Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, Piazza Menghini 1, 06129, Perugia, Italy.
Institute of Pediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.
Ital J Pediatr. 2018 Jul 16;44(1):81. doi: 10.1186/s13052-018-0523-8.
Cryptorchidism, the most common male genital abnormality observed in paediatrics, might often be associated with long-term functional consequences and can even reoccur after a successful orchidopexy. Serum markers that identify cryptorchid boys with gonadal dysfunction early should be useful in a decision-making process. Inhibin B, produced during all of childhood but altered in cryptorchid subjects, appears strictly related to Sertoli cells, and its levels directly reflect the status of the testis germinative epithelium. Unfortunately, its precise roles in bilateral and unilateral cryptorchidism are still debated and being unravelled. Herein, we report the most current knowledge about inhibin B in both healthy boys and those with cryptorchidism to discuss and clarify its potential clinical applications.
Inhibin B represents a simple and repeatable serum marker and it seems to well asses the presence and function of the testicular tissue. Testicular tissue in prepubertal age is largely made up of Sertoli cells; inhibin B, coming from working Sertoli cells, allows to indirectly evaluate their function. Besides, inhibin B is produced throughout childhood, even before puberty, in contrast with central hormones, and it is not influenced by androgens during puberty, in contrast with other testicular hormones. Although further studies are needed, low levels of inhibin B have been related with low testicular score and/or with consistent alterations of testicular parameters at histological examination. This means that inhibin B could be an indirect marker of testicular functions that could even replace testicular biopsies, but current data are inconsistent to confirm this potential role of inhibin B in cryptorchidism.
Inhibin B represents an effective candidate for early identification of testicular dysfunction after orchidopexy for cryptorchidism. Unfortunately, current data cannot exactly clarify the real role of inhibin B as a predictor of future testicular function in cryptorchidism and future long-term follow-up studies, with repeated inhibin B checks both in cryptorchid and in formerly cryptorchid children and adolescents, will permit to assess if previous normal levels of inhibin B would match with future normal pubertal development and fertility potential.
隐睾症是儿科最常见的男性生殖器异常，常与长期功能后果有关，甚至在成功的睾丸固定术后也会再次发生。识别隐睾男孩性腺功能障碍的血清标志物在决策过程中应该是有用的。在整个儿童期产生但在隐睾患者中改变的抑制素 B 似乎与支持细胞严格相关，其水平直接反映了睾丸生殖上皮的状态。不幸的是，其在双侧和单侧隐睾症中的确切作用仍存在争议并正在被揭示。在此，我们报告了关于抑制素 B 在健康男孩和隐睾症男孩中的最新知识，以讨论和阐明其潜在的临床应用。
抑制素 B 是一种简单且可重复的血清标志物，它似乎可以很好地评估睾丸组织的存在和功能。青春期前睾丸组织主要由支持细胞组成；来自工作支持细胞的抑制素 B 允许间接评估其功能。此外，抑制素 B 在整个儿童期产生，甚至在青春期之前，与中枢激素不同，并且在青春期与其他睾丸激素不同，不受雄激素的影响。尽管需要进一步的研究，但低水平的抑制素 B 与低睾丸评分和/或组织学检查中睾丸参数的一致改变有关。这意味着抑制素 B 可能是睾丸功能的间接标志物，甚至可以替代睾丸活检，但目前的数据不一致，无法证实抑制素 B 在隐睾症中的这种潜在作用。
抑制素 B 是隐睾症睾丸固定术后早期识别睾丸功能障碍的有效候选标志物。不幸的是，目前的数据不能准确阐明抑制素 B 作为隐睾症未来睾丸功能预测因子的真正作用，未来的长期随访研究，在隐睾和以前的隐睾儿童和青少年中重复检查抑制素 B，将评估以前正常的抑制素 B 水平是否与未来正常的青春期发育和生育潜力相匹配。
