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Commentary to ‘Environmental, parental and gestational factors that influence the occurrence of hypospadias in male patients’
Journal of Pediatric Urology (2015) 11, 20
Commentary to ‘Environmental, parental and gestational factors that influence the occurrence of hypospadias in male patients’ Service de Chirurgie Visce ´rale et Urologique Pe ´diatrique, Ho ˆpital Lapeyronie, CHU Montpellier and Universite ´ de Montpellier, France [email protected] (N. Kalfa) Available online 7 February 2015
Nicolas Kalfa Hypospadias is the archetypical malformation that appears to be at the crossroads of genetics, hormones and the environment. Whereas the new-generation sequencing methods are still try to identify the gene that could be responsible for this malformation, the increasing incidence of hypospadias in certain regions or time periods has led to the suspicion that environmental chemicals may also be detrimental to fetal, male genital development. Twenty years ago, the theory of testicular dysgenesis syndrome was proposed; this seducing hypothesis still remains to be confirmed. Eight percent of all known chemicals exhibit antiandrogen activity, and their
widespread use raises concerns. Unfortunately, most studies that are reviewed are retrospective and based on databanks with limited clinical details and, sometimes, a wide variability in phenotypes and non-homogenous cohorts. Ethnic pair-based comparison groups are often missing, as is concomitant genetic testing to rule out genetic causes, making it difficult to draw conclusions. Whether the results of in vitro and animal experiments can be transposed to human pathology is questionable. Therefore, a multicenter, prospective phenotype-specific study is mandatory and is already underway.
DOI of original article: http://dx.doi.org/10.1016/j.jpurol.2014.10.003. http://dx.doi.org/10.1016/j.jpurol.2014.12.002 1477-5131/ª 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
Commentary to ‘Environmental, parental and gestational factors that influence the occurrence of hypospadias in male patients’ Service de Chirurgie Visce ´rale et Urologique Pe ´diatrique, Ho ˆpital Lapeyronie, CHU Montpellier and Universite ´ de Montpellier, France [email protected] (N. Kalfa) Available online 7 February 2015
Nicolas Kalfa Hypospadias is the archetypical malformation that appears to be at the crossroads of genetics, hormones and the environment. Whereas the new-generation sequencing methods are still try to identify the gene that could be responsible for this malformation, the increasing incidence of hypospadias in certain regions or time periods has led to the suspicion that environmental chemicals may also be detrimental to fetal, male genital development. Twenty years ago, the theory of testicular dysgenesis syndrome was proposed; this seducing hypothesis still remains to be confirmed. Eight percent of all known chemicals exhibit antiandrogen activity, and their
widespread use raises concerns. Unfortunately, most studies that are reviewed are retrospective and based on databanks with limited clinical details and, sometimes, a wide variability in phenotypes and non-homogenous cohorts. Ethnic pair-based comparison groups are often missing, as is concomitant genetic testing to rule out genetic causes, making it difficult to draw conclusions. Whether the results of in vitro and animal experiments can be transposed to human pathology is questionable. Therefore, a multicenter, prospective phenotype-specific study is mandatory and is already underway.
DOI of original article: http://dx.doi.org/10.1016/j.jpurol.2014.10.003. http://dx.doi.org/10.1016/j.jpurol.2014.12.002 1477-5131/ª 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.