Jilma B, Eichler H G, Köppl C, Weber B, Pidlich J P, Ferenci P, Müller C
Department of Clinical Pharmacology, Vienna University Hospital School of Medicine, Austria.
Liver. 1998 Jun;18(3):162-5. doi: 10.1111/j.1600-0676.1998.tb00144.x.
AIMS/BACKGROUND: There is epidemiological evidence that progression of hepatitis B virus (HBV)-induced liver disease is adversely influenced by male gender. Furthermore, in male transgenic mice, HBsAg levels increase after puberty, resulting in 4- to 10-fold higher HBsAg levels than in female transgenic mice. Castration reduces HBsAg levels by 90-95%, while substitution of testosterone to castrated animals rapidly increases HBsAg concentrations. We hypothesized that suppression of endogenous testosterone levels may have similar effects on HBsAg serum levels in men, as observed in male mice.
To test our hypothesis, we studied the influence of reversible testosterone suppression by the LHRH-analog triptorelin on serum concentrations of HBsAg and HBV-DNA. Eight male patients, who were chronically infected with HBV, were studied in a prospective interventional study.
Triptorelin decreased serum testosterone levels to castration levels for several weeks. However, this reversible testosterone suppression had no effect on HBsAg or HBV-DNA serum concentrations (p > 0.05).
Suppression of endogenous testosterone levels had no effect on HBsAg levels in men, which points to a different regulation of HBsAg expression in men compared with transgenic mice.
目的/背景：有流行病学证据表明，男性会对乙型肝炎病毒（HBV）所致肝病的进展产生不利影响。此外，在雄性转基因小鼠中，青春期后HBsAg水平会升高，导致其HBsAg水平比雌性转基因小鼠高4至10倍。去势可使HBsAg水平降低90 - 95%，而给去势动物补充睾酮则会迅速提高HBsAg浓度。我们推测，抑制内源性睾酮水平可能会对男性的HBsAg血清水平产生与雄性小鼠中观察到的类似影响。
为验证我们的假设，我们研究了促性腺激素释放激素（LHRH）类似物曲普瑞林对HBsAg和HBV - DNA血清浓度的可逆性睾酮抑制作用。在一项前瞻性干预研究中，对8例慢性感染HBV的男性患者进行了研究。
曲普瑞林使血清睾酮水平降至去势水平并持续了数周。然而，这种可逆性睾酮抑制对HBsAg或HBV - DNA血清浓度没有影响（p>0.05）。
抑制内源性睾酮水平对男性的HBsAg水平没有影响，这表明与转基因小鼠相比，男性中HBsAg表达的调节方式有所不同。
