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La diferenciación sexual: ¿masculino o femenino?

By: | Tags: | Comments: 892 | enero 13th, 2018

-Lo que ocurre en el embrión:

La diferenciación sexual en el embrión humano, es en sí misma la diferenciación en sentido masculino, ya que el sexo por defecto es el femenino; esto quiere decir que para que se desarrolle el embrión masculino, debe desviarse ese camino natural que llevaría al embrión a diferenciarse en sentido femenino.
Esto se logra a partir del producto de un gen, el gen SRY, que se encuentra en el cromosoma Y, de los varones, el que entre sus acciones más importantes, estimula la persistencia de los cordones sexuales primarios, lo que es sinónimo de la transformación de la gónada indiferenciada en testículo, ya que de atrofiarse los mismos, serían reemplazados por los cordones sexuales secundarios, característicos del ovario.
Una vez que la gónada del embrión se ha diferenciado en testículo, en él podemos encontrar las células de Sértoli y las de Leydig, cada una con funciones importantes en este mecanismo de diferenciación en sentido masculino:
Las células de Sértoli elaboran hormona anti-mülleriana (HAM) que induce la involución del conducto de Müller (Muller 1832).Las células de Leydig sintetizan andrógenos (testosterona) que cumplen una doble función en este mecanismo: por un lado estimulan la persistencia y desarrollo de los conductos de Wolff (Caspar Wolff, 1820) y por otra parte masculinizan los genitales externos.
En el embrión femenino, en el ovario, no encontramos ninguno de estos dos tipos celulares, por lo tanto no habra ni HAM, por lo tanto no se atrofia el conducto de Müller y ante la falta de andrógenos, sí desaparece el de Wolff (por falta de testosterona) de esta manera, los genitales externos evolucionarán en sentido femenino.
Es sorprendente la cantidad de trastornos y patologías que hay, por estas complejas cascadas que existen para la generación de hormonas, como por ejemplo el síndrome de Morris o pseudohermafroditismo masculino, ya que es una enfermedad donde el individuo afectado tiene un genotipo y fenotipo (caracterísicas heredadas y apariencia externa) de diferentes sexos, vendría a ser como el caso de un transgénero congénito, en sentido figurado, por causas naturales, sin que intervenga, ningún agente externo.

-El síndrome de Morris:

Este síndrome se define como una anomalía física, en la que una persona cuenta con la genética de un sexo (masculino) y los genitales de otro (femenino). Esto también es conocido como (SIA): sindrome de insensibilidad a los andrógenos (testosterona), por ausencia de receptores.
La anomalía se debe a que los hombres son resistentes a las hormonas masculinas, es decir, los andrógenos (testosterona entre ellos). Lo cual provoca el desarrollo no sólo de los órganos genitales del otro sexo, sino que también el aspecto será el de una mujer y no darse cuenta nadie, de que hay una patología, hasta la adolescencia, en la que no aparecerá la menstruación.Por lo tanto la asignación sexual, será de mujer, desde el nacimiento.
Presentarán rasgos femeninos, órganos sexuales femeninos o similares, testosterona con niveles similares a los del hombre, pero debido a la patología los andrógenos no pueden actuar normalmente.
El síndrome de Morris( descrito 1953) es una enfermedad rara, (fué descrita como síndrome de feminización testicular), ya que afecta tan sólo a 1 de cada 40.000 bebés niños nacidos. Sin embargo, debido a solo se conocen algunos casos, es posible que la prevalencia sea aún mayor.Se considera que es la tercera causa de amenorrea en la pubertad.
En la forma severa, los genitales son femeninos pero a veces pueden presentar problemas como un tamaño más reducido de la vagina, y sin conexión a otro órgano, con hipoplasia de los labios de la misma.La mayoría poseen testículos, pero estos no descendieron y permanecen en el abdomen. Los cuales suelen extirparse, cuando se hace el dianóstico para evitar el desarrollo de cáncer en el futuro.
A las personas afectadas no les aparece (o lo hace de forma escasa) vello en las axilas o en el pubis. En la pubertad no hay menstruación, ya que genéticamente son hombres.Los individuos afectados son infértiles, ya que no se han desarrollado, ni los ovarios, ni el útero.
Causas del síndrome de Morris:
La enfermedad es de carácter hereditario, donde existe una mutación en un gen, llamado AR, que se encuentra en el cromosoma X, ya que los hombres solo tienen un cromosoma X, es más fácil que desarrollen la enfermedad, en tanto la mujer puede ser portadora de la mutación del gen, y transmitirla a un hijo . Lo que provoca el problema, es la ausencia de receptores, que son las proteínas AR (receptores de andrógenos), lo cual no permite actuar en conjunto con la testosterona para la formación o desarrollo masculino; lo que significa que la persona es resistente a la testosterona.
Para explicar el proceso de forma mucho más sencilla, debe tenerse en cuenta que las mujeres presentan los cromosomas XX, mientras que los hombres los XY. Su principal diferencia es que los hombres producen testosterona y esta hormona se encarga del desarrollo del individuo masculino. Cuando el cuerpo tiene ausencia de la misma, (en este caso la hay, generada por el propio embrión pero es como si no la hubiera, ya que al no haber receptores, se transformá en estrógeno), entonces el individuo se desarrolla como una mujer externamente a pesar que en el interior sigue siendo hombre, en sus genes.

Diagnóstico del síndrome de Morris:

El diagnóstico no suele hacerse en la etapa de la niñez del individuo, puesto que en ese momento aún no presenta síntomas que indiquen que padec e esta henfermedad. Es en la etapa de la pubertad cuando el problema es manifiesto, donde los médicos podrán realizar diferentes pruebas para diagnosticar a la persona:
Un estudio cromosómico puede constatar la existencia del cariotipo 46 XY, característico de las personas que presentan el síndrome.Debido a que la vagina suele ser ciega y de menor tamaño, con la ayuda de una ecografía ginecológico se podría observar la ausencia de útero y ovarios.
Las personas afectadas con el síndrome, reciben tres tratamientos: terapia de dilatación, gonadectomía y terapia psicológica que ayudará a que el paciente pueda sentirse a gusto con su cuerpo, como debe ser y evitar complejos absurdos.
En la pubertad, se desarrollan los caracteres sexuales femeninos, alcanzando una total apariencia de mujer, por la acción del estradiol,que se genera a partir de la testosterona, que es transformada por la acción de una enzima llamada aromatasa.
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