World Journal of Mens Health最新文献

Environmental endocrine disruptors, as exogenous chemicals that interfere with hormonal behavior, are known to cause testicular Leydig cell death and senescence. The incidence of diseases of the male reproductive system has been increasing over the past half-century. Genetic defects alone cannot explain the rapid increase in incidence, and there is growing evidence that environmental factors or lifestyle changes are responsible for the high incidence in recent years. Testicular Leydig cells occupy an important role in the male reproductive system. In this study, we review the mechanisms by which environmental endocrine disruptors promote both death and senescence of testicular Leydig cells, refine the former into two programmed death modes, apoptosis, and autophagy, and further explore the interactions among them, thus summarizing the advances of the toxic effects of environmental endocrine disruptors on testicular Leydig cells, and expecting to provide a new therapeutic idea.

Purpose: Sex hormones affect development and prognosis of gastric cancer (GC). This study aimed to compare the sex hormone receptor expression between control and GC, and to evaluate its correlation with patient characteristics.

Materials and methods: 110 patients (74 with GC, 36 controls) underwent immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) for estrogen receptors (ERs) α and β and androgen receptor (AR). The effect of ERs and AR on the clinicopathological and tumor characteristics were analyzed.

Results: The positive rate of ERα, ERβ, and AR in GC tissue was 64.9%, 78.4%, and 60.8% by IHC and 41.4%, 27.6%, and 48.3% in RT-PCR respectively. In control, the positive rate of those was 16.7%, 80.6%, and 38.9% by IHC and 22.2%, 58.3%, and 19.4% in RT-PCR respectively. The IHC and RT-PCR results showed concordance with each other, and ERα and AR expressions were positively correlated with cancer, while ERβ showed the opposite pattern. ERα expression was correlated with Helicobacter pylori negativity (p<0.001), diffuse or mixed-type histology (p=0.014), and undifferentiated histology (p<0.001), and AR expression was related to H. pylori negativity (p<0.001), cardiac cancer (p=0.040), and undifferentiated histology (p<0.001). The higher expression rate of ERα in males and that of AR in females seemed to be related with cancer, showing sex differences.

Conclusions: The expression rates of ERα, ERβ, and AR were different depending on sex, histologic type and H. pylori infection status, which may explain sex-based differences in GC.

Purpose: Suicide is a substantial public health concern, and there are a variety of contributing factors. Prostate cancer is known to be a disease at high risk of suicide regardless of country and age. Nonetheless, comprehensive information about associated risk levels and underlying determinants remains limited. To systematically evaluate the suicide risk in prostate cancer patients compared to control by systematic review and meta-analysis.

Materials and methods: PubMed, Embase, and the Cochrane Library were searched from the earliest available indexing date through May 2024. The criteria for selecting the subjects were as follows: (1) studies including patients who had prostate cancer, (2) intervention was not specified, (3) comparison was made with people without prostate cancer selected as the control group, and (4) outcomes were measured as standardized mortality ratio (SMR) or relative risk (RR), or hazard ratio (HR) of suicide in prostate cancer. Random-effects model were used to estimate pooled effect sizes. Meta-regression analyses were conducted to identify the potential moderator effects between prostate cancer and the risk of suicide.

Results: A systematic review and meta-analysis of these 25 studies that included a total of 4,987,941 participants were performed. The pooled SMR for overall suicide risk in prostate cancer compared with control groups was 1.251 (95% confidence interval [95% CI]: 1.120-1.383). The pooled RR or HR was 1.712 (95% CI: 1.306-2.243). The suicide risk of prostate cancer patients showed statistically significant in all cases of SMR and RR or HR. The suicide risk was also significantly higher in most subgroup analyses according to age and research follow-up period.

Conclusions: The findings of this systematic review and meta-analysis support the association between prostate cancer and increased risk of suicidal tendencies. Follow-up for prostate cancer patients should be highly integrated with psychiatric and psychological care to improve the psychosocial function of patients.

Purpose: Esophageal cancer is a predominantly male disease. However, the sex differences associated with esophageal cancer have not been thoroughly investigated. This study aimed to evaluate the differences between esophageal cancer in males and females in the Korean population.

Materials and methods: We assessed patients diagnosed with esophageal cancer between 2005 and 2015 at a tertiary referral center. The clinical features of patients, histopathologic characteristics of tumors, and treatment and survival outcomes were compared between male and female patients.

Results: We enrolled 2,068 patients, comprising 1,924 (93.0%) males and 144 (7.0%) females. The median age at diagnosis was younger for females than males (65 vs. 63 years, p=0.004). Squamous cell carcinoma was the predominant pathological type (99.0% in males and 93.1% in females); however, the proportion of adenocarcinoma cases was higher in females than males (0.8% vs. 5.6%, p<0.001). Multivariate analysis indicated favorable overall survival for female patients (hazard ratio [HR], 0.685; 95% confidence interval [CI], 0.548-0.857) and patients with high body mass index (≥25 kg/m², HR, 0.432; 95% CI, 0.355-0.526), and in early tumor stage (Stage 4, HR, 12.684; 95% CI, 7.451-21.591). The 5-year overall survival (44.8% vs. 53.5%, p=0.016) and recurrence-free survival rates (74.0% vs. 84.3%, p=0.036) were higher in females than in males.

Conclusions: We found significant sex differences in esophageal cancer among the Korean population, with female patients demonstrating distinct clinical characteristics and more favorable survival outcomes compared to male patients. These findings underscore the importance of considering sex-specific factors in the management and prognosis of esophageal cancer.

Purpose: In recent years, many genes have been associated with male infertility; however, testing of monogenic forms has not yet been clinically implemented in the diagnosis of severe forms of idiopathic male infertility, as the diagnostic utility has not been established yet. The aim of this study was therefore to answer if the implementation of genetic testing for monogenic forms of male infertility could contribute to the clinical diagnosis of men with severe forms of idiopathic male infertility.

Materials and methods: Based on the ClinGene curation protocol, we defined a panel of genes with sufficient evidence for the involvement with severe male infertility. We tested the 21-gene panel in a representative multicentric cohort of men with significantly impaired spermatogenesis. We performed whole exome sequencing on 191 infertile men with severe forms of idiopathic male infertility; non-obstructive azoospermia, and severe oligozoospermia (<5 million spermatozoa/mL). The control group consisted of 216 men who fathered a child. DNA was prepared based on the Twist CORE exome protocol and sequenced on the Illumina NovaSeq 6000 platform. Variants were classified using the Association for Clinical Genomic Science (ACGS) Best Practice Guidelines for Variant Classification in Rare Disease 2020.

Results: We identified potential monogenic disease-causing variants in four infertile men. Pathogenic/likely pathogenic variants in STAG3 (c.2776C>T, p.Arg926^*; c.2817delG, p.Leu940fs), MSH4 (c.1392delG, p.Ile465fs; c.2261C>T, p.Ser754Leu), TEX15 (c.6848_6849delGA, p.Arg2283fs; c.6271dupA, p.Arg2091fs), and TEX14 (c.1021C>T, p.Arg341^*) genes were found.

Conclusions: In the present multicentric cohort study, a monogenic cause in 2.1% of infertile men was identified. These findings confirm the utility of monogenic testing and suggest the clinical use of monogenic testing for men with severe forms of idiopathic male infertility.

Purpose: This study investigated 1) the frequency of quotation errors in multi-authored medical manuscripts in andrology, 2) analyzed common types of quotation errors and the methods used to rectify them, and 3) evaluated their impact on manuscript accuracy, credibility, and research conclusions.

Materials and methods: Twelve manuscripts written by the Global Andrology Forum (GAF) members between 2023 and 2024 were randomly selected for this study. The manuscripts and "Quotation Verification Sheets" were analyzed by senior GAF researchers to detect the number and types of quotation errors. The error rate was calculated by the total number of quotation errors and total number of all cited references in each manuscript. The impact on manuscript sections was assessed using a 0-4 grading scale. The Spearman correlation test was used to assess the correlation between scalar variables, and the Mann-Whitney U test was utilized to compare scalar variables between two groups.

Results: The median value of quotation errors was 10.3%. Factual inaccuracy was the most common type of error, and was observed in all twelve manuscripts at various rates. The number of errors was significantly associated with the number of references (ρ=0.706; p=0.010) and in-text citations (ρ=0.636; p=0.026). Factual inaccuracy (ρ=0.588; p=0.044) and factual interpretation (ρ=0.861; p=0.013) were also correlated with the total number of quotation errors. However, no significant associations were found between quotation errors and author numbers or their qualifications. The quotation errors adversely impacted the manuscript discussion, followed by the overall message.

Conclusions: Quotation errors are common in multi-authored medical manuscripts in andrology-related scientific articles. Journal editorial offices should incorporate quotation verification into the review process. Limiting references and in-text citations to only strictly necessary ones may help improve quotation accuracy. The quotation verification model proposed by GAF offers a practical and structured approach for detecting and correcting quotation errors.

Purpose: Patients with diabetes mellitus (DM) often exhibit refractory erectile dysfunction (ED). Red-light-controllable nitric oxide donor (NORD-1) and red-light irradiation have successfully enhanced erectile function in intact rats. In this study, we investigated whether the combination of NORD-1 and red-light irradiation effectively treated ED in streptozotocin (STZ)-treated rats with DM.

Materials and methods: Seven-week-old male Sprague-Dawley rats were used in this study. Rats in the DM and sham groups received intravenous STZ (50 mg/kg) and saline, respectively. One week after treatment, the blood glucose level of rats in the DM group was >250 mg/dL. Five weeks after the treatment, we performed a functional study by measuring intracavernous pressure (ICP) under cavernous nerve stimulation before and after NORD-1 treatment with and without light irradiation. Additionally, we performed an isometric tension study using the corpus cavernosum of rats treated with NORD-1 or the control compound, SiR650.

Results: The ICP/mean arterial pressure (MAP) ratio was significantly lower in the DM group than in the sham group before and after NORD-1 treatment without light irradiation (both p<0.05). After NORD-1 treatment with light irradiation, the ICP/MAP ratio in the sham and DM groups was significantly enhanced than before and after NORD-1 treatment without light irradiation (all p<0.05). The ICP/MAP ratio in the DM group after NORD-1 with light irradiation was similar to that in the sham group under normal conditions before NORD-1 treatment. Moreover, the systemic blood pressure was not affected by NORD-1 or light irradiation. In the tension study, the corpus cavernosum of rats treated with SiR650 was not changed by red light in the sham or DM groups. However, the rats treated with NORD-1 were strongly relaxed by red light in both groups.

Conclusions: NORD-1 and red-light irradiation could improve ED in the presence of DM without lowering blood pressure.

Purpose: Finasteride and dutasteride are used to treat benign prostatic hyperplasia (BPH) and reduce the risk of developing prostate cancer. Finasteride blocks only the type 2 form of 5-alpha-reductase, whereas dutasteride blocks both type 1 and 2 forms of the enzyme. Previous studies suggest the possibility that dutasteride may be superior to finasteride in preventing prostate cancer. We directly compared the effects of finasteride and dutasteride on the risk of prostate cancer in patients with BPH using a pooled analysis of 15 real-world databases.

Materials and methods: We conducted a multicenter, cohort study of new-users of finasteride and dutasteride. We include patients who were prescribed 5 mg finasteride or dutasteride for the first time to treat BPH and had at least 180 days of prescription. We excluded patients with a history of prostate cancer or a prostate-specific antigen level ≥ 4 ng/mL before the study drug prescription. Cox regression analysis was performed to examine the hazard ratio (HR) for prostate cancer after propensity score (PS) matching.

Results: A total of 8,284 patients of new-users of finasteride and 8,670 patients of new-users of dutasteride were included across the 15 databases. In the overall population, compared to dutasteride, finasteride was associated with a lower risk of prostate cancer in both on-treatment and intent-to-treat time-at-risk periods. After 1:1 PS matching, 4,897 patients using finasteride and 4,897 patients using dutasteride were enrolled in the present study. No significant differences were observed for risk of prostate cancer between finasteride and dutasteride both on-treatment (HR=0.66, 95% confidence interval [CI]: 0.44-1.00; p=0.051) and intent-to-treat time-at-risk periods (HR=0.87, 95% CI: 0.67-1.14; p=0.310).

Conclusions: Using real-world databases, the present study demonstrated that dutasteride was not associated with a lower risk of prostate cancer than finasteride in patients with BPH.

Purpose: Androgen signaling is associated with various secondary cancer, which could be promising for potential treatment using androgen deprivation therapy (ADT). This study investigated whether ADT use was associated with secondary cancers other than prostate cancer in a nationwide population-based cohort.

Materials and methods: A total, 278,434 men with newly diagnosed prostate cancer between January 1, 2002 and December 31, 2017 were identified. After applying the exclusion criteria, 170,416 men were enrolled. The study cohort was divided into ADT and non-ADT groups by individual matching followed by propensity score matching (PSM). Study outcomes were incidence of all male cancers. Cox proportional hazard regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of events.

Results: During a median follow-up of 4.5 years, a total of 11,059 deaths (6,329 in the ADT group and 4,730 in the non-ADT group) after PSM were found. After PSM, the overall all-cause of secondary cancer incidence risk of the ADT group was higher than that of the non-ADT group (HR: 1.312, 95% CI: 1.23-1.36; adjusted HR: 1.344, 95% CI: 1.29-1.40). The ADT group showed higher risk of overall brain and other central nervous system (CNS) cancer-specific incidence than the non-ADT group (adjusted HR: 1.648, 95% CI: 1.21-2.24). The ADT group showed lower risks of overall cancer-specific incidence for stomach, colon/rectum, liver/inflammatory bowel disease (IBD), gall bladder/extrahepatic bile duct, lung, bladder, and kidney cancers than the non-ADT group. When the duration of ADT was more than 2 years of ADT, the ADT group showed higher risk of cancer-specific incidence for brain and other CNS cancers but lower risk of cancer-specific incidence for liver/IBD and lung cancers than the non-ADT group.

Conclusions: This study demonstrates that ADT could affect cancer-specific incidence for various cancers.

Purpose: Erectile dysfunction (ED) is a common male sexual dysfunction. Gut microbiota plays an important role in various diseases. To investigate the effects and mechanisms of intestinal flora dysregulation induced by high-fat diet (HFD) on erectile function.

Materials and methods: Male Sprague-Dawley rats aged 8 weeks were randomly divided into the normal diet (ND) and HFD groups. After 24 weeks, a measurement of erectile function was performed. We performed 16S rRNA sequencing of stool samples. Then, we established fecal microbiota transplantation (FMT) rat models by transplanting fecal microbiota from rats of ND group and HFD group to two new groups of rats respectively. After 24 weeks, erectile function of the rats was evaluated and 16S rRNA sequencing was performed, and serum samples were collected for the untargeted metabolomics detection.

Results: The erectile function of rats and the species diversity of intestinal microbiota in the HFD group was significantly lower, and the characteristics of the intestinal microbiota community structure were also significantly different between the two groups. The erectile function of rats in the HFD-FMT group was significantly lower than that of rats in the ND-FMT group. The characteristics of the intestinal microbiota community structure were significantly different. In the HFD-FMT group, 27 metabolites were significantly different and they were mainly involved in the several inflammation-related pathways.

Conclusions: Intestinal microbiota disorders induced by HFD can damage the intestinal barrier of rats, change the serum metabolic profile, induce low-grade inflammation and apoptosis in the corpus cavernosum of the penis, and lead to ED.