Андрологические аспекты эффектов агонистов гонадотропин-рилизинг-гормона в эксперименте и клинике

Проведён литературный поиск для изучения работ, посвящённых результатам применения агонистов гонадотропин-рилизинг-гормона (ГнРГ) у мужчин в клинических условиях и самцов животных в эксперименте. Практически все исследователи утверждают, что агонисты ГнРГ подавляют функции яичек. Но  относительно механизмов этого эффекта нет однозначного мнения: часть учёных считают возможным прямое действие препаратов на клетки яичек, другие полагают такое воздействие опосредованным через другие гормоны, в том числе гипофизарные. Большинство опубликованных статей приводят факты об уменьшении массы с атрофией тканей предстательной железы и семенных пузырьков после применения аналогов ГнРГ. Эффект аналогичен хирургической кастрации, но  проявляется несколько позже и иногда менее выражен, так как синтез тестостерона полностью не подавляется. Препараты данной группы при комплексном терапевтическом лечении рака предстательной железы обеспечивают сравнимую эффективность с орхиэктомией или высокими дозами эстрогенов, при этом зарегистрирована меньшая частота побочных эффектов. ГнРГ оказывает антипролиферативное действие на клеточные элементы карцином предстательной железы, но вместе с тем есть мнение о том, что агонисты ГнРГ не ингибируют пролиферацию клеток рака простаты, прямое подавление митотической активности вряд ли является основным механизмом противоопухолевого действия подобных препаратов. При изучении данных о защитном действии препаратов ГнРГ на клетки и ткани половых органов при химиотерапии и облучении обращает на себя внимание явная противоречивость публикаций: от хорошего эффекта с быстрым восстановлением функциональной активности до слабой или даже полностью отсутствующей положительной динамики. В любом случае противоречивость публикаций по каждому из аспектов эффектов ГнРГ свидетельствует об их малой изученности, целесообразности дальнейшего продолжения не только прикладных, но и фундаментальных исследований в связи с возможной высокой перспективностью.

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