Introduction br Methods br Results

Introduction
Methods
Results
Discussion It has been confirmed that ACI has strong teratogenic effects in humans and animals. Thus, women of childbearing age must use contraception for at least 2 years after the withdrawal of treatment. There is a large number of studies on the teratogenicity and embryotoxicity of retinoids after their oral and topical administration in animals, but retinoid risk assessments in humans mainly include indirect data of pharmacokinetic analysis in animals and humans after systematic administration experiments and topical retinoid application in humans, which also referred to the results of in vitro teratogenic tests in animals and humans. The most direct determinants of teratogenic effects depend on the concentration-time relationship of drugs in target tissues, the drugs’ physicochemical and structure-activity properties, and their concentration and affinity in the terminal target organs. Although pharmacological and pharmacokinetic preventive measures have been proposed, they are still widely used clinically because of their efficacy. Currently, there are few studies on the effects of retinoids on the male reproductive system. These studies are based on tests and literature, and most of them consider retinoid treatment to be safe from the viewpoint of andrology. Given the wide clinical usage of retinoids, clarification of whether retinoids affect the reproductive system in male patients of childbearing age is urgently needed. As one of the most active and damage-susceptible TCEP in vivo, the development and maturation of sperm cells are complex. These processes mainly occur in testes and seminiferous tubes, and consist of three phases that together last 2–3 months: the proliferation and division of spermatogonia, reduction division of spermatocytes, and spermatogenesis. Routine tests and analysis of semen and sperm are a direct and objective experimental method in clinical practice. The comprehensive assessment of semen volume and liquefaction time, as well as sperm concentration, motility, viability, morphology, and other indexes could be used as an important basis for understanding male fertility. The male reproductive hormone levels depend on the hypothalamic-pituitary-gonadal axis, and changes to this axis are directly related to changes in sperm concentration, motility, and morphology seen in semen analysis. To understand the effects of different doses of ACI on sperm, we compared the semen volume, motility, survival ratio, sperm concentration, percentage of sperm with normal morphology, damaged DNA fragment index, and certain genital hormones among 15 psoriatic patients administered 20 mg of ACI/d, 16 psoriatic patients administered 30 mg of ACI/d, and 14 healthy volunteers before the treatment and 1 month and 3 months after treatment. The results showed that ACI can improve the clinical symptoms of psoriatic patients, but different doses of ACI did not cause significant changes in sperm concentration, sperm morphology, total sperm count, sperm motility, or reproductive hormone levels 1 month or 3 months after treatment. Three months after withdrawal of treatment (one period of spermatogenesis), we rechecked the semen quality and reproductive hormone levels of 27 patients (3 patients retired from active military service, and 1 patient quit). The results did not reveal any abnormalities, indicating that long-term oral treatment with ACI did not affect spermatogenesis and that ACI did not affect sperm concentration, reduce sperm motility, or affect sperm morphology. ACI had no significant effect on the male hypothalamic-pituitary-gonadal axis or its regulated reproductive hormone levels during or after treatment. Compared with the previous experiments, the patients in this study were younger and the volunteers were young soldiers without psoriasis; therefore, the study samples were easily managed and followed up, and their compliance was better. The sample size was larger than in previous studies, the treatment protocol used conventional doses (no more than 30 mg/d), and the conclusions obtained were consistent. Therefore, the study confirmed that long-term treatment with therapeutic doses of retinoids has no adverse effects on reproductive function in psoriatic male patients.