Background/aims-Androgens have been reported to influence the structural organisation, functional activity, and/or pathological features of many ocular tissues. In addition, these hormones have been proposed as a topical therapy for such conditions as dry eye syndromes, corneal wound healing, and high intraocular pressure. To advance our understanding of androgen action in the eye, the purpose of the present study was twofold: firstly, to determine whether tissues of the anterior and posterior segments contain androgen receptor protein, which might make them susceptible to hormone eVects following topical application; and, secondly, to examine whether these tissues contain the mRNA for types 1 and/or 2 5 -reductase, an enzyme that converts testosterone to the very potent metabolite, dihydrotestosterone. During the past several decades, it has become quite apparent that androgens exert a significant influence on the structural organisation, functional activity, and/or pathological features of many ocular tissues, including the lacrimal gland, meibomian gland, conjunctiva, cornea, lens, uvea, and/or retina. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] The nature of this hormone action appears to involve the regulation of such ocular factors as glandular morphology, gene expression, protein synthesis and secretion, lipid production, tear film stability, immune function, epithelial cell mitosis, aqueous outflow pathway characteristics, intraocular pressure, and vascular permeability.
Methods-Human1-5 10 13-16 In addition, androgens have been proposed as a topical therapy for such conditions as aqueous deficient and evaporative dry eye syndromes, corneal wound healing, and glaucoma. However, despite these findings, very little information exists concerning the precise target cells for androgen action, the specific ocular processes controlled by these hormones, or the mechanisms underlying androgen-eye interactions in humans.The mechanism(s) by which androgens act on the human eye most likely involves the local, intracrine synthesis of these hormones from adrenal sex steroid precursors (that is, dehydroepiandrosterone (DHEA) and DHEA sulphate (DHEA-S)) and a consequent androgen association with saturable, high aYnity, and steroid specific receptors in ocular tissues.
19The rationale for this hypothesis is twofold. Firstly, a large proportion of androgens in men, and the majority of these hormones in women, are produced in peripheral tissues from adrenal precursors. 18 In fact, humans and primates are unique in possessing adrenal glands that secrete large amounts of DHEA and DHEA-S, which are then converted into potent androgens and oestrogens by steroidogenic enzymes in peripheral sites and thereby permit target tissues to adjust the formation and metabolism of sex steroids to local requirements. 18 20 Secondly, androgen receptors, which are members of the steroid/thyroid hormone/retinoic acid family of ligand activated transcription factors, appear to mediate almost all of the "classic" actions ...