In order to avoid any confusion, this conversation specifically applies to antidepressants and their interaction with 3a-HSD.
You have to think of this in terms of two separate time frames:
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While taking antidepressant: AD induces (activates) 3a-HSD, causing a drop in DHT levels inside the cell (and an increase in 3a-diol-G). This presumably leads to “PFS” with certain AD users (calles “Post SSRI Sexual Dysfunction”).
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After aquiring “PFS”: Patient has become androgen resistant, causing a drop in AR signaling, which in turn downregulates 3a-HSD, causing a drop in 3a-diol-G (3a-HSD is induced/activated by AR signaling).
Is that any clearer?
That’s like asking me what the result of a fooball game will be before knowing who is playing.
Seriously, as said before, we need to find out more about the problem before your question can be answered. What the basic problem is seems pretty clear at this point. We are talking about a problem, and this should be no surprise, which is going on at the cell level. One of the key factors determining how a cell is working, and if it is working correctly, is called gene expression. Everything which goes on inside a cell is ultimately governed by genes. Genes (combined with epigenetics) are the blueprint, which tell the cell who it is and what it must do.
Genes encode proteins and it is these proteins, which make things happen inside the cell. The steps involved in this process are called transcription, translation and post translational modification. We have basically found something to be wrong at the protein (AR) level. But we don’t know yet as to why. The next major experiment, which we currently lining up, will look at precisely that question. We will be looking at gene expression, which will tell us which genes are not behaving as expected.
Once we know that, then we hopefully will have a potential therapeutic target. But it really is like the proverbial box of chocolates; you don’t know what’s in it until you open it up and look inside. If we find 100+ genes deregulated, then we obviously will have a big problem finding a therapeutic target. If we find only a few genes out of whack, then it will be easier to potentially target the right gene(s).
The next question will be if there is a know substance that can help us alter the gene expression signature in a favorable way. There are various databases which allow you to match gene expression signatures with known substances. Such databases can help us find potential candidate drugs to attempt a therapy. But maybe there isn’t a known substance that will help us rectify the problem. We need to precisely know what we are dealing with in order to answer that.
Then, it could be that the expression of certain genes has been persistently altered by an epigenetic modification, such as methylation. This is likely and could add additional complexity to the problem. Again, we can’t really dig into that aspect before we understand exactly which genes are involved.
In short, finding a cure of some sort, or at least a substantial alleviation of the symptoms, is not impossible - but it’s no easy task. At this point, we simply need more information. It boils down to the same thing I said many times before: We need to continue going down this path in order to find out if we will get to our destination. The only thing that I can say for sure at this point is, that the other option - standing still - will get us no where. So even if this route doesn’t promise a sure outcome, it’s for sure a lot better than standing still. What at least is encouraging at this point, is that we have found very strong evidence that we are on the right path.
The next step, however, will not be for free. For it to happen, we will need the support of every member on this forum to help fund this project. We will be looking for a sum in the area of about USD 40 - 50K. Pulling off a research project like this is not an easy venture. After a very successful first round of experiments, we have been working for many months now to prepare the next steps. Many factors have to be lined up for a project like this to work. Once we have everything finalized, and we hope this will be the case sometimes in this quarter, we will clearly communicate what has been found so far, why what we found from penile skin is relevant to the problem as a whole, and what we are planning on doing next.
It then will be up to all of us to help make it happen.