晚期发生的莱伯遗传性视神经病变和前列腺癌的抗雄激素:是否存在因果关系?
Giulia Amore1,2, Michele Carbonelli3, Diego D'Angeli3
1Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy.
Frontiers in neurology
|September 2, 2025
概括
在患有前列腺癌的男性中,缺少雄激素治疗 (ADT) 可能会引发晚发的Leber遗传性视神经病变 (LHON). 这种荷尔蒙失衡,尤其是低雌激素水平,会导致线粒体DNA复制量减少和视力丧失.
科学领域:
- 眼科 眼科
- 遗传学
- 内分泌学
背景情况:
- 莱伯遗传性视神经病 (LHON) 是一种母体遗传的线粒体DNA疾病,通常影响年轻男性,并表现出女性的保护作用,可能是由于雌激素.
- 晚期LHON通常与毒性暴露有关,但与这些因素无关的病例不太了解.
研究的目的:
- 在前列腺癌的老年男性中报告了两例不寻常的LHON病例.
- 调查抗雄激素抑制疗法 (ADT) 在这些患者中引发LHON的潜在作用.
主要方法:
- 详细的临床病例报告两名患者晚期LHON.
- 对受影响个体的荷尔蒙特征 (雄激素,雌激素,雄激素) 和线粒体DNA (mtDNA) 拷贝数进行分析.
主要成果:
- 在开始治疗前列腺癌的ADT (酶胺和乐利德) 后,这两名患者都出现了LHON.
- 患者表现出非常低的淋巴激素,雌激素和雄激素血清水平,与ADT一致.
- 与对照组相比,两位患者的mtDNA复制数显著减少.
结论:
- 通过改变激素平衡 (雌激素-雄激素比率) 并可能减少mtDNA复制数,ADT可能会在敏感个体中引发晚期LHON.
- 这表明在LHON的发病过程中,荷尔蒙状态和线粒体功能之间存在复杂的相互作用.
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