Radix Paeoniae Alba increases serum estrogen level and up‐regulates estrogen receptor expression in uterus and vagina of immature/ovariectomized mice

Radix Paeoniae Alba (RPA) is widely used in clinical treatment for gynecological diseases, particularly abnormal menstruation, menstrual pain, and breast tenderness; however, no scientific evidence base links RPA to estrogen replacement therapy. In this study, we characterize estrogenic activity of RPA using immature and ovariectomized (OVX) mice together with in vitro studies focus on estrogen receptor (ER) pathway for molecular mechanism. RPA treatments demonstrated significant estrogenic activity, as indicated by promoting the development of uterus and vagina in immature mice, reversing the atrophy of uterus and vagina in OVX mice, up‐regulating the expressions of ERα and ERβ at protein and mRNA level in reproductive tissues. Meanwhile, RPA significantly increased serum estradiol and clearly decreased serum luteinizing hormone and follicle‐stimulating hormone of immature/OVX mice. Moreover, RPA could induce ER positive MCF‐7 cell from S‐phase to G2 stage and induce proliferation and no influence on ER negative MDA‐MB‐231 cell. RPA could bind with ERα and ERβ and significantly stimulate ERα/β‐estrogen response element (ERE) luciferase reporter gene expression. All activities were inhibited by the ER antagonist ICI 182,780. This study illustrates RPA exerts estrogenic effects by stimulating biosynthesis of estrogen in circulation, up‐regulating ERs in target tissues, and mimicking the estrogen through ER‐ERE‐dependent pathway.     

Human biomonitoring pilot study DEMOCOPHES in Germany: Contribution to a harmonized European approach

Human biomonitoring (HBM) is an effective tool to assess human exposure to environmental pollutants, but comparable HBM data in Europe are lacking. In order to expedite harmonization of HBM studies on a European scale, the twin projects COPHES (Consortium to Perform Human Biomonitoring on a European Scale) and DEMOCOPHES (Demonstration of a study to Coordinate and Perform Human Biomonitoring on a European Scale) were formed, comprising 35 partners from 27 European countries.In COPHES a research scheme and guidelines were developed to exemplarily measure in a pilot study mercury in hair, cadmium, cotinine and several phthalate metabolites in urine of 6–11 year old children and their mothers in an urban and a rural region. Seventeen European countries simultaneously conducted this cross-sectional DEMOCOPHES feasibility study.The German study population was taken in the city of Bochum and in the Higher Sauerland District, comprising 120 mother-child pairs. In the present paper features of the study implementation are presented. German exposure concentrations of the pollutants are reported and compared with European average concentrations from DEMOCOPHES and with those measured in the representative German Environmental Survey (GerES IV).German DEMOCOPHES concentrations for mercury and cotinine were lower than the European average. However, 47% of the children were still exposed to environmental tobacco smoke (ETS) outside their home, which gives further potential for enhancing protection of children from ETS.Compared with samples from the other European countries German participating children had lower concentrations of the phthalate metabolites MEP and of the sum of 3 DEHP-metabolites (MEHP, 5OH-MEHP and 5oxo-MEHP), about the same concentrations of the phthalate metabolites MBzP and MiBP and higher concentrations of the phthalate metabolite MnBP. 2.5% of the German children had concentrations of the sum of 4 DEHP-metabolites and 4.2% had concentrations of MnBP that exceeded health based guidance values, indicating reasons for concern.Continuous HBM is necessary to track changes of pollutant exposure over time. Therefore Germany will continue to cooperate on the harmonisation of European human biomonitoring to support the chemicals regulation with the best possible exposure data to protect Europe’s people against environmental health risks.     

Different types of opioid receptors mediating analgesia induced by morphine,DAMGO, DPDPE,DADLE and β-endorphin in mice

Summary The effects of intracerebroventricular (i.c.v.) administration of d-Phe-Cys-Tyr-d-Try-Orn-Thr-Pen-Thr-NH₂ (CTOP), a selective mu-opioid receptor antagonist, (Allyl)2-Tyr-Aib-Aib-Phe-Leu-OH (ICI 174864) and (N,N-Bisallyl-Tyr-Gly-Gly--(CH₂S)-Phe-Leu-OH (ICI 154129), selective delta-opioid receptor antagonists on blocking analgesia induced by -endorphin, morphine, d-Ala²-NMePhe⁴-Gly-ol-enkephalin (DAMGO), d-Ala²-d-Leu⁵-enkephalin (DADLE) and d-Pen²-enkephalin (DPDPE) administered i.c.v. were studied in male ICR mice. The analgesia was assessed by the tail-flick and paw-licking (hot-plate) tests. The potencies of opioid agonists injected i.c.v. for producing analgesia were DAMGO > DADLE > -endorphin > morphine > DPDPE. Intracerebroventricular administration of CTOP (0.05 g) selectively antagonized inhibition of the tail-flick and paw-licking response induced by morphine, DAMGO or DADLE but not -endorphin or DPDPE. ICI 174864 (5 g) and ICI 154129 (5 g) injected i.c.v. selectively antagonized analgesia induced by DPDPE or DADLE but not -endorphin, morphine or DAMGO injected i.c.v. These results indicate that analgesia induced by morphine and DAMGO is mediated by the stimulation of mu-opioid receptors while analgesia induced by DPDPE is mediated by the stimulation of delta-opioid receptors. DADLE-induced analgesia is mediated by the stimulation of both mu- and delta-opioid receptors. Analgesia induced by -endorphin is mediated by neither munor delta-opioid receptors.Abbreviations i.c.v. intracerebroventricular - i.t. intrathecal - CTOP d-Phe-Cys-Tyr-d-Try-Orn-Thr-Pen-Thr-NHZ - DAMGO d-Ala²-NMePhe²-Gly-ol-enkephalin - DADLE d-Ala²-d-Leus-enke-phalin - DPDPE dd-Pen²-dd-Pen⁵-enkephalin - ICI 174864 (Allyl)2Tyr-Aib-Aib-Phe-Leu-OH - ICI 154129 (N,N-Bisallyl-Tyr-Gly-Gly-(CH₂S)-Phe-Leu-OH     

Factors affecting tumor responders and predictive biomarkers of toxicities in cancer patients treated with immune checkpoint inhibitors

Cancer immunotherapy has brought a great revolution in the treatment of advanced human cancer. Immune checkpoint inhibitors (ICIs) that target cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and the programmed cell death protein 1 pathway (PD-1/PD-L1) have been widely administrated in the past years and demonstrated promising in a variety of malignancies. While some patients show benefit from ICIs, others do not respond or even develop resistance to these therapies. Among the responders, the treatments are consequently accompanied with immune-related adverse effects (irAEs), which are diverse in their effected organs, degree of severity and timing. Some of the toxicities are fatal and result in discontinuance of immunotherapy. The toxicity profile from anti-CTLA-4 to anti-PD-1/PD-L1 immunotherapies is distinct from those caused by conventional anticancer therapies, though their presentation may be similar. In order to better help clinicians recognize, monitor and manage irAEs in a growing population of cancer patients who are receiving ICI therapy, this article summarizes the FDA approved ICIs and focuses on (1) existing toxic evidence related to ICIs, (2) occurrence of irAEs, (3) factors influencing tumor responders treated with ICIs, (4) predictive biomarkers of irAEs, and (5) new potential mechanisms of resistance to ICI therapy.     

Pre- and Post-Injection Needle Pain in Patients Undergoing First Intracavernosal Injection

BackgroundIntracavernosal injections (ICI) are a well-established treatment option for men with erectile dysfunction (ED); however, the anticipation of pain with injection remains a significant barrier to the use of ICI.AimTo evaluate the patient-anticipated degree of pain versus the experienced degree of pain pre- and post-ICI in men undergoing their first injection with an erectile agent.MethodsWe studied 51 patients who underwent their first ICI in our men's health clinic. Anticipated needle-associated pain was judged with a pre-injection score, and pain experienced during the injection was judged with a post-injection score. All patients graded their pre- and post-ICI pain using a standard 10-point scale (0–10).OutcomesPre- and post-ICI pain was defined with the visual analogue scale (0–10) in men undergoing their first penile injection.ResultsMedians and interquartile ranges (IQRs) of the patients' age [65 years (54.5–68.0)], pre-injection pain [5 (4–7)], and post-injection pain [1 (1–2)] were recorded. Most men in the study had erectile dysfunction (68.6%) and/or Peyronie's Disease (64.7%). The average pre-injection prediction pain score was 5.45 ± 2.15; the average post-injection perceived pain score was 1.20 ± 0.73. Thus, there was an average discrepancy of over 4 points in predicted pain vs perceived pain. A paired t-test was performed which showed a statistically significant difference between pre- and post-injection scores (P < .05). A Wilcoxson Signed Rank Test showed statistical significance in the difference between pre- and post-injection pain scores (P < .05).Clinical ImplicationsICI is a safe, effective treatment for patients with ED and is associated with significantly less pain than is anticipated by patients.Strengths & LimitationsThis is the first report to describe the discrepancy between pre-ICI anticipated pain and post-ICI experienced pain. Limitations include an overall small sample size.ConclusionPatients experience significantly less pain with ICI than they anticipate having. This represents an important factor to consider when counseling patients about available ED treatments.Baird B, Wajswol E, Ericson C et al. Pre- and Post-Injection Needle Pain in Patients Undergoing First Intracavernosal Injection. J Sex Med 2022;19:590–593.     

Natural killer cell immunotherapies against cancer: checkpoint inhibitors and more

After many years of research, recent advances have shed new light on the role of the immune system in advanced-stage cancer. Various types of immune cells may be useful for therapeutic purposes, along with chemical molecules and engineered monoclonal antibodies. The immune effectors suitable for manipulation for adoptive transfer or drug targeting in vivo include natural killer (NK) cells. These cells are of particular interest because they are tightly regulated by an array of inhibitory and activating receptors, enabling them to kill tumor cells while sparing normal cells. New therapeutic antibodies blocking the interactions of inhibitory receptors (immune checkpoint inhibitors, ICI) with their ligands have been developed and can potentiate NK cell functions in vivo.     

硝普钠阴茎海绵体内注射治疗阳萎的临床研究

本研究选择４２例阳萎患者，采用硝普钠进行阴茎海绵体注射（ＩＣＩ），并选择罂粟碱／酚妥拉明进行对照，结果表明，硝普钠ＩＣＩ后：（１）阴茎外形性状（长度、周径等）明显改变。（２）Ｖｉｒａｇ硬度计点表明硝普钠与罂粟碱／酚妥拉明效果之间无明显差别。（３）所有测试患者无一例出现低血压或局部不适等副反应，与罂粟碱／酚妥拉明相比各有优劣，但总体差异不大，这充分表明，硝普钠作为一种ＮＯ供体可导致阴茎平滑肌松弛，血窦充盈阴茎勃起，其副反应较小，有其临床应用之价值。     

Protein Kinase C<Emphasis Type="Bold"> α</Emphasis> is a marker for antiestrogen resistance and is involved in the growth of tamoxifen resistant human breast cancer cells

Development of resistance to antiestrogen treatment in breast cancer patients is a serious therapeutic problem. The molecular mechanisms contributing to resistance are currently unclear; however it is known that increased activation of growth signaling pathways is involved. Protein Kinase C α (PKCα) is associated with a diverse range of cancers and is previously shown to be overexpressed in three out of four antiestrogen resistant breast cancer cell lines. In this study we investigated whether PKCα contributes to antiestrogen resistant growth. A panel of nine resistant cell lines was investigated, all of which displayed elevated levels of PKCα expression relative to parental MCF-7 cells. Stable PKCα overexpression in MCF-7 cells significantly reduced sensitivity to the antiestrogens, tamoxifen and ICI 182,780. Two resistant cell lines were chosen for further studies: tamoxifen resistant MCF-7/TAM^R-1 (TAM^R-1) and ICI 182,780 resistant MCF-7/182^R-6 (182^R-6). Treatment with the PKCα inhibitor Ro-32–0432 resulted in a preferential growth inhibition of these two cell lines relative to MCF-7 cells. Moreover, transient down-regulation of PKCα resulted in a 30–40% growth inhibition of TAM^R-1 and 182^R-6, while MCF-7 remained unaffected. Stable PKCα knock-down in TAM^R-1 using small hairpin RNA, resulted in a tamoxifen sensitive “MCF-7–like” growth phenotype, while the same approach in 182^R-6 cells did not alter their sensitivity to ICI 182,780. These results demonstrate a functional contribution of PKCα to tamoxifen resistant growth. Furthermore, our data suggest the potential for PKCα as a marker for antiestrogen resistance and as a promising therapeutic target in the treatment of tamoxifen resistant breast cancer.     

(-)-Epigallocatechin-3-gallate downregulates estrogen receptor alpha function in MCF-7 breast carcinoma cells

Background: (−)-Epigallocatechin-3-gallate (EGCG) is the most active catechin present in green tea, demonstrated to have chemopreventive action and to kill cancer cells selectively. As a previous study found that catechins could compete with 17-β-estradiol for binding to estrogen receptor alpha (ERα), we asked whether EGCG could regulate ERα action. Methods: We used MCF-7, a breast carcinoma cell line having a high level of ERα expression. The cells were treated with various EGCG concentrations and cell viability was evaluated by MTT assay. ERα and pS2 expression were analyzed by RT-PCR after RNA extraction. To better define EGCG action in relation to ERα, we studied EGCG cytotoxicity on MCF-7 resistant to tamoxifen (MCF-7tam), MCF-7 treated with 10⁻⁷ M ICI 182,780 for 8 days and on MDA-MB-231, a cell line that lacked ERα by flow cytometry (FCM). Results: Both ERα and pS2 mRNA were expressed in samples treated with low EGCG concentration (30 μg/ml). At this concentration, no cell change was detectable. In contrast, pS2 expression was lost in samples treated with 100 μg/ml EGCG for 24 h, indicating ERα alteration. EGCG cytotoxicity was lower when ERα was not present (MDA-MB-231) or inactivated (by tamoxifen or ICI 182,780). Conclusions: Functionally active ERα may have a role in EGCG cytotoxicity, increasing the sensitivity to the drug. As higher EGCG concentrations also killed cells resistant to tamoxifen or treated by 10⁻⁷ M ICI 182,780, EGCG ought to be better investigated in breast carcinoma cells treated with drugs targeted to steroid receptors, as a potential complement of therapy.     

Induction of insulin‐like growth factor binding protein expression by ICI 182,780 in a tamoxifen‐resistant human breast cancer cell line

Earlier studies in our laboratory demonstrated that the steroidal antiestrogen ICI 182,780 is very effective in abolishing the tamoxifenresistant proliferation of MCF 7/523 cells [1]. In addition, preliminary binding studies showed that ICI 182,780 increased the binding of insulinlike growth factor (IGF)I to the MCF 7/523 cells, although this finding was not the result of an increase in the expression of the insulinlike growth factorI receptor (IGFIR). Hence, we reasoned that the inhibition of tamoxifenresistant cell growth by ICI 182,780 might have been due to increased expression of insulinlike growth factor binding proteins (IGFBPs).We observed the upregulation of noninsulinsuppressible IGFI binding in both the tamoxifensensitive MCF 7/521 cell line (1.5fold) and the tamoxifenresistant MCF 7/523 cell line (2.5fold) after 5 days of treatment with ICI 182,780 (10^–7 M) in serumfree medium, suggesting a role for cellassociated IGFBPs. Affinity crosslinking experiments confirmed the presence of an IGFI:IGFBP complex of approximately 38kDa in tamoxifen or ICI 182,780treated cells. Western ligand blots showed higher levels of a soluble 30kDa IGFBP in media conditioned by either of the subclones that had been treated with ICI 182,780, an effect consistently opposed by estrogen (E₂:10^–9 M). RTPCR showed higher levels of IGFBP5 mRNA than any of the other known IGFBPs, suggesting that this was the major IGFBP subtype. The protein was subsequently identified by Western immunoblotting as IGFBP5. In conclusion, we postulate that this may be a mechanism contributing to the greater potency of ICI 182,780 in the growth inhibition of the MCF 7/523, tamoxifenresistant cell line.