Anabolic Androgenic Steroids: Chemistry, Biological Action, Clinical Applications and New Molecular Biomarkers

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Hematology and Immunology".

Deadline for manuscript submissions: closed (30 September 2020) | Viewed by 25894

Special Issue Editor

Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy
Interests: forensics; autopsy; forensic pathology; forensic toxicology; drugs of abuse; postmortem; technology and forensics; genomic application in pathology; anabolic androgenic steroids
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Special Issue Information

Dear Colleagues,

Even if anabolic androgenic steroid (AAS) abuse is clearly associated with a vast number of collateral effects, adolescents and athletes frequently use a large group of synthetic derivatives of testosterone, both for aesthetic uses and for improving performance. The market for performance-enhancing drugs is now huge and continuously increasing—for example, the online market has facilitated the uncontrolled sale of AASs. To date, the phenomenon of doping no longer affects only professional athletes, but is also found in those practicing sports activities at an amateur level, becoming an important problem for public health. For these reasons, the interest in all of the aspects involved in AAS use/abuse is of great importance for the scientific community. Finally, the identification of new molecular biomarkers for antidoping purposes remains an ambitious target.

Given the importance of the topic, the journal Medicina is launching a Special Issue entitled “Anabolic Androgenic Steroids: Chemistry, Mechanism of Action, Adverse Effects, and New Molecular Biomarkers”, with the aim of gathering together accurate and up-to-date scientific information on all aspects of AAS use/abuse. We are pleased to invite you and your co-workers to submit your original research articles reporting on the biochemical and molecular issues of AAS use/abuse, including the pathophysiological mechanisms. Moreover, we invite you to submit interesting case reports or case series about the topic, providing an up to date literature revision. We also encourage the submission of original manuscripts spanning basic to clinical research and focusing the AAS use/abuse combined with dietary, lifestyle, and pharmacological interventions; moreover, it could be very interesting track a map of AAS use/abuse around the world, as well as the state-of-the-art on the experimental studies conducted to find new molecular biomarkers. We would also like to invite you to submit review articles aimed at providing a comprehensive overview of the recent advances in understanding of all of the discussed aspects about AAS use/abuse.

Prof. Cristoforo Pomara
Guest Editor

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Keywords

  • Anabolic androgenic steroids (AAS)
  • AASs use/abuse
  • Chemistry
  • Biological action
  • Adverse effects
  • New molecular biomarkers

Published Papers (2 papers)

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Review

24 pages, 3909 KiB  
Review
Nandrolone Decanoate: Use, Abuse and Side Effects
by Federico Giuseppe Patanè, Aldo Liberto, Andreana Nicoletta Maria Maglitto, Pasquale Malandrino, Massimiliano Esposito, Francesco Amico, Giuseppe Cocimano, Giuseppe Li Rosi, Dario Condorelli, Nunzio Di Nunno and Angelo Montana
Medicina 2020, 56(11), 606; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56110606 - 11 Nov 2020
Cited by 38 | Viewed by 13268
Abstract
Background and Objectives: Androgens play a significant role in the development of male reproductive organs. The clinical use of synthetic testosterone derivatives, such as nandrolone, is focused on maximizing the anabolic effects and minimizing the androgenic ones. Class II anabolic androgenic steroids (AAS), [...] Read more.
Background and Objectives: Androgens play a significant role in the development of male reproductive organs. The clinical use of synthetic testosterone derivatives, such as nandrolone, is focused on maximizing the anabolic effects and minimizing the androgenic ones. Class II anabolic androgenic steroids (AAS), including nandrolone, are rapidly becoming a widespread group of drugs used both clinically and illicitly. The illicit use of AAS is diffused among adolescent and bodybuilders because of their anabolic proprieties and their capacity to increase tolerance to exercise. This systematic review aims to focus on side effects related to illicit AAS abuse, evaluating the scientific literature in order to underline the most frequent side effects on AAS abusers’ bodies. Materials and Methods: A systematic review of the scientific literature was performed using the PubMed database and the keywords “nandrolone decanoate”. The inclusion criteria for articles or abstracts were English language and the presence of the following words: “abuse” or “adverse effects”. After applying the exclusion and inclusion criteria, from a total of 766 articles, only 148 were considered eligible for the study. Results: The most reported adverse effects (found in more than 5% of the studies) were endocrine effects (18 studies, 42%), such as virilization, gynecomastia, hormonal disorders, dyslipidemia, genital alterations, and infertility; cardiovascular dysfunctions (six studies, 14%) such as vascular damage, coagulation disorders, and arteriosus hypertension; skin disorders (five studies, 12%) such as pricking, acne, and skin spots; psychiatric and mood disorders (four studies, 9%) such as aggressiveness, sleep disorders and anxiety; musculoskeletal disorders (two studies, 5%), excretory disorders (two studies, 5%), and gastrointestinal disorders (two studies, 5%). Conclusions: Based on the result of our study, the most common adverse effects secondary to the abuse of nandrolone decanoate (ND) involve the endocrine, cardiovascular, skin, and psychiatric systems. These data could prove useful to healthcare professionals in both sports and clinical settings. Full article
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19 pages, 991 KiB  
Review
Sudden Cardiac Death in Anabolic-Androgenic Steroid Users: A Literature Review
by Marco Torrisi, Giuliana Pennisi, Ilenia Russo, Francesco Amico, Massimiliano Esposito, Aldo Liberto, Giuseppe Cocimano, Monica Salerno, Giuseppe Li Rosi, Nunzio Di Nunno and Angelo Montana
Medicina 2020, 56(11), 587; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56110587 - 04 Nov 2020
Cited by 48 | Viewed by 11876
Abstract
Background and objectives: Anabolic-androgenic steroids (AASs) are a group of synthetic molecules derived from testosterone and its related precursors. AASs are widely used illicitly by adolescents and athletes, especially by bodybuilders, both for aesthetic uses and as performance enhancers to increase muscle growth [...] Read more.
Background and objectives: Anabolic-androgenic steroids (AASs) are a group of synthetic molecules derived from testosterone and its related precursors. AASs are widely used illicitly by adolescents and athletes, especially by bodybuilders, both for aesthetic uses and as performance enhancers to increase muscle growth and lean body mass. When used illicitly they can damage health and cause disorders affecting several functions. Sudden cardiac death (SCD) is the most common medical cause of death in athletes. SCD in athletes has also been associated with the use of performance-enhancing drugs. This review aimed to focus on deaths related to AAS abuse to investigate the cardiac pathophysiological mechanism that underlies this type of death, which still needs to be fully investigated. Materials and Methods: This review was conducted using PubMed Central and Google Scholar databases, until 21 July 2020, using the following key terms: “((Sudden cardiac death) OR (Sudden death)) AND ((androgenic anabolic steroid) OR (androgenic anabolic steroids) OR (anabolic-androgenic steroids) OR (anabolic-androgenic steroid))”. Thirteen articles met the inclusion and exclusion criteria, for a total of 33 reported cases. Results: Of the 33 cases, 31 (93.9%) were males while only 2 (61%) were females. Mean age was 29.79 and, among sportsmen, the most represented sports activity was bodybuilding. In all cases there was a history of AAS abuse or a physical phenotype suggesting AAS use; the total usage period was unspecified in most cases. In 24 cases the results of the toxicological analysis were reported. The most detected AASs were nandrolone, testosterone, and stanozolol. The most frequently reported macroscopic alterations were cardiomegaly and left ventricular hypertrophy, while the histological alterations were foci of fibrosis and necrosis of the myocardial tissue. Conclusions: Four principal mechanisms responsible for SCD have been proposed in AAS abusers: the atherogenic model, the thrombosis model, the model of vasospasm induced by the release of nitric oxide, and the direct myocardial injury model. Hypertrophy, fibrosis, and necrosis represent a substrate for arrhythmias, especially when combined with exercise. Indeed, AAS use has been shown to change physiological cardiac remodeling of athletes to pathophysiological cardiac hypertrophy with an increased risk of life-threatening arrhythmias. Full article
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