Puberty is a complex sequence of events leading to maturation of sexual characteristics until attainment of full reproductive capacity. The hallmark of pubertal onset is reactivation of the hypothalamic–pituitary–gonadal (HPG) axis, likely due to increases in activators and decreases in inhibitors of the axis. Pubertal timing is regulated by the interplay of genetic, environmental, nutritional, and epigenetic factors. However, the mechanisms by which timely or precocious pubertal onset begins remains largely unknown. Precocious puberty (PP) is defined as onset of puberty before 8 years of age in girls and before 9 years in boys. Epidemiological evidence suggests that early age of puberty is becoming more frequent, possibly in association with the escalating prevalence of obesity. Thus, it is debatable if the age of PP should be redefined.
Most cases of PP result from early HPG axis activation and are mostly idiopathic, but may also represent pathologies or result from peripheral or exogenous hormonal exposure. There is no good diagnostic marker to differentiate central precocious puberty (CPP) from other diagnoses, especially at initial presentation. Therapy for CPP is based on long-acting GnrH analogs in different formulations. Early pubertal timing may be associated with adverse health outcomes, including higher risk of breast cancer and cardiovascular disease in adulthood. Earlier ages at menarche were also associated with higher rates of both depressive symptoms and antisocial behaviors in early-middle adulthood. Data regarding long-term reproductive and health outcome in patients with previous PP, treated and untreated are sparse. This is especially true for data on long-term patient's satisfaction and quality of life. The prevalence of PP is about 10 times as high in girls as in boys, thus, information on all aspects of PP in boys is limited.
The main objective of this Research Topic is to provide an update on the most recent research in PP, shedding light on the genetic, nutritional, epigentic, and environmental (including endocrine diruptors compounds) factors affecting puberty. Understanding the mechanisms could lead to development of diagnostic tools, new therapies and to improved practices of current therapy.
Extending the knowledge on gender differences and therapy , as well as on short and long term outcome (reproductive , general health, and psychosocial), may contribute to improvement of follow-up and prevention.
The aim of this special issue is to gather original research manuscripts, meta-analyses, and new reviews dealing with precocious puberty. The presentations of extremely rare cases of great importance will also be considered.
Areas to be covered in this Research Topic may include, but are not limited to:
• Secular trends in puberty onset;
• Etiologies, genetics and epigenetics of CPP;
• PP associated with endocrine disrupters and exogenous exposures;
• PP in McCune Albright syndrome and Familial Male Precocious Puberty;
• Diagnostic and monitoring considerations in CPP;
• Management of CPP; who should be treated?;
• Newer treatment options in CPP and future directions;
• Psychological aspects of CPP;
• Tumor associated PP;
• Long term outcomes in CPP.
Puberty is a complex sequence of events leading to maturation of sexual characteristics until attainment of full reproductive capacity. The hallmark of pubertal onset is reactivation of the hypothalamic–pituitary–gonadal (HPG) axis, likely due to increases in activators and decreases in inhibitors of the axis. Pubertal timing is regulated by the interplay of genetic, environmental, nutritional, and epigenetic factors. However, the mechanisms by which timely or precocious pubertal onset begins remains largely unknown. Precocious puberty (PP) is defined as onset of puberty before 8 years of age in girls and before 9 years in boys. Epidemiological evidence suggests that early age of puberty is becoming more frequent, possibly in association with the escalating prevalence of obesity. Thus, it is debatable if the age of PP should be redefined.
Most cases of PP result from early HPG axis activation and are mostly idiopathic, but may also represent pathologies or result from peripheral or exogenous hormonal exposure. There is no good diagnostic marker to differentiate central precocious puberty (CPP) from other diagnoses, especially at initial presentation. Therapy for CPP is based on long-acting GnrH analogs in different formulations. Early pubertal timing may be associated with adverse health outcomes, including higher risk of breast cancer and cardiovascular disease in adulthood. Earlier ages at menarche were also associated with higher rates of both depressive symptoms and antisocial behaviors in early-middle adulthood. Data regarding long-term reproductive and health outcome in patients with previous PP, treated and untreated are sparse. This is especially true for data on long-term patient's satisfaction and quality of life. The prevalence of PP is about 10 times as high in girls as in boys, thus, information on all aspects of PP in boys is limited.
The main objective of this Research Topic is to provide an update on the most recent research in PP, shedding light on the genetic, nutritional, epigentic, and environmental (including endocrine diruptors compounds) factors affecting puberty. Understanding the mechanisms could lead to development of diagnostic tools, new therapies and to improved practices of current therapy.
Extending the knowledge on gender differences and therapy , as well as on short and long term outcome (reproductive , general health, and psychosocial), may contribute to improvement of follow-up and prevention.
The aim of this special issue is to gather original research manuscripts, meta-analyses, and new reviews dealing with precocious puberty. The presentations of extremely rare cases of great importance will also be considered.
Areas to be covered in this Research Topic may include, but are not limited to:
• Secular trends in puberty onset;
• Etiologies, genetics and epigenetics of CPP;
• PP associated with endocrine disrupters and exogenous exposures;
• PP in McCune Albright syndrome and Familial Male Precocious Puberty;
• Diagnostic and monitoring considerations in CPP;
• Management of CPP; who should be treated?;
• Newer treatment options in CPP and future directions;
• Psychological aspects of CPP;
• Tumor associated PP;
• Long term outcomes in CPP.