Fig. 1

Androgen production pathways leading to the progression of prostate cancer. This diagram illustrates the hormonal regulation and production of androgens in the context of prostate cancer, highlighting the roles of the hypothalamus, testes, adrenal glands, and the prostate. Hypothalamus: the hypothalamus secretes luteinizing hormone-releasing hormone (LHRH) and corticotropin-releasing hormone (CRH). LHRH stimulates the anterior pituitary gland to release luteinizing hormone (LH), while CRH stimulates the release of adrenocorticotropic hormone (ACTH). In response to LHRH, the anterior pituitary releases LH, which acts on the Leydig cells in the testes to stimulate testosterone production. In response to CRH, the anterior pituitary releases ACTH, which stimulates the adrenal glands to produce androgens. LH binds to receptors (LHR) on Leydig cells, leading to the production and release of testosterone. Testosterone is the primary androgen and can be converted to the more potent dihydrotestosterone (DHT) by the enzyme 5α-reductase in target tissues, including the prostate. ACTH stimulates the adrenal cortex to produce androgens such as androstenedione and dehydroepiandrosterone (DHEA). These adrenal androgens can be converted to testosterone and other active androgens in peripheral tissues. Prostate cancer cells can utilize testosterone and DHT for growth and proliferation. Additionally, these cells can express enzymes that convert adrenal androgens to testosterone, maintaining androgen receptor signaling even when circulating testosterone levels are low. Created with Biorender (https://www.Biorender.com).