Persistence of androgenic effects on the production of proinflammatory cytokines by circulating antigen-presenting cells after withdrawal of testosterone treatment in aging type 2 diabetic men with partial androgen deficiency

Objective To test the hypothesis that T treatment withdrawal could be associated with an enhancement of proinflammatory cytokine production by peripheral blood monocytes and dendritic cells. Design A prospective intervention study. Setting Tertiary university hospital. Patient(s) Thirteen type 2 diabetic men aged >55 years with partial androgen deficiency and eight age-matched healthy men (controls). Intervention(s) Analyses were performed before and 12 months after T replacement therapy and the results compared with those obtained for the same patients after a 3-month T withdrawal period. Main Outcome Measure(s) Distribution of circulating T, B, and natural killer lymphocytes, monocytes, and CD33 hi myeloid, CD16+, and plasmacytoid dendritic cell subsets. Spontaneous and stimulated ex vivo production of inflammatory cytokines (interleukin-1β, interleukin-6, and tumor necrosis factor-α) by circulating monocytes and dendritic cells, which represent the most potent antigen-presenting cells. Result(s) The reduction or complete abrogation of spontaneous ex vivo production of proinflammatory cytokines by monocytes and dendritic cells observed after 12 months of T replacement therapy was maintained 3 months after T withdrawal. Conclusion(s) These are the first results showing that exogenous T treatment deprivation is not associated with an immunologic enhancement of proinflammatory cytokine production by antigen-presenting cells.