Purpose of review 

In this review, we outline the most recent advances in the development of Leydig stem cells (LSCs) and summarize the current and upcoming treatments for hypogonadism.

Recent findings 

In-vitro and in-vivo studies show that inducing stem cells to differentiate into testosterone-producing adult Leydig cells is possible. In addition, LSCs can be grafted with Sertoli cells to increase testosterone levels in vivo. This therapy causes minimal effects on luteinizing hormone and follicle stimulating hormone levels. Novel therapies for hypogonadism include varying methods of testosterone delivery such as intranasal and oral agents, as well as novel selective estrogen and androgen receptor modulators.

Summary 

LSC therapies provide an effective way of increasing testosterone levels without detrimentally affecting gonadotropin levels. Next steps in developing viable Leydig cell grafting options for the treatment of hypogonadism should include the assessment of efficacy and potency of current animal models in human trials. Recently, both intranasal and oral testosterone have been made available and shown promising results in treating hypogonadism while maintaining fertility. Enclomiphene citrate and selective androgen receptor modulators have been suggested as future therapies for hypogonadism; however, further studies assessing efficacy and adverse effects are needed.

中文翻译：

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Leydig干细胞和性腺功能减退的未来疗法

审查目的 

在这篇综述中，我们概述了Leydig干细胞（LSC）开发的最新进展，并总结了性腺功能减退症的当前和即将到来的治疗方法。

最近的发现 

体外和体内研究表明，诱导干细胞分化为产生睾丸激素的成年Leydig细胞是可能的。另外，LSC可以与支持细胞一起移植以增加体内睾丸激素水平。这种疗法对促黄体生成激素和促卵泡激素水平的影响很小。性腺功能减退的新疗法包括各种睾丸激素递送方法，例如鼻内和口服药物，以及新型选择性雌激素和雄激素受体调节剂。

概要 

LSC疗法提供了一种增加睾丸激素水平而又不影响促性腺激素水平的有效方法。开发用于治疗性腺功能减退症的可行的Leydig细胞移植选择的下一步应包括在人体试验中评估当前动物模型的功效和效能。最近，鼻内和口服睾丸激素都已可用，并显示出在保持生育力的同时治疗性腺机能减退的有希望的结果。有人建议将柠檬酸恩诺米酚和选择性雄激素受体调节剂作为性腺功能减退症的未来疗法。但是，还需要进一步评估疗效和不良反应的研究。