Inhibin B in healthy and cryptorchid boys

Background: Cryptorchidism, the most common male genital abnormality observed in paediatrics, might often be\r\nassociated with long-term functional consequences and can even reoccur after a successful orchidopexy. Serum\r\nmarkers that identify cryptorchid boys with gonadal dysfunction early should be useful in a decision-making\r\nprocess. Inhibin B, produced during all of childhood but altered in cryptorchid subjects, appears strictly related to\r\nSertoli cells, and its levels directly reflect the status of the testis germinative epithelium. Unfortunately, its precise\r\nroles in bilateral and unilateral cryptorchidism are still debated and being unravelled. Herein, we report the most\r\ncurrent knowledge about inhibin B in both healthy boys and those with cryptorchidism to discuss and clarify its\r\npotential clinical applications.\r\nDiscussion: Inhibin B represents a simple and repeatable serum marker and it seems to well asses the presence\r\nand function of the testicular tissue. Testicular tissue in prepubertal age is largely made up of Sertoli cells; inhibin B,\r\ncoming from working Sertoli cells, allows to indirectly evaluate their function. Besides, inhibin B is produced\r\nthroughout childhood, even before puberty, in contrast with central hormones, and it is not influenced by\r\nandrogens during puberty, in contrast with other testicular hormones. Although further studies are needed, low\r\nlevels of inhibin B have been related with low testicular score and/or with consistent alterations of testicular\r\nparameters at histological examination. This means that inhibin B could be an indirect marker of testicular functions\r\nthat could even replace testicular biopsies, but current data are inconsistent to confirm this potential role of inhibin\r\nB in cryptorchidism.\r\nConclusion: Inhibin B represents an effective candidate for early identification of testicular dysfunction after\r\norchidopexy for cryptorchidism. Unfortunately, current data cannot exactly clarify the real role of inhibin B as a\r\npredictor of future testicular function in cryptorchidism and future long-term follow-up studies, with repeated\r\ninhibin B checks both in cryptorchid and in formerly cryptorchid children and adolescents, will permit to assess if\r\nprevious normal levels of inhibin B would match with future normal pubertal development and fertility potential.