Urology Department, Royal Children's Hospital, Parkville 3052, Victoria, Australia.
Endocr Rev. 2013 Oct;34(5):725-52. doi: 10.1210/er.2012-1089. Epub 2013 May 10.
The first half of this review examines the boundary between endocrinology and embryonic development, with the aim of highlighting the way hormones and signaling systems regulate the complex morphological changes to enable the intra-abdominal fetal testes to reach the scrotum. The genitoinguinal ligament, or gubernaculum, first enlarges to hold the testis near the groin, and then it develops limb-bud-like properties and migrates across the pubic region to reach the scrotum. Recent advances show key roles for insulin-like hormone 3 in the first step, with androgen and the genitofemoral nerve involved in the second step. The mammary line may also be involved in initiating the migration. The key events in early postnatal germ cell development are then reviewed because there is mounting evidence for this to be crucial in preventing infertility and malignancy later in life. We review the recent advances in what is known about the etiology of cryptorchidism and summarize the syndromes where a specific molecular cause has been found. Finally, we cover the recent literature on timing of surgery, the issues around acquired cryptorchidism, and the limited role of hormone therapy. We conclude with some observations about the differences between animal models and baby boys with cryptorchidism.
这篇综述的前半部分探讨了内分泌学和胚胎发育之间的界限，旨在强调激素和信号系统如何调节复杂的形态变化，使腹腔内胎儿的睾丸能够到达阴囊。生殖股管韧带，或精索，首先增大，将睾丸固定在腹股沟附近，然后它发育出肢芽样的特性，并迁移穿过耻骨区域到达阴囊。最近的进展表明胰岛素样激素 3 在第一步中起关键作用，雄激素和生殖股神经参与第二步。乳腺线也可能参与启动迁移。然后回顾了早期出生后生殖细胞发育的关键事件，因为越来越多的证据表明这对于预防以后生活中的不育症和恶性肿瘤至关重要。我们综述了关于隐睾症病因的最新进展，并总结了已发现特定分子病因的综合征。最后，我们涵盖了关于手术时机、获得性隐睾症的问题以及激素治疗有限作用的最新文献。最后，我们对动物模型和患有隐睾症的男婴之间的差异进行了一些观察。
