Luteinizing hormone regulation by sex steroids in men with germinal and Leydig cell tumours

Reznik, Yves; Rieu, M; Jm, Kuhn; Jc, Mandard; Bottet, P.; Lemonnier, Daniel; Bekka, S.; Mahoudeau, J

doi:10.1111/j.1365-2265.1993.tb00344.x

Cited by 24 publications

(14 citation statements)

References 25 publications

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“…They are consistent with data already obtained in men (Bagatell et al, 1994;Kuhn et al, 1994). It was previously suggested that androgens and oestrogens could act synergistically on gonadotrophin secretion (Handa et al, 1987;Roselli, 1991) and that the inhibitory effects of both steroids are required to obtain a complete suppression of gonadotrophin release in mammals or in man (Korach & Muldoon, 1974;Sawin et al, 1978;Winters et al, 1979;Spijkstra et al, 1988;Reznik et al, 1993). Thus, it might be hypothesized that the absence of suppressive effect of DHT upon GnRH-stimulated LH secretion could be because of the lack of sufficient amounts of endogenous E2.…”

Section: Discussionsupporting

confidence: 91%

Impact level of dihydrotestosterone on the hypothalamic‐pituitary‐leydig cell axis in men

et al. 2009

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Dihydrotestosterone (DHT) the physiologically most potent androgen cannot be aromatised into oestrogen. DHT is used as a treatment for idiopathic gynaecomastia. In order to investigate the different sites of action of DHT on the hypothalamic-pituitary-testicular axis, two groups of adult men were studied. Group I included 10 gonadotropin-releasing hormone (GnRH)-deficient men who were evaluated before and during a pulsatile infusion of GnRH alone for 2 weeks and then in association with DHT given transdermally at doses used in the treatment of gynaecomastia for further two weeks. Luteinizing hormone (LH) pulsatility was assessed at the end of each step of the study. Plasma LH levels were measured every 15 min. Plasma testosterone (T), DHT, oestradiol (E2), free alpha-subunit (FAS) of glycoproteic hormones and LH bioactivity were measured on pooled plasma samples. Group II included 12 healthy men in whom plasma T, DHT and E2 were measured before and then 24, 48 and 72 h after the injection of 5000 IU hCG alone or in combination with either DHT or the pure anti-androgen nilutamide. Two weeks separated each of the 3 hCG testing. In group I, except for bioactive/immunoreactive (B/I) LH ratio which was unchanged, GnRH treatment induced significant rises (p < 0.01) in all plasma hormone levels, LH pulse amplitude and frequency. During treatment with GnRH+DHT, plasma DHT levels increased up to 16.8 +/- 2.5 nm, while plasma hormone levels, B/I LH ratio, LH pulse amplitude and frequency were similar to those obtained with GnRH alone. In group II, the peak of hCG-induced T rise was not modified by either DHT or nilutamide. In contrast, DHT reduced by 50% (p < 0.01) the E2 peak in response to hCG. These data show that DHT exerts no direct action on the pituitary to retroregulate LH secretion and to modify either B/I LH ratio or FAS secretion. Its reducing effect on LH secretion is likely mediated at the hypothalamic level. DHT does not appear to have a physiological influence on Leydig cells steroidogenesis. Administered at therapeutic doses, DHT directly reduces testicular aromatase activity that combined with its antigonadotropic effect leads to the gain in the symptomatic treatment of gynaecomastia.

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Section: Discussionsupporting

confidence: 91%

Impact level of dihydrotestosterone on the hypothalamic‐pituitary‐leydig cell axis in men

et al. 2009

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“…Both androgens and oestrogens can act at the pituitary level. As suggested previously in hCG-secreting tumours, it is possible that, at a plasma E2 level similar to that observed in LCT, only a combined oversecretion of both testosterone and E2 can lead to complete suppression of gonadotrophin secretion (34). The frequency of spontaneous LH pulses reflects endogenous GnRH secretion (28,35,36).…”

Section: Discussionmentioning

confidence: 51%

“…Group I included 42 male partners (aged [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] years) of infertile couples. They were taking no medication and did not have any history of disease.…”

Section: Subjects Studiedmentioning

confidence: 99%

Evidence of oestradiol-induced changes in gonadotrophin secretion in men with feminizing Leydig cell tumours

Kuhn

Duranteau²,

Rieu³

et al. 1994

European Journal of Endocrinology

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To study the sex steroid-gonadotrophin relationship, plasma oestradiol (E2), testosterone and gonadotrophin-releasing hormone (GnRH)-induced (100 micrograms iv) gonadotrophin response were measured in 42 male partners of infertile couples with normal sperm count (group I) and in 21 men with Leydig cell tumour (LCT, group II) in which a basal evaluation was repeated after tumour removal. Plasma free alpha-subunit (FAS), immunoreactive alpha-inhibin and luteinizing hormone (LH) pulse analysis were assessed in 10 LCT before and in six of them after surgery. Testosterone was significantly (p < 0.01) lower whereas E2 was significantly (p < 0.001) higher in group II than in group I. Gonadotrophin data were similar in both groups. The mean FAS was higher in group II than in group I and alpha-inhibin was higher than the normal range in 6/10 LCT. In group II, E2 levels were significantly (p < 0.01) and negatively correlated with testosterone, FSH, GnRH-induced gonadotrophin rise and LH pulse amplitude but not frequency. Significant (p < 0.001) changes were observed after surgery: E2 and alpha-inhibin fell; testosterone, LH and FSH rose; whereas FAS did not change significantly. The LH pulse amplitude but not frequency increased significantly (p < 0.05). In conclusion E2 oversecreted by LCT decreased LH and testosterone levels concomitantly. The GnRH-induced gonadotrophin level rose and the LH pulse amplitude decreased when the plasma E2 level rose, whereas the pulse frequency remained unaffected. A concomitant increase in alpha-inhibin and E2 is likely to be responsible for the drop in plasma FSH levels. These data support an action of excessive amounts of E2 at pituitary level, perhaps by decreasing the sensitivity of gonadotrophs to GnRH.

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“…There have been reported cases of Leydig cell tumor which demonstrated only an increase of serum E2 and suppression of serum testosterone as a consequence of increased aromatase activity in tumoral Leydig cells [33]. The direct inhibitory action of elevated E2 on the enzymes involved in steroidogenesis and the negative feedback action on luteinizing hormone secretion of the E2 possibly caused the suppression of serum testosterone [34]. Due to the significant increase in weight of the patient, in our case hormonal changes were rather considered a consequence of aromatization in adipose tissue of testosterone to estradiol and gynecomastia as a consequence of increased levels of estradiol and change of estrogen/androgen ratio.…”

Section: Discussionmentioning

confidence: 99%

Leydig cell tumors of the testis: a case report

Gheorghisan-Galateanu

2014

BMC Res Notes

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BackgroundLeydig cell tumors are the most common non-germ cell gonadal tumors with apparent increased incidence in the last few years. They are usually benign tumors. We report a case of Leydig cell tumor of testis in a patient presenting atypical features.Case presentationA 29-year-old Caucasian man, born with right cryptorchidism, corrected without medical treatment before the age of two years, was diagnosed with Leydig cell tumor. Two years after diagnosis was identified moderately elevated estradiol serum level, in the context of a significant overweight, hormonal changes which had maintained after unilateral orchiectomy and after the patient's return to normal weight. Four years after unilateral orchiectomy, elevated value of estradiol persisted and subdiaphragmatic micro lymphadenopathy was observed.ConclusionsDespite the favorable evolution of the patient four years after unilateral orchiectomy, long-term follow-up is necessary to exclude recurrence or metastasis to the testis. The endocrine profile and imaging investigations need to be repeated periodically. The changes in the hormonal assay and any new aspects on computed tomography scan can be used as a marker of tumor recurrence and require careful screening and the correct therapeutic decisions.

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Luteinizing hormone regulation by sex steroids in men with germinal and Leydig cell tumours

Cited by 24 publications

References 25 publications

Impact level of dihydrotestosterone on the hypothalamic‐pituitary‐leydig cell axis in men

Impact level of dihydrotestosterone on the hypothalamic‐pituitary‐leydig cell axis in men

Evidence of oestradiol-induced changes in gonadotrophin secretion in men with feminizing Leydig cell tumours

Leydig cell tumors of the testis: a case report

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