A clinician looks at androgen resistance

Rina Balducci, Paolo Ghirri, Terry R. Brown, Shayne Bradford, Antonio Boldrini, Brunetto Boscherini, Francesco Sciarra, Vincenzo Toscano

Research output: Contribution to journalArticle

Abstract

Androgen resistance in genetic males occurs when gonadotropins and testosterone are normal, but the physiological androgen response in androgen target organs is absent or decreased. In androgen-dependent target tissues two main defects may be found: 1) defective testosterone metabolism (5α- reductase type 2 deficiency) and 2) anomalies in androgen receptors (androgen insensitivity syndrome (AIS)). The clinical manifestations of these defects vary from subjects with female external genitalia to subjects with mild forms of impaired masculinization. In particular, in the complete form of AIS (CAIS) the phenotype is feminine, and in the partial form (PAIS) the external genitalia are ambiguous with an extremely variable phenotype. The diagnosis requires clinical, hormonal, genetic, and molecular investigation for appropriate gender assignation and treatment. In AIS, cloning of androgen receptor cDNA using the polymerase chain reaction, denaturing gradient gel electrophoresis, and nucleotide sequencing have enabled a variety of molecular defects in the androgen receptor to be identified. The complexity of phenotypic presentation of AIS probably reflects the heterogeneity of androgen receptor gene mutations, but to date a relationship between genotype/phenotype has been difficult to establish, with the same point mutation reported to be associated with different phenotypic expressions. Other factors must therefore also contribute to the clinical presentation of AIS, although none have yet been identified. Establishing the functional consequences of androgen receptor mutations in in vitro systems and correlating them with clinical presentation may ultimately provide an explanation for the variable clinical presentation of AIS and perhaps enable prediction of the response to androgen therapy in infants with PAIS.

Original languageEnglish (US)
Pages (from-to)205-211
Number of pages7
JournalSteroids
Volume61
Issue number4
DOIs
StatePublished - Apr 1996

Fingerprint

Androgen-Insensitivity Syndrome
Androgens
Androgen Receptors
Phenotype
Female Genitalia
Disorders of Sex Development
Denaturing Gradient Gel Electrophoresis
Mutation
Defects
Gonadotropins
Point Mutation
Testosterone
Organism Cloning
Molecular Biology
Oxidoreductases
Nucleotides
Complementary DNA
Genotype
Polymerase Chain Reaction
Cloning

Keywords

  • 5α-reductase deficiency
  • androgen insensitivity
  • male pseudohermaphroditism

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology
  • Molecular Biology

Cite this

Balducci, R., Ghirri, P., Brown, T. R., Bradford, S., Boldrini, A., Boscherini, B., ... Toscano, V. (1996). A clinician looks at androgen resistance. Steroids, 61(4), 205-211. https://doi.org/10.1016/0039-128X(96)00015-3

A clinician looks at androgen resistance. / Balducci, Rina; Ghirri, Paolo; Brown, Terry R.; Bradford, Shayne; Boldrini, Antonio; Boscherini, Brunetto; Sciarra, Francesco; Toscano, Vincenzo.

In: Steroids, Vol. 61, No. 4, 04.1996, p. 205-211.

Research output: Contribution to journalArticle

Balducci, R, Ghirri, P, Brown, TR, Bradford, S, Boldrini, A, Boscherini, B, Sciarra, F & Toscano, V 1996, 'A clinician looks at androgen resistance', Steroids, vol. 61, no. 4, pp. 205-211. https://doi.org/10.1016/0039-128X(96)00015-3
Balducci R, Ghirri P, Brown TR, Bradford S, Boldrini A, Boscherini B et al. A clinician looks at androgen resistance. Steroids. 1996 Apr;61(4):205-211. https://doi.org/10.1016/0039-128X(96)00015-3
Balducci, Rina ; Ghirri, Paolo ; Brown, Terry R. ; Bradford, Shayne ; Boldrini, Antonio ; Boscherini, Brunetto ; Sciarra, Francesco ; Toscano, Vincenzo. / A clinician looks at androgen resistance. In: Steroids. 1996 ; Vol. 61, No. 4. pp. 205-211.
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