Genetic and hormonal control of male sexual differentiation.

Phenotypic sexual differentiation during embryogenesis is a complex process involving the action of at least 18 genes. These genes regulate gonadal differentiation, gonadal hormone formation, and in the male the cellular action of three necessary hormones, namely mullerian regression factor, testosterone, and dihydrotestosterone. Analysis of two of the mutations affecting sexual development is consistent with the thesis that the two androgens testosterone and dihydrotestosterone have separate and specific roles in virilization of the male urogenital tract, testosterone stimulating wolffian duct development and dihydrotestosterone mediating development of the urogenital sinus and external genitalia. In the disorder familial incomplete male pseudohermphroditism, type 2, deficient dihydrotestosterone formation is associated with a selective failure of virilization of the urogenital sinus and external genitalia, whereas the wolffian duct derivatives develop normally. On the other hand, in the testicular feminization syndrome there is a complete failure in the development of the male phenotype, indicating that the primary defect involves an abnormality in some biochemical step that is common to the action of both androgens. Evidence from studies in the submandibular gland of the mouse with testicular feminization suggest that the fundamental defect lies in the translocation and/or nuclear binding of the cytoplasmic androgen receptor. It remains to be proven whether these events in the postnatal, sexually dimorphic submandibular gland of the testicular feminization mouse reflect prenatal events occurring in the urogenital tissues during embryogenesis.