Castilla-Cortazar Inma, Diez Nieves, Garcia-Fernandez Maria, Puche Juan-Enrique, Diez-Caballero Fernando, Quiroga Jorge, Diaz-Sanchez Matias, Castilla Alberto, Casares Amelia-Diaz, Varela-Nieto Isabel, Prieto Jesus, Gonzalez-Baron Salvador
Department of Human Physiology, School of Medicine, University of Navarra, Pamplona, Spain.
World J Gastroenterol. 2004 Sep 1;10(17):2529-34. doi: 10.3748/wjg.v10.i17.2529.
The pathogenesis of hypogonadism in liver cirrhosis is not well understood. Previous results from our laboratory showed that IGF-1 deficiency might play a pathogenetic role in hypogonadism of cirrhosis. The administration of IGF-1 for a short period of time reverted the testicular atrophy associated with advanced experimental cirrhosis. The aim of this study was to establish the historical progression of the described alterations in the testes, explore testicular morphology, histopathology, cellular proliferation, integrity of testicular barrier and hypophyso-gonadal axis in rats with no ascitic cirrhosis.
Male Wistar rats with histologically-proven cirrhosis induced with carbon tetrachloride (CCl4) for 11 wk, were allocated into two groups (n = 12, each) to receive recombinant IGF-1 (2 microg/100 g.d, sc) for two weeks or vehicle. Healthy rats receiving vehicle were used as control group (n = 12).
Compared to controls, rats with compensated cirrhosis showed a normal testicular size and weight and very few histopathological testicular abnormalities. However, these animals showed a significant diminution of cellular proliferation and a reduction of testicular transferrin expression. In addition, pituitary-gonadal axis was altered, with significant higher levels of FSH (P<0.001 vs controls) and increased levels of LH in untreated cirrhotic animals. Interestingly, IGF-1 treatment normalized testicular transferrin expression and cellular proliferation and reduced serum levels of LH (P = ns vs controls, and P<0.01 vs untreated cirrhotic group).
The testicular barrier is altered from an early stage of cirrhosis, shown by a reduction of transferrin expression in Sertoli cells, a diminished cellular proliferation and an altered gonadal axis. The treatment with IGF-1 could be also useful in this initial stage of testicular disorder associated with compensated cirrhosis.
肝硬化性腺功能减退的发病机制尚未完全明确。我们实验室之前的研究结果表明,胰岛素样生长因子-1(IGF-1)缺乏可能在肝硬化性腺功能减退的发病过程中起作用。短期给予IGF-1可逆转与晚期实验性肝硬化相关的睾丸萎缩。本研究的目的是确定无腹水肝硬化大鼠睾丸上述改变的历史进程,探究睾丸形态、组织病理学、细胞增殖、睾丸屏障完整性及垂体-性腺轴情况。
将经组织学证实由四氯化碳(CCl4)诱导肝硬化11周的雄性Wistar大鼠分为两组(每组n = 12),分别接受重组IGF-1(2微克/100克·天,皮下注射)两周或给予赋形剂。接受赋形剂的健康大鼠作为对照组(n = 12)。
与对照组相比,代偿期肝硬化大鼠睾丸大小和重量正常,睾丸组织病理学异常极少。然而,这些动物的细胞增殖显著减少,睾丸转铁蛋白表达降低。此外,垂体-性腺轴发生改变,未治疗的肝硬化动物促卵泡激素(FSH)水平显著升高(与对照组相比P<0.001),促黄体生成素(LH)水平升高。有趣的是,IGF-1治疗使睾丸转铁蛋白表达和细胞增殖恢复正常,并降低了血清LH水平(与对照组相比P = 无显著性差异,与未治疗的肝硬化组相比P<0.01)。
肝硬化早期睾丸屏障就已改变,表现为支持细胞中转铁蛋白表达减少、细胞增殖减弱及性腺轴改变。IGF-1治疗在与代偿期肝硬化相关的睾丸疾病初始阶段可能也有作用。