Crawford E David, Schally Andrew V, Pinthus Jehonathan H, Block Norman L, Rick Ferenc G, Garnick Marc B, Eckel Robert H, Keane Thomas E, Shore Neal D, Dahdal David N, Beveridge Thomas J R, Marshall Dennis C
Department of Urologic Oncology, School of Medicine, University of Colorado, Denver, Denver, CO.
Endocrine, Polypeptide and Cancer Institute, Miami Veterans Affairs Medical Center, Miami, FL; Department of Pathology, University of Miami School of Medicine, Miami, FL; Department of Medicine, University of Miami School of Medicine, Miami, FL.
Urol Oncol. 2017 May;35(5):183-191. doi: 10.1016/j.urolonc.2017.01.025. Epub 2017 Mar 18.
To explore how follicle-stimulating hormone (FSH) may contribute to cardiovascular, metabolic, skeletal, and cognitive events in men treated for prostate cancer, with various forms of androgen deprivation therapy (ADT).
A colloquium of prostate cancer experts was convened in May 2015, to discuss the role of FSH in the development of unwanted effects associated with ADT. Subsequently, a literature review (Medline, PubMed, and relevant congress abstract databases) was performed to further explore and evaluate the collected evidence.
It has become evident that, in the setting of ADT, FSH can promote the development of atherosclerotic plaque formation, metabolic syndrome, and insulin resistance. Data also suggest that FSH is an important mediator of bone remodeling, particularly bone resorption, and thereby increases the risk for bone fracture. Additional evidence implicates a role for FSH in bone metastasis as well. The influence of FSH on ADT-induced cognitive deficits awaits further elucidation; however, the possibility that FSH may be involved therein cannot be ruled out.
The widespread molecular and physiological consequences of FSH system activation in normal and pathological conditions are becoming better understood. Progress in this area has been achieved by the development of additional investigative and clinical measures to better evaluate specific adverse effects. More research is needed on FSH function in the development of cancer as well as its association with cardiovascular, metabolic, musculoskeletal, and cognitive effects in ADT.
探讨在接受各种形式雄激素剥夺治疗（ADT）的前列腺癌男性患者中，促卵泡激素（FSH）如何影响心血管、代谢、骨骼和认知方面的情况。
2015年5月召开了一次前列腺癌专家座谈会，讨论FSH在与ADT相关的不良效应发生过程中的作用。随后，进行了文献综述（检索Medline、PubMed及相关会议摘要数据库），以进一步探究和评估所收集的证据。
现已明确，在ADT背景下，FSH可促进动脉粥样硬化斑块形成、代谢综合征和胰岛素抵抗的发展。数据还表明，FSH是骨重塑（尤其是骨吸收）的重要介质，从而增加骨折风险。另有证据表明FSH在骨转移中也起作用。FSH对ADT诱导的认知缺陷的影响有待进一步阐明；然而，不能排除FSH可能参与其中的可能性。
在正常和病理条件下，FSH系统激活所产生的广泛分子和生理后果正逐渐得到更好的理解。通过开发更多的研究和临床措施以更好地评估特定不良反应，该领域已取得进展。关于FSH在癌症发生过程中的功能及其与ADT中心血管、代谢、肌肉骨骼和认知效应的关联，还需要更多研究。
