Hormônio Anti-Mülleriano: importância na prática pediátrica

Intrauterine sexual differentiation: biosyntesis and action of sexual steroid hormones

“…From that point, the dorsal and ventral pyramidal epithelium penetrates the germinal plate forming a genital ridge (Domenice et al 2002;Moore and Persaud 2008;Blaschko et al 2012). The tubular system of genital organs originates from the tubules and ducts of pro and mesonephros (Wolff); the efferent duct of the testicles are formed from the tubules of mesonephros; the epididymis, vas deferens, vesicular glands and their ampoules are composed from the structures of mesonephros (Okay 2003). Some Wolff tubules that are separated from the ducts of mesonephros persist as vestiges along the epididymis and spermatic cord constituting the paradidymis, which are commonly found in the males of some species of mammals (Grunert et al 2005;Moore and Persaud 2008).…”

“…This process is due to the presence of the Y chromosome containing SRY gene, responsible for the testicular cell line support, resulting in the differentiation of precursor Sertoli cells and secretion of antiMüllerian hormone (Rey 2005;Blaschko et al 2012), which induces regression of Müllerian duct. This hormone continues to be produced until puberty, and then decreases until reaching residual values (Okay 2003). The cell line of testicular interstice differentiates into Leydig cells, which produce testosterone, promoting the development of Wolff ducts and their subsequent derivative organs (Vainio et al 1999;Domenice et al 2002;Arnold 2009;Blaschko et al 2012).…”

“…Both Wolff and Müller ducts are present in sexually undifferentiated embryo (Okay 2003). In the females, the Müllerian ducts develop into a duct-gonadal system and the Wolff ducts atrophy and in the males, the reverse occurs (Moore and Persaud 2008;Sadler 2012).…”

“…However, the anti-Müllerian hormone begins to be produced in small amounts in ovarian granulosa cells from the birth until menopause. In women, this hormone is related to the activity of the aromatase enzyme (Okay 2003). In females, the development has been traditionally considered as a state that results primarily in the absence of testicular determining factor (SRY).The consequent absence of antiMullerian hormone and testosterone synthesis in the intrauterine period, results in the development of female gonads, steroidogenesis and maintenance of oocytes (Nef and Parada 2000;Domenice et al 2002;Arnold 2009).…”

“…Several studies have shown that some sexual differences are not explained by these sexual hormone effects, but induced by the effect of encoded-genes on the sexual chromosomes (Arnold 2009). Thus, great importance must be given to sexual differentiation processes during embryonic and fetal period and its relationship to various diseases, which are generally related to genic mutations (Blaschko et al 2012;Bondesson et al 2014;Tannour-Louet et al 2014), especially those related to the biosynthesis of sexual steroid hormones associated with steroidogenic enzymes (Gaucher et al 2004;Miller 2012) or antiMüllerian hormone (Nef and Parada 2000;Okay 2003). In addition to the pathologies of sexual differentiation, importance has also been given to interspecific dimorphism during ontogeny in experimental models used for studies on sexual differentiation (Conley et al 2006;Yang et al 2010;Blaschko et al 2012;Santos et al 2014aSantos et al , 2015.…”