Indirect mechanisms and cascades of androgen action.

Androgens are the main hormones responsible for the induction of the male phenotype. This process involves a complex combination of reversible and irreversible effects. As for other steroid hormones, many of the effects of androgens are mediated by a specific intracellular receptor that interacts with cis-acting regulatory regions (AREs) in the affected genes. Apart from these direct effects, however, androgens may indirectly affect the expression of a variety of genes that do not necessarily contain AREs. Indirect effects may be related to androgen-induced changes in the concentration or activity of secondary transcription factors, autocrine and paracrine mediators, and circulating hormones. Such indirect effects may induce cascade-like actions and may play an important role in more complex effects of androgens involving coordinated responses of genes, cells and organs.