The enzyme 5 alpha-reductase (5 alpha R), by virtue of its peripheral 5 alpha-reduction of testosterone (T) to dihydrotestosterone (DHT), is believed to play a major role in the differentiation and the subsequent growth of the penis. However, recent studies have reported 5 alpha R deficiency (5 alpha RD) in patients with isolated micropenis and hypothesized that 5 alpha RD is not invariably associated with genital ambiguity. In Egypt, 5 alpha RD has been reported frequently among intersex patients. The aim of this study was to assess the role of 5 alpha RD in the development of micropenis among Egyptian patients with abnormal sexual development. The study included 29 patients who were categorized into three groups (isolated micropenis, 9 patients; microphallus with genital ambiguity, 11 patients; genital ambiguity with normal-sized phallus, 9 patients). Activity of 5 alpha R was assessed by estimating T/DHT ratios in the basal state in pubertal subjects and following human chorionic gonadotropin (HCG) stimulation test in prepubertals. The results showed that the incidence of 5 alpha RD was much higher in cases of ambiguous genitalia with micropenis (5 families out of 10, 50%) than in those with isolated microphallus (1/9, 11.1%) or those with ambiguous genitalia and normal-sized phallus (1/8, 12.5%). In conclusion, the study showed that isolated micropenis is a heterogeneous disorder and that 5 alpha RD, despite its relative prevalence in Egypt, has a minimal role in the aetiology. On the other hand, 5 alpha RD seems to correlate with penile length in intersex cases.
The effect of various ergot alkaloids on prolactin (Pr) secretion in adult female rats was determined by radioimmunoassay. Ergocornine (ECO) and ergocristine (ECR) in doses of 0.25 to 1.0 mg lowered serum Pr markedly by 1 h with the effect persisting for 24 h at the larger doses. Several other ergots had similar effects while the dihydro derivatives had diverse responses. The pro-oestrous surge of Pr could be blocked by ECR or ECO without interfering with the oestrous cycle. ECO or ECR could suppress the rise in serum Pr induced by oestradiol benzoate (OeB) (5–50 μg) in oophorectomized rats. Perphenazine (PE) stimulation of Pr could be partially antagonized by ECO depending on dose and timing of injections. ECO 2 mg produced an abrupt cessation of lactation with concomitant fall in serum Pr, and ovine prolactin restored this function. Evaluation of pituitary Pr concentration in lactating and intact rats receiving ECO leads to the conclusion that release of Pr from the pituitary is affected. ECO 1 or 2 mg produced a regression of dimethylbenz(a)anthracene (DMBA) induced rat mammary tumours which could not be reversed by OeB 5 μg, with persisting low serum Pr. PE 1 mg was able to raise serum Pr and stimulated tumour growth. Several of the ergot alkaloids have a profound inhibiting effect on Pr secretion and may be used for studies on Pr action, as well as in medical therapeutics.
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