OESTROGEN PRODUCTION BY SERTOLI CELLS IN THE ETIOLOGY OF BENIGN SENILE HYPERTROPHY OF THE HUMAN PROSTATE

Abstract

The lipoid content of the Sertoli and Leydig cells was estimated in 32 non-selected post-mortem cases at ages from infancy to 88 yrs., including several cases of marked prostatic hypertrophy. Examinations of the testicular "lipoid cell ratio" in various decades of life revealed the following main types the infantile-type without any demonstrable lipoid content in Leydig and Sertoli cells; the adult (androgenic) type from early puberty to ages of about 45-55 yrs., when a gradual increase of Sertoli cell lipoid occurs simultaneously with a decrease of spermatogenesis and lipoid Leydig cells; and the senile (estrogenic) type, of common occurrence after age 60, with marked preponderance of lipoid Sertoli cells. This last type was very marked in all cases of clinical and morphological hypertrophy of the prostate. From a study of hormonally active testicular and ovarian tumors (the androblastoma group) in man and from the excretion of androgenic and estrogenic substances in the urine, it is assumed that the lipoidal Leydig cells produce androgens and the lipoidal Sertoli cells, estrogens. The "lipoid cell ratio" in the testis and the ratio of estrogenic to androgenic substances in the urine are closely correlated. The evolution of the testis in man and in most animals is accompanied by a Leydig cell lipoid predominance, while the senile involution of the testis in man always involves a transitory phase with marked Sertoli cell lipoid predominance. The theory of the hormonal etiology of the benign senile hypertrophy of the prostate in man is evaluated in the light of these findings.