Asian journal of andrology最新文献

{"title":"Modifiable key factors and semen quality in men undergoing preconception evaluation: a cross-sectional study.","authors":"Hai-Lin Yao, Ting-Ting Yang, Run Tian, Chang Zhao, Fan Yang, Zhen-Mi Liu, Fu-Ping Li","doi":"10.4103/aja20263","DOIUrl":"10.4103/aja20263","url":null,"abstract":"<p><p>Male preconception lifestyle factors, such as smoking, alcohol consumption, and body mass index, may affect semen quality, but their dose-dependent and nonlinear effects remain unclear. We retrospectively analyzed 3336 men attending the Department of Andrology, West China Second University Hospital, Sichuan University (Chengdu, China) between January 2019 and June 2023 and collected their demographic information, lifestyle behaviors, and semen parameters. Associations were examined using multivariable regression models with natural cubic splines, with adjustment for age, abstinence period, and season. Smoking showed a clear dose-dependent adverse effect on semen quality as shown by a decline in sperm concentrations, total sperm count, and sperm motility in men who smoked more than 20 cigarettes each day or for longer than 10 years. Former drinkers showed limited improvement in sperm motility. The body mass index showed complex nonlinear associations with semen volume and sperm morphology, and some parameters peaked in mildly overweight men, while obesity remained associated with impaired semen quality. These findings highlight the substantial role of lifestyle factors in male reproductive health during the preconception period and emphasize the importance of smoking cessation and weight management. Even modest changes in body weight may meaningfully improve semen parameters, supporting targeted lifestyle guidance in preconception care.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"596-602"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of sulfur dioxide exposure with sperm quality in reproductive-aged men: the mediating and moderating roles of essential elements in seminal plasma.","authors":"Tao Yin, Xin-Yu Zhou, Xiao-Qing Li, Rui Dong, Qian Li, Xin-Yu Yue, Dong-Yang Zhang, Xun Su, Fang-Biao Tao, Gui-Ying Luo, Dong-Mei Ji, Chun-Mei Liang, Yun-Xia Cao","doi":"10.4103/aja202574","DOIUrl":"10.4103/aja202574","url":null,"abstract":"<p><p>Currently, there are limited data to support the association between sulfur dioxide (SO 2 ) exposure and semen quality. Here, we analyzed nine elements including vanadium (V), chromium (Cr), iron (Fe), copper (Cu), cobalt (Co), nickel (Ni), manganese (Mn), selenium (Se), and strontium (Sr) in seminal plasma of 738 participants using inductively coupled plasma mass spectrometry (ICP-MS). Each participant was assigned an average SO 2 exposure of 0-90 days preceding semen collection. Associations were determined using multivariable linear models, susceptible exposure windows were identified via distributed lag nonlinear models (DLNM), and indirect effects and effect modification were examined based on mediation and interaction analyses. Notably, SO 2 exposure was negatively associated with sperm concentration ( β : -0.07; 95% confidence interval [CI]: -0.13 to -0.01; P = 0.02), total sperm count ( β : -0.09; 95% CI: -0.15 to -0.03; P < 0.01), progressive motility ( β : -0.04; 95% CI: -0.07 to -0.01; P = 0.02), and total motility ( β : -0.03; 95% CI: -0.07 to -0.01; P < 0.01), but positively associated with sperm abnormal morphology ( β : 0.27; 95% CI: 0.12 to 0.42; P < 0.01). DLNM identified a susceptibility window during spermiogenesis (lags 37-69 days). Se was positively associated with sperm concentration ( β : 0.34; 95% CI: 0.23 to 0.45; P < 0.01) and total sperm count ( β : 0.28, 95% CI: 0.16 to 0.40; P < 0.01), mediating 23.6% and 14.6% of the effects of SO 2 , respectively. A significant interaction between SO 2 and Ni was detected in sperm abnormal morphology ( β : 0.28; 95% CI: 0.05 to 0.51; P = 0.02). These results indicate that SO 2 exposure may reduce semen quality, and this effect may be mediated by Se and modified by Ni.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"586-595"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human pyriform sperm heads in infertile men and assisted reproductive technology outcomes: a retrospective cohort study based on propensity score matching.","authors":"Ye-Lin Jia, Ting-Ting Yang, Qing-Yuan Cheng, Ying-Bi Wu, Yan Zheng, Lin Yu, Fu-Ping Li","doi":"10.4103/aja202595","DOIUrl":"10.4103/aja202595","url":null,"abstract":"<p><p>This study explores the effect of pyriform sperm heads on basic semen parameters, advanced sperm functions, and assisted reproductive technology outcomes. From 2300 patients with pyriform sperm heads in semen, a cohort of 59 couples from the Andrology Clinic of West China Second University Hospital (Sichuan University, Chengdu, China) between January 2022 and July 2024 undergoing assisted reproductive technology were studied. After 108 cycles with 81 embryos transferred, 37 couples achieved clinical pregnancy. Sperm concentration, percentage vitality, total motility, normal morphology, nuclear maturity, acrosomal integrity, acrosome reaction, and mitochondrial membrane potential were significantly lower in the pyriform sperm head group than those in the control group by propensity score matching (all P < 0.05). Non-progressive motility, immotile spermatozoa, the teratozoospermia, sperm deformity, DNA fragmentation index, and DNA stainability were higher in the pyriform sperm head group than those in the control group after propensity score matching (all P < 0.05). Nine morphometric parameters from 2805 typical pyriform sperm heads were evaluated. Cut-off values for predictive diagnostic use of 24.0%, 31.6%, 29.8%, 16.1%, 17.3%, 22.1%, and 9.2% were proposed for the proportion of pyriform sperm heads in seminal samples with abnormal DNA fragmentation index, high DNA stainability, sperm nuclear maturity, sperm acrosome integrity, acrosome reaction, acrosin activity, and mitochondrial membrane potential, respectively. High-quality embryos (35.2% vs 16.8%), clinical pregnancy (46.2% vs 43.8%), and live birth rates (21.5% vs 18.8%) were higher of spermatozoa from samples with a low proportion of pyriform sperm heads (≤38.5%) than with a high proportion of pyriform spermatozoa (>38.5%). The percentage of pyriform sperm heads could be introduced as a diagnostic evaluation parameter before treatment of sperm function and assisted reproductive technology.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"568-577"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects and mechanism of low-intensity pulsed ultrasounds on testicular steroidogenesis in rats.","authors":"Xianghu Meng, Feng Zhou, Majken Højrup Wiborg, Caipeng Qin, Lia Banie, Weerayut Wiriyabanditkul, Guifang Wang, Guiting Lin, Tom F Lue","doi":"10.4103/aja20262","DOIUrl":"10.4103/aja20262","url":null,"abstract":"<p><p>Low-intensity pulsed ultrasound (LIPUS) has emerged as a non-invasive therapeutic approach with regenerative potential in various tissues. This study explores its effects on testicular steroidogenesis in male rats. Twenty-four 9-month-old rats were allocated into three groups: control, LIPUS, and LIPUS-M. The LIPUS group underwent pulsed ultrasound therapy targeting the testes twice weekly for 4 weeks, whereas the LIPUS-M group continued with maintenance therapy administered once every 2 weeks for 6 months. At the end of the experiment (16 months), blood and testicular tissues were collected for analysis. Our results showed that LIPUS therapy significantly elevated serum testosterone level and increased the number of Leydig cells (LCs), as indicated by steroidogenic acute regulatory protein (STAR) and 3 β -hydroxysteroid dehydrogenase (3 β -HSD) immunofluorescence. Collagen IV staining showed increased interstitial vascularization, and senescence-associated β -galactosidase (SA- β -Gal) staining suggested reduced cellular senescence. Although the LIPUS-M group also showed increased LC counts and angiogenesis, serum testosterone levels were not elevated. These findings demonstrate that LIPUS can activate LCs and enhance endogenous testosterone production, supporting its potential as a noninvasive regenerative approach for hypogonadism.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"674-679"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel biallelic FSIP2 variants cause male infertility with multiple morphological abnormalities of sperm flagella in humans.","authors":"Jie Yang, Ting-Ting He, Ya-Nan Gu, Yu Xue, Qi Chen, Man Yu, Sen Qiao, Sheng-Jia Shi","doi":"10.4103/aja202611","DOIUrl":"10.4103/aja202611","url":null,"abstract":"<p><p>Biallelic variants in fibrous sheath-interacting protein 2 ( FSIP2 ) gene are a known cause of multiple morphological abnormalities of the sperm flagella (MMAF). This study aimed to identify novel FSIP2 variants and evaluate their impact on sperm ultrastructure and intracytoplasmic sperm injection (ICSI) outcomes. Whole-exome sequencing (WES) was employed to screen a cohort of 92 MMAF patients, with candidate variants validated via Sanger sequencing and third-generation sequencing. We identified one homozygous variant in a proband from a consanguineous family and two pairs of compound heterozygous variants in two unrelated, non-consanguineous families. Routine semen analysis demonstrated markedly reduced motility across all probands. Detailed morphological and ultrastructural assessments using Papanicolaou staining, scanning electron microscopy (SEM), and transmission electron microscopy (TEM) demonstrated that approximately 80.0% of spermatozoa exhibited pathological elongation of the mitochondrial sheath in the midpiece. Furthermore, 50.0%-70.0% of spermatozoa displayed fibrous sheath dysplasia or loss in the principal piece. Immunofluorescence assays and Western blotting confirmed that FSIP2 protein localization was disrupted, and the expression of key axonemal assembly factors was dysregulated. Notably, successful pregnancies were achieved via ICSI in the partners of two probands. This study expands the mutational spectrum of FSIP2 in both consanguineous and non-consanguineous populations. Ultrastructural abnormalities, such as mitochondrial sheath elongation and fibrous sheath disassembly, highlight FSIP2 's critical role in flagellar assembly. Clinical results further support ICSI as an effective therapeutic intervention for affected individuals.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"680-689"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of semen abnormalities and the impact of genital pathogens on male infertility: a retrospective analysis of 131 183 patients.","authors":"Jing-Jing Cui, Wen Zhong, Yi-Qiang Zhang, Xin-Yuan Zhang, Hai-Yan Zhang, Shu Li, Chun-Li Li","doi":"10.4103/aja20264","DOIUrl":"10.4103/aja20264","url":null,"abstract":"<p><p>Infertility affects approximately 15% of couples of reproductive age worldwide, with male factors contributing to nearly 40%-50% of cases. Because semen quality is a fundamental indicator of male fertility, understanding its determinants is essential for clinical assessment. In this retrospective cohort study involving 131 183 patients, we compared semen parameters between infertile men and healthy controls and explored the relationships among age, infectious microorganisms, and semen quality. Our analysis demonstrated that infertile men had significantly poorer semen quality than controls did. Age also played a critical role, with the lowest risk of male infertility observed in the 25-29 years age group; across all age groups, risk followed a U-shaped pattern. Furthermore, the presence of antisperm antibodies, Neisseria gonorrhea, Chlamydia trachomatis, Ureaplasma urealyticum , and/or Mycoplasma genitalium was associated with reduced semen quality and increased infertility risk. In contrast, although herpes simplex virus II was detected in some semen samples, its overall prevalence was low, and no significant impact on semen parameters was detected. These findings emphasize the complex interplay among age, infection, and immune factors in shaping male reproductive potential. They also highlight the need for targeted prevention and treatment strategies to mitigate the burden of male infertility and to improve future therapeutic outcomes.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"620-627"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors shaping fertility potential and reproductive outcomes in men with Klinefelter syndrome.","authors":"Itai Atar, Shimi Barda, Yael Kalma, Sandra E Kleiman, Foad Azem, Ron Hauser, Snir Dekalo, Noga Fuchs Weizman","doi":"10.4103/aja202586","DOIUrl":"10.4103/aja202586","url":null,"abstract":"<p><p>Klinefelter syndrome (KS), marked by testicular heterogeneity, provides a rationale for testicular sperm extraction in azoospermic men, yet large-scale evaluations of predictive and reproductive outcomes remain limited. This retrospective study included 79 karyotype-confirmed KS patients who underwent conventional testicular sperm extraction (cTESE) and microdissection testicular sperm extraction (micro-TESE) between February 2001 and August 2024. Clinical, hormonal, histological, embryological, and reproductive data were analyzed, with successful sperm retrieval (SR) defined as the presence of at least one spermatozoon. SR was achieved in 40.5% of patients and was significantly associated with larger testicular volumes (left: P = 0.018; right: P = 0.028), lower follicle-stimulating hormone (mean ± standard deviation [s.d.]: 29.06 ± 14.49 IU l -1vs 38.22 ± 16.97 IU l -1 ; P = 0.016), and lower luteinizing hormone levels (mean ± s.d.: 16.41 ± 7.46 IU l -1vs 20.65 ± 9.59 IU l -1 ; P = 0.047). These parameters also correlated with the number of frozen sperm vials. Among those with SR, 46 embryo transfer cycles were conducted, involving 79 embryos. Fertilization, cleavage, and blastulation rates were 50.3%, 80.7%, and 40.2%, respectively. Good-quality embryos were observed in 45.1% on day 3 and 55.0% on day 5, with clinical pregnancy and live birth rates of 39.1% and 39.5% per transfer. These findings indicate that favorable hormonal profiles and testicular characteristics are predictive of SR success and that reproductive outcomes among KS patients with sperm retrieval are comparable to those in non-KS populations. Overall, the results support the continued use of testicular sperm extraction as a viable path to genetic parenthood in this population.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"548-555"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The therapeutic effect and mechanism of low-intensity pulsed ultrasound for erectile dysfunction.","authors":"Mei-Li-Yang Wu, Wen-Chao Xu, Tao Wang, Ji-Hong Liu, Hao Li","doi":"10.4103/aja2025110","DOIUrl":"10.4103/aja2025110","url":null,"abstract":"<p><p>As an emerging therapeutic option for erectile dysfunction (ED), low-intensity pulsed ultrasound (LIPUS) has attracted increasing attention. The therapeutic effect of LIPUS is comparable to low-intensity extracorporeal shockwave therapy. However, the underlying mechanism of LIPUS remains unclear. We summarized the current literature to assess the efficacy of LIPUS for ED and elucidate the biological effects caused by LIPUS in different ED models. Preliminary clinical studies demonstrate that LIPUS is beneficial for ED with varying degrees of severity, and its therapeutic effect can be enhanced when combined with phosphodiesterase 5 inhibitors. Basic researches have shown that LIPUS can treat ED resulting from type 1 diabetes mellitus, cavernous nerve injury, or cavernosa injury. The underlying mechanisms involve upregulating endothelial and neuronal nitric oxide synthase expression, increasing smooth muscle and endothelium content, inhibiting cavernosal fibrosis mediated by the transforming growth factor-β1/drosophila mothers against decapentaplegic protein/connective tissue growth factor (TGF-β1/Smad/CTGF) pathway, and ameliorating oxidative stress via microtubule-associated protein 1 light chain 3 (LC3)- and Parkin-dependent mitophagy in type 1 diabetic ED. Yes-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ), activated by LIPUS, contribute to the recovery of neurogenic ED. Furthermore, the survival and secretion function of Schwann cells are improved by LIPUS through activating tropomyosin receptor kinase B/protein kinase B/cyclic adenosine monophosphate-response element-binding protein (TrkB/Akt/CREB) pathway, thereby accelerating cavernous nerve repair. LIPUS is a safe and effective treatment modality for ED, which can restore the pathological changes in corpus cavernosum via multiple pathways. The long-term efficacy of LIPUS needs further investigation.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"478-484"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypic modulation of corpus cavernosum smooth muscle cells in type 2 diabetic rats is mediated by regulated exosomes secretion via neutral sphingomyelinase-2.","authors":"Feng-Zhi Chen, Xin-Tao Zhang, Qin-Yu Zeng, Bing-Xin Lu, Li Wang, Hong-Bing Mei, An-Yang Wei","doi":"10.4103/aja202569","DOIUrl":"10.4103/aja202569","url":null,"abstract":"<p><p>Phenotypic modulation of corpus cavernosum smooth muscle cells (CCSMCs) is closely related to the occurrence of erectile dysfunction (ED). However, the effect of exosomes (EXOs) on the phenotypic modulation of CCSMCs with diabetes mellitus (DM)-related ED is not fully understood. Using a rat model of type 2 DM, we found an important role for phenotypic modulation of CCSMCs in DM-related ED. EXO secretion by CCSMCs is also driven by pathological changes to the corpus cavernosum in diabetic rats. We used CCSMCs subjected to platelet-derived growth factor-BB as an in vitro model of phenotypic modulation and isolated EXOs from the supernatants of cultured CCSMCs by ultracentrifugation. The results suggest that phenotypic modulation enhances the capacity of CCSMCs to secrete EXOs and that inhibiting EXO secretion could restore the contractile phenotype of CCSMCs in vitro . Notably, a further mechanistic study revealed that regulated EXO secretion could change the phenotype of CCSMCs via the neutral sphingomyelinase-2 (nSMase2) pathway. Taken together, our results indicate that the modulation of EXO biogenesis and secretion may be a novel therapeutic approach to improve type 2 DM-induced ED by maintaining the contractile phenotype of CCSMCs.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"516-525"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"177 Lu-PSMA for prostate cancer: progress, challenges and future perspectives.","authors":"Zhen Xi, Shi-Yu Ji, Yu Zhang, Ming-Hui Sun, Gao-Zhen Jia, Qi Jiang","doi":"10.4103/aja2025103","DOIUrl":"10.4103/aja2025103","url":null,"abstract":"<p><p>Prostate cancer is a malignant tumor posing significant threats to the health of men worldwide. In advanced stages, it frequently progresses to castration-resistant prostate cancer, which is characterized by complex mechanisms and poor prognosis. In such cases, conventional treatments have limited effectiveness. However, the emergence of radionuclide therapy has provided new hope. Lutetium-177-labeled prostate-specific membrane antigen ( 177 Lu-PSMA), currently the most promising radioligand in clinical research, received approval from the U.S. Food and Drug Administration (FDA) in 2022. This review comprehensively summarizes recent advancements, efficacy assessments, and safety evaluations of 177 Lu-PSMA therapy. Additionally, we analyze its current limitations and suggest future research directions for PSMA-targeted radioligand therapy (RLT). Undoubtedly, 177 Lu-PSMA-617 is transforming metastatic castration-resistant prostate cancer (mCRPC) treatment. However, challenges remain regarding its potential standardization for use in non-mCRPC cases, the optimal treatment sequence, standardized imaging/molecular biomarkers, and toxicity management, all of which require further prospective validation.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"467-477"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}