人绒毛膜促性腺激素对青春期前低促性腺激素性腺发育不良型小阴茎皮肤组织雄激素受体及热休克蛋白90α的影响

Effects of human chorionic gonadotropin on the expression of androgen receptor and heat shock protein 90a in foreskin tissues of prepubertal children with micropenis in hypogonadotropic hypogonadism

目的 观察人绒毛膜促性腺激素（HCG）对青春期前低促性腺激素性腺发育不良型小阴茎皮肤组织雄激素受体（AR）及热休克蛋白90α（HSP90α）的影响.方法 10例经临床确诊的青春期前低促性腺激素性腺发育不良型小阴茎患儿予以HCG治疗.10例正常儿童为对照组.分别于治疗前、治疗后3个月进行阴茎长度测量;用免疫组织化学染色（SP法）检测阴茎皮肤组织AR和HSP90α的表达.结果 所有患儿治疗前阴茎长度（2.44±0.24）cm较对照组（4.29±0.26）cm短（P＜0.01）;其阴茎皮肤组织AR的吸光度（AD）为0.155±0.060,较对照组（0.260±0.049）低（P＜0.01）;其阴茎皮肤组织HSP90α的AD为0.115±0.034,较对照组（0.178±0.043）低（P＜0.01）.经HCG治疗后其阴茎长度（3.97±0.27）cm较治疗前（2.44±0.24）cm明显增长（P＜0.01）;其阴茎皮肤组织AR的AD为0.224±0.072,较治疗前（0.155±0.060）升高（P＜0.05）;其阴茎皮肤组织HSP90α的AD为0.163±0.054,较治疗前（0.115±0.034）升高（P＜0.05）.结论 青春期前低促性腺激素性腺发育不良型小阴茎组织内的AR及HSP90α表达水平低于正常同龄期儿童;HCG可促进青春期前低促性腺激素性腺发育不良型小阴茎组织细胞内AR与HSP90α的表达,从而促进阴茎生长发育.

Objective To investigate the effects of human chorionic gonadotropin （hCG） on the expression of androgen receptor （AR） and heat shock protein 90α （HSP90α） in foreskin tissues of prepubertal children with micropenis in hypogonadotropic hypogonadism. Methods Ten patients were treated with hCG, and 10 normal prepubertal children served as controls. Their penis length was measured before and 3 months after treatment of hCG. The expression of AR and HSP90α in foreskin tissues was detected by immunohistochemistry. Results Mean penis length of all patients was （3.44 ± 0.24） cm, shorter than that of the control group [ （4.29 ±0.26） cm, P 〈0.01 ]. Mean absorbance of AR in foreskin tissues of all patients was 0.155 ± 0.060, lower than that of the control group [ （0.260 ± 0.049）, P 〈 0.01 ]. Mean absorbance of HSP90α in foreskin tissues of all patients was 0.115 ±0.034, lower than that of the control group [ （0.178 ± 0.043）, P 〈 0.01 ]. Mean penis length of all patients was （3.44 ± 0.24） cm, shorter than that after treatment with hCG [ （3.97 ±0.27） , cm, P 〈0.01 ]. Mean absorbance of AR in foreskin tissues of all patients was 0.155 ± 0.060, lower than that after treatment with hCG [ （0.224 ± 0.072）, P 〈 0.05 ]. Mean absorbance of HSP90α in foreskin tissues of all patients was 0.115 ±0.034, lower than that after treatment with hCG [ （0.163 ± 0.054）, P〈0.05]. Conclusion Expression of AR and HSP90α in the penile tissue of prepubertal children with micropenis in hypogonadotropic hypogonadism is lower than that of normal prepubertal children. The hCG treatment on prepubertal children with micropenis in hypogonadotropic hypogonadism can play an active role in the expression of AR and HSP90α in the penile tissue, promoting the growth of micropenis.