Production of 11-Oxygenated Androgens by Testicular Adrenal Rest Tumors.
J Clin Endocrinol Metab
; 107(1): e272-e280, 2022 01 01.
Article
em En
| MEDLINE
| ID: mdl-34390337
ABSTRACT
CONTEXT Testicular adrenal rest tumors (TART) are a common complication in males with classic 21-hydroxylase deficiency (21OHD). TART are likely to contribute to the androgen excess in 21OHD patients, but a direct quantification of steroidogenesis from these tumors has not been yet done. OBJECTIVE:
We aimed to define the production of 11-oxygenated 19-carbon (11oxC19) steroids by TART.METHODS:
Using liquid chromatography-tandem mass spectrometry, steroids were measured in left (nâ =â 7) and right (nâ =â 4) spermatic vein and simultaneously drawn peripheral blood (nâ =â 7) samples from 7 men with 21OHD and TART. For comparison, we also measured the peripheral steroid concentrations in 5 adrenalectomized patients and 12 age- and BMI-matched controls. Additionally, steroids were quantified in TART cell- and adrenal cell-conditioned medium, with and without adrenocorticotropic hormone (ACTH) stimulation.RESULTS:
Compared with peripheral blood from 21OHD patients with TART, the spermatic vein samples displayed the highest gradient for 11ß-hydroxytestosterone (11OHT; 96-fold) of the 11oxC19 steroids, followed by 11-ketotestosterone (47-fold) and 11ß-hydroxyandrostenedione (11OHA4; 29-fold), suggesting production of these steroids in TART. TART cells produced higher levels of testosterone and lower levels of A4 and 11OHA4 after ACTH stimulation compared with adrenal cells, indicating ACTH-induced production of testosterone in TART.CONCLUSION:
In patients with 21OHD, TART produce 11oxC19 steroids, but in different proportions than the adrenals. The very high ratio of 11OHT in spermatic vs peripheral vein blood suggests the 11-hydroxylation of testosterone by TART, and the in vitro results indicate that this metabolism is ACTH-sensitive.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Testiculares
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Testículo
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Glândulas Suprarrenais
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Hiperplasia Suprarrenal Congênita
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Tumor de Resto Suprarrenal
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adult
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Clin Endocrinol Metab
Ano de publicação:
2022
Tipo de documento:
Article