腮腺炎性睾丸炎患者的激素改变
作者：1P. Tzvetkova, 2D. Tzvetkov, 2M. Georgiev, 3朱 伟杰, 4L. Imchinetskaja
单位：
关键词：激素类；血浆；睾丸炎；流行性腮腺炎
中国病理生理杂志/990701Hormonal changes in patients with mumps orchitis
1P. Tzvetkova, 2D. Tzvetkov, 2M. Georgiev, 3Zhu Wei- Jie, 4L. Imchinetskaja
1 Institute of Biology and Immunology of Reproduction, Bulgarian Academy of Science, Sofia, Bulgaria
, http://www.100md.com
2 Andrological Clinic, Medical University, Sofia, Bulgaria
3 Center for Reproductive Immunology Research, Jinan University, Guangzhou (5 10632), China
4 Department of Sexopathology, Institute of Urology and Nephrology, Kiev, Ukr aine
Abstract AIM：To investigate changes in levels of the m ajor hormones regulating the process of reproduction in patients with mumps orch itis. METHODS: Twenty-two patients were divided into three groups according to the age when the patients were infected with mumps orchitis as a co mplication of parotitis epidemica infection. Plasma LH, FSH, prolactin, estradio l and testosterone were examined by using radioimmunoassay. RESULTS: There were marked changes in synthesis and secretion of studied hormones in these three groups, especially in patients who were infecte d during puberty (group Ⅱ). Comparing with the control group, plasma LH, FSH, p ro lactin and estradiol level in group Ⅱ were significantly increased with 1.97, 2 .87, 1.81 and 1.98 fold, respectively. Testosterone was significantly decreased with 6.41 fold. CONCLUSION: There were disturbances of reproduct ive endocrine control in patients with mumps orchitis. Hormonal changes in the pati ents related to the age at which patients were infected.
, 百拇医药
MeSH Hormones; Plasma; Orchitis; Mumps
1 Institute of Biology and Immunology of Reproduction, Bulgrian Aca demy of Science, Sofia, Bulgaria; 2 Andrological Clinic, Medical University, Sofia, Bulgaria; 3 暨南大学生殖免疫研究中心(中国广州 510632); 4Department of Sexopathology, Institute of Urology and Nephrology, Kiev, Ukraine
摘 要 目的：检测不同年龄感染腮腺炎性睾丸炎患者 的激 素水平改变。方法： 应用放射免疫法测定3组患者的FSH、LH、催 乳素、雌二醇和睾酮水平。结果： 3组患者均存在不同程度的激 素 紊乱，尤其以青春期发生感染的组Ⅱ有显著激素水平改变。与对照组比较，组Ⅱ的FSH、L H、催乳素和雌二醇分别升高2.87、1.97、1.81和1.98倍，睾酮减少6.41倍。结论： 感染腮腺炎性睾丸炎患者的生殖激素有明显改变，且与感染时患者 的年龄有关。
, http://www.100md.com
INTRODUCTION
Testis has dual functions and its alterations explain the disturbance in both endocrine and exocrine activities. Combination of these altered functions m ay cause severe damage to male infertility. Changes in the main hormonal regulat o ry mechanism of sexual function, subordinated to partotitis epidemica, acting th roughout the endocrine axis of hypothalamus, pituitary and gonadal glands are ma jor ethiopathogenetic causes for occurrence of male infertility.
, 百拇医药
Unfortunately the available data are insufficient and inconclusive. The majo rity of authors are trying to explaining infertility as a result of mumps orchit is causing not only morphological but also hormonal changes. Previous reports de monstrated that patients with mumps orchitis decreased secretion of main androge n, testosterone (T) and increased levels of gonadotropins, follicle stimulating hormone (FSH)and luteinizing hormone (LH). On the other hand, considerable alter ation of fertility in patients with mumps orchitis closely related to the age a t which they suffered the disease[1～3].
, http://www.100md.com
The above mentioned facts made us conducting a study in which we investiga ted changes in levels of the major hormones regulating process of reproduction i n patients with mumps orchitis. We also tried to find out if there were correlat ion between these changes and the age at which patients had the infection.
MATERIALS AND METHODS
Patients: The clinical investigation involved a total of 22 patients who had been affected with mumps orchitis, at age from 16 to 45 years (mean age 28.6±1.6 years). Depending on the age when the patients were infected with mump s orchitis as a complication of parotitis epidemica infection, they were divided into three groups:
, http://www.100md.com
Group Ⅰ: patients who were ill with mumps orchitis below their 12 years of age (n=6).
Group Ⅱ: patients who were ill with mumps orchitis from 12 to 17 years of a ges (n=11).
Group Ⅲ: patients who were ill with mumps orchitis after 17 years of age ( n=5).
Ten healthy men (mean age 24.4±1.5 years) as a control group were used.
Assay:Plasma LH, FSH, Estradiol (E2), Prolactin (PRL)were t ested by a standard radioimmunoassay, and T concentration was measured using the radioimmunoassay method of Kanchev et al[4].
, http://www.100md.com
Statistic method:All data are presented as
±s. Di ffer ences between the treating group and the control group were analyzed statistical ly by student t-test.
RESULTS
The results for LH, FSH, E2，PRL and T levels from three patient groups a nd the control group are shown in Table 1. There were significant changes in syn thesis and secretion of studied hormones in these three groups compared with the ir levels in the control group. Group Ⅱ had the most influence among three grou ps. Comparing with hormone levels of the control group, plasma LH, FSH, PRL and E2 level in group Ⅱ were significantly increased with 1.97, 2.87, 1.81 and 1. 98 fold, respectively.
, 百拇医药
Synthesis and secretion of T were statistically decreased in three groups. T concentration among three groups, group Ⅱ had the lowest value, and was signif icantly decreased with 6.41 fold compared with the control group. T level in gro up Ⅰ was in the lower limit of physiological reference range (3.14±0.08) ng/mL .
Tab 1 Levels of LH, FSH, PRL, E2 and T in patients with m umps orchitis (±s) Group
, http://www.100md.com
LH
FSH
PRL
E2
T
(mIU/mL)
(mIU/mL)
(ng/mL)
(ng/mL)
(ng/mL)
Group Ⅰ(n=6)
8.76±0.33
, 百拇医药
6.83±0 .94
9.32±0.72
45.00±0.05
2.63±0.48
Group Ⅱ(n=11)
16.86
±2.12**
18.09±1.23**
15.40±2.12**
81.09±3.23**
, http://www.100md.com
0.49±0.25**
Group Ⅲ(n=5)
8.87±0.97
8.78±2.24
9.10±0.91
56.18±0.54**
2.07±0.04**
Control (n=10)
8.52±0.49
6.30±0.56
8.5±0.92
, 百拇医药
41.20±2.82
3.14 ±0.25
*P<0.05, **P<0.01, vs control group
DISCUSSION
The severity of morphological and functional damage of testicular tis sue closely relates to the age at which the patient suffered patotitis epidemica and strongly depends on localization of the inflammation[3，5～7]. O ur results demonstrated disturbance of endocrine control of reproduction in pati ents with mumps orchitis in different age groups. Among three patient group, we found out marked changes in synthesis and secretion of studied hormones especial ly in patients who were infected during their puberty. These patients had the lo west T concentration among three patient groups. The decreased T concentration r eflected the situation of damaged Leydig cell function, which would also relate to irreversible changes of testicular morphology and function and lead to male i nfertility[8～10].
, 百拇医药
What quite reasonable was the increased gonadotropine levels observed in gro up Ⅱ, 2.87 and 1.97 fold for FSH and LH, respectively. For PRL and E2 levels in group Ⅱ, there also was an increase with 1.81 and 1.98 fold, respectively. It is obvious that changes in secretion of these hormones are a consequence of t he disease which causes to a different extent alterations in testicular function . Previous work showed that the synthesis of PRL in different forms of hypogonad ism did not cause additional damage to testicular tubules. We don't have evidenc e whether elevated levels of PRL could produce direct action on semineferous epi thelium. It has been suggested that higher level of this hormone affects spermat ogenesis mainly by changing T secretion.
, 百拇医药
* Project supported by Grant L 714/1997 of Ministry of Science and Education, Bulgaria
REFERENCES
1 Stehun F. Mumps orchids-the reason of the male infertility. Uro Nephrol,1982,45:38.
2 Diehl K. Treatment results and andrological follow-up in orchids due t o mumps. Wien Klin Wochenchrift,1990,9:647.
3 Manson A. Mumps orchitis. Urology,1990,36:355.
, 百拇医药
4 Kanchev L, Dobson H, Ward R, et al. Concentration of steroids in bovi n e peripheral plasma during the estrous cycle and the effect of beta-methasone tr eatment. J Reprod Fertil,1976,43:341.
5 Mimra I, Farnil J. The epidemic process in infections before and afte r acute immunization. Cesk Epidemiol Microbiol Immunol,1993,42:3.
6 Berger R. Infection of the male reproductive tract. Curr Ther En docrinol Metab,1994,35:305.
, 百拇医药
7 Zimmermann H, Matter H, Kiener T. Mumps epidemiology. Soz Praventiv M ed,1995,40:80.
8 Diehl K, Hondl H. Mumps orchids-symptoms and treatment possibilities. J Urol Nephrol,1990,83:243.
9 Erpenbach K. Systemic treatment with interferon-alpha 28: an effectiv e method to prevent sterility after bilateral mumps orchitis. J Urol,1991,146:54 .
10 Preveden T, Jovanovic J, Ristic D, et al. Clinical features of mumps orchitis and its influence on male infertility. Arch Urol,1996,18:53.
(Received 1998-08-13,Accepted 1999-03-05), http://www.100md.com
单位：
关键词：激素类；血浆；睾丸炎；流行性腮腺炎
中国病理生理杂志/990701Hormonal changes in patients with mumps orchitis
1P. Tzvetkova, 2D. Tzvetkov, 2M. Georgiev, 3Zhu Wei- Jie, 4L. Imchinetskaja
1 Institute of Biology and Immunology of Reproduction, Bulgarian Academy of Science, Sofia, Bulgaria
, http://www.100md.com
2 Andrological Clinic, Medical University, Sofia, Bulgaria
3 Center for Reproductive Immunology Research, Jinan University, Guangzhou (5 10632), China
4 Department of Sexopathology, Institute of Urology and Nephrology, Kiev, Ukr aine
Abstract AIM：To investigate changes in levels of the m ajor hormones regulating the process of reproduction in patients with mumps orch itis. METHODS: Twenty-two patients were divided into three groups according to the age when the patients were infected with mumps orchitis as a co mplication of parotitis epidemica infection. Plasma LH, FSH, prolactin, estradio l and testosterone were examined by using radioimmunoassay. RESULTS: There were marked changes in synthesis and secretion of studied hormones in these three groups, especially in patients who were infecte d during puberty (group Ⅱ). Comparing with the control group, plasma LH, FSH, p ro lactin and estradiol level in group Ⅱ were significantly increased with 1.97, 2 .87, 1.81 and 1.98 fold, respectively. Testosterone was significantly decreased with 6.41 fold. CONCLUSION: There were disturbances of reproduct ive endocrine control in patients with mumps orchitis. Hormonal changes in the pati ents related to the age at which patients were infected.
, 百拇医药
MeSH Hormones; Plasma; Orchitis; Mumps
1 Institute of Biology and Immunology of Reproduction, Bulgrian Aca demy of Science, Sofia, Bulgaria; 2 Andrological Clinic, Medical University, Sofia, Bulgaria; 3 暨南大学生殖免疫研究中心(中国广州 510632); 4Department of Sexopathology, Institute of Urology and Nephrology, Kiev, Ukraine
摘 要 目的：检测不同年龄感染腮腺炎性睾丸炎患者 的激 素水平改变。方法： 应用放射免疫法测定3组患者的FSH、LH、催 乳素、雌二醇和睾酮水平。结果： 3组患者均存在不同程度的激 素 紊乱，尤其以青春期发生感染的组Ⅱ有显著激素水平改变。与对照组比较，组Ⅱ的FSH、L H、催乳素和雌二醇分别升高2.87、1.97、1.81和1.98倍，睾酮减少6.41倍。结论： 感染腮腺炎性睾丸炎患者的生殖激素有明显改变，且与感染时患者 的年龄有关。
, http://www.100md.com
INTRODUCTION
Testis has dual functions and its alterations explain the disturbance in both endocrine and exocrine activities. Combination of these altered functions m ay cause severe damage to male infertility. Changes in the main hormonal regulat o ry mechanism of sexual function, subordinated to partotitis epidemica, acting th roughout the endocrine axis of hypothalamus, pituitary and gonadal glands are ma jor ethiopathogenetic causes for occurrence of male infertility.
, 百拇医药
Unfortunately the available data are insufficient and inconclusive. The majo rity of authors are trying to explaining infertility as a result of mumps orchit is causing not only morphological but also hormonal changes. Previous reports de monstrated that patients with mumps orchitis decreased secretion of main androge n, testosterone (T) and increased levels of gonadotropins, follicle stimulating hormone (FSH)and luteinizing hormone (LH). On the other hand, considerable alter ation of fertility in patients with mumps orchitis closely related to the age a t which they suffered the disease[1～3].
, http://www.100md.com
The above mentioned facts made us conducting a study in which we investiga ted changes in levels of the major hormones regulating process of reproduction i n patients with mumps orchitis. We also tried to find out if there were correlat ion between these changes and the age at which patients had the infection.
MATERIALS AND METHODS
Patients: The clinical investigation involved a total of 22 patients who had been affected with mumps orchitis, at age from 16 to 45 years (mean age 28.6±1.6 years). Depending on the age when the patients were infected with mump s orchitis as a complication of parotitis epidemica infection, they were divided into three groups:
, http://www.100md.com
Group Ⅰ: patients who were ill with mumps orchitis below their 12 years of age (n=6).
Group Ⅱ: patients who were ill with mumps orchitis from 12 to 17 years of a ges (n=11).
Group Ⅲ: patients who were ill with mumps orchitis after 17 years of age ( n=5).
Ten healthy men (mean age 24.4±1.5 years) as a control group were used.
Assay:Plasma LH, FSH, Estradiol (E2), Prolactin (PRL)were t ested by a standard radioimmunoassay, and T concentration was measured using the radioimmunoassay method of Kanchev et al[4].
, http://www.100md.com
Statistic method:All data are presented as
±s. Di ffer ences between the treating group and the control group were analyzed statistical ly by student t-test.RESULTS
The results for LH, FSH, E2，PRL and T levels from three patient groups a nd the control group are shown in Table 1. There were significant changes in syn thesis and secretion of studied hormones in these three groups compared with the ir levels in the control group. Group Ⅱ had the most influence among three grou ps. Comparing with hormone levels of the control group, plasma LH, FSH, PRL and E2 level in group Ⅱ were significantly increased with 1.97, 2.87, 1.81 and 1. 98 fold, respectively.
, 百拇医药
Synthesis and secretion of T were statistically decreased in three groups. T concentration among three groups, group Ⅱ had the lowest value, and was signif icantly decreased with 6.41 fold compared with the control group. T level in gro up Ⅰ was in the lower limit of physiological reference range (3.14±0.08) ng/mL .
Tab 1 Levels of LH, FSH, PRL, E2 and T in patients with m umps orchitis (
±s) Group, http://www.100md.com
LH
FSH
PRL
E2
T
(mIU/mL)
(mIU/mL)
(ng/mL)
(ng/mL)
(ng/mL)
Group Ⅰ(n=6)
8.76±0.33
, 百拇医药
6.83±0 .94
9.32±0.72
45.00±0.05
2.63±0.48
Group Ⅱ(n=11)
16.86
±2.12**
18.09±1.23**
15.40±2.12**
81.09±3.23**
, http://www.100md.com
0.49±0.25**
Group Ⅲ(n=5)
8.87±0.97
8.78±2.24
9.10±0.91
56.18±0.54**
2.07±0.04**
Control (n=10)
8.52±0.49
6.30±0.56
8.5±0.92
, 百拇医药
41.20±2.82
3.14 ±0.25
*P<0.05, **P<0.01, vs control group
DISCUSSION
The severity of morphological and functional damage of testicular tis sue closely relates to the age at which the patient suffered patotitis epidemica and strongly depends on localization of the inflammation[3，5～7]. O ur results demonstrated disturbance of endocrine control of reproduction in pati ents with mumps orchitis in different age groups. Among three patient group, we found out marked changes in synthesis and secretion of studied hormones especial ly in patients who were infected during their puberty. These patients had the lo west T concentration among three patient groups. The decreased T concentration r eflected the situation of damaged Leydig cell function, which would also relate to irreversible changes of testicular morphology and function and lead to male i nfertility[8～10].
, 百拇医药
What quite reasonable was the increased gonadotropine levels observed in gro up Ⅱ, 2.87 and 1.97 fold for FSH and LH, respectively. For PRL and E2 levels in group Ⅱ, there also was an increase with 1.81 and 1.98 fold, respectively. It is obvious that changes in secretion of these hormones are a consequence of t he disease which causes to a different extent alterations in testicular function . Previous work showed that the synthesis of PRL in different forms of hypogonad ism did not cause additional damage to testicular tubules. We don't have evidenc e whether elevated levels of PRL could produce direct action on semineferous epi thelium. It has been suggested that higher level of this hormone affects spermat ogenesis mainly by changing T secretion.
, 百拇医药
* Project supported by Grant L 714/1997 of Ministry of Science and Education, Bulgaria
REFERENCES
1 Stehun F. Mumps orchids-the reason of the male infertility. Uro Nephrol,1982,45:38.
2 Diehl K. Treatment results and andrological follow-up in orchids due t o mumps. Wien Klin Wochenchrift,1990,9:647.
3 Manson A. Mumps orchitis. Urology,1990,36:355.
, 百拇医药
4 Kanchev L, Dobson H, Ward R, et al. Concentration of steroids in bovi n e peripheral plasma during the estrous cycle and the effect of beta-methasone tr eatment. J Reprod Fertil,1976,43:341.
5 Mimra I, Farnil J. The epidemic process in infections before and afte r acute immunization. Cesk Epidemiol Microbiol Immunol,1993,42:3.
6 Berger R. Infection of the male reproductive tract. Curr Ther En docrinol Metab,1994,35:305.
, 百拇医药
7 Zimmermann H, Matter H, Kiener T. Mumps epidemiology. Soz Praventiv M ed,1995,40:80.
8 Diehl K, Hondl H. Mumps orchids-symptoms and treatment possibilities. J Urol Nephrol,1990,83:243.
9 Erpenbach K. Systemic treatment with interferon-alpha 28: an effectiv e method to prevent sterility after bilateral mumps orchitis. J Urol,1991,146:54 .
10 Preveden T, Jovanovic J, Ristic D, et al. Clinical features of mumps orchitis and its influence on male infertility. Arch Urol,1996,18:53.
(Received 1998-08-13,Accepted 1999-03-05), http://www.100md.com