/31/2021] [Indexed: 11/25/2022]
Abstract
Gonadotropin-releasing hormone agonist (GnRHa) for final oocyte maturation, along with vitrification of all usable embryos followed by transfer in a subsequent frozen-thawed cycle, is the most effective strategy to avoid ovarian hyperstimulation syndrome (OHSS). However, less is known about the ovulation induction triggers effect on early embryo development and blastocyst formation. This study is a secondary analysis of a multicenter, randomized controlled trial, with the aim to compare embryo development in normo-ovulatory women, randomized to GnRHa or human chorionic gonadotropin (hCG) trigger. In all, 4056 retrieved oocytes were observed, 1998 from the GnRHa group (216 women) and 2058 from the hCG group (218 women). A number of retrieved oocytes, mature and fertilized oocytes, and high-quality embryos and blastocysts were similar between the groups. A sub-analysis in 250 women enrolled at the main trial site including 2073 oocytes was conducted to compare embryo morphokinetics and cleavage patterns with EmbryoScope time-lapse system. In total, 1013 oocytes were retrieved from the GnRHa group (124 women) and 1060 oocytes were retrieved from the hCG group (126 women). Morphokinetic parameters and cleavage patterns were comparable between the groups. However, embryos derived from the GnRHa group were less likely to perform rolling during their development than the embryos from the hCG trigger group (OR = 0.41 (95%CI 0.25; 0.67), p-value 0.0003). The comparable results on embryo development and utilization rates between the GnRHa and hCG triggers is of clinical relevance to professionals and infertile patients, when GnRHa trigger and freeze-all is performed to avoid OHSS development. ClinicalTrials.gov Identifier: NCT02746562.
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Affiliation(s)
- Evaggelia Alexopoulou
- The Fertility Clinic, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark.
| | - Sacha Stormlund
- The Fertility Clinic, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark
| | - Kristine Løssl
- The Fertility Clinic, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen Ø, Denmark
| | - Lisbeth Prætorius
- The Fertility Clinic, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark
| | - Negjyp Sopa
- The Fertility Clinic, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark
| | - Jeanette Wulff Bogstad
- The Fertility Clinic, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark.,The Fertility Clinic, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen Ø, Denmark
| | - Anne Lis Mikkelsen
- The Fertility Clinic, Department of Obstetrics and Gynecology, Sealland University Hospital Køge, Lykkebækvej 1, DK-4600, Køge, Denmark
| | - Julie Forman
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5B, DK-1014, Copenhagen, Denmark
| | - Nina la Cour Freiesleben
- The Fertility Clinic, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark
| | - Janni Vikkelsø Jeppesen
- The Fertility Clinic, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen Ø, Denmark
| | - Christina Bergh
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Marie Louise Grøndahl
- The Fertility Clinic, Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Borgmester Ib Juuls vej 9, DK-2750, Herlev, Denmark
| | - Anne Zedeler
- The Fertility Clinic, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark
| | - Anja Bisgaard Pinborg
- The Fertility Clinic, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark.,The Fertility Clinic, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen Ø, Denmark
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29
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Kookaram K, Mojazi Amiri B, Dorkoosh FA, Nematollahi MA, Mortazavian E, Abed Elmdoust A. Effect of oral administration of GnRHa+nanoparticles of chitosan in oogenesis acceleration of goldfish Carassius auratus. Fish Physiol Biochem 2021; 47:477-486. [PMID: 33569680 DOI: 10.1007/s10695-021-00926-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Several methods have been used to accelerate previtellogenesis and vitellogenesis stages in fish, including hormonal induction, sustained-release delivery systems, and oral delivery of gonadotropin-releasing hormone (GnRH). In this study, we proposed the oral administration of GnRH analog + nanoparticles of chitosan to accelerate oogenesis in goldfish as a model fish in reproductive biology and aquaculture. In this regard, adult female goldfish were fed with six experimental groups: chitosan, 50 μg GnRHa/kg b.w., 100 μg GnRHa/kg b.w., chitosan + 50 μg GnRHa/kg b.w., and chitosan + 100 μg GnRHa/kg b.w., and diet without any additive as the control for 40 days in triplicate. Every 10 days, ovarian samples were collected, and gonadosomatic index (GSI), oocyte diameter (OD), zona radiata thickness (Zr), and diameter of the follicular layer (Fl) were measured to assess ovarian developmental stage for each treatment. Additionally, blood sampling was done to measure serum 17β-estradiol concentration at the end of the experiment. All parameters remained unchanged during the experiment in the chitosan-fed group. In the group fed with 100 μg GnRH or chitosan nanoparticle + 100 μg GnRHa, these parameters in general were increased. However, the effects in 50 μg GnRHa or chitosan nanoparticle + 50 μg GnRHa treatments were uncertain; they affected serum E2 levels as a trend toward a significant increase was observed in goldfish treated with chitosan nanoparticle + 100 μg GnRHa. Finally, the results indicated the oral administration of chitosan + 100 μg GnRHa/kg b.w. significantly accelerated the oocyte development and growth of ovary.
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Affiliation(s)
- Kazem Kookaram
- Department of Fisheries, Faculty of Natural Resources, University of Tehran, Karaj, 31585-4314, Iran
| | - Bagher Mojazi Amiri
- Department of Fisheries, Faculty of Natural Resources, University of Tehran, Karaj, 31585-4314, Iran.
| | | | - Mohammad Ali Nematollahi
- Department of Fisheries, Faculty of Natural Resources, University of Tehran, Karaj, 31585-4314, Iran
| | - Elaheh Mortazavian
- Department of Pharmaceutics, Tehran University of Medical Science, Tehran, Iran
| | - Amirreza Abed Elmdoust
- Department of Fisheries, Faculty of Natural Resources, University of Tehran, Karaj, 31585-4314, Iran
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30
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Brancati S, Gozzo L, Longo L, Vitale DC, Russo G, Drago F. Fertility Preservation in Female Pediatric Patients With Cancer: A Clinical and Regulatory Issue. Front Oncol 2021; 11:641450. [PMID: 33796467 PMCID: PMC8008167 DOI: 10.3389/fonc.2021.641450] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/29/2021] [Indexed: 12/22/2022] Open
Abstract
Fertility preservation represents one important goal of cancer patients’ management due to the high impact on health and quality of life of survivors. The available preventive measures cannot be performed in all patients and are not feasible in all health-care facilities. Therefore, the pharmacological treatment with GnRHa has become a valuable non-invasive and well-tolerated alternative, especially in those who cannot access to cryopreservation options due to clinical and/or logistic issues. Supporting data demonstrate a significant advantage for the survivors who received GnRHa in the long-term maintenance of ovarian function and preservation of fertility. The prevention of the risk of ovarian failure with GnRHa is a typical off-label use, defined as the administration of a medicinal product not in accordance with the authorized product information. Italy has officially recognized the off-label use of GnRHa in adult women at risk of premature and permanent menopause following chemotherapy. However, fertility preservation still represents an unmet medical need in adolescents who cannot access to other treatment options.
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Affiliation(s)
- Serena Brancati
- Clinical Pharmacology Unit/Regional Pharmacovigilance Centre, University Hospital of Catania, Catania, Italy
| | - Lucia Gozzo
- Clinical Pharmacology Unit/Regional Pharmacovigilance Centre, University Hospital of Catania, Catania, Italy.,Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Laura Longo
- Clinical Pharmacology Unit/Regional Pharmacovigilance Centre, University Hospital of Catania, Catania, Italy
| | - Daniela Cristina Vitale
- Clinical Pharmacology Unit/Regional Pharmacovigilance Centre, University Hospital of Catania, Catania, Italy
| | - Giovanna Russo
- Pediatric Onco-Hematology, University Hospital of Catania, Catania, Italy
| | - Filippo Drago
- Clinical Pharmacology Unit/Regional Pharmacovigilance Centre, University Hospital of Catania, Catania, Italy.,Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.,Centre for Research and Consultancy in HTA and drug Regulatory Affairs (CERD), University of Catania, Catania, Italy
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31
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Zhu S, Long L, Hu Y, Tuo Y, Li Y, Yu Z. GnRHa/Stanozolol Combined Therapy Maintains Normal Bone Growth in Central Precocious Puberty. Front Endocrinol (Lausanne) 2021; 12:678797. [PMID: 34177807 PMCID: PMC8221533 DOI: 10.3389/fendo.2021.678797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/19/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Gonadotropin-releasing hormone agonist (GnRHa) is the gold standard in the treatment of Central Precocious Puberty (CPP) with progressive puberty and accelerative growth. However, GnRHa treatment is reported to result in growth deceleration and prevents growth plate development which leads to a reduction in height velocity. Stanozolol (ST) has been used to stimulate growth in patients with delayed growth and puberty, nevertheless, the effects and mechanisms of ST on CPP with GnRHa treatment are currently unclear. METHODS AND RESULTS In the current study, we recorded the following vital observations that provided insights into ST induced chondrogenic differentiation and the maintenance of normal growth plate development: (1) ST efficiently prevented growth deceleration and maintained normal growth plate development in rats undergoing GnRHa treatment; (2) ST suppressed the inhibitory effect of GnRHa to promote chondrogenic differentiation; (3) ST induced chondrogenic differentiation through the activation of the JNK/c-Jun/Sox9 signaling pathway; (4) ST promoted chondrogenic differentiation and growth plate development through the JNK/Sox9 signaling pathway in vivo. CONCLUSIONS ST mitigated the inhibitory effects of GnRHa and promoted growth plate development in rats. ST induced the differentiation of chondrocytes and maintained normal growth plate development through the activation of JNK/c-Jun/Sox9 signaling. These novel findings indicated that ST could be a potential agent for maintaining normal bone growth in cases of CPP undergoing GnRHa treatment.
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Affiliation(s)
- Shunye Zhu
- Department of Pediatrics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Shunye Zhu, ; Zhenhua Yu,
| | - Lingli Long
- Research Center of Translational Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yue Hu
- Research Center of Translational Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ying Tuo
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yubin Li
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhenhua Yu
- Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Shunye Zhu, ; Zhenhua Yu,
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32
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Chen D, Strang JF, Kolbuck VD, Rosenthal SM, Wallen K, Waber DP, Steinberg L, Sisk CL, Ross J, Paus T, Mueller SC, McCarthy MM, Micevych PE, Martin CL, Kreukels BPC, Kenworthy L, Herting MM, Herlitz A, Haraldsen IRJH, Dahl R, Crone EA, Chelune GJ, Burke SM, Berenbaum SA, Beltz AM, Bakker J, Eliot L, Vilain E, Wallace GL, Nelson EE, Garofalo R. Consensus Parameter: Research Methodologies to Evaluate Neurodevelopmental Effects of Pubertal Suppression in Transgender Youth. Transgend Health 2020; 5:246-257. [PMID: 33376803 PMCID: PMC7759272 DOI: 10.1089/trgh.2020.0006] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose: Pubertal suppression is standard of care for early pubertal transgender youth to prevent the development of undesired and distressing secondary sex characteristics incongruent with gender identity. Preliminary evidence suggests pubertal suppression improves mental health functioning. Given the widespread changes in brain and cognition that occur during puberty, a critical question is whether this treatment impacts neurodevelopment. Methods: A Delphi consensus procedure engaged 24 international experts in neurodevelopment, gender development, puberty/adolescence, neuroendocrinology, and statistics/psychometrics to identify priority research methodologies to address the empirical question: is pubertal suppression treatment associated with real-world neurocognitive sequelae? Recommended study approaches reaching 80% consensus were included in the consensus parameter. Results: The Delphi procedure identified 160 initial expert recommendations, 44 of which ultimately achieved consensus. Consensus study design elements include the following: a minimum of three measurement time points, pubertal staging at baseline, statistical modeling of sex in analyses, use of analytic approaches that account for heterogeneity, and use of multiple comparison groups to minimize the limitations of any one group. Consensus study comparison groups include untreated transgender youth matched on pubertal stage, cisgender (i.e., gender congruent) youth matched on pubertal stage, and an independent sample from a large-scale youth development database. The consensus domains for assessment includes: mental health, executive function/cognitive control, and social awareness/functioning. Conclusion: An international interdisciplinary team of experts achieved consensus around primary methods and domains for assessing neurodevelopmental effects (i.e., benefits and/or difficulties) of pubertal suppression treatment in transgender youth.
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Affiliation(s)
- Diane Chen
- Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - John F Strang
- Division of Neuropsychology, Children's National Medical Center, Washington, District of Columbia, USA.,Center for Neuroscience, Children's Research Institute, Children's National Medical Center, Washington, District of Columbia, USA.,Department of Pediatrics, George Washington University School of Medicine, Washington, District of Columbia, USA.,Department of Neurology, George Washington University School of Medicine, Washington, District of Columbia, USA.,Department of Psychiatry, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Victoria D Kolbuck
- Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Stephen M Rosenthal
- Division of Endocrinology, Benioff Children's Hospital, University of California San Francisco, San Francisco, California, USA
| | - Kim Wallen
- Department of Psychology, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA
| | - Deborah P Waber
- Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Laurence Steinberg
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Cheryl L Sisk
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Judith Ross
- Nemours duPont Hospital for Children, Wilmington, Delaware, USA.,Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Tomas Paus
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
| | - Margaret M McCarthy
- Program in Neuroscience, Department of Pharmacology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Paul E Micevych
- David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Carol L Martin
- School of Social and Family Dynamics, Arizona State University, Tempe, Arizona, USA
| | - Baudewijntje P C Kreukels
- Amsterdam UMC, Location VUmc, Department of Medical Psychology and Center of Expertise on Gender Dysphoria, Amsterdam, The Netherlands
| | - Lauren Kenworthy
- Division of Neuropsychology, Children's National Medical Center, Washington, District of Columbia, USA.,Center for Neuroscience, Children's Research Institute, Children's National Medical Center, Washington, District of Columbia, USA.,Department of Pediatrics, George Washington University School of Medicine, Washington, District of Columbia, USA.,Department of Neurology, George Washington University School of Medicine, Washington, District of Columbia, USA.,Department of Psychiatry, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Megan M Herting
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA.,Department of Pediatrics, University of Southern California, Los Angeles, California, USA
| | - Agneta Herlitz
- Section of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Ronald Dahl
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Eveline A Crone
- Department of Developmental and Educational Psychology, Brain and Development Research Center, Leiden University, Leiden, The Netherlands
| | - Gordon J Chelune
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Sarah M Burke
- Department of Developmental and Educational Psychology, Brain and Development Research Center, Leiden University, Leiden, The Netherlands
| | - Sheri A Berenbaum
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA.,Department of Pediatrics, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Adriene M Beltz
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Julie Bakker
- GIGA Neurosciences, Liège University, Liège, Belgium
| | - Lise Eliot
- Department of Neuroscience, Rosalind Franklin University of Medicine & Science, Chicago, Illinois, USA
| | - Eric Vilain
- Center for Genetic Medicine Research, Children's National Medical Center, Washington, District of Columbia, USA.,Department of Genomics and Precision Medicine, George Washington University, Washington, District of Columbia, USA.,Epigenetics, Data, & Politics at Centre National de la Recherche Scientifique, Paris, France
| | - Gregory L Wallace
- Department of Speech, Language, and Hearing Science, George Washington University, Washington, District of Columbia, USA
| | - Eric E Nelson
- Center for Biobehavioral Health, The Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Robert Garofalo
- Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Wang R, Wen L, Ma H, Lv M, Chen Z, Du X, Lin Y, Yang H. Effects of gonadotropin-releasing hormone analog ( GnRHa) immunization on the gonadal transcriptome and proteome of tilapia (Oreochromis niloticus). Comp Biochem Physiol Part D Genomics Proteomics 2021; 37:100780. [PMID: 33296765 DOI: 10.1016/j.cbd.2020.100780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 11/15/2020] [Accepted: 11/18/2020] [Indexed: 11/21/2022]
Abstract
Gonadotropin releasing hormone (GnRH) plays an important role in the regulation of vertebrate reproduction. Studies have shown that immunization against GnRHa can induce sexually sterile tilapia. To explore the mechanism behind this, in this study, RNA-seq and data-independent acquisition (DIA) techniques were used to study the transcriptome and proteome of the gonad of tilapia immunized with GnRHa. 644 differentially expressed genes (80 upregulated and 564 downregulated) and 1150 differentially expressed proteins (351 upregulated and 799 downregulated) were identified. There were 209 genes with consistent differential expression patterns in the transcriptomic and proteomic analyses, of which 9 were upregulated and 200 downregulated, indicating that the gonad gene expression was inhibited by GnRHa immunization. The downregulated genes were particularly involved in the functions of single-organism process, binding, cellular process, metabolic process and catalytic activity, and associated with the pathways including ECM-receptor interaction, focal adhesion, cardiac muscle contraction and oxidative phosphorylation. The expression of six differentially expressed genes involved in the GnRH signaling pathway was all downregulated. In addition, several important functional genes related to gonadal development after GnRHa immunization were screened. This study confirmed the expression of corresponding genes was affected by GnRHa on the gonad development in tilapia at the molecular level, and laid a foundation for elucidating the mechanism of GnRHa immunization.
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Zhu SY, Wu YS, Gu ZY, Zhang J, Jia SZ, Shi JH, Dai Y, Leng JH, Li XY. Preventive therapeutic options for postoperative recurrence of ovarian endometrioma: gonadotropin-releasing hormone agonist with or without levonorgestrel intrauterine system insertion. Arch Gynecol Obstet 2020; 303:533-539. [PMID: 33104866 DOI: 10.1007/s00404-020-05843-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/13/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Here, we compared endometrioma recurrence rates in patients who have undergone a laparoscopic cystectomy and treated with a gonadotropin-releasing hormone agonist (GnRHa) alone or a GnRHa combined with a levonogestrel intrauterine system (LND-IUS). METHODS We enrolled endometrioma patients who underwent laparoscopic cyst enucleation and divided them into two groups according to postoperative management: GnRHa alone and GnRHa in combination with LND-IUS. We compared preoperative history, perioperative parameters, postoperative endometrioma recurrence, and symptoms between these two groups. RESULTS A total of 320 patients were included in the final analysis. With a median 84.6 months of follow-up, we detected significant differences between the two groups with respect to age at surgery (31.6 ± 4.8 vs. 37.6 ± 4.2 years, χ2 = 1.978, p < 0.001), gravida (0 vs. 2, χ2 = 4.391, p < 0.001), parity (0 vs. 1, χ2 = 0.035, p < 0.001), body mass index (21.0 ± 2.5 vs. 21.9 ± 2.4, χ2 = 0.0096, p = 0.009), r-AFS score (48 vs. 64, χ2 = 4.888, p = 0.001), and operation time (60 vs. 75 min, χ2 = 9.119, p = 0.003). Patients treated with both GnRHa and LND-IUS achieved significantly less endometrioma recurrence (23.6 vs. 11.5%, χ2 = 5.202, p = 0.023) and higher rates of pain remission (92.1 vs. 100%, χ2 = 6.511, p = 0.011), while those with GnRHa alone suffered more recurrent and painful symptoms (χ2 = 9.280, p = 0.026). Multivariate analysis using a Cox regression demonstrated that combined GnRHa and LNG-IUS treatment correlated with a decreased endometrioma recurrence rate after laparoscopic cystectomy (RR 0.369, 95% CI 0.182-0.749, p = 0.006). CONCLUSIONS Combination treatment of GnRHa and LNG-IUS exhibited superior pain relief and recurrence prevention among endometrioma patients after fertility-sparing surgery. Thus, combination treatment is a preferable long-term option for patients without intent for pregnancy in the near future.
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Affiliation(s)
- Shi-Yang Zhu
- Department of Obstetrics and Gynecology, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Shuaifuyuan No. 1, Beijing, China
| | - Yu-Shi Wu
- Department of Obstetrics and Gynecology, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Shuaifuyuan No. 1, Beijing, China
| | - Zhi-Yue Gu
- Department of Obstetrics and Gynecology, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Shuaifuyuan No. 1, Beijing, China
| | - Jing Zhang
- Department of Obstetrics and Gynecology, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Shuaifuyuan No. 1, Beijing, China
| | - Shuang-Zheng Jia
- Department of Obstetrics and Gynecology, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Shuaifuyuan No. 1, Beijing, China
| | - Jing-Hua Shi
- Department of Obstetrics and Gynecology, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Shuaifuyuan No. 1, Beijing, China
| | - Yi Dai
- Department of Obstetrics and Gynecology, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Shuaifuyuan No. 1, Beijing, China
| | - Jin-Hua Leng
- Department of Obstetrics and Gynecology, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Shuaifuyuan No. 1, Beijing, China
| | - Xiao-Yan Li
- Department of Obstetrics and Gynecology, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Shuaifuyuan No. 1, Beijing, China.
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Fakriadis I, Zanatta EM, Fleck RPDS, Sena Mateo DL, Papadaki M, Mylonas CC. Endocrine regulation of long-term enhancement of spermiation in meagre (Argyrosomus regius) with GnRHa controlled-delivery systems. Gen Comp Endocrinol 2020; 297:113549. [PMID: 32679157 DOI: 10.1016/j.ygcen.2020.113549] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 07/02/2020] [Accepted: 07/09/2020] [Indexed: 12/30/2022]
Abstract
Meagre (Argyrosomus regius) undergo spermatogenesis and spermiation when reared in captivity, but often produce low milt volumes, sometimes with reduced quality and for a limited time period. In the present study we a) compared the efficiency of gonadotropin releasing hormone agonist (GnRHa) implants versus injections on testicular stimulation and spermiation enhancement, b) investigated the effect of GnRHa on the endocrine spermiation regulation (sex steroid hormones), and c) evaluated a commercial induced spawning simulation scenario. Firstly, males (n = 5) were injected with 15.0 ± 0.2 μg GnRHa kg-1 (Injections) or implanted with 51.0 ± 5.1 μg GnRHa kg-1 (Implant) and compared their sperm production response. Secondly, the best hormonal treatment (Implant) was tested treating males (n = 8) with 57.5 ± 7.5 μg GnRHa kg-1 every 3 weeks for a period of 70 days. Milt production was improved by the GnRHa implants with only minor sperm quality alterations (improved sperm motility percentage). Elevated plasma testosterone (T) and 11-ketotestosterone (11-KT) levels were recorded in response to GnRHa implants, while no significant difference for 17,20β-dihydroxy-4-pregnen-3-one (17,20β-P) was observed. In the commercial induced spawning simulation, it was shown that meagre females are capable of on-demand induction of spawning at random intervals (5-21 days) using GnRHa injections, over a period of at least 2.5 months. During this period, spermiation enhancement was achieved with GnRHa implants every 3 weeks, producing sperm with stable, in general, quality and motility parameters. Percentage of motile cells, motility duration and density fluctuated significantly, but remained within levels that are considered appropriate for high fertilization success in this species.
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Affiliation(s)
- Ioannis Fakriadis
- Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Centre for Marine Research, P.O. Box 2214, Heraklion, Crete 71003, Greece
| | - Eugenio Maria Zanatta
- Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Centre for Marine Research, P.O. Box 2214, Heraklion, Crete 71003, Greece; University of Padua, Department of Biology, Padua, Italy
| | - Renata Pontes Dos Santos Fleck
- Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Centre for Marine Research, P.O. Box 2214, Heraklion, Crete 71003, Greece; University of Algavre, Faro, Portugal
| | - Daybet Lorena Sena Mateo
- Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Centre for Marine Research, P.O. Box 2214, Heraklion, Crete 71003, Greece; University of Barcelona, Spain
| | - Maria Papadaki
- Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Centre for Marine Research, P.O. Box 2214, Heraklion, Crete 71003, Greece
| | - Constantinos C Mylonas
- Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Centre for Marine Research, P.O. Box 2214, Heraklion, Crete 71003, Greece.
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An J, Li L, Zhang X, Liu L, Wang L, Zhang X. A clinical and basic study of optimal endometrial preparation protocols for patients with infertility undergoing frozen-thawed embryo transfer. Exp Ther Med 2020; 20:2191-2199. [PMID: 32765695 PMCID: PMC7401479 DOI: 10.3892/etm.2020.8914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 04/17/2020] [Indexed: 11/05/2022] Open
Abstract
The optimal protocol for endometrial preparation in patients with infertility remains unclear. Due to this, the current study retrospectively analyzed 1,589 patients with infertility and regular menstrual cycles to assess reproductive outcomes per embryo transferred and per embryo transfer (ET) cycle following the transfer of frozen-thawed embryos (FET) in a modified natural cycle (mNC) or hormone therapy cycle (HT) with or without gonadotropin-releasing hormone agonist (GnRHa)-induced pituitary suppression. The molecular mechanisms involved were also studied using tissues from endometrial biopsies. Patients who underwent FET were assigned to 5 groups as follows: Group A underwent a mNC (n=276); group B (n=338) received estradiol (E2) and progesterone (P4); group C received 1 cycle of GnRHa, E2 and P4 (n=323); group D received 2 cycles of GnRHa, E2 and P4 (n=329); and group E received 3 cycles of GnRHa, E2 and P4 (n=323). Tissues from endometrial biopsies of 91 patients performed on the day of ET were tested for endometrial receptivity marker mRNA expression and microRNA (miR)-223-3p mRNA. Furthermore, endometrial stromal cells (ESCs) were used for an in-depth study of the molecular mechanisms involved. Among the 5 groups of patients, implantation rates, clinical pregnancy rates and live birth rates were not significantly different. However, endometrial receptivity was enhanced in group E when compared with groups A-D, which was associated with endometrial leukemia inhibitory factor (LIF), osteopontin, vascular endothelial growth factor, integrin β3 and homeobox gene 10 and 11 mRNA upregulation, and miR-223-3p miRNA downregulation. Transfection of ESCs with an miR-223-3p mimic significantly reduced levels of LIF mRNA and protein. In addition, pre-treating ESCs with GnRHa upregulated mRNA and protein expression of the decidualization markers prolactin and insulin-like growth factor binding protein-1 in a time-dependent manner. In conclusion, these results indicated that HT with GnRHa may be a potential endometrial preparation protocol for FET.
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Affiliation(s)
- Junxia An
- The Reproductive Medicine Special Hospital of The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China.,Key Laboratory for Reproductive Medicine and Embryo of Gansu, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Lifei Li
- The Reproductive Medicine Special Hospital of The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China.,Key Laboratory for Reproductive Medicine and Embryo of Gansu, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Xiang Zhang
- The Reproductive Medicine Special Hospital of The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China.,Key Laboratory for Reproductive Medicine and Embryo of Gansu, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Lin Liu
- The Reproductive Medicine Special Hospital of The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China.,Key Laboratory for Reproductive Medicine and Embryo of Gansu, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Liyan Wang
- The Reproductive Medicine Special Hospital of The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China.,Key Laboratory for Reproductive Medicine and Embryo of Gansu, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Xuehong Zhang
- The Reproductive Medicine Special Hospital of The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China.,Key Laboratory for Reproductive Medicine and Embryo of Gansu, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
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Gong YF, Han W, Cui Y, Li LY, Lu LY, Ren CN. Therapeutic effect and underlying mechanism of Gonadotropin-releasing hormone in uterine fibroids. J BIOL REG HOMEOS AG 2020; 34:1437-1443. [PMID: 32893608 DOI: 10.23812/20-182-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Y F Gong
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Mudanjiang Medical University, Mudanjiang City, Heilongjiang Province, China
| | - W Han
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Mudanjiang Medical University, Mudanjiang City, Heilongjiang Province, China
| | - Y Cui
- Department of Gynaecology, Affiliated Hongqi Hospital to Mudanjiang Medical University, Mudanjiang City, Heilongjiang Province, China
| | - L Y Li
- The Second Affiliated Hospital of Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - L Y Lu
- Personnel Section, The Second Affiliated Hospital of Mudanjiang Medical University, Mudanjiang, Mudanjiang City, Heilongjiang Province, China
| | - C N Ren
- Clinical Laboratory, The Second Affiliated Hospital of Mudanjiang Medical University, Mudanjiang City, Heilongjiang Province, China
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Haiyan S, Lin W, Shuhua H, Wang W. High-intensity focused ultrasound (HIFU) combined with gonadotropin-releasing hormone analogs ( GnRHa) and levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis: a case series with long-term follow up. Int J Hyperthermia 2020; 36:1179-1185. [PMID: 31793356 DOI: 10.1080/02656736.2019.1679892] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Objective: This research was conducted to assess the long-term outcomes of a combination treatment of High-intensity focused ultrasound (HIFU) ablation, gonadotropin-releasing hormone analogs (GnRHa) and Levonorgestrel-releasing intrauterine system (LNG-IUS) for women with adenomyosis (AD).Methods: One hundred and forty-two patients with AD were enrolled and treated with HIFU conservative treatment in combination with adjuvant therapy of GnRHa and LNG-IUS. All the cases were followed up to 5 years after treatment. The volumes of uteri, AD lesions, and menstrual blood, and dysmenorrhea scores were measured. Also, the incidences of recurrence and complications were recorded.Results: Both the uterine and lesion volumes significantly decreased after treatment. The uterine volume gradually reduced after treatment, reaching the lowest level of 122.07 ± 44.12 cm3 at 12 months after treatment, with an average reduction rate of 45%, and then increased slightly, maintaining a reduction rate of about 35% compared with the baseline level. Similar decreases in AD lesion volumes, dysmenorrhea scores, and menstrual flow were also demonstrated. Hemoglobin levels increased. Moreover, the long-term recurrence rates were low, with 5.68% and 7.91% in dysmenorrhea and menorrhagia, respectively. No serious complications or adverse events were reported.Conclusions: HIFU ablation, in combination with GnRHa and LNG-LUS, might be a safe and effective alternative in the treatment for women with adenomyosis.
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Affiliation(s)
- Sun Haiyan
- Department of Gynecology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Wang Lin
- Department of Gynecology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Huang Shuhua
- Department of Gynecology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Wei Wang
- Department of Gynecology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
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Vuralli D, Ozon ZA, Gonc EN, Alikasifoglu A, Kandemir N. Long-term effects of GnRH agonist treatment on body mass index in girls with idiopathic central precocious puberty. J Pediatr Endocrinol Metab 2020; 33:99-105. [PMID: 31804960 DOI: 10.1515/jpem-2019-0214] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 09/27/2019] [Indexed: 11/15/2022]
Abstract
Introduction Studies evaluating effects of gonadotropin-releasing hormone agonist (GnRHa) on weight and body-mass-index (BMI) in girls with idiopathic central precocious puberty (iCPP) include short-term effects. The aim of this study is to investigate changes in BMI during and 2 years after completion of GnRHa to determine the factors that may impact BMI in girls with iCPP. Methods Medical files of 138 girls who completed GnRHa were evaluated. All patients had weight and height measurements at the beginning and end of treatment, and 111 patients had anthropometric measurements 2 years after the completion of treatment. Results In the beginning, 82 (59.4%) had normal weight (NW), 42 (30.4%) were overweight (OW), and 14 (10.2%) were obese (OB). Analysis of BMI-standard deviation score (SDS) in the whole group showed an overall increase during GnRHa treatment (0.92 ± 0.74 vs. 1.20 ± 0.51, p < 0.001). Changes in BMI-SDS (ΔBMI-SDS) during GnRHa differed between NW and OW/OB (0.45 ± 0.31 vs. 0.03 ± 0.20, p < 0.001). BMI-SDSs of both groups returned to baseline scores (or initial levels) 2 years after the completion of treatment. Two factors affecting ΔBMI-SDS in multiple linear regression analyses were baseline BMI and Δheight-SDS, both correlated negatively with ΔBMI-SDS. Conclusions The present study is one of the studies evaluating BMI change over a long period of time in girls with CPP. Although BMI-SDS increased during GnRHa in NW girls, it was reversible in follow-up after treatment. However, BMI-SDS did not change during and in follow-up in OW/OB girls. Conserving BMI-SDS in OW/OB girls may be related to the fact that weight management programs were recommended for these patients. Dietary recommendations should be provided for children with NW who undergo GnRHa, as is the case for OW patients.
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Affiliation(s)
- Dogus Vuralli
- Division of Pediatric Endocrinology, Department of Pediatrics, Hacettepe University Medical School, Ankara, Turkey
| | - Zeynep Alev Ozon
- Division of Pediatric Endocrinology, Department of Pediatrics, Hacettepe University Medical School, Ankara, Turkey
| | - Elmas Nazli Gonc
- Division of Pediatric Endocrinology, Department of Pediatrics, Hacettepe University Medical School, Ankara, Turkey
| | - Ayfer Alikasifoglu
- Division of Pediatric Endocrinology, Department of Pediatrics, Hacettepe University Medical School, Ankara, Turkey
| | - Nurgun Kandemir
- Division of Pediatric Endocrinology, Department of Pediatrics, Hacettepe University Medical School, Ankara, Turkey
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Hadziselimovic F, Verkauskas G, Vincel B, Stadler MB. Testicular expression of long non-coding RNAs is affected by curative GnRHa treatment of cryptorchidism. Basic Clin Androl 2019; 29:18. [PMID: 31890219 PMCID: PMC6933710 DOI: 10.1186/s12610-019-0097-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 12/10/2019] [Indexed: 12/27/2022] Open
Abstract
Background Cryptorchidism is a frequent endocrinopathy in boys that has been associated with an increased risk of developing testicular cancer and infertility. The condition is curable by combined surgery and hormonal treatment during early pre-pubertal stages using gonadotropin releasing hormone agonist (GnRHa). However, whether the treatment also alters the expression of testicular long non-coding RNAs (lncRNAs) is unknown. To gain insight into the effect of GnRHa on testicular lncRNA levels, we re-analyzed an expression dataset generated from testicular biopsies obtained during orchidopexy for bilateral cryptorchidism. Results We identified EGFR-AS1, Linc-ROR, LINC00221, LINC00261, LINC00282, LINC00293, LINC00303, LINC00898, LINC00994, LINC01121, LINC01553, and MTOR-AS1 as potentially relevant for the stimulation of cell proliferation mediated by GnRHa based on their direct or indirect association with rapidly dividing cells in normal and pathological tissues. Surgery alone failed to alter the expression of these transcripts. Conclusion Given that lncRNAs can cooperate with chromatin-modifying enzymes to promote epigenetic regulation of genes, GnRHa treatment may act as a surrogate for mini-puberty by triggering the differentiation of Ad spermatogonia via lncRNA-mediated epigenetic effects. Our work provides additional molecular evidence that infertility and azoospermia in cryptorchidism, resulting from defective mini-puberty cannot be cured with successful orchidopexy alone.
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Affiliation(s)
- Faruk Hadziselimovic
- Cryptorchidism Research Institute, Children's Day Care Center, 4410 Liestal, Switzerland
| | - Gilvydas Verkauskas
- 2Children's Surgery Centre, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania
| | - Beata Vincel
- 3Children's Surgery Centre, Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Michael B Stadler
- 4Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland.,5Swiss Institute of Bioinformatics, Basel, Switzerland
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Sinthuprasith P, Dejkhamron P, Wejaphikul K, Unachak K. Near final adult height, and body mass index in overweight/obese and normal-weight children with idiopathic central precocious puberty and treated with gonadotropin-releasing hormone analogs. J Pediatr Endocrinol Metab 2019; 32:1369-1375. [PMID: 31605579 DOI: 10.1515/jpem-2019-0136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 08/28/2019] [Indexed: 12/17/2022]
Abstract
Background The standard treatment of central precocious puberty (CPP) is gonadotropin-releasing hormone analogues (GnRHa). It is a concern that children treated with GnRHa are at risk of developing obesity which could impair the treatment outcomes. This study aimed to investigate the effect of GnRHa on body mass index (BMI) standard deviation score (SDS), and the influence of BMI status on treatment outcomes in children with idiopathic CPP (iCPP). Methods A retrospective cohort study in children with iCPP who completed GnRHa treatment and had attained near final adult height (NFAH) was conducted. Children with a history of disease or drug ingestion which could affect their BMI were excluded. BMI, BMI SDS, height (Ht), Ht SDS, predicted adult height (PAH), and NFAH were compared at baseline, 1 and 2 years during treatment, and at NFAH according to the baseline BMI status; normal weight and overweight/obesity. Results Fifty-eight children with iCPP treated with GnRHa were enrolled. The BMI SDS was significantly increased at 1 and 2 years during treatment in the overweight/obese group and at 1 year during treatment in the normal-weight group. However, at NFAH (2 years after treatment discontinuation), the BMI SDS was not statistically different from baseline in both groups. Ht gain, change in Ht SDS and BMI SDS were not statistically different from the baseline in both groups. Conclusions GnRHa results in a transient increase in BMI SDS during treatment and returned to baseline after treatment cessation. The benefit of GnRHa treatment on final Ht improvement is similar between overweight/obese and normal-weight patients.
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Affiliation(s)
| | - Prapai Dejkhamron
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand, Phone: +66-53-93-6462, Fax: +66-53-93-6461
| | - Karn Wejaphikul
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kevalee Unachak
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Ciccarone M, Hohaus S, Pulsoni A, Cavaceppi P, Franzò S, Fabbri R, Cudillo L, Battistini R, Di Rocco A, Annibali O, Cox MC, Provenzano I, Abruzzese E, Renzi D, Tesei C, Anticoli Borza P, Cuccaro A, Andriani A, D'Elia GM, Facchiano A, Marchetti P, Cantonetti M. Preliminary results of a counselling programme for fertility preservation in female cancer patients: The experience of the GEMME DORMIENTI network. Eur J Cancer Care (Engl) 2019; 29:e13174. [PMID: 31571303 DOI: 10.1111/ecc.13174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 08/09/2019] [Accepted: 09/04/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe a population of patients referred for fertility preservation (FP), how to efficiently provide FP care, and how FP care changed over time. METHODS This longitudinal observational study enrolled 281 female cancer patients referred between 2013 and 2016 to the non-profit organisation Gemme Dormienti ONLUS (GD) for FP care. All patients underwent the same battery of instrumental and laboratory diagnostic tests. GnRHa therapy was started at least seven days before CTh treatment. RESULTS From 2013 to 2016, we observed a progressive increase in the number of patients referred for FP care. Out of 251 eligible patients, 135 patients were treated with GnRHa only, and 72 patients underwent GnRHa therapy and cryopreservation. The median time from GD referral to oocyte and ovarian tissue cryopreservation was 11 and 5 days respectively. Tissue cryopreservation requests increased during our study period (from four cases in 2013 to 17 cases in 2016). During follow-up, 17β-estradiol and FSH levels were significantly increased (p < .0001), and AMH levels were significantly decreased (p < .0001). CONCLUSION The rapid increase in the number of patients who requested FP care and in the complexity of FP procedures overtime reflects the need to improve quality of life for cancer patients.
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Affiliation(s)
- Mariavita Ciccarone
- Department of Gynaecology, San Carlo di Nancy Hospital, Rome, Italy.,Gemme Dormienti Association ONLUS, Rome, Italy
| | - Stefan Hohaus
- Policlinico Gemelli Foundation, Catholic University of the Sacred Heart, Rome, Italy
| | - Alessandro Pulsoni
- Department of Cellular Biotechnology and Haematology, Sapienza University, Rome, Italy
| | | | | | - Raffaella Fabbri
- Gynaecology and Physiopathology of Human Reproduction Unit, Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Laura Cudillo
- Haematology and Stem Cell Transplant Unit, Tor Vergata University, Roma, Italy
| | - Roberta Battistini
- A.O. San Camillo Forlanini U.O.C. Ematologia e Trapianti CSE, Rome, Italy
| | - Alice Di Rocco
- Department of Cellular Biotechnology and Haematology, Sapienza University, Rome, Italy
| | - Ombretta Annibali
- UOC Haematology Stem Cell Transplantation, University Campus Bio Medico, Rome, Italy
| | - Maria Christina Cox
- Haematology Unit, Azienda Ospedaliera-Universitaria Sant'Andrea, Rome, Italy
| | - Ida Provenzano
- UOC Oncoematologia Fondazione Policlinico Tor Vergata, Rome, Italy
| | | | - Daniela Renzi
- Haematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | - Annarosa Cuccaro
- Policlinico Gemelli Foundation, Catholic University of the Sacred Heart, Rome, Italy
| | - Alessandro Andriani
- UOSD di Ematologia, Rome, Italy.,UOC di Ematologia, Osp. F. Spaziani, ASL Frosinone, Rome, Italy
| | - Gianna Maria D'Elia
- Department of Cellular Biotechnology and Haematology, Sapienza University, Rome, Italy
| | | | - Paolo Marchetti
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University, Rome, Italy
| | - Maria Cantonetti
- UOC Oncoematologia Fondazione Policlinico Tor Vergata, Rome, Italy
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Rahmawati E, Yang WCV, Lei YP, Maurya PK, Chen HW, Tzeng CR. Decreased Level of Neurotrophic Factor Neuritin 1 in Women with Ovarian Endometriosis after Receiving Gonadotropin-Releasing Hormone Agonist Treatment. Int J Mol Sci 2019; 20:E4352. [PMID: 31491902 PMCID: PMC6770869 DOI: 10.3390/ijms20184352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 08/31/2019] [Accepted: 09/03/2019] [Indexed: 12/19/2022] Open
Abstract
This study aimed to investigate the effect of gonadotropin-releasing hormone agonist (GnRHa) treatment on the expression of neuritin 1 (NRN1) in women with ovarian endometriosis. We collected tissues and serum from women with endometriosis treated with (n = 45) or without (n = 37) GnRHa. NRN1 mRNA and protein levels were measured using qPCR and Western blot. Immunolocalization of NRN1 in endometriotic tissues was examined using immunohistochemistry. In addition, a follow-up study was carried out to monitor the serum level of NRN1 in patients before and after GnRHa treatment. Both mRNA (p = 0.046) and protein (p = 0.0155) levels of NRN1 were significantly lower in endometriotic tissues from patients receiving GnRHa treatment compared to the untreated group. Both epithelial and stromal cells of endometriotic tissues from untreated women with endometriosis exhibited stronger staining of NRN1 but not in those who were treated with GnRHa. The follow-up study showed that the serum level of the NRN1 concentration decreased significantly from 1149 ± 192.3 to 379.2 ± 80.16 pg/mL after GnRHa treatment (p = 0.0098). The expression of NRN1 was significantly lower in women with ovarian endometriosis treated with GnRHa. These results suggest that NRN1 may be a biomarker response to the effect of GnRHa treatment for patients with ovarian endometriosis.
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Affiliation(s)
- Endah Rahmawati
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
- Department of Obstetrics and Gynecology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia.
| | - Wei-Chung Vivian Yang
- The PhD Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan.
| | - Yen-Ping Lei
- Department of Obstetrics and Gynecology, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
| | - Pawan Kumar Maurya
- Department of Biochemistry, Central University of Haryana, Mahendergarh 123031, India.
- Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei 10051, Taiwan.
| | - Huei-Wen Chen
- Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei 10051, Taiwan.
| | - Chii-Ruey Tzeng
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
- Department of Obstetrics and Gynecology, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei 11031, Taiwan.
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44
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Xu L, Ding L, Jiang J, Liu P, Wei D, Qin Y. Effects of oral contraceptive pretreatment on IVF outcomes in women following a GnRH agonist protocol. Reprod Biomed Online 2019; 39:924-930. [PMID: 31680062 DOI: 10.1016/j.rbmo.2019.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 07/09/2019] [Accepted: 08/12/2019] [Indexed: 11/17/2022]
Abstract
RESEARCH QUESTION Does oral contraceptive pretreatment impact IVF-embryo transfer cycle outcomes in women following the gonadotrophin-releasing hormone agonist (GnRHa) protocol? DESIGN This retrospective study was designed to compare cycle outcomes after oral contraceptive pretreatment versus the standard protocol in women within the GnRHa long protocol or the GnRHa short protocol. A total of 2052 women undergoing their first IVF treatment with the GnRHa long protocol and 3557 women with the GnRHa short protocol between 2012 and 2017 were enrolled. RESULTS No significant differences in the rates of clinical pregnancy (long protocol: 49.2% versus 46.7%; short protocol: 39.4% versus 38.0%) or live birth (long protocol: 44.3% versus 41.3%; short protocol: 32.8% versus 31.4%) after fresh embryo transfer were observed between the oral contraceptive group and the control group in either the long protocol or the short protocol. CONCLUSIONS Oral contraceptive pretreatment has no effect on IVF outcomes in either the GnRHa long protocol or short protocol.
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Affiliation(s)
- Lan Xu
- Centre for Reproductive Medicine, Shandong University, Centre for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China
| | - Lingling Ding
- Centre for Reproductive Medicine, Shandong University, Centre for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China
| | - Jingjing Jiang
- Centre for Reproductive Medicine, Shandong University, Centre for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China
| | - Peihao Liu
- Centre for Reproductive Medicine, Shandong University, Centre for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China
| | - Daimin Wei
- Centre for Reproductive Medicine, Shandong University, Centre for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China.
| | - Yingying Qin
- Centre for Reproductive Medicine, Shandong University, Centre for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China.
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45
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Brambila-Souza G, Mylonas CC, Mello PH, Kuradomi RY, Batlouni SR, Tolussi CE, Moreira RG. Thermal manipulation and GnRHa therapy applied to the reproduction of lambari-do-rabo-amarelo, Astyanax altiparanae females (Characiformes: Characidae) during the non-breeding season. Gen Comp Endocrinol 2019; 279:120-128. [PMID: 30769013 DOI: 10.1016/j.ygcen.2019.02.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/16/2019] [Accepted: 02/12/2019] [Indexed: 01/17/2023]
Abstract
Lambari-do-rabo-amarelo Astyanax altiparanae in the wild reproduce during spring and summer, but females undergo vitellogenesis throughout the year, including the non-spawning winter period when water temperatures are low. The present study investigated the physiological role of temperature modulation on the hypothalamus-pituitary-gonads axis of lambari during winter, as well as the effects of gonadotropin releasing hormone agonist (GnRHa) therapy. Captive females were exposed to two different temperatures (20 °C and 27 °C) and were injected weekly with GnRHa for 21 days during winter (Control, CTR; Low dose; LD and high dose of GnRHa, HD). At the end of the 21-days period gonadosomatic index (GSI), oocyte stage of development and theoretical fecundity were evaluated, together with plasma levels of 17β-estradiol (E2). Gene expression of the two pituitary gonadotropins follicle-stimulating hormone (fshβ) and luteinizing hormone (lhβ), as well as hepatic vitellogenin-A (vtgA) expression were also analyzed. At the end of the experimental period, females from the six different experimental conditions were induced to spawn using human chorionic gonadotropin (hCG). Spawning performance parameters and plasma levels of the maturation inducing steroid (MIS) were analyzed. Gene expression of fshβ did not change with temperature manipulation, but females exposed to 27 °C and supplemented with a HD of GnRHa exhibited an increased fshβ gene expression, associated with higher E2 levels. The higher water temperature alone was able to increase E2 levels. At both water temperatures GnRHa injections induced a decrease in E2 levels. GnRHa injected females had a lower vtgA gene expression levels at 20 °C. Even with differences in the gene expression of gonadotropins among the various temperature/GnRHa treatments, GSI and oocyte diameter did not change, but GnRHa enhanced the number of vitellogenic oocytes at 20 °C. The reproductive performance of lambari induced to spawn with hCG was better after the combined treatment with GnRHa and summer temperature.
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Affiliation(s)
- G Brambila-Souza
- UNESP - Universidade Estadual Paulista - Centro de Aquicultura, Jaboticabal, SP, Brazil
| | - C C Mylonas
- Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Center for Marine Research, Heraklion, Crete, Greece
| | - P H Mello
- UNESP - Universidade Estadual Paulista - Centro de Aquicultura, Jaboticabal, SP, Brazil
| | | | - S R Batlouni
- UNESP - Universidade Estadual Paulista - Centro de Aquicultura, Jaboticabal, SP, Brazil
| | - C E Tolussi
- Universidade Anhembi Morumbi, São Paulo, SP, Brazil
| | - R G Moreira
- Instituto de Biociências - USP, São Paulo, SP, Brazil.
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Poggio F, Lambertini M, Bighin C, Conte B, Blondeaux E, D'Alonzo A, Dellepiane C, Buzzatti G, Molinelli C, Boccardo F, Del Mastro L. Potential Mechanisms of Ovarian Protection with Gonadotropin-Releasing Hormone Agonist in Breast Cancer Patients: A Review. Clin Med Insights Reprod Health 2019; 13:1179558119864584. [PMID: 31391786 PMCID: PMC6669835 DOI: 10.1177/1179558119864584] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 06/25/2019] [Indexed: 01/22/2023]
Abstract
The use of chemotherapy in premenopausal cancer patients may lead to chemotherapy-induced premature ovarian failure. Pharmacological temporary ovarian suppression obtained with the gonadotropin-releasing hormone agonist (GnRHa) administered concomitantly with chemotherapy has been investigated as a technique capable to reduce the gonadotoxicity, reducing the risk of developing premature menopause. In recent years, important evidence has become available on the efficacy and safety of this strategy that should now be considered a standard option for ovarian function preservation in premenopausal breast cancer patients. However, in women interested in fertility preservation, this is not an alternative to cryopreservation strategies, which remains the first option to be proposed. The purpose of this review is to summarize the mechanisms of GnRHa in the preservation of fertility in premenopausal cancer patient candidates to receive chemotherapy, highlighting the areas of doubt that require further investigation.
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Affiliation(s)
| | - Matteo Lambertini
- Department of Medical Oncology, Clinica di Oncologia Medica, IRCCS San Martino Hospital, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genova, Genova, Italy
| | - Claudia Bighin
- UO Breast Unit, IRCCS San Martino Hospital, IST, Genova, Italy
| | - Benedetta Conte
- UO Breast Unit, IRCCS San Martino Hospital, IST, Genova, Italy
| | - Eva Blondeaux
- UO Breast Unit, IRCCS San Martino Hospital, IST, Genova, Italy
| | | | | | - Giulia Buzzatti
- UO Breast Unit, IRCCS San Martino Hospital, IST, Genova, Italy
| | | | - Francesco Boccardo
- Department of Medical Oncology, Clinica di Oncologia Medica, IRCCS San Martino Hospital, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genova, Genova, Italy
| | - Lucia Del Mastro
- UO Breast Unit, IRCCS San Martino Hospital, IST, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genova, Genova, Italy
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47
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Ristori J, Fisher AD, Castellini G, Sensi C, Cipriani A, Ricca V, Maggi M. Gender Dysphoria and Anorexia Nervosa Symptoms in Two Adolescents. Arch Sex Behav 2019; 48:1625-1631. [PMID: 30815831 DOI: 10.1007/s10508-019-1396-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 01/05/2019] [Accepted: 01/07/2019] [Indexed: 05/28/2023]
Abstract
The co-occurrence of gender dysphoria and anorexia nervosa has been described in the scientific literature. This paper presents two adolescents with gender dysphoria and pathological eating behaviors and questions with longitudinal observations the clinical meaning of anorexia nervosa symptoms (e.g., restricting eating behaviors and fear of gaining weight) in adolescents with gender dysphoria. Both received psychological evaluations at different times: at first admission to the gender dysphoria clinic (T0) and 6 months after starting treatment with gonadotropin-releasing analogues (GnRHa; T1). In both cases, treatment with GnRHa not only improved psychological functioning, but also resolved pathological eating behaviors. In fact, both adolescents reported quick restoring of healthy food habits with restricting eating behaviors as well as intensive exercise no longer needed after treatment with GnRHa. Therefore, pathological eating behaviors (e.g., food avoidance and weight loss) could be assessed as a dysfunctional coping strategy adopted to gain control over a body developing in an unwanted direction and to block irreversible physical pubertal changes. This psychopathological conceptualization of pathological eating behaviors in adolescents with gender dysphoria stresses the importance of providing, in selected cases, early medical intervention such as pubertal suppression with GnRHa. Mental health professionals should therefore perform a specific and detailed assessment on gender identity within the evaluation of apparent eating disorders in adolescents. Restrictive eating behaviors as well as the intense fear of gaining weight or of becoming fat may, in fact, be considered secondary to a gender dysphoria diagnosis instead of anorexia nervosa symptoms.
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Affiliation(s)
- Jiska Ristori
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - Alessandra D Fisher
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Carolina Sensi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Agnese Cipriani
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Mario Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy.
- Endocrinology Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
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48
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Affiliation(s)
| | - Julie Maxwell
- Child Health Services, Hampshire Hospitals NHS Foundation Trust, Winchester, UK
| | - Noel McCune
- Retired, Child and Adolescent Mental Health Service, Southern Health and Social Care Trust, Portadown, Northern Ireland, UK
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49
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Abstract
Gonadotropin-releasing-hormone analogues (GnRHa) are widely used in the treatment of premenopausal breast cancer. The anti-tumor effect of GnRHa is similar to that of surgical castration or chemotherapy, through reversibly inhibiting ovarian function and downregulating the estrogen level in premenopausal female. At the same time, GnRHa can protect the ovarian function, avoiding premature ovarian failure. Also GnRHa can reduce the breast density and endometrial thickness, as a result of which GnRHa may be used to prevent breast cancer in the higher risk population and promote quality of life in breast cancer patients. We here review the clinical roles and research progress of GnRHa in breast cancer.
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Affiliation(s)
- X L Li
- Department of Breast Surgery, Shanghai Jiao Tong University affiliated Shanghai Sixth People's Hospital, Shanghai 200233, China
| | - Y Yu
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - X Y Zong
- Department of Breast Surgery, Shanghai Jiao Tong University affiliated Shanghai Sixth People's Hospital, Shanghai 200233, China
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50
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Lambertini M, Richard F, Nguyen B, Viglietti G, Villarreal-Garza C. Ovarian Function and Fertility Preservation in Breast Cancer: Should Gonadotropin-Releasing Hormone Agonist be administered to All Premenopausal Patients Receiving Chemotherapy? Clin Med Insights Reprod Health 2019; 13:1179558119828393. [PMID: 30886529 PMCID: PMC6410390 DOI: 10.1177/1179558119828393] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 01/10/2019] [Indexed: 11/15/2022]
Abstract
Chemotherapy-induced premature ovarian insufficiency (POI) is one of the potential drawbacks of chemotherapy use of particular concern for newly diagnosed premenopausal breast cancer patients. Temporary ovarian suppression obtained pharmacologically with the administration of a gonadotropin-releasing hormone agonist (GnRHa) during chemotherapy has been specifically developed as a method to counteract chemotherapy-induced gonadotoxicity with the main goal of diminishing the risk of POI. In recent years, important clinical evidence has become available on the efficacy and safety of this strategy that should now be considered a standard option for ovarian function preservation in premenopausal breast cancer patients, including women who are not interested in conceiving after treatment or that would not be candidates for fertility preservation strategies because of their age. Nevertheless, in women interested in fertility preservation, this is not an alternative to gamete cryopreservation, which remains as the first option to be offered. In this setting, temporary ovarian suppression with GnRHa during chemotherapy should be also proposed following gamete cryopreservation or to women who have no access, refuse, or have contraindications to surgical fertility preservation techniques. In this article, we present an overview about the role of temporary ovarian suppression with GnRHa during chemotherapy in breast cancer patients by addressing the available clinical evidence with the aim of identifying both the best candidates for the use of this strategy and the still existing gray zones requiring further investigation.
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Affiliation(s)
- Matteo Lambertini
- Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - François Richard
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Bastien Nguyen
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Giulia Viglietti
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Cynthia Villarreal-Garza
- Centro de Cancer de Mama del Hospital Zambrano Hellion, Tecnologico de Monterrey, Nuevo Leon, Mexico.,Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
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