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Keywords = gonadal dysfunction

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22 pages, 1283 KB  
Article
Comparative Proteomic Analysis of Gonadal Tissue in Solea senegalensis Reveals Reproductive Deregulation Associated with F1 Individuals
by Marco Anaya-Romero, Alberto Arias-Pérez, María Esther Rodríguez, Manuel Alejandro Merlo, Silvia Portela-Bens, Ismael Cross and Laureana Rebordinos
Biomolecules 2026, 16(2), 312; https://doi.org/10.3390/biom16020312 - 16 Feb 2026
Abstract
Reproductive dysfunction in captive-bred Senegalese sole (Solea senegalensis) limits aquaculture production consolidation, particularly due to reduced fertility and poor sperm quality in F1 males. To elucidate the molecular mechanisms underlying this problem, a quantitative proteomic analysis was conducted using LC–MS/MS on [...] Read more.
Reproductive dysfunction in captive-bred Senegalese sole (Solea senegalensis) limits aquaculture production consolidation, particularly due to reduced fertility and poor sperm quality in F1 males. To elucidate the molecular mechanisms underlying this problem, a quantitative proteomic analysis was conducted using LC–MS/MS on gonadal tissues from wild and F1 males and females. A total of 2221 proteins were identified, of which 1797 were retained after quality filtering. Comparative analyses revealed clear segregation by origin (F1 [cultivated] and wild) and sex (male and female), and 86 proteins were differentially expressed between F1 and wild males. Functional enrichment showed significant downregulation of key reproductive processes in F1 males, including sperm–egg recognition, binding of sperm to zona pellucida, and acrosome reaction, suggesting impaired gamete interaction and fertilization ability. Conversely, F1 males displayed metabolic and proteolytic pathway enrichment, which is indicative of compensatory energy demands. Protein–protein interaction network analysis identified a reproductive subnetwork dominated by zona pellucida sperm-binding proteins, which exhibited reduced connectivity in F1 males. These results demonstrate a coordinated suppression of molecular components essential for sperm–egg communication and acrosomal exocytosis, providing proteomic evidence for the systemic deregulation of the reproductive machinery in F1 fish. This study identifies potential protein biomarkers linked to reproductive performance, offering molecular targets to improve broodstock management and fertilization success in S. senegalensis aquaculture. Full article
(This article belongs to the Special Issue Molecular Insights into Sex and Evolution)
19 pages, 7165 KB  
Article
A Pseudotumorous Syndrome Associated with an As-Yet-Unidentified Eukaryotic Parasite Causing Functional Gonadal Arrest in Largefin Longbarbel Catfish (Hemibagrus macropterus)
by Yang Feng, Senyue Liu, Hongyu Ke, Huadong Li, Han Zhao, Xinyan Dang, Chengyan Mou, Jian Zhou, Zhipeng Huang, Yongqiang Deng and Qiang Li
Microorganisms 2026, 14(2), 362; https://doi.org/10.3390/microorganisms14020362 - 3 Feb 2026
Viewed by 202
Abstract
This study presents the first documented case of a disease syndrome in cultured largefin longbarbel catfish (Hemibagrus macropterus). The condition is characterized by massive abdominal pseudotumor formation, severe cachexia, and functional gonadal arrest. Comprehensive pathological investigation revealed that the pseudotumor was [...] Read more.
This study presents the first documented case of a disease syndrome in cultured largefin longbarbel catfish (Hemibagrus macropterus). The condition is characterized by massive abdominal pseudotumor formation, severe cachexia, and functional gonadal arrest. Comprehensive pathological investigation revealed that the pseudotumor was encapsulated by fibroblasts and primarily composed of host-derived, poorly differentiated hyperplastic cells, interspersed with invasive, basophilic Type III cells. These cells and associated inflammatory–fibrotic lesions were also disseminated in the gill, kidney and spleen. Systematic diagnostic approaches, including microbiology and transmission electron microscopy, found no evidence of conventional bacterial or viral pathogens. Metagenomic analysis further supported these findings and suggested a link to infection by an as-yet-unidentified eukaryotic parasite, with Microsporidia or Ichthyosporea being the primary candidates. Functional (KEGG) profiling of the pseudotumor tissue further revealed a molecular signature consistent with active cellular proliferation and metabolism. We propose that the pseudotumor acts as a metabolically active “nutrient sink,” driving the systemic catabolism that underlies the severe cachexia and reproductive arrest. This work provides the first case of a eukaryotic parasite-induced pseudotumorous syndrome in fish, which represents an emerging threat to conservation aquaculture and offering novel insights into parasite-mediated host metabolic hijacking and tumor-mimicry. Full article
(This article belongs to the Section Microbiomes)
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26 pages, 1075 KB  
Review
Energy Allocation Resilience and Endocrine Integration
by Corey B. Schuler, Allison B. Sayre, Lara Zakaria, Shawn Tassone, Alexander Rinehart and Richard Harris
Int. J. Mol. Sci. 2026, 27(3), 1345; https://doi.org/10.3390/ijms27031345 - 29 Jan 2026
Viewed by 966
Abstract
Resilience is commonly framed as a psychological trait, yet clinical and experimental evidence demonstrates that resilience failures emerge concurrently across metabolic, endocrine, immune, and cognitive domains. This review examines resilience as a bioenergetic property constrained by how organisms allocate finite metabolic resources under [...] Read more.
Resilience is commonly framed as a psychological trait, yet clinical and experimental evidence demonstrates that resilience failures emerge concurrently across metabolic, endocrine, immune, and cognitive domains. This review examines resilience as a bioenergetic property constrained by how organisms allocate finite metabolic resources under stress. We synthesize evidence from endocrinology, mitochondrial biology, immunometabolism, and stress physiology to propose a parsimonious, hypothesis-driven Energy Allocation System (EAS) in which the hypothalamic-pituitary-adrenal (HPA), thyroid (HPT), and gonadal (HPG) axes are conceptualized as a coordinated energy-governance network. Despite extensive investigation within these individual fields, the literature lacks an integrative physiological framework explaining why multisystem stress responses co-occur in predictable endocrine and metabolic patterns. Within this framework, mitochondrial reserve capacity serves as the limiting substrate through which hormonal signals regulate mobilization, metabolic pacing, immune tolerance, and recovery. The reviewed literature supports predictable patterns of endocrine reorganization during energetic strain, including prioritization of glucocorticoid-mediated mobilization, constrained thyroid hormone activation, suppression of long-term anabolic investment, and impaired recovery following stress. These configurations reflect adaptive energy-conserving strategies rather than isolated organ dysfunction. The novelty of this review lies in organizing established biological mechanisms into a unified, energy-allocation-based framework that generates falsifiable predictions linking endocrine coordination to bioenergetic capacity and recovery dynamics. We further discuss how routinely available biomarkers and validated psychometric measures can be interpreted as functional readouts of energetic allocation rather than static disease markers. Framing resilience through coordinated energy governance offers a unifying mechanistic lens for interpreting multisystem stress responses and generates testable predictions for future experimental and clinical investigation. Full article
(This article belongs to the Section Molecular Endocrinology and Metabolism)
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35 pages, 4952 KB  
Systematic Review
Hodgkin Lymphoma—The Effect of Chemotherapy on Gonadal Function and Fertility Is Strongly Related to the Treatment Regimen, Age, and Sex: A Systematic Review and Meta-Analysis
by Mareike Roth-Hochreutener, Maria Karakitsiou, Angela Vidal, Susanna Weidlinger, Janna Pape, Tanya Karrer, Karolin Behringer and Michael von Wolff
Cancers 2026, 18(3), 425; https://doi.org/10.3390/cancers18030425 - 28 Jan 2026
Viewed by 170
Abstract
Background/Objectives: Hodgkin lymphoma (HL) primarily affects individuals of reproductive age, making gonadal dysfunction after chemotherapy a critical survivorship concern. While fertility preservation options including gamete and gonadal tissue cryopreservation are available before treatment, evidence-based counseling requires regimen-specific risk estimates accounting for patient [...] Read more.
Background/Objectives: Hodgkin lymphoma (HL) primarily affects individuals of reproductive age, making gonadal dysfunction after chemotherapy a critical survivorship concern. While fertility preservation options including gamete and gonadal tissue cryopreservation are available before treatment, evidence-based counseling requires regimen-specific risk estimates accounting for patient age and sex. Therefore, a meta-analysis was performed to assess presumed infertility in HL patients, stratified by chemotherapy regimen, age, and sex. Methods: This systematic review and meta-analysis, conducted within the FertiTOX project, included studies published between 2000 and February 2024. Eligible studies reported gonadal function outcomes ≥ 1 year after chemotherapy, excluding patients who received pelvic radiotherapy or stem cell transplantation, or had recurrent disease. Presumed infertility was defined by surrogate markers, including amenorrhea, premature ovarian failure, or abnormal hormonal levels in women, and azoospermia, oligozoospermia, or abnormal hormonal levels in men. Results: Of 2376 screened studies, 50 were included (meta-analysis: 43 studies; 5564 female and 1631 male patients). Overall presumed infertility prevalence was 21% in women (95% CI: 0.14–0.29) and 45% in men (95% CI: 0.29–0.62). The highest prevalence occurred after BEACOPP (women 38%; men 81%), while ABVD was associated with the lowest (6% each in women and men). Childhood/adolescent HL treatment resulted in lower prevalence in women (8%) but remained high in men (67%). Conclusions: Fertility risk depends on regimen, age, and sex, requiring tailored counseling. For female children/adolescents and all patients receiving ABVD, post-treatment fertility evaluation and treatment may suffice. However, pre-treatment fertility preservation is strongly recommended for male adolescents and patients receiving other regimens. Full article
(This article belongs to the Section Systematic Review or Meta-Analysis in Cancer Research)
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30 pages, 2443 KB  
Review
Psychological Stress and Male Infertility: Oxidative Stress as the Common Downstream Pathway
by Aris Kaltsas, Stamatis Papaharitou, Fotios Dimitriadis, Michael Chrisofos and Nikolaos Sofikitis
Biomedicines 2026, 14(2), 259; https://doi.org/10.3390/biomedicines14020259 - 23 Jan 2026
Viewed by 544
Abstract
Psychological stress is increasingly investigated as a potentially modifiable factor in male infertility, in part through oxidative stress. This narrative review synthesizes mechanistic and translational evidence linking stress-related neuroendocrine activation and coping behaviors with redox imbalance in the male reproductive tract. Chronic activation [...] Read more.
Psychological stress is increasingly investigated as a potentially modifiable factor in male infertility, in part through oxidative stress. This narrative review synthesizes mechanistic and translational evidence linking stress-related neuroendocrine activation and coping behaviors with redox imbalance in the male reproductive tract. Chronic activation of the hypothalamic–pituitary–adrenal axis and sympathetic outflow elevates glucocorticoids and catecholamines. In controlled animal stress paradigms, this is accompanied by suppression of the hypothalamic–pituitary–gonadal axis and by immune and metabolic changes that favor reactive oxygen species generation. The resulting oxidative stress may reduce Leydig cell steroidogenesis, impair testicular and epididymal function, and induce lipid peroxidation, mitochondrial dysfunction, and sperm DNA fragmentation. In such models, these lesions, together with apoptosis of germ and supporting cells, are associated with lower sperm concentration, reduced motility, compromised viability, and diminished fertilizing potential. Overall, preclinical animal studies using defined stress paradigms provide experimental evidence consistent with causal effects of stress on oxidative injury and reproductive impairment in preclinical settings. Human studies linking perceived stress, anxiety/depression, and disturbed sleep to adverse semen parameters and oxidative biomarkers are summarized. However, the human evidence is predominantly associative, and the available studies are cross sectional and remain vulnerable to residual confounding and reverse causality. Potential effect modifiers, including smoking, alcohol use, and circadian disruption, are also discussed as contributors to heterogeneity across clinical studies. Standardized assessment of stress biology and redox status, longitudinal designs aligned with spermatogenic timing, and well-powered intervention trials are needed to define dose–response relationships and support individualized prevention and care. Full article
(This article belongs to the Special Issue Oxidative Stress in Health and Disease)
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14 pages, 2704 KB  
Case Report
46,XY DSD with Partial Gonadal Dysgenesis and Growth Failure in a Patient with 3q27.1 Microdeletion: Candidate Gene Curation After Exhaustive Literature Review
by Lourdes Correa Brito, Sofía Suco, Bárbara Casali, Florencia Villegas, Paula Scaglia, Agustín Izquierdo, Jimena Lopez Dacal, Miguel Podestá, Martín Medin, Romina P. Grinspon, María Gabriela Ropelato and Rodolfo A. Rey
Int. J. Mol. Sci. 2026, 27(2), 821; https://doi.org/10.3390/ijms27020821 - 14 Jan 2026
Viewed by 295
Abstract
Complex genetic syndromes represent a diagnostic challenge due to their diverse phenotypic presentations, which often evolve over time and may not be fully evident at birth. Disorders of sex development (DSD) comprise congenital conditions with discordance between chromosomal, gonadal, and/or genital sex. In [...] Read more.
Complex genetic syndromes represent a diagnostic challenge due to their diverse phenotypic presentations, which often evolve over time and may not be fully evident at birth. Disorders of sex development (DSD) comprise congenital conditions with discordance between chromosomal, gonadal, and/or genital sex. In 46,XY gonadal dysgenesis, undervirilisation or female-appearing genitalia may occur despite a normal karyotype, and diagnosis increasingly relies on genomic approaches. Prenatal and postnatal growth failure has been described in patients with syndromic 46,XY DSD. We report a male patient with SGA, lack of postnatal catch-up growth, and syndromic dysgenetic 46,XY DSD followed longitudinally from infancy to 11 years, in whom whole-exome sequencing (WES) reanalysis revealed a pathogenic 2.7 Mb microdeletion at 3q27.1q27.2. Systematic review of previously reported 3q27.1 deletions identified overlapping phenotypes but limited documentation of gonadal dysfunction. Curation of 71 genes within the deleted region highlighted DVL3 and CLCN2 as potential contributors to the gonadal phenotype, although functional evidence remains lacking. This case expands the phenotypic spectrum of 3q27.1 microdeletion syndrome, suggesting that 46,XY gonadal dysgenesis may represent an under-recognised feature. It also underscores the importance of copy number variant (CNV) analysis and periodic re-evaluation of sequencing data to increase diagnostic yield. Full article
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19 pages, 774 KB  
Review
The Global Burden of Obstructive Sleep Apnea on Fertility: Pathophysiology, Clinical Evidence, and Therapeutic Perspectives
by Matteo Lazzeroni, Mario Lentini, Antonella Maruca, Pasquale Capaccio, Jerome Rene Lechien, Basilio Pecorino, Benito Chiofalo, Giuseppe Scibilia, Salvatore Maira, Paolo Scollo and Antonino Maniaci
Reprod. Med. 2026, 7(1), 4; https://doi.org/10.3390/reprodmed7010004 - 12 Jan 2026
Viewed by 394
Abstract
Obstructive sleep apnea (OSA) is a highly prevalent disorder with far-reaching systemic consequences. While its cardiometabolic and neurocognitive impacts are well established, growing evidence highlights OSA as a contributor to infertility in both men and women. The pathophysiological mechanisms include intermittent hypoxia, oxidative [...] Read more.
Obstructive sleep apnea (OSA) is a highly prevalent disorder with far-reaching systemic consequences. While its cardiometabolic and neurocognitive impacts are well established, growing evidence highlights OSA as a contributor to infertility in both men and women. The pathophysiological mechanisms include intermittent hypoxia, oxidative stress, systemic inflammation, and endocrine disruption, all of which can impair spermatogenesis, reduce semen quality, alter gonadal hormone secretion, and compromise ovarian function. Clinical studies consistently demonstrate associations between OSA and impaired semen parameters, reduced testosterone, and erectile dysfunction in men. In women, OSA is frequently observed in those with polycystic ovary syndrome, is associated with ovulatory dysfunction, and negatively affects in vitro fertilization outcomes, pregnancy rates, and miscarriage risk. Despite these findings, infertility is not systematically included in global burden estimates of OSA, leading to the underestimation of its true health and socioeconomic impact. Therapeutic strategies such as weight loss, continuous positive airway pressure, and integrative approaches show promise, though robust evidence from randomized trials is still lacking. Integrating sleep health into reproductive medicine may provide a cost-effective and equitable pathway to improve fertility outcomes worldwide. Full article
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27 pages, 1424 KB  
Systematic Review
Insights into the Genetic and Epigenetic Landscape of Endocrine Autoimmunity: A Systematic Review
by Gerdi Tuli, Jessica Munarin, Katherine Stephanie Davalos Flores and Luisa De Sanctis
Genes 2025, 16(12), 1506; https://doi.org/10.3390/genes16121506 - 16 Dec 2025
Viewed by 918
Abstract
Background/Objectives: Endocrine autoimmune diseases, including autoimmune thyroid, pituitary, parathyroid, adrenal, and gonadal diseases, result from complex interactions between genetic susceptibility and environmental triggers. Advances in genomics and epigenomics have provided novel insights into the molecular pathways leading to immune dysregulation and endocrine tissue [...] Read more.
Background/Objectives: Endocrine autoimmune diseases, including autoimmune thyroid, pituitary, parathyroid, adrenal, and gonadal diseases, result from complex interactions between genetic susceptibility and environmental triggers. Advances in genomics and epigenomics have provided novel insights into the molecular pathways leading to immune dysregulation and endocrine tissue destruction. This review summarizes recent progress in understanding the genetic and epigenetic bases, emphasizing shared and disease-specific mechanisms that contribute to autoimmunity and endocrine dysfunction. Methods: A comprehensive literature search was performed in PubMed, Scopus, and Web of Science up to August 2025, focusing on genome-wide association studies (GWAS), next-generation sequencing, and epigenetic profiling (DNA methylation, histone modification, and non-coding RNA regulation). Results: More than 60 susceptibility loci have been identified across endocrine autoimmune diseases (EADs), including key genes in immune tolerance (HLA, CTLA4, PTPN22) and endocrine-specific pathways. Epigenetic studies reveal that altered DNA methylation and histone acetylation patterns in immune and endocrine cells modulate gene expression without changing the DNA sequence, linking environmental exposures to disease onset. Dysregulated microRNAs further influence immune signaling and cytokine networks. Conclusions: Genetic and epigenetic discoveries highlight the multifactorial nature of EADs and reveal potential biomarkers for early detection and targets for precision immunotherapy. Future research integrating multi-omics and longitudinal analyses will be crucial to unravel causal mechanisms and develop personalized preventive strategies. Full article
(This article belongs to the Special Issue Genetic and Epigenetic Factors for Autoimmune Diseases)
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23 pages, 1234 KB  
Review
From Gynecological Endocrine Disorders to Cardiovascular Risk: Insights from Rat Models
by Csanád Endre Lőrincz, Zoltán Virág, András Nagy, Viktória Kiss, Ákos Tóbiás, Denise Börzsei, Csaba Varga and Renáta Szabó
Biomedicines 2025, 13(12), 3081; https://doi.org/10.3390/biomedicines13123081 - 13 Dec 2025
Viewed by 1599
Abstract
Gynecological endocrine disorders, including polycystic ovary syndrome (PCOS), endometriosis as well as primary ovarian insufficiency (POI)/premature ovarian failure (POF), significantly impact women’s reproductive health and overall well-being. While these conditions are primarily driven by disturbances of the hypothalamic–pituitary–gonadal axis, yet growing evidence indicates [...] Read more.
Gynecological endocrine disorders, including polycystic ovary syndrome (PCOS), endometriosis as well as primary ovarian insufficiency (POI)/premature ovarian failure (POF), significantly impact women’s reproductive health and overall well-being. While these conditions are primarily driven by disturbances of the hypothalamic–pituitary–gonadal axis, yet growing evidence indicates that oxidative stress plays a crucial role in their development and progression. The combined impact of hormonal imbalance and impaired redox homeostasis contributes to infertility, metabolic dysfunction, and other co-morbidities, such as increased cardiovascular risk. Given that women may live for many years with these chronic conditions, investigating their pathophysiology and associated complications is of particular importance. This narrative review summarizes current knowledge on PCOS, endometriosis, and POI/PMF, emphasizing the contribution of oxidative stress and also highlights the association between these disorders and cardiovascular risk. Furthermore, the utility of rat models is presented to support the advancement of preventive and therapeutic research. Full article
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19 pages, 563 KB  
Review
Gonadal Function and Reproductive Health Challenges in Triple a Syndrome: A Narrative Review
by Ana Gheorghe-Milea and Carmen Emanuela Georgescu
Medicina 2025, 61(11), 2073; https://doi.org/10.3390/medicina61112073 - 20 Nov 2025
Viewed by 560
Abstract
Background and Objectives: Triple A syndrome (TAS) is a rare autosomal recessive disorder characterized by the triad of adrenocorticotropic hormone (ACTH)-resistant adrenal insufficiency, alacrimia (absence of tear production), and achalasia. This article aims to provide a better understanding of gonadal function and reproductive [...] Read more.
Background and Objectives: Triple A syndrome (TAS) is a rare autosomal recessive disorder characterized by the triad of adrenocorticotropic hormone (ACTH)-resistant adrenal insufficiency, alacrimia (absence of tear production), and achalasia. This article aims to provide a better understanding of gonadal function and reproductive health in TAS by summarizing existing data from the literature regarding this topic. Materials and Methods: A comprehensive literature review was carried out until September 2025, using four electronic databases (PubMed, Embase, Web of Science and Scopus). Results: The review included a total of 25 articles. The most frequent findings in the articles included in the review were erectile dysfunction, ejaculatory dysfunction, delayed puberty, hypogonadism and fertility issues. Furthermore, several studies revealed reduced adrenal androgen levels in male patients, while other case reports documented the presence of osteoporosis in individuals with TAS. Conclusions: Gonadal dysfunction and reproductive health challenges in TAS remain underexplored aspects. The multisystemic nature of TAS requires a comprehensive approach to patient care for optimizing quality of life, and this review underscores the importance of evaluating reproductive function in individuals with this rare syndrome. Full article
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15 pages, 920 KB  
Review
Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions
by Ignazio Cammisa, Elena Malavolta, Giorgio Sodero, Donato Rigante and Clelia Cipolla
Children 2025, 12(11), 1484; https://doi.org/10.3390/children12111484 - 3 Nov 2025
Viewed by 1205
Abstract
Traumatic brain injury (TBI) in childhood is a major global health concern and a leading cause of morbidity and mortality in the pediatric population. Its incidence is rising worldwide, with early childhood and adolescence representing the most vulnerable age groups. Beyond acute neurological [...] Read more.
Traumatic brain injury (TBI) in childhood is a major global health concern and a leading cause of morbidity and mortality in the pediatric population. Its incidence is rising worldwide, with early childhood and adolescence representing the most vulnerable age groups. Beyond acute neurological injury, post-traumatic endocrine dysfunction has emerged as an underrecognized but clinically significant sequela, with potential long-term consequences for growth, puberty, metabolism, and overall quality of life. The hypothalamic–pituitary axis (HPA) is uniquely vulnerable due to its anatomical and vascular characteristics, making pituitary cells—particularly somatotrophs and gonadotrophs—susceptible to ischemic, traumatic, and inflammatory damage. Reported prevalence of post-TBI pituitary dysfunction in children ranges from 5 to 57%, reflecting a deep heterogeneity in injury severity, diagnostic methods, and timing of evaluations. Growth hormone deficiency (GHD) is the most frequently reported abnormality, with presentations varying from transient to persistent forms. Gonadal axis disturbances, including hypogonadotropic hypogonadism and, less commonly, central precocious puberty, highlight the impact of TBI on pubertal development. Adrenal dysfunctions, though less frequent, may be life-threatening if unrecognized, while posterior pituitary disorders, such as diabetes insipidus, usually revealed acutely, are often transient. Importantly, many endocrine sequelae manifest months to years after the initial trauma, complicating a timely diagnosis. Current evidence underscores the need for structured, longitudinal endocrine surveillance after pediatric TBI, with baseline and follow-up assessments at defined intervals. Early recognition and intervention, including hormone replacement when appropriate, may improve neurocognitive recovery and overall rehabilitation outcomes. Future multicenter studies and standardized screening protocols should be considered essential to clarify incidence, natural history, and optimal management strategies for post-traumatic endocrine dysfunction in children. Full article
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23 pages, 803 KB  
Review
Clinical Spectrum, Surgical Management, and Outcomes of NR5A1-Related 46,XY Differences of Sex Development: A Narrative Review
by Stefania Vicario, Maria Escolino, Giorgia Esposito, Mauro Porcaro, Raffaella Di Mase, Mustafa Azizoglu and Ciro Esposito
Medicina 2025, 61(11), 1965; https://doi.org/10.3390/medicina61111965 - 1 Nov 2025
Viewed by 1499
Abstract
Background and Objectives: NR5A1-related 46,XY differences of sex development (DSD) represent a heterogeneous group of conditions characterized by variable degrees of undervirilization, gonadal dysgenesis, and endocrine dysfunction. Mutations in the NR5A1 gene affect critical pathways of gonadal development and steroidogenesis, leading [...] Read more.
Background and Objectives: NR5A1-related 46,XY differences of sex development (DSD) represent a heterogeneous group of conditions characterized by variable degrees of undervirilization, gonadal dysgenesis, and endocrine dysfunction. Mutations in the NR5A1 gene affect critical pathways of gonadal development and steroidogenesis, leading to complex diagnostic and management challenges. This narrative review aims to summarize the clinical spectrum, diagnostic algorithms, surgical management, and outcome data of pediatric NR5A1-related 46,XY DSD. Materials and Methods: A comprehensive search of PubMed, Scopus, and Web of Science databases was conducted, using terms related to NR5A1 mutations, ambiguous genitalia, gonadal dysgenesis, tumor risk, and surgical management. A total of 26 studies were initially identified, of which 16 met the inclusion criteria for pediatric patients (≤18 years) with confirmed 46,XY karyotype, NR5A1 mutation, and available clinical or surgical data. Results: NR5A1 mutations are associated with phenotypes ranging from complete female external genitalia to apparently normal males with later infertility. While Sertoli cell function during fetal life is often preserved, Leydig cell dysfunction leads to incomplete masculinization. Spontaneous virilization during puberty has been reported. Management of gonadal dysgenesis remains controversial: while streak-like intra-abdominal gonads carry high germ cell tumor risk, warranting early gonadectomy, well-formed testes may be preserved under strict surveillance. Conclusions: NR5A1-related 46,XY DSD requires individualized, multidisciplinary management integrating genetic, endocrine, surgical, and psychosocial expertise. Gonadectomy decisions should be risk-stratified and, when possible, delayed to allow patients to participate in decision-making. Early psychological support and lifelong follow-up are essential to optimize physical and psychosocial outcomes. Full article
(This article belongs to the Section Urology & Nephrology)
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27 pages, 1462 KB  
Review
Testosterone and Obesity in an Aging Society
by Takahiro Tsutsumi and Kyoichiro Tsuchiya
Biomolecules 2025, 15(11), 1521; https://doi.org/10.3390/biom15111521 - 28 Oct 2025
Viewed by 8042
Abstract
Testosterone is a hormone that plays a crucial role in men, maintaining muscle mass and bone density and regulating sexual function. This hormone is associated with the inhibition of obesity and the prevention of obesity-related diseases, such as type 2 diabetes, impaired glucose [...] Read more.
Testosterone is a hormone that plays a crucial role in men, maintaining muscle mass and bone density and regulating sexual function. This hormone is associated with the inhibition of obesity and the prevention of obesity-related diseases, such as type 2 diabetes, impaired glucose tolerance, dyslipidemia, hypertension, coronary artery disease, and non-alcoholic fatty liver disease. Obesity has a complex effect on testosterone production and metabolism. Chronic inflammation and hormones associated with obesity cause dysfunction of the hypothalamic-pituitary-gonadal axis, leading to reduced testosterone production. Studies have demonstrated that blood testosterone levels decrease in obese men, suggesting a reciprocal interaction between decreased testosterone and obesity. Additionally, decreased testosterone levels are closely associated with aging. The natural decline in testosterone levels with age can lead to visceral obesity, thus increasing the risk of type 2 diabetes and other chronic metabolic diseases. In many countries, the population is aging, and the importance of testosterone replacement therapy (TRT) for aging men with low testosterone is increasing. Recent studies have expanded our understanding of TRT, highlighting its potential benefits in obese individuals, its interaction with gut microbiota, and the influence of racial differences and genetic polymorphisms on treatment efficacy. This review provides a comprehensive overview of the physiological mechanisms linking obesity and testosterone, current therapeutic approaches including TRT, and emerging research directions that may inform personalized treatment strategies. Full article
(This article belongs to the Section Biological Factors)
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15 pages, 1196 KB  
Review
Sleep Deprivation: A Lifestyle Risk Factor for Male Infertility
by Tarak Davuluri, Vivek Aslot, Brayden J. Seliger, Andrew Edgington, Nagalakshmi Nadiminty, Tariq Shah and Puneet Sindhwani
Uro 2025, 5(3), 17; https://doi.org/10.3390/uro5030017 - 10 Sep 2025
Viewed by 5412
Abstract
Male infertility is a growing global concern with increasing prevalence in both developing and developed nations. While many associations between environmental factors and male infertility have been explored, the relationship between sleep deprivation and male infertility remains underexplored. This narrative review examines the [...] Read more.
Male infertility is a growing global concern with increasing prevalence in both developing and developed nations. While many associations between environmental factors and male infertility have been explored, the relationship between sleep deprivation and male infertility remains underexplored. This narrative review examines the reported effects of sleep deprivation on the Hypothalamic––Gonadal (HPG) axis, Hypothalamic–Pituitary–Adrenal (HPA) axis, oxidative stress, and testicular function, and their consequential effects on male infertility. Disruption of the HPG axis results in altered follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels, leading to fluctuation in testosterone levels, negatively affecting spermatogenesis and other critical reproductive processes. Activation of the HPA axis, often due to stress, elevates cortisol levels, which, in turn, suppresses gonadotropin-releasing hormone (GnRH), impairing reproductive function. Reactive oxidative species (ROS) accumulate in periods of oxidative stress and have been shown to damage sperm and reduce their quality. The blood–testis barrier (BTB) is disrupted in states of sleep deprivation, leading to decreased sperm quality. A literature review was conducted using PubMed and Google Scholar to assess peer-reviewed studies from 1990 to 2024, revealing a complex interplay between sleep deprivation and male reproductive dysfunction. While existing studies support a link between sleep disturbances and hormonal dysregulation, further research is needed to establish causal relationships and identify potential therapeutic interventions. Addressing sleep deprivation may represent a modifiable factor in improving male fertility outcomes. Full article
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18 pages, 583 KB  
Review
Energy Homeostasis and Kisspeptin System, Roles of Exercise and Outcomes with a Focus on Male Reproductive Health
by Mario Ruggiero, Antonella Vicidomini, Domenico Tafuri, Filomena Mazzeo and Rosaria Meccariello
Endocrines 2025, 6(3), 43; https://doi.org/10.3390/endocrines6030043 - 28 Aug 2025
Cited by 2 | Viewed by 6306
Abstract
Background: Obesity is a multisystemic health problem causing chronic diseases like diabetes or cardiovascular diseases, but also reproductive dysfunctions like infertility in adults or altered puberty onset in children. Exercise is a recognized intervention to control or prevent energy imbalance, thus deeply contributing [...] Read more.
Background: Obesity is a multisystemic health problem causing chronic diseases like diabetes or cardiovascular diseases, but also reproductive dysfunctions like infertility in adults or altered puberty onset in children. Exercise is a recognized intervention to control or prevent energy imbalance, thus deeply contributing to metabolic health in physiological and pathological conditions. The kisspeptin system (KS), the main gatekeeper of reproduction and puberty onset in mammals, is also an upcoming “metabolic sensor”, linking energy homeostasis to reproductive ability both centrally and peripherally. Objectives: This narrative review aims at summarizing recent evidence from animal models and human studies on the role of the KS in energy homeostasis, with a focus on the upcoming role of the KS as a metabolic sensor able to modulate the functionality of the hypothalamus–pituitary–gonad axis in males as an adaptive response to exercise. Methods: PubMed and Scopus search (date: 2015–2025; keywords: kisspeptin and metabolism, male reproduction or exercise; kisspeptin and doping). Results and Conclusions: This review article illustrates the crucial role of the KS in linking energy homeostasis and male reproduction at the central and peripheral levels, and modulation of the KS by exercise in physiological and pathological conditions. Due to the large amount of data from animal models, knowledge gaps occur in the analysis of the relationship among KS, energy homeostasis, male reproduction and exercise in humans, particularly in the case of overtraining. Lastly, kisspeptin inclusion in the doping list is also discussed. Full article
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