Re: Klinefelter Syndrome: How, What, and Why?

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    MALE INFERTILITY 657ia. That may make sense from an economical perspective. However, the occasional manho undergoes surgery that nearly certainly will not yield sperm might feel otherwise.

    Craig Niederberger, M.D.

    : ATP Secretion in the Male Reproductive Tract: Essential Role of CFTR

    C. Ruan, W. W. Shum, C. Belleanne, N. Da Silva and S. Bretongram in Membrane Biology, Massachusetts General Hospital, Boston, Massachusetts

    hysiol 2012; 590: 42094222.

    TR is expressed in principal cells but not clear cells in mouse cauda epididymis. Inhibition orockdown of CFTR inhibits ATP release from mouse epididymal principal cells. Inhibition of CFTRduces ATP release into the lumen of cauda epididymis in mice in vivo. These results show thevolvement of CFTR in the regulation of ATP release from epithelial principal cells in the caudaididymidis. Defective ATP signalling in the epididymis might contribute to dysfunction of the maleproductive tract associated with CFTR mutations.

    itorial Comment: It is well known that mutations in the cystic fibrosis transmembranenductance regulator gene may result in maldevelopment of enough of the wolffian ductleave a man without a vas. But how does that work? These investigators provide

    egant evidence that adenosine triphosphate signaling in the epididymis is defectived might be the culprit.

    Craig Niederberger, M.D.

    : Klinefelter Syndrome: How, What, and Why?

    . Sigmanision of Urology, Brown University and Rhode Island Hospital, Providence, Rhode Island

    til Steril 2012; 98: 251252.

    inefelter syndrome is commonly encountered by the physician dealing with male infertility. Despitee success of sperm retrieval and ICSI, there remain many areas of controversy about the mecha-sms and natural history of spermatogenesis, as well as the appropriate management of thesetients. This collection of articles provides a state of the art review of what is known and what isknown about this syndrome and reports a variety of management approaches to these patients.

    itorial Comment: This is the lead article of a 6-part series written by leaders in the fieldKlinefelter syndrome, including its genetics, medical and endocrine implications, and

    edical and surgical therapy. It is a review worth reading for trainees and practitionersike.

    Craig Niederberger, M.D.

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