title: The prepubertal testis: biomarkers and functions.
abstract: OBJECTIVE
  Biomarkers of prepubertal testicular function have become widely available only in recent years. The aim of this review is to update the knowledge on key biomarkers used to assess hypogonadism in boys.
  
  
  RESULTS
  Sertoli cells are the most representative cells of the prepubertal testis. Anti-Müllerian hormone and inhibin B are essential biomarkers of Sertoli cell function. Also, INSL3 arises as an additional marker of Leydig cell dysfunction.
  
  
  CONCLUSIONS
  The widespread use of these biomarkers has enhanced our knowledge on the pathophysiology and diagnosis of prepubertal male hypogonadism. Beyond their well known germ-cell toxicity, oncologic treatments may also affect Sertoli cell function. Pathophysiology is not the same in all aneuploidies leading to infertility: while hypogonadism is not evident until mid-puberty in Klinefelter syndrome, it is established in early infancy in Down syndrome. In Noonan syndrome, the occurrence of primary hypogonadism depends on the existence of cryptorchidism, and Prader-Willi syndrome may present with either primary or combined forms of hypogonadism. Prepubertal testicular markers have also provided insights into the effects of environmental disruptors on gonadal function from early life, and helped dissipate concerns about testicular function in boys born preterm or small for gestational age or conceived by assisted reproductive technique procedures.
authors.affiliation: Centro de Investigaciones Endocrinológicas (CEDIE), División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina.
authors.forename: Clara
authors.initials: C
authors.lastname: Valeri
authors.forename: Helena F
authors.initials: HF
authors.lastname: Schteingart
authors.forename: Rodolfo A
authors.initials: RA
authors.lastname: Rey
mesh_terms: D054304:Anti-Mullerian Hormone / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D002657:Child Development; D012734:Disorders of Sex Development / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007223:Infant; D007265:Inhibins / Q000378:metabolism; D007328:Insulin / Q000378:metabolism; D007985:Leydig Cells / Q000166:cytology / Q000378:metabolism / Q000473:pathology; D008297:Male; D011506:Proteins / Q000378:metabolism; D012708:Sertoli Cells / Q000166:cytology / Q000378:metabolism / Q000473:pathology; D013091:Spermatogenesis; D013737:Testis / Q000166:cytology / Q000254:growth & development* / Q000378:metabolism / Q000473:pathology
chemical_list: D015415:Biomarkers; D007328:Insulin; C084797:Leydig insulin-like protein; D011506:Proteins; C422364:inhibin B; D007265:Inhibins; D054304:Anti-Mullerian Hormone