RESUMEN
Non-prescription use of anabolic androgenic steroids (AAS) is associated with an increased risk of premature death. However, these substances are seldom screened in connection with forensic cause-of-death investigation, unless the forensic pathologist specifically suspects use, often based on a positive AAS use history. Since AAS use is often concealed from others, this practice may lead to mistargeting of these analyses and significant underestimation of the true number of AAS positive cases undergoing forensic autopsy. Thus, more accurate diagnostic tools are needed to identify these cases. The main objective of this study was to determine, whether a multivariable model could predict AAS urine assay positivity in forensic autopsies. We analyzed retrospectively the autopsy reports of all cases that had been screened for AAS during forensic cause-of-death investigation between 2016-2019 at the Finnish Institute for Health and Welfare forensic units (n = 46). Binary logistic regression with penalized maximum likelihood estimation was used to generate a nine-variable model combining circumferential and macroscopic autopsy-derived variables. The multivariable model predicted AAS assay positivity significantly better than a "conventional" model with anamnestic information about AAS use only (area under the receiver operating characteristic curve [AUC] = 0.968 vs. 0.802, p = 0.005). Temporal validation was conducted in an independent sample of AAS screened cases between 2020-2022 (n = 31), where the superiority of the multivariable model was replicated (AUC = 0.856 vs. 0.644, p = 0.004). Based on the model, a calculator predicting AAS assay positivity is released as a decision-aiding tool for forensic pathologists working in the autopsy room.
Asunto(s)
Anabolizantes , Autopsia , Detección de Abuso de Sustancias , Humanos , Masculino , Estudios Retrospectivos , Adulto , Anabolizantes/análisis , Anabolizantes/orina , Detección de Abuso de Sustancias/métodos , Femenino , Adulto Joven , Modelos Logísticos , Andrógenos/análisis , Persona de Mediana Edad , Finlandia , Curva ROC , Esteroides Anabólicos AndrogénicosRESUMEN
Solid-phase microextraction (SPME) coupled with electrospray ionization mass spectrometry (ESI-MS) was developed for rapid and sensitive determination of endogenous androgens. The SPME probe is coated with covalent organic frameworks (COFs) synthesized by reacting 1,3,5-tri(4-aminophenyl)benzene (TPB) with 2,5-dioctyloxybenzaldehyde (C8PDA). This COFs-SPME probe offers several advantages, including enhanced extraction efficiency and stability. The analytical method exhibited wide linearity (0.1-100.0 µg L-1), low limits of detection (0.03-0.07 µg L-1), high enrichment factors (37-154), and satisfactory relative standard deviations (RSDs) for both within one probe (4.0-14.8%) and between different probes (3.4-12.7%). These remarkable performance characteristics highlight the reliability and precision of the COFs-SPME-ESI-MS method. The developed method was successfully applied to detect five kinds of endogenous androgens in female serum samples, indicating that the developed analytical method has great potential for application in preliminary clinical diagnosis.
Asunto(s)
Andrógenos , Límite de Detección , Microextracción en Fase Sólida , Espectrometría de Masa por Ionización de Electrospray , Microextracción en Fase Sólida/métodos , Espectrometría de Masa por Ionización de Electrospray/métodos , Humanos , Andrógenos/sangre , Andrógenos/análisis , Andrógenos/química , Femenino , Estructuras Metalorgánicas/química , Reproducibilidad de los ResultadosRESUMEN
PURPOSE: The aim of this study was to investigate the effect of solid fuel use on serum sex hormone levels. Furthermore, the effects of improved kitchen ventilation and duration of cooking time on the relationship between solid fuel use and serum sex hormone levels will be further explored. METHODS: In this cross-sectional study, 5386 individuals were recruited. Gender and menopausal status modified associations between solid fuel type and serum sex hormone levels was investigated through generalized linear models and further analyzed by improving kitchen ventilation and length of cooking time on the relationship between solid fuel use and serum sex hormone levels. To identify the causal association, mendelian randomization of two-sample was performed. RESULTS: In observational analyses, for ln-17-hydroxyprogesterone, ln-testosterone, and ln-androstenedione among premenopausal women, the estimated ß and 95 % CI of sex hormone levels for the effect of solid fuel users was -0.337 (-0.657, -0.017), -0.233 (-0.47, 0.005), and - 0.240 (-0.452, -0.028) respectively, and - 0.150 (-0.296, -0.004) in ln-progesterone among postmenopausal women. It was found that combining solid fuels with long cooking periods or no ventilation more effectively reduced testosterone and androstenedione in premenopausal women. We further found the adverse effects of using solid fuel on progesterone, testosterone, and androstenedione levels were enhanced with the increases of PM1, PM2.5, PM10, and NO2. Corresponding genetic, the causal risk effect of solid fuel were - 0.056 (-0.513, 0.4) and 0.026 (-3.495, 3.547) for testosterone levels and sex hormone binding globulin, respectively. CONCLUSION: Using gas or solid fuel was negatively related to sex hormone levels. A combination of using solid fuels, cooking for a long time, or cooking without ventilation had a stronger effect on sex hormone levels. However, genetic evidence did not support causality for the associations. WHAT IS ALREADY KNOWN ON THIS TOPIC?: The mechanisms underlying these associations household air pollution (HAP) from incomplete combustion of such fuels and occurrence of chronic diseases remained obscure. Recent years, extensive evidences from animal as well as human researches have suggested that progestogen and androgen hormones are involved in the development of diabetes, hypertension, and cardiovascular disease, which indicated that changes in serum progestogen and androgen hormones levels might play a role in these pathological mechanisms. However, limited evidence exists examining the effect of HAP from solid fuel use on serum sex hormone levels.
Asunto(s)
Contaminación del Aire Interior , Humanos , Femenino , Contaminación del Aire Interior/análisis , Estudios Transversales , Progesterona/análisis , Progestinas/análisis , Andrógenos/análisis , Androstenodiona/análisis , Análisis de la Aleatorización Mendeliana , Culinaria , Testosterona , ChinaRESUMEN
To analyze a complex sample for endocrine activity, different tests must be performed to clarify androgen/estrogen agonism, antagonism, cytotoxicity, anti-cytotoxicity, and corresponding false-positive reactions. This means a large amount of work. Therefore, a six-fold planar multiplex bioassay concept was developed to evaluate up to the mentioned six endpoints or mechanisms simultaneously in the same sample analysis. Separation of active constituents from interfering matrix via high-performance thin-layer chromatography and effect differentiation via four vertical stripes (of agonists and end-products of the respective enzyme-substrate reaction) applied along each separated sample track were key to success. First, duplex endocrine bioassay versions were established. For the androgen/anti-androgen bioassay applied via piezoelectric spraying, the mean limit of biological detection of bisphenol A was 14 ng/band and its mean half maximal inhibitory concentration IC50 was 116 ng/band. Applied to trace analysis of six migrate samples from food packaging materials, 19 compound zones with agonistic or antagonistic estrogen/androgen activities were detected, with up to seven active compound zones within one migrate. For the first time, the S9 metabolism of endocrine effective compounds was studied on the same surface and revealed partial deactivation. Coupled to high-resolution mass spectrometry, molecular formulas were tentatively assigned to compounds, known to be present in packaging materials or endocrine active or previously unknown. Finally, the detection of cytotoxicity/anti-cytotoxicity and false-positives was integrated into the duplex androgen/anti-androgen bioassay. The resulting six-fold multiplex planar bioassay was evaluated with positive control standards and successfully applied to one migrate sample. The streamlined stripe concept for multiplex planar bioassays made it possible to assign different mechanisms to individual active compounds in a complex sample. The concept is generic and can be transferred to other assays.
Asunto(s)
Bioensayo , Bioensayo/métodos , Humanos , Disruptores Endocrinos/análisis , Disruptores Endocrinos/farmacología , Reacciones Falso Positivas , Fenoles/análisis , Fenoles/química , Fenoles/farmacología , Compuestos de Bencidrilo/análisis , Compuestos de Bencidrilo/farmacología , Compuestos de Bencidrilo/química , Andrógenos/análisis , Andrógenos/metabolismo , Antagonistas de Andrógenos/análisis , Antagonistas de Andrógenos/farmacologíaRESUMEN
The synthetic 20-keto-steroid S42 (1) demonstrated selective androgen receptor modulator (SARM) properties in preclinical studies and, consequently, received growing attention also in the context of sports drug testing programs. Fundamental understanding of the behavior of S42 (1) and of relevant derivatives in gas chromatography-electron ionization MS experiments at high resolution (GC-EI-HRMS) is indispensable to develop a reliable qualitative and quantitative doping control method for S42 (1) and its metabolites in body fluid matrices. We present important fundamental mechanistic data on the EI fragmentation behavior of S42 (1) and of silyl ether derivatives as well as of stable isotope-labelled reference material.
Asunto(s)
Doping en los Deportes , Cromatografía de Gases y Espectrometría de Masas , Receptores Androgénicos , Cromatografía de Gases y Espectrometría de Masas/métodos , Doping en los Deportes/prevención & control , Humanos , Receptores Androgénicos/metabolismo , Receptores Androgénicos/análisis , Receptores Androgénicos/química , Anabolizantes/análisis , Anabolizantes/química , Detección de Abuso de Sustancias/métodos , Espectrometría de Masa por Ionización de Electrospray/métodos , Andrógenos/análisis , Andrógenos/química , Esteroides/análisis , Esteroides/químicaRESUMEN
Clinical case: a girl of 7 ½ years who consulted for early pubarche without thelark, with a percentile size of 75 for a genetic target size in the 10th percentile, overweight with a 90th percentile BMI, and normal blood pressure. The biochemical study showed high levels of androgens: testosterone: 7.2 ng/dL, androstenedione of 5.1 ng / ml, 17OHP: 15 ng / dL with low normal DHEAS (0.26 ug/ml), Plasma Renin Activity normal low: 0.22 ng/mL/h. Initial imaging study showed a bone age of 10 years 6 months and normal abdominal and pelvic ultrasound. Molecular study showed no pathogenic variants in the CYP21A2 gene (21 Hydroxylase). With a probable diagnosis of non-classical congenital adrenal hyperplasia (HSRNC) and no known mutation, he started treatment with hydrocortisone (12 mg/m2). At 8.7 years, pubertal development begins and braking begins with LHRH analogues, which are administered for 18 months. Despite the treatment, signs of virilization and elevation of androgens (testosterone up to 130 ng/ml) are progressively accentuated, which do not diminish when trying different corticosteroid schemes. MRI of the abdomen and pelvis shows the normal adrenal glands and a solid nodular image of 2.1 x 1.6 cm in the right ovary (Figure 2), later demonstrated with pelvic ultrasound (Figure 2). Right laparoscopic oophorectomy was performed, whose biopsy demonstrated a Leydig cell tumor. One month after surgery, all androgenic levels were normalized, so the gradual suspension of corticosteroids began. Conclusion: Although HSRNC is the most frequent pathological cause of early pubarche, when it is associated with progressive clinical and biochemical hyperandrogenism despite adequate treatment and without pathogenic variants in the CYP21A2 gene, even with high levels of 17OHP, other causes should be considered, specifically, androgen producing tumors.
Caso clínico: niña de 7½ años que consulta por pubarquia precoz sin telarquia, con talla en percentil 75 para una talla objetivo genético en percentil 10, sobrepeso con IMC percentil 90 y presión arterial normal. El estudio bioquímico mostró niveles elevados de andrógenos: testosterona: 7,2 ng/dL, androstenediona de 5,1 ng/ml, 17OHP: 15 ng/dL con DHEAS normal baja (0,26 ug/ml), Actividad de Renina Plasmática normal baja: 0.22 ng/ mL/h. Estudio de imágenes inicial mostró una edad ósea de 10 años 6 meses y ecografía abdominal y pelviana normales. Estudio molecular no mostró variantes patogénicas en el gen CYP21A2 (21 Hidroxilasa). Con diagnosticó probable de hiperplasia suprarrenal congénita no clásica (HSRNC) y sin mutación conocida,inició el tratamiento con hidrocortisona (12 mg/m2). A los 8.7 años comienza desarrollo puberal y se inicia frenación con análogos de LHRH, los cuales se administran por 18 meses. A pesar del tratamiento se acentúan progresivamente los signos de virilización y hayelevación de los andrógenos (testosterona hasta 130 ng/ml), que no disminuyen intentando diferentes esquemas de corticoides. Se realiza RM de abdomen y pelvis que muestra las glándulas suprarrenales normales y una imagen nodular sólida de 2.1 x 1.6 cm en el ovario derecho (Figura 2), demostrada posteriormente con Ecografía pelviana (Figura 2). Se realiza ooforectomía derecha por vía laparoscópica, cuya biopsia demostró un tumor de células de Leydig. Un mes después de la cirugía, se normalizan todos los niveles androgénicos por lo que se inició la suspensión gradual de los corticoides. Conclusión: Aunque la HSRNC es la causa patológica más frecuente de la pubarquia precoz, cuando se asocia con un hiperandrogenismo clínico y bioquímico progresivo a pesar de un tratamiento adecuado y sin variantes patógenicas en el gen CYP21A2, incluso con niveles elevados de 17OHP, otras causas deben ser consideradas, específicamente tumores productores de andrógenos.
Asunto(s)
Humanos , Femenino , Niño , Neoplasias Ováricas/complicaciones , Neoplasias Ováricas/diagnóstico , Pubertad Precoz/etiología , Tumor de Células de Leydig/complicaciones , Tumor de Células de Leydig/diagnóstico , Testosterona/análisis , Hiperandrogenismo/etiología , Hiperplasia Suprarrenal Congénita/diagnóstico , 17-alfa-Hidroxiprogesterona/análisis , Hirsutismo/etiología , Andrógenos/análisis , Androstenodiona/análisisRESUMEN
RESUMEN Diversos estudios bioquímicos adicionales a la evaluación de Testosterona total (TT), biodisponible (Tbio) y libre (TL) han sido realizados a los efectos que pudieran resultar de mayor utilidad para el diagnóstico de patologías concomitantes en el SOP, entre otros. En la hormona anti Mülleriana, cuando la concentración supera a los 3,0 ng/ml existen evidencias de que el 79% de las mismas pueden ser identificadas correctamente como SOP. El Antígeno Prostático Específico (PSA), marcador de singular importancia en pacientes con cáncer de Próstata, con técnicas ultrasensibles ha podido ser detectado en más del 50% en mujeres. En un grupo de pacientes con SOP, los niveles circulantes de PSA fueron significativamente mayores que en las mujeres sin SOP. El Kiss-1 aislado de la placenta y demostrado en otros tejidos, presenta niveles aumentados que correlacionan con la LH, TT, TL y resistencia a la insulina (RI) en adolescentes con SOP versus adolescentes sin SOP, sugiriendo que el Kiss-1 podría estar involucrado en el desarrollo del SOP en estas pacientes. Algunas pacientes con SOP están asociadas a patologías relevantes, de las cuales han sido comunicadas el aumento del BMI, mayor grado de dislipemia, adiposidad central, RI y Síndrome Metabólico (SMe). En las pacientes con un fenotipo clásico (hiperandrogenismo, alteración del ciclo menstrual y ovarios poliquísticos), estas patologías son de mayor frecuencia y severidad que en los otros fenotipos, particularmente aquellos sin hiperandrogenismo. Otras determinaciones como TNFα, interleuquinas, test de tolerancia a la glucosa, ApoB, partículas pequeñas de LDL e Inhibidor del Activador del Plasminógeno-1 han sido comunicados que podrían ser de utilidad para tener mayor sensibilidad en la definición de patología concomitantes en el SOP. Actualmente se ha comenzado a evaluar otros marcadores como el Fetuin-A; Quemerina, Nesfatina-1, Neopterina y Endocannabinoides, cuyos resultados preliminares parecerían ser un aporte importante para evaluar SMe y RI en paciente con SOP y tratar de definir su prevalencia en los distintos fenotipos de esta patología.
ABSTRACT Several biochemical studies in addition to the evaluation of total Testosterone (TT), bioavailable (bioT) and free (FT) have been performed to the effects that could be of greater use for the diagnosis of concomitant pathologies in the PCOS, among others. The anti-Müllerian hormone whose concentration when exceeds 3.0 ng/ml, there is evidence that 79% of these patients can be correctly identified as PCOS. The Prostate-Specific Antigen (PSA), a marker of singular importance in patients with prostate cancer, with ultra-sensitive techniques, has been detected in more than 50% of women. In a group of patients with PCOS, circulating levels of PSA are significantly higher than in women without PCOS. The Kiss-1 isolated from the placenta and demonstrated in other tissues, has increased levels that correlate with LH, TT, TL and insulin resistance (IR) in adolescents with PCOS respect to adolescents without PCOS, suggesting that Kiss-1 could be involved in the development of the PCOS in these patients. In some patients with PCOS, they are associated with relevant pathologies, of which the increase in BMI, higher degree of dyslipidemia, central adiposity, IR and Metabolic Syndrome (MeS) have been reported. Those that show a classic phenotype (hyperandrogenism, alteration of the menstrual cycle and polycystic ovaries) these characteristics are of greater frequency and severity than in the other phenotypes, particularly those without hyperandrogenism. Other determinations such as TNFα, interleukins, glucose tolerance test, ApoB, small particles of LDL and Plasminogen Activator Inhibitor-1 have been reported that could be useful to have greater sensitivity in the definition of concomitant pathology in the PCOS. Currently, other markers such as Fetuin-A, Chemerin, Nesfatin-1 Neopterin and Endocannabinoids have been evaluated. The preliminary results suggest to be an important contribution to define MeS and IR in patient with PCOS and to try to determine its prevalence in the different phenotypes of this pathology.
Asunto(s)
Humanos , Femenino , Síndrome del Ovario Poliquístico/complicaciones , Síndrome del Ovario Poliquístico/fisiopatología , Biomarcadores/análisis , Síndrome del Ovario Poliquístico/sangre , Síndrome Metabólico/complicaciones , Dislipidemias/complicaciones , Andrógenos/análisisRESUMEN
Abstract BACKGROUND: Although the pathogenesis of androgenetic alopecia is not completely understood, the roles of genetic susceptibility and androgens are well-known. A lower ratio of the second digit (index finger = 2D) to the fourth digit (ring finger = 4D) length has been hypothesized to reflect prenatal androgen exposure and/or higher sensitivity to androgens. OBJECTIVES: To determine the relationship between the second to fourth digit length ratio and androgenetic alopecia. METHODS: Finger length measurements were made by a digital vernier calliper. Androgenetic alopecia severity was assessed using the Hamilton-Norwood scale. Subjects with an androgenetic alopecia score of grade III or more were included in the study. RESULTS: A total of 189 males with androgenetic alopecia and 171 healthy controls were enrolled in the study. The age range of participants was 19-65 years. The 2D:4D ratios in patients with androgenetic alopecia were significantly lower than those of healthy controls for the right hand; however, no significant difference was found for the left hand. Average 2D:4D ratios in androgenetic alopecia patients were also lower than in controls. No significant relationship was observed between androgenetic alopecia severity and 2D:4D ratios. CONCLUSION: Our data support the anatomical evidence of in utero androgen exposure and/or an individual’s sensitivity to androgens in patients with androgenetic alopecia. Furthermore, the right hand 2D:4D ratio might be an indicator of androgenetic alopecia development.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Anciano , Adulto Joven , Efectos Tardíos de la Exposición Prenatal/diagnóstico , Alopecia/diagnóstico , Dedos/anatomía & histología , Tamaño de los Órganos , Estándares de Referencia , Valores de Referencia , Índice de Severidad de la Enfermedad , Embarazo , Marcadores Genéticos , Estudios de Casos y Controles , Antropometría/métodos , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Predisposición Genética a la Enfermedad , Alopecia/etiología , Andrógenos/análisis , Andrógenos/fisiologíaRESUMEN
Objetivou-se estudar a morfometria corpórea, as características do sêmen, o perfil proteico do plasma seminal em SDS-PAGE e a concentração sérica de testosterona em cervos-sambar (Cervus unicolor), criados em cativeiro, na estação reprodutiva da primavera. Quatro machos com idades entre 12 e 36 meses foram avaliados em quatro momentos, com intervalos de sete dias, com peso corpóreo (60,5 a 89,0kg), índice de massa corporal (93,07kg/m2 a 126,56kg/m2), volume do ejaculado (0,50±0,35mL a 0,75±0,28mL), motilidade espermática (87,75±4,78% a 90,00±7,07%), defeitos totais (17,25±5,81% a 47,72±17,55%), testosterona sérica (6,43±4,33ng/dL a 166,00±64,48ng/dL) e proteínas do plasma seminal com bandas entre 7,6 e 142kDa. As características dos ejaculados não diferiram (P>0,05) entre as três primeiras colheitas. Houve diferença (P<0,05) para os defeitos espermáticos com elevação na quarta colheita. No plasma seminal de cada cervo, foram identificadas de 16 a 27 bandas de proteínas entre 7,6 e 142kDa. Conclui-se que a qualidade espermática foi satisfatória na primavera. O estresse das contenções sucessivas causou queda da qualidade espermática. A idade influi na concentração sérica de testosterona, a qual foi maior nos cervos aos 36 meses...
The aim of this work was to study the body morphometry, semen characteristics, seminal plasma protein profile in SDS-PAGE and serum testosterone concentration in Sambar Deer (Cervus unicolor), in captivity in the breeding season (spring). Four males aged between 12 and 36 months were assessed in four moments with intervals of seven days with body weight (60.5 to 89.0kg), body mass index (93.07 to 126.56kg/m2), ejaculate volume (0.50±0.35mL to 0.75±0.28mL), sperm motility (87.75±4.78% to 90.00±7.07% ), total defects (17.25±5.81% to 47.72±17.55%), serum testosterone (6.43±4.33 ng/dL to 166.00±64.48ng/dL) and seminal plasma proteins with bands between 7.6 and 142 kDa. The characteristics of ejaculates did not differ (P>0.05) among ejaculates (1st, 2nd and 3rd). There were differences (P<0.05) for sperm defects elevation on the fourth ejaculate. In seminal plasma 16 to 27 protein bands between 7.6 and 142 kDa were identified. In conclusion, sperm quality was satisfactory in the spring and the stress of successive contentions decreased sperm quality. Also, there is influence of age upon serum testosterone concentration which was higher in deer at 36 months...
Asunto(s)
Animales , Análisis de Semen/veterinaria , Ciervos , Capacitación Espermática , Andrógenos/análisis , Electroforesis en Gel de Poliacrilamida/veterinaria , Testosterona/análisisRESUMEN
O lincRNA PVT1 (Plasmacytoma Variant Translocation 1) é um RNA longo não codificador de proteínas (ncRNA) descrito como um oncogene sendo superexpresso em vários tipos de cânceres. LincRNA PVT1 está localizado na região genômica 8q24, também conhecida como 'gene desert'. O nível de expressão do lincRNA PVT1 está associado ao aumento do risco de câncer de próstata (PCa) e está correlacionado com os níveis de expressão do receptor de andrógeno (AR). No entanto, o mecanismo do envolvimento do lincRNA PVT1 com o AR no desenvolvimento de câncer de próstata ainda não está bem esclarecido. Aqui, nós testamos a hipótese que a formação do complexo AR-EZH2-PVT1 participa na regulação da expressão gênica em câncer de próstata, nas células LNCaP. A imunoprecipitação de ribonucleoproteínas seguida de PCR quantitativo (RIP-qPCR) revelou que o lincRNA PVT1 está associado fisicamente ao AR (12% do input) e à metiltransferase EZH2, proteína componente do complexo repressor Polycomb 2 (36% do input) sob condições suplementadas com andrógeno (+R1881). O lincRNA PVT1 também está associado fisicamente ao AR (10% de input) e à EZH2 (42% de input) em condições de privação de andrógeno (-R1881). Assim, a associação física entre lincRNA PVT1, AR e EZH2 é independente do hormônio andrógeno. Usando uma abordagem de estudo em larga-escala de perda e ganho de função, nossos resultados mostraram que o silenciamento do lincRNA PVT1 em células LNCaP na presença de andrógeno restaura a expressão parcialmente, totalmente ou causa superexpressão de 160 genes que tiveram a expressão inibida por andrógeno. Entre esses genes, destacamos genes envolvidos na regulação da diferenciação celular, em componentes da junção célula-célula, na inibição da migração e invasão celular e no desencadeamento da via apoptótica. Imunoprecipitação da cromatina seguida de PCR quantitativo (ChIP-qPCR), em cultura de células LNCaP suplementada com andrógeno sob silenciamento do lincRNA PVT1, mostrou aumento significativo na ocupação pela marca de histona ativadora H3K27Ac do promotor do gene NOV, um dos genes que tiveram sua expressão aumentada com o silenciamento de PVT1. O ChIP-qPCR também mostrou, após o silenciamento do lincRNA PVT1, um aumento significativo da marca H3K27me3 na região enhancer do gene NOV, uma característica de enhancers poised (prontos para ativação). Em conclusão, nós fornecemos a primeira evidência experimental para um mecanismo de ação do oncogene lincRNA PVT1 em células de câncer de próstata e demonstramos que sua ação inibidora da expressão afeta genes alvo que facilitam a proliferação e migração de células do câncer de próstata, sugerindo que o lincRNA PVT1 é um novo agente no complexo mecanismo de repressão transcricional envolvendo um RNA silenciador, o receptor de andrógeno (AR) e o potenciador de Zeste homólogo 2 (EZH2) no remodelamento da cromatina em células LNCaP
Long non-coding RNA (lncRNA) plasmacytoma variant translocation 1 (PVT1) is an oncogene known to be overexpressed in various types of cancer. PVT1 lincRNA is located in the wellknown cancer-related genomic region 8q24, also known as 'gene desert. PVT1 lincRNA level of expression is associated with increased prostate cancer (PCa) risk and is correlated with androgen receptor (AR) expression levels. However, the mechanism of PVT1 and AR involvement in the development of prostate cancer is still unclear. Here, we tested the hypothesis that formation of the complex AR-EZH2-PVT1 participates in the regulation of gene expression in prostate cancer, in LNCaP cells. Ribonucleoprotein immunoprecipitation followed by quantitative PCR (RIP-qPCR) revealed that PVT1 lincRNA binds both the AR (12 % of PVT1 input) and the methyltransferase EZH2 from the Polycomb repressive complex 2 (36 % of input) under androgen-supplemented conditions (+R1881). PVT1 also binds both AR (10 % of input) and EZH2 (42 % of input) under androgen-deprived conditions (-R1881). Thus, PVT1 binding to AR and EZH2 is independent of the androgen hormone. Using a large-scale loss and gain of function approach, our results show that PVT1 knockdown (KD) in LNCaP in the presence of androgen restores the expression partially, fully or causes overexpression of 160 genes that are inhibited by androgen. Among these genes, we highlight genes involved in regulation of cell differentiation, in components of cell-cell junction, in inhibition of cell migration and invasion and in triggering of the apoptotic pathway. Chromatin immunoprecipitation followed by quantitative PCR (ChIP-qPCR) with LNCaP cells in androgen-supplemented cultures under PVT1 lincRNA knockdown showed a significant increase in occupancy by the histone activation mark H3K27Ac of the promoter region of the NOV gene, one of the genes that had an increased expression upon PVT1 silencing. ChIPqPCR also showed a significant increase upon PVT1 lincRNA silencing of the H3K27me3 histone mark in the enhancer region of the NOV gene, a distinct feature of poised enhancers. In conclusion, we provide first experimental evidence for a mechanism of action of PVT1 lincRNA oncogene in prostate cancer cells, and show that its inhibitory action affects targetgenes that facilitate proliferation and migration of prostate cancer cells, thus suggesting PVT1 lincRNA as a novel lncRNA player in the complex mechanism of transcriptional repression involving a silencer RNA, the androgen receptor (AR) and the Enhancer of zeste homolog 2 (EZH2) in chromatin remodeling in LNCaP cells
Asunto(s)
Plasmacitoma , ARN Largo no Codificante/efectos adversos , Proteína Potenciadora del Homólogo Zeste 2/análisis , Andrógenos/análisis , Neoplasias de la Próstata/diagnósticoRESUMEN
Objetivo: Relacionar los niveles de hormonas esteroideas foliculares con el ciclo de estimulación ovárica y sus resultados globales. Métodos: Se incluyeron pacientes < 38 años, con esterilidad de causa masculina, tubárica o desconocida, que recibieron un protocolo largo con agonistas de GnRH y rFSH. Se recogieron las muestras de la primera y segunda aspiración folicular de cada ovario y se realizó un quimioinmunoanálisis de estradiol, progesterona, testosterona y DHEAS. Resultados: Se obtuvieron cifras menores de DHEAS folicular en las pacientes con más días de frenado con agonistas de GnRH (p=0,0003). Cuantos más días de rFSH administrados, mayores fueron los niveles de testosterona y DHEAS folicular (p=0,03; p=0,03). En los resultados globales del ciclo, se obtuvo una correlación negativa entre las cifras de testosterona folicular y el número de complejos puncionados (r= -0,360; p=0,002) y entre la testosterona folicular y el número de embriones de calidad D (r= -0,233; p=0,047). El número de ovocitos maduros fue menor en pacientes con mayores niveles de testosterona folicular (p=0,008). La progesterona folicular fue superior en ovocitos de buena calidad frente a los de calidad no destacable (p=0,006) y muy mala calidad (p=0,04). Conclusiones: Las cifras altas de testosterona folicular se correlacionaron con menor número de complejos puncionados, ovocitos maduros y embriones de calidad D. La buena calidad ovocitaria se asoció a niveles de progesterona folicular superiores.
Objective: To relate the levels of follicular steroid hormones with the ovarian stimulation cycle and its overall results. Method: It was included patients < 38 years old with sterility of male, tubaric or unknown origin who underwent a long protocol with GnRH agonists and rFSH. Samples were obtained from the first and second follicular aspiration of each ovary. A chemiluminescent immunoassay of estradiol, progesterone, testosterone and DHEAS was performed. Results: Figures of follicular DHEAS decreased as the days of treatment with GnRH agonists increased (p=0.0003) and levels of follicular testosterone and DHEAS increased along with the days of treatment with rFSH (p=0.03, p=0.03). In regard to the outcomes of the overall cycle it was found a negative correlation between follicular testosterone levels and the number of punctured complexes (r= -0.360; p=0.002) and between follicular testosterone and the number of D quality embryos (r= -0.233; p=0.047). The number of mature oocytes was lower in patients with higher levels of follicular testosterone (p=0.008). Follicular progesterone was higher in good quality oocytes as compared to those of no remarkable quality (p=0.006) and very poor quality (p=0.04). Conclusions: High levels of follicular testosterone were correlated with a fewer number of punctured complexes, mature oocytes and D quality embryos. Good oocyte quality was associated with higher follicular progesterone levels.
Asunto(s)
Humanos , Adulto , Femenino , Hormonas Esteroides Gonadales/análisis , Líquido Folicular/química , Inducción de la Ovulación , Andrógenos/análisis , Estradiol/análisis , Folículo Ovárico , Estudios Prospectivos , Progesterona/análisisRESUMEN
El síndrome de poliquistosis ovárica (PCOS) es un desorden endocrino-metabólico de naturaleza multifactorial, con una marcada predisposición genética, que afecta al 6% de las mujeres en edad reproductiva. Se caracteriza por la presencia de hiperandrogenismo, oligo-anovulación y ovarios poliquísticos. Entre los genes candidatos se encuentran aquellos que codifican para enzimas que actúan en la síntesis de andrógenos. Dos de los genes candidatos son el CYP17 y el CYP11alfa que codifican para la 17alfa hidroxilasa (P45017alfa) y para el P450scc (colesterol side chain cleavage) respectivamente. Los polimorfismos en estos genes están asociados al desarrollo del fenotipo hiperandrogénico. Nuestro objetivo fue analizar las frecuencias alélicas de los polimorfismos de los dos genes mencionados en población con PCOS, compararla con población normal y analizar la relación de cada variante alélica con el fenotipo hiperandrogénico correspondiente. Se analizaron 65 pacientes y 58 controles sanos en los que se determinaron niveles de testosterona y frecuencia de polimorfismos en los genes mencionados. Se observó una diferencia estadísticamente significativa cuando se asoció el grupo de mayor nivel de androgenemia con la presencia del genotipo A2/A2 del gen CYP17, y se hallaron mayores niveles de andrógenos circulantes en las pacientes con PCOS portadoras del alelo 216- del gen CYP11alfa. Nuestros resultados sugieren que ambos alelos juegan un rol menor en el desarrollo de PCOS y podrían ser considerados como potenciales marcadores de riesgo genético para el desarrollo del fenotipo hiperandrogénico.
The polycystic ovary syndrome (PCOS) is a heterogeneous multifactorial endocrine metabolic disorder with genetic predisposition affecting 6% of women in the reproductive age. This syndrome is characterized by the presence of oligo-anovulation, hyperandrogenism and polycystic ovaries. Several genes have been postulated as responsible for the etiology of this disorder. Among these genes are those encoding the enzymes involved in the ovarian androgen biosynthesis. Two of the candidate genes are the CYP17 and the CYP11alpha, encoding the 17-alpha-hydroxylase (P45017alpha) and the cholesterol side chain cleavage (P450scc) respectively. The polymorphisms of these genes are linked to the development of an hyperandrogenic phenotype. The aim of this work was to analyze the allelic frequencies of such polymorphisms in a cohort of women with PCOS and to compare them with those of healthy women. Furthermore, the correlation between each allelic variant and the corresponding hyperandrogenic phenotype was also assessed. Therefore, 65 patients and 58 age matched healthy controls were analyzed. The serum levels of testosterone and the frequency of each polymorphism were determined. When the PCOS population was analyzed, a significant statistical difference was found when relating the group with the highest androgenemia level with the presence of A2/A2 genotype of CYP 17 gene, and a higher level of circulating androgen was found in PCO women carrying the 216- allele of CYP11alpha gene (that did not reach statistical significance). Our results suggest that both alleles play a minor role in the development of PCOS and could be a genetic risk marker of the hyperandrogenic phenotype.
Asunto(s)
Femenino , Humanos , Enzima de Desdoblamiento de la Cadena Lateral del Colesterol/genética , Hiperandrogenismo/genética , Síndrome del Ovario Poliquístico/genética , Polimorfismo Genético/genética , /genética , Andrógenos/análisis , Andrógenos/farmacocinética , Disponibilidad Biológica , Estudios de Casos y Controles , Marcadores Genéticos/genética , Reacción en Cadena de la Polimerasa , Polimorfismo de Longitud del Fragmento de Restricción , Testosterona/análisis , Testosterona/farmacocinéticaRESUMEN
In captive common marmoset groups, the reproductive inhibition observed in subordinate female seems to be a result of olfactory, visual and behavioral cues from the dominant female. However, few studies have examined the relationship among adult males living in the same social group. These studies have shown that reproductive failure among peer males seems to be based on hormonal and behavioral mechanisms. New insights on sexual strategies in primates have been shown using fecal steroids, but so far no information is available for common marmoset males. In the present study, we evaluated the influence of light-dark cycle, age and reproductive condition on the profile of fecal androgens in males living in the same family group. Feces were collected from six fathers and six sons for androgen determination during the light phase of the 24-h cycle for eight days randomly distributed over a 4-week period. Androgen levels were determined by enzyme immunoassay technique. Adult sons showed higher androgen levels (166.97 ± 22.95 ng/g) than fathers (80.69 ± 44.38 ng/g) and juveniles (49.06 ± 23.15 ng/g; P < 0.05). No diurnal variation (P > 0.05) in fecal androgen profile was observed in adults or juveniles. No indication of androgen-mediated social competition between fathers and adult sons was demonstrable. These results provide basic information on fecal androgen profile useful to investigate the socioendocrinology of free-ranging common marmoset males and verify that, in contrast to daughters, the reproductive suppression of sons is not based on physiological inhibition of their gonads.
Asunto(s)
Animales , Masculino , Femenino , Embarazo , Andrógenos/análisis , Ritmo Circadiano , Callithrix/fisiología , Heces/química , Conducta Sexual Animal , Conducta Social , Técnicas para Inmunoenzimas , Reproducción/fisiologíaRESUMEN
Nonclassical adrenal hyperplasia (NC-CAH) is caused by a deficiency in the activity of the 21-hydroxylase enzyme and is the most common autosomal recessive disorder. The clinical features of the disease sre highly variable, and therefore the diagnosis may be overseen. The disorder is characterized by hyperandrogenism of adrenal origin that may become evident during childhood, adolescence or adulthood. The symptoms vary from premature pubarche, mestrual disturbances, hirsutism and virilization to those cases without any clinical evidence of the disease, as described in the cryptic form. The diagnostic approach includes an initial measurement of plasmatic 17OH-progesterone (17OHP) and androgen levels, and an ACTH test in those with elevated baseline 17OHP. The definitive diagnosis of this entity is performed with the documentation of abnormalities in both alleles of the CYP21A2 gene. This paper reviews the clinical, molecular and treatment of patients with NC-CAH.
Asunto(s)
Humanos , Masculino , Femenino , Hiperplasia Suprarrenal Congénita/diagnóstico , Hiperplasia Suprarrenal Congénita/genética , /análisis , Andrógenos/análisis , /genética , Pruebas Genéticas , Genotipo , Hiperandrogenismo , Hiperplasia Suprarrenal Congénita/terapia , Hormona Adrenocorticotrópica , Infertilidad , Mutación , Pubertad PrecozRESUMEN
El presente estudio explora la relación entre los niveles de andrógenos, el estilo educativo parental y medidas de agresión física, verbal e indirecta en niños y niñas de 5-6 años. 129 niños (60 chicos y 69 chicas) fueron evaluados respecto a sus niveles de agresión a través de una técnica de estimación por pares. Los padres cumplimentaron el Parenting Styles Dimensions Questionnaire, a partir del cual se obtuvieron los estilos educativos parentales. Los niveles de testosterona, androstenediona y dehidroepiandrosterona (DHEA) fueron evaluados utilizando una técnica de enzimoinmunoensayo en muestras de saliva. Un análisis de regresión indicó que la interacción madre directiva-androstenediona a los 5 años fue predictiva de la agresión física a los 6 años. De forma específica, se observó que en los chicos con altos niveles de androstenediona, la conducta maternal directiva se asoció con la agresión física. Se discuten los resultados a la luz de planteamientos relacionados con la educación y la crianza característicos de la psicología del desarrollo, y se sugiere una posible relación de los resultados con la hipótesis de la dominancia maternal (AU)
This study explores the relationship between androgen levels, parenting styles, and physical, verbal, and indirect aggression measures in 5-6-year-old children. 129 children (60 boys and 69 girls) were assessed in relation to their aggression levels using a peer-rating technique. Parents completed the Parenting Styles and Dimensions Questionnaire, from which the different parenting styles were obtained. Testosterone, androstenedione and dehydroepiandrosterone (DHEA) were measured using an enzymoimmunoassay technique in saliva samples. A regression analysis indicated that the directive mother-androstenedione interaction at the age of 5 was predictive of physical aggression at the age of 6. In specific terms, the results showed that, in boys with high androstenedione levels, directive maternal behavior is associated with physical aggression. The results are subsequently discussed in light of postulates related to parenting characteristic of developmental psychology and we suggest a potential link of our results with the hypothesis of maternal dominance (AU)
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Andrógenos/análisis , Agresión/psicología , Violencia/psicología , Crianza del Niño/psicología , Educación no Profesional/tendencias , Relaciones Madre-Hijo/psicología , Hormonas Gonadales/análisisRESUMEN
In the present study we determined the efficacy of the measurement of fecal cortisol and androgen metabolite concentrations to monitor adrenal and testicular activity in the jaguar (Panthera onca). Three captive male jaguars were chemically restrained and electroejaculated once or twice within a period of two months. Fecal samples were collected daily for 5 days before and 5 days after the procedure and stored at -20ºC until extraction. Variations in the concentrations of cortisol and androgen metabolites before and after the procedure were determined by solid phase cortisol and testosterone radioimmunoassay and feces dry weight was determined by drying at 37ºC for 24 h under vacuum. On four occasions, fecal cortisol metabolite levels were elevated above baseline (307.8 ± 17.5 ng/g dry feces) in the first fecal sample collected after the procedure (100 to 350 percent above baseline). On one occasion, we did not detect any variation. Mean (± SEM) fecal androgen concentration did not change after chemical restraint and electroejaculation (before: 131.1 ± 26.7, after: 213.7 ± 43.6 ng/g dry feces). These data show that determination of fecal cortisol and androgen metabolites can be very useful for a noninvasive assessment of animal well-being and as a complement to behavioral, physiological, and pathological studies. It can also be useful for the study of the relationship between adrenal activity and reproductive performance in the jaguar.
Asunto(s)
Animales , Masculino , Corteza Suprarrenal/fisiología , Andrógenos/análisis , Carnívoros/metabolismo , Heces/química , Hidrocortisona/análisis , Estrés Fisiológico , Pruebas de Función de la Corteza Suprarrenal/métodos , Pruebas de Función de la Corteza Suprarrenal/veterinaria , Carnívoros/fisiología , Eyaculación/fisiología , Reproducibilidad de los Resultados , Estrés Fisiológico , Factores de TiempoRESUMEN
Introducción. Los apéndices o hidátides del testículo son estructuras que se consideran restos embrionarios. En la hidátide testicular se han demostrado receptores estrogénicos pero en la epididimaria los resultados varían. Se ha teorizado que la elevación de los niveles de estrógenos en la pubertad puede producir una inflamación y torsión de la hidátide, sin embargo, en las epididimarias en las que no está clara la expresión de estrógenos (y también se torsionan) la teoría se pone en duda. Esta controversia nos lleva a la realización de este trabajo. Material y método. Se realiza un estudio prospectivo en 20 apéndices testiculares, de los cuales 7 son epididimarios extirpados de pacientes a los que se realiza una exploración escrotal en el desarrollo de cirugía de procesos del canal inguino-escrotal (hidroceles, criptorquídias).Se analizan mediante microscopía óptica y estudio inmunohistoquímico empleando anticuerpos monoclonales prediluidos, para receptores de estrógenos, androgenos e indice proliferativo. Los resultados fueron procesados y analizados mediante el programa estadístico SPSS. Resultados. Todas la hidátides, testiculares y epididimarias expresaron receptores para estrógenos sin diferencia significativa entre ellas, no existiendo diferencia en cuanto a la localización de dichos receptores dentro de los tres compartimentos de la hidátide. El número de receptores de estrógenos estaba en relación con la edad del paciente. Sólo las hidátides epididimarias expresaron receptores de andrógenos y localizados fundamentalmente a nivel de los ductus. No hemos encontrado relación significativa entre el índice proliferativo y la expresión de receptores de estrógenos. El índice proliferativo fue más elevado a nivel delos ductus. Conclusiones. 1) Tanto los apéndices testiculares como epididimarios expresaron receptores de estrógenos a nivel de los tres compartimentos. Ello hace pensar en un mismo origen embrionario, si bien sólo los epididimarios expresaron receptores de andrógenos. 2) La observación de receptores de estrógenos en ambos tipos de hidátides, así como la relación del número de los mismos con la edad del paciente, hace pensar que el aumento de estrógenos en la pubertad puede participar en la patogenia de la torsión de estos apéndices (AU)
Introduction. The appendices or hidátides of the testicle are structures that are considered an embryonic rest. In testicular hidátide estrogen receivers have been demonstrated but in the epididimys the results vary. Has been theorized that the elevation of the estrogen levels in the puberty can produce an inflammation and torsion of hidátide, nevertheless, in the epididimys in which the estrogen expression is not clear (and also they are twisted) the theory is put in doubt. This controversy takes us to the accomplishment of this work. Material and method. A prospective study is made in 20 testicular appendices, of which 7 from the epididimys are extirpated of patients to whom an escrotal exploration is made in the development of surgery of processes of the inguino-escrotal channel (hidroceles, hernias). Opticalmicroscopy and inmunohistoquímical study are analyzed by means of using prediluted monoclonales antibodies, for receivers of estrogens, androgens and proliferative index. The results were proceed and analyzed by means of SPSS statistical program. Results. All hidátides, testicular and from the epididimarys expressed receivers for estrogens without significant difference among them, not existing differences as far as the location of receiving sayings within the three compartments of hidátide. The number of estrogen receivers was in relation to the age of the patient. Only hidátides from the epididimys fundamentally expressed receivers of located androgens and at level of ductus. We have not found significant relation between the proliferative index and the expression of estrogen receivers. The proliferative index was more elevated at level of ductus. Conclusions. 1) As much the testicular appendices as those from the epididimays expressed receivers of estrogens at level of the three compartments. It makes think about a same embryonic origin, although only the epididimal ones expressed androgen receivers. 2) the observation of estrogen receivers in both types of hidátides, as well as the relation of the number of such with the age of the patient, makes think that the increase of estrogens in the puberty can participate in patogénia of the torsion of these appendices (AU)
Asunto(s)
Humanos , Masculino , Niño , Escroto/fisiopatología , Inflamación/etiología , Testículo/patología , Estrógenos/análisis , Andrógenos/análisis , Andrógenos , Torsión del Cordón Espermático/complicaciones , Torsión del Cordón Espermático/diagnóstico , Torsión del Cordón Espermático/fisiopatología , Inmunohistoquímica/métodos , Testículo/anomalías , Torsión del Cordón Espermático/etiología , Estudios Prospectivos , MicroscopíaRESUMEN
El ovario es un órgano con capacidad germinal y endocrina, que sintetiza estrógenos, progesterona, andrógenos, factores locales de crecimiento, inhibinas, activina y folistatina. En este artículo se revisa: 1. La fisiología del eje hipófiso-gonadal y las diferentes técnicas de laboratorio utilizadas en la determinación de los parámetros informativos de la función germinal y endocrina, así como sus aplicaciones clínicas en entidades como la pubertad precoz y retrasada, los trastornos de la ovulación, el hiperandrogenismo ovárico y los trastornos gonadales secundarios a trastornos inmunológicos, radioterapia y quimioterapia. 2. Las pruebas de estimulación y supresión utilizadas en el diagnóstico diferencial de los trastornos puberales y del hiperandrogenismo ovárico. 3. La utilidad del cariotipo en la caracterización de los trastornos gonadales, específicamente el síndrome de Turner y el fallo ovárico precoz (AU)
The ovary has both endocrine and reproductive functions and synthesizes estrogens, progesterone, androgens, growth factors, inhibins, activins and follistatin. The present article reviews the following: 1. The physiology of the pituitary-gonadal axis and the laboratory techniques used to assess both reproductive and endocrine functions, as well as their clinical application, specifically in precocious and delayed puberty, ovulatory dysfunction, ovarian hyperandrogenism, and gonadal abnormalities due to autoimmune diseases, chemotherapy and radiotherapy. 2. The stimulation and suppression tests used in the differential diagnosis of pubertal disorders and ovarian hyperandrogenism. 3. The usefulness of karyotype in the characterization of gonadal disorders, specifically Turner's syndrome and premature ovarian failure (AU)
Asunto(s)
Femenino , Humanos , Trastornos Gonadales/diagnóstico , Trastornos Gonadales/genética , Ovario/fisiología , Ovario , Estrógenos/análisis , Andrógenos/análisis , Inhibinas/análisis , Cariotipificación , Globulina de Unión a Hormona Sexual/análisis , Inducción de la Ovulación/métodos , BiomarcadoresRESUMEN
This study was conducted to investigate if the injection of a single dose of dexamethasonemay cause disruption of adult female rat gonadal function in terms ofplasma and ovarian level of both androgen and estrogen, ovarian morphology, andchanges in localization of androgen, estrogen and glucocorticoid receptors. Adultfemale Long Evans rats (n=50, 250-300 g) were used. At day 0 rats received subcutaneously1 ml of saline (n=25; control group) or dexamethasone at 0.1 mg/kg (n=25,treated group). Rats were sacrificed in groups of five on days 10, 15, 20, 25 and 30after injection. Blood samples and one ovary were collected to analyze dexamethasone,17â-estradiol (E2), testosterone (T) and androstenedione (A4) concentrationsby amplified EIA. The remaining ovary was removed and processed for histopathologyand immunocytochemistry. Differences between individual means were analyzedby Pairwise t-test and Bonferroni post test to asses whether values presentedstatistical significance. Increased E2, T and A4 levels were observed both in plasmaand ovary samples in treated group when comparing with control (p< 0.01) at alldays post-injection even when dexamethasone was undetectable. Ovarian morphologyof treated group showed features compatible with female infertility. Inmmunolocalizationof androgen and estrogen receptors showed that both were negativein treated group while controls showed highest positivity (AR +++, ER ++).Glucocorticoid receptor showed higher positivity in dexamethasone treated rats(GR ++) than in controls (GR +). Obtained results showed clear evidence that a singledose of dexamethasone may disrupt gonadal function in rats, and that possiblyleads to infertility (AU)
No disponible
Asunto(s)
Femenino , Ratas , Animales , Dexametasona/farmacocinética , Ovario , Infertilidad Femenina/fisiopatología , Andrógenos/análisis , Estrógenos/análisis , Glucocorticoides/análisis , Ratas Long-Evans/fisiologíaRESUMEN
De acuerdo a nuestra experiencia, que incluye la realización de 115 pruebas dinámicas de supresión/estimulación en 10 mujeres normales controles y 105 pacientes clínicamente hiperandrogénicas, dicha prueba resulta idónea y útil para la investigación clínica, el díagnóstico y la orientación terapéutica en los hiperandrogenismos femeninos siempre que en su realización se respeten determinadas pautas: efectuarla en la segunda mitad del ciclo, con una supresión propiamente dicha de por lo menos ocho días de duración y lograda con 3mg díarios de dxm, para agregarle al cabo de ese lapso la estimulación ovárica simultánea con 5000 UI de HCG por día durante tres días consecutivos. Los dosajes esteroideos basales y dinámicos se harán en orina y plasma. En base a los resultados obtenidos se calcularán las contribuciones sectoriales, cuyo análisis e interpretación se harán medíante las Tablas confeccionadas con los datos obtenidos por el monitoreo dinámico de los controles normales