Celayir Aysenur, Moralioglu Serdar, Cetiner Handan, Kir Gozde, Celayir Sinan
Department of Pediatric Surgery, Health Science University Istanbul Zeynep Kamil Maternity and Children's Diseases Health Training and Research Center, Istanbul, Turkey.
Department of Pathology, Health Science University Istabnbul Zeynep Kamil Maternity and Children's Diseases Health Training and Research Center, Istanbul, Turkey.
North Clin Istanb. 2018 Sep 24;6(2):110-116. doi: 10.14744/nci.2018.47108. eCollection 2019.
Androgen (AR), Estrogen (ER) and Progesterone (PR) hormones play an important role in the prenatal and postnatal development of urogenital tract and especially the penis. The expressions of AR, ER and PR receptors in penile tissues in children with hypospadiases had also been shown previously. In this leading study, to demonstrate of the sex hormone receptor expression in cases with different types of hypospadias were aimed.
This study was designed in children operated due to hypospadiases without DSD. Biopsy samples of 3 mm's were obtained from three different sytes as the lateral parameatal tissue and the anterior corner of the prepuce, and inner layer of posterior prepuce. The presence of AR, ER and PR receptors was investigated immunehistochemically.
Mean age was 5.4 years in 18 children with hypospadiases; in totally 33 specimens were taken in 5 subcoronal as 5 specimens, and 7 penile as 15 specimens, and 6 penoscrotal as 13 specimens. According to sytes of samples; 13 samples were from lateral para-meatal tissues, and 13 were from anterior corners of prepuces, and 7 were from inner layers of posterior prepuces. In regard to receptor expression; ER and AR receptors were positive in 29 (87.8%) and 12 (36.4%) respectively; PR receptors were negative.
This study emphasized the dominant expression of estrogen receptors in penile tissues of children with hypospadias. Although there was not a manifest correlation of androgen receptors absence in regard to the severity of hypospadias patients, there was a marked estrogen receptors presence in penile tissues. These findings suggest that the disrupted androgen and estrogen receptor interaction and/or balance could play a role during the development of external genitalia in hypospadias patients. Progesterone receptor was not present and therefore the active role in the postnatal development of hypospadias is still debatable.
雄激素(AR)、雌激素(ER)和孕激素(PR)激素在泌尿生殖道尤其是阴茎的产前和产后发育中起重要作用。此前也已显示尿道下裂患儿阴茎组织中AR、ER和PR受体的表达情况。在这项前沿研究中,旨在证明不同类型尿道下裂病例中性激素受体的表达情况。
本研究针对因尿道下裂接受手术且无性发育障碍(DSD)的儿童设计。从三个不同部位获取3毫米的活检样本,分别为尿道旁侧组织、包皮前角以及包皮后内层。采用免疫组织化学方法研究AR、ER和PR受体的存在情况。
18例尿道下裂患儿的平均年龄为5.4岁;共采集了33个标本,其中冠状沟下5例5个标本,阴茎型7例15个标本,阴茎阴囊型6例13个标本。根据样本部位;13个样本来自尿道旁侧组织,13个来自包皮前角,7个来自包皮后内层。关于受体表达;ER和AR受体阳性分别为29例(87.8%)和12例(36.4%);PR受体均为阴性。
本研究强调了雌激素受体在尿道下裂患儿阴茎组织中的优势表达。虽然尿道下裂患者雄激素受体缺失与病情严重程度之间没有明显相关性,但阴茎组织中雌激素受体明显存在。这些发现表明,雄激素和雌激素受体相互作用及/或平衡的破坏可能在尿道下裂患者外生殖器发育过程中起作用。孕激素受体不存在,因此其在尿道下裂产后发育中的积极作用仍有争议。