Abstract

In addition to testosterone (T), the emerging role of sex hormone-binding globulin (SHBG) in pathogenesis of metabolic syndrome (MetS) has been noted recently. However, reports of associations with serum adipocytokine levels are still limited. Therefore, we conducted this study to evaluate whether serum T and SHBG levels are independent predictors for the risk of MetS that are associated with adiponectin and leptin levels in 614 Taiwanese men over 40 years old collected from a free health screening. Subjects in the lowest quartile of TT and SHBG levels are exposed to a 1.58 and 3.22 times risk of developing MetS, as compared to those in the highest quartile of TT and SHBG levels. However, SHBG retains its significance independent of TT as a MetS risk predictor, but not vice versa. In addition, SHBG was significantly correlated with both adiponectin and leptin levels even after adjusting for TT levels. In conclusion, SHBG served as a major predictor for the risk of MetS and was correlated with serum adiponectin and leptin levels that are independent of T. Further studies are needed to elucidate the true role of SHBG in the pathogenesis of MetS and possible mechanisms associated with serum adiponectin and leptin levels.

Abstract

We aimed to explore the associations between different lipid profiles and semen quality in a large-scale general male population. Sperm concentration, total sperm motility, progressive motility, and normal sperm morphology were recorded of total 7601 participants were recorded. The association of these semen parameters with the triglyceride, total cholesterol, high density lipoprotein, low density lipoprotein, and very low density lipoprotein of serum lipid profiles were analyzed. Sperm concentration was statistically positively correlated with triglyceride and very low density lipoprotein (adjusted P= 0.001, and P = 0.005, respectively). Total sperm motility and progressive motility were statistically increased with increasing low density lipoprotein and cholesterol levels (both adjusted P = 0.008, and P <0.001, respectively). The similar J-shaped associations (high-low-low-high) were noted between individual lipid profile and normal sperm morphology, especially low density lipoprotein and cholesterol with statistical significance (adjusted P = 0.017 and P = 0.021, respectively). The prevalence of abnormal total sperm motility and progressive motility were decreased in participants with high levels of cholesterol (P = 0.008, and P = 0.019, respectively), and the reverse J-shaped associations (low-high-high-low) were noted between high density lipoprotein, triglyceride, very low density lipoprotein and the prevalence of abnormal normal sperm morphology (P = 0.010, P = 0.037, and P = 0.025, respectively). A high cholesterol level was associated with better sperm motility. Similar J-shaped associations were noted between all lipid profiles and normal sperm morphology, meanwhile, the reverse J-shaped trends were identified between them and abnormal normal sperm morphology prevalence.

Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene cause cystic fibrosis (CF) and are associated with congenital bilateral absence of the vas deferens (CBAVD), which is the major cause of infertility in male patients with CF. However, most Taiwanese patients with CBAVD do not carry major CFTR mutations. Some patients have a single copy deletion of the solute carrier family 9 isoform 3 (SLC9A3) gene. SLC9A3 is a Na+/H+ exchanger, and depleted Slc9a3 in male mice causes infertility due to the abnormal dilated lumen of the rete testis and efferent ductules. Furthermore, SLC9A3 interacts with CFTR in the pancreatic duct and functions as a genetic modifier of CF. However, SLC9A3 function and its relation to CFTR expression in the male reproductive tract in vivo remain elusive. In the present study, we found that CFTR expression was dramatically decreased in the epididymis and vas deferens of Slc9a3 knockout mice. Adult Slc9a3^-/- mice showed not only significantly decreased epididymis and vas deferens weight but also increased testis weight. Furthermore, Slc9a3^-/- mice developed obstructive azoospermia because of abnormal abundant secretions and calcification in the lumen of the reproductive tract. Ultrastructural analysis of the epithelium in Slc9a3–/–epididymis and vas deferens displayed disorganized and reduced number of stereocilia and numerous secretory apparatuses. Our data revealed that interdependence between SLC9A3 and CFTR is critical for maintaining a precise microenvironment in the epithelial cytoarchitecture of the male reproductive tract. The Slc9a3-deficient mice with impaired male excurrent ducts in this study provide proof for our clinical findings that some Taiwanese of CBAVD carry SLC9A3 deletion but without major CFTR mutations.

Abstract

Platelet-rich plasma (PRP) containing autologous growth factors is applied in regenerative medicine, but the lack of an optimized PRP preparation protocol causes unstable therapeutic effects. The aim of this study was to optimize the PRP preparation method and compare the effects of PRP from different preparation methods in restoration of erectile function in a rat model. The in vivo experiments used Sprague–Dawley male rats (n=24), which were randomly divided into four groups of equal numbers: group I underwent sham operation, while the remaining three groups underwent bilateral CN crush. Crush injury groups were treated at the time of injury with an application of general PRP, optimized PRP [with the largest amount of platelet-derived growth factor (PDGF)–AB] or normal saline-only injection in the corpus cavernosum, respectively. Four weeks later, erectile function was assessed by CN electrosimulation, and penile tissue was collected for histology. Results demonstrated that in the PRP group prepared with the ACD-A anticoagulant, chitosan and incubated at 20°C for 15 days had the largest amount of PDGF-AB and showed a synergistic effect on release (p<0.05). Functional outcome measurement and immunofluorescence staining for the dorsal nerve revealed that improvement after bilateral CN injury occurred in the optimized PRP group (p<0.05). It was concluded that optimized PRP with a high level of growth factors was more stable, and its injection into the corpus cavernosum facilitated recovery of erectile function.

Abstract

This study aimed to investigate the effects of anti-tumor necrosis factor (TNF)-α antibody (Ab) on alteration of penile structure in the hyperprolactinemia (hyperPRL) rat model. HyperPRL was induced in 8-week-old male Sprague-Dawley rats by allografting anterior pituitary (AP) glands under the renal capsule (+AP rats). Rats implanted with cerebral cortex(CX) were used as sham control (+CX rats). At 6 weeks post implantation, rats received either a single intra-testicular dose of TNF-α Ab (12.5 μg/kg) or testosterone replacement (2 doses of testosterone enanthate [TE], 3 mg/kg), and they were sacrificed 1 week later. Blood and penile tissue was collected for analysis. Compared to +CX rats, the +AP group had lower serum testosterone concentration and neuronal nitric oxide synthase (nNOS) expression, but exhibited a higher ratio of collagen III/I in the corpus cavernosum. Smooth muscle content exhibited no significant changes. At 1 week post TNF-α Ab injection, the collagen III/I ratio in the +AP group was decreased, and the smooth muscle content and nNOS expression increased significantly. These findings were comparable to those observed in+AP rats receiving TE. Testicular TNF-α suppresses testosterone release, which in turn results in the erectile dysfunction (ED) seen in hyperPRL. Intra-testicular TNF-α Ab treatment is as effective as testosterone supplementation on penile structure normalization inthe hyperPRL model.

Abstract

Objective: The aim of this study was to report our preliminary experience of the treatment with mirabegron and to identify the predictors of a successful treatment with mirabegron in overactive bladder (OAB) patients.

Materials and Methods: Between October 2015 and February 2016, 234 consecutive patients (167 men and 67 women; mean age: 65.6 years; standard deviation: 16.3) diagnosed with OAB and receiving mirabegron monotherapy were enrolled retrospectively. Four weeks after mirabegron treatment, a global response assessment (GRA) was performed for all patients and analyses were performed to identify possible predictors of successful mirabegron treatment (defined as GRA ≥ 1). Mirabegron was intended being given for at least 12 weeks. Adverse events (AEs) and reasons for discontinuing mirabegron were recorded between 4 to 12 weeks of following-up.

Results: The rate of successful mirabegron treatment (GRA ≥ 1) was 70.5%. The proportion of patients with a successful response was significantly higher in men than in women (75.3% vs. 60.5%, p = 0.022). The success rates as well as the percentage of older patients between groups with or without diabetes, hypertension, nocturia, urge incontinence, or prior anticholinergic treatment were not significantly different. Multivariable analysis showed that male sex was a significant independent predictor (p < 0.05) for successful treatment. The overall rate of AEs was 3.8%, including five cases with hypertension (2.1%) and three with severe voiding difficulty (1.3%). A total of 136 patients (58%) were administered mirabegron for more than 12 weeks. The reasons for discontinuing mirabegron included symptom improvement (17%), loss to follow-up (13%), poor treatment efficacy (8%), and side effects (4%).

Conclusions: The success rate of mirabegron treatment for OAB patients was high and the rate of overall AEs was low. Although only 58% patients continued mirabegron at 12 weeks, most patients (17%) discontinued the treatment because of reduction in symptoms. Male sex showed better response to mirabegron treatment.