Prevention of early postmenopausal bone loss using low doses of conjugated estrogens and the non-hormonal,bone-active drug ipriflavone

Hormone replacement therapy is the optimal therapeutic choice for postmenopausal syndrome. While low doses of estrogens (0.3 mg/day of conjugated estrogens) can counteract neurovegetative menopausal symptoms, higher doses (0.625 mg/day of conjugated estrogens) are required to prevent bone loss in postmenopausal women. Experimental and clinical studies have shown that ipriflavone, a non-hormonal isoflavone derivative, is effective in the prevention and treatment of postmenopausal osteoporosis. The aim of the present investigation was to evaluate the efficacy and toler-ability of ipriflavone and very low doses of equine conjugated estrogens on bone loss in early postmenopausal women. Eighty-three healthy postmenopausal women (50.3±0.7 years) were enrolled for this 1-year multicenter study. All subjects were randomly allocated to receive: double placebo (n=24; group A), placebo plus conjugated equine estrogens 0.30 mg/day (n=31; group B) or conjugated equine estrogens 0.30 mg/day plus oral ipriflavone 200 mg tris in die at meals (n=28; group C), according to a double-masked design. Among women who completed the treatment period (valid completers), those of group A showed a progressive decrease in forearm bone density (FBD; measured by dual photon absorptiometry) that reached 1.7% after 12 months. The women in group B maintained their FBD in the first 6 months of treatment but, at the end of the study, showed a bone loss of 1.4% compared with basal values. By contrast, women in group C showed a significant increase in FBD after 1 year of treatment (+5.6%;p<0.01). Bothvalid completers andintention to treat analyses revealed a significant difference (p<0.05) between group A and group C over the study period. None of the treatments produced significant changes of biochemical markers of bone turnover, while hot flushes and other climacteric symptoms were significantly reduced after the sixth month of treatment in women receiving estrogens. Adverse events were generally mild, and did not differ among the groups. The results of this study suggest that low doses of estrogens combined with ipriflavone could represent a new therapeutic approach to the treatment of the postmenopausal syndrome.     

Alpha2-HS glycoprotein phenotypes and quantitative hormone and bone measures in postmenopausal women

Summary It has been suggested that inherited traits play a role in the development of osteoporosis by providing a background for the modulation of gene expression. In this study, we examine the influence of the different alleles of alpha₂-HS glycoprotein (AHSG), a protein of the bone matrix, on quantitative estrogens, estrone and estradiol, and bone measures, bone area and density. Estrogens provide a protective effect against fractures in older women and were thus included in the analyses. Isoelectric focusing of AHSG from sera followed by immunoblotting was used to type 163 white post-menopausal women participating in a clinical trial of the effects of walking on bone loss. Plasma hormones were measured by a combination of extraction, column chromatography, and radioimmunoassay; bone measures on the dominant radius were determined with computerized tomography. Analysis of variance was done on estrogen and bone measures after controlling for the effects of age and body mass index. The two major alleles of AHSG result in three phenotypes, designated AHSG 1-1, AHSG 2-1, and AHSG 2-2. The AHSG 1-1 homozygote showed a decreased concentration of estradiol, the AHSG 2-2 homozygote showed an increased concentration, and the AHSG 2-1 heterozygote was intermediate (P=0.001). Estrone demonstrated a similar pattern in residual analysis although it did not reach statistical significance.     

App17肽防治去卵巢大鼠海马神经细胞的凋亡

目的:观察去卵巢大鼠几种神经元凋亡相关蛋白的表达,并用TUNEL试剂盒检测,研究缺乏雌激素是否引起神经元凋亡;评估App17肽是否能改善去卵巢大鼠的神经细胞凋亡,初步探讨App17肽的神经保护作用机制。方法:雌性Wistar大鼠随机分3组:假手术组(shamcontrol组),卵巢去势对照组(OVX组),App17肽实验组(17P+OVX组)。Sham组做假手术,OVX组和17P+OVX组做双侧卵巢切除术。17P+OVX组从卵巢去势第7周开始用App17肽治疗6周,用免疫组化和Westernblot方法观察AIF、Bax、Bcl-2的表达,用TUNEL法检测凋亡情况。结果:免疫组织化学和Westernblot结果表明App17肽实验组AIF、Bax表达明显少于去卵巢组;Bcl-2在App17肽实验组的表达明显高于去卵巢组。TUNEL结果表明App17肽实验组凋亡细胞明显少于去卵巢组。结论:雌激素缺乏引起去卵巢大鼠海马和皮层神经细胞凋亡相关蛋白改变和出现凋亡细胞,App17肽具有明显的防治作用。     

Sarcolemmal K(ATP) channels in ageing

This review highlights some recent research addressing sarcolemmal K(ATP) channels in ageing. These channels are abundant in cardiac myocytes where they are essential in coupling the cellular metabolic state with membrane excitability. The opening of sarcolemmal ATP-sensitive K+ (K(ATP)) channels occurs during ischaemia and protect the heart against injury. Age-dependent changes in the myocardial susceptibility to ischemia have been observed in different species, including humans. Recent research has demonstrated that ageing is associated with decrease in numbers of sarcolemmal K(ATP) in hearts from females, but not males. This phenomenon seems to be associated with age-dependent decrease in concentration of circulating estrogens. In the heart, SUR2A, a regulatory subunit of K(ATP) channels, is present in excess over Kir6.2, a pore-forming K(ATP) channel subunit. The consequence of this is that SUR2A is a subunit that controls the number of sarcolemmal K(ATP) channels. Estrogens specifically up-regulate SUR2A and, thereby, control the number of sarcolemmal K(ATP) channels. Age-dependent loss of sarcolemmal K(ATP) channels creates a cardiac phenotype more sensitive to ischaemia, which may explain, at least in part, an ageing-associated decrease of myocardial tolerance to stress that occurs in elderly women.     

Hereditary uroporphyrinogen-decarboxylase deficiency predisposing porphyria cutanea tarda (chronic hepatic porphyria) in females after oral contraceptive medication

Summary Porphyria cutanea tarda (PCT) was diagnosed in 27 women aged 23–48 years (mean, 35 years) who had been under oral-hormonal-contraceptive medication for 1–18 years, in 3 women under substitutional estrogen treatment in the menopause, and in 2 men aged 65 and 76 years after estrogen treatment of prostatic carcinoma. In all patients, total urinary porphyrin excretion was elevated, with an average uro-and heptacarboxyporphyrin predominance of 88%, thus proving PCT. On the patients, 84% showed a significant decrease of erythrocyte uroporphyrinogen-decarboxylase (UD; EC 4.1.1.37) activity to 50% of control levels suggesting a hereditary predisposition for the development of a chronic hepatic porphyria. Estrogens and alcohol are capable of reducing hepatic UD activity. Women with hereditary red cell UD deficiency may be regarded as predisposed to PCT when under estrogen intake, especially in combination with the potentiating influence of alcohol and chronic liver disease. Normal erythrocyte UD values in patients with additive alcohol consumption may implicate a stronger inhibitory effect for alcohol on UD, suggesting a merely toxic form of chronic hepatic porphyria.     

Drug-induced intrahepatic cholestasis: characterization of different pathomechanisms

The pathogenesis of intrahepatic cholestasis in rats was studied using isolated perfused livers as an experimental model. Three basic mechanisms were differentiated: 1. Permeabilization of the bilio-sinusoidal barrier associated with electron microscopic alterations of the tight junctional complexes was found in livers of rats treated with -naphthylisothiocyanate (ANIT, 250 mg/kg body weight). Consequences of these alterations were: reflux of bile constituents such as taurocholate and sulfobromophthalein and increased access to the biliary space of paracellular markers such as inulin and sucrose. The clear-cut mechanism of ANIT cholestasis was used to distinguish other mechanisms of intrahepatic cholestasis. 2. Inhibition of the basic process of fluid secretion was found to be the primary event in the development of cholestasis induced by estrogens. After 5 days of treating rats with ethinyl estradiol (5 mg/kg/day), bile flow was diminished in isolated livers while the permeability of the biliary tract to sucrose and inulin was not affected. Accordingly, the maximal concentration of taurocholate in bile was increased, indicating that its secretion was sustained. The same effect was observed after 1 week of treatment with the depot estrogen estradiol valerate (1 mg/kg/week). After 3 weeks of treatment, however, the taurocholate concentration in bile was lowered and the clearance of sucrose was increased. Bile flow remained at the same cholestatic level for 20 weeks. These results suggest that estrogens have the potency to increase tight junctional permeability only in a second step in the development of cholestasis, following the inhibition of bile flow. 3. An additional mode of secretory inhibition was induced by lowering the concentration of Ca²⁺ in the perfusate of isolated liver. Using ANIT-pretreated livers, i. e., livers with very low capacity to secrete foreign dyes, a high rate of efflux of sulfobromophthalein into the perfusate of preloaded livers suggests stimulation of the efflux of cholephilic solutes across the sinusoidal membrane of liver cells.The results demonstrate that the term intrahepatic cholestasis comprises a number of different sites of interference with the complex process of bile secretion.Dedicated to Professor Dr. med. Herbert Remmer on the occasion of his 65th birthday     

大豆黄酮对卵巢切除大鼠鼻黏膜上皮细胞凋亡的保护作用

目的　观察双侧卵巢切除诱导大鼠鼻黏膜上皮细胞凋亡 ,研究尼尔雌醇、大豆黄酮对此的保护作用。方法　将 60只大鼠随机分为 4组 :健康对照组 ,卵巢切除组 ,卵巢切除 +尼尔雌醇组 ,卵巢切除 +大豆黄酮组。各组动物分期分 3批处死 ,流式细胞仪检测各组动物鼻中隔黏膜的早期凋亡细胞。结果　双侧卵巢切除后 ,大鼠鼻黏膜的早期凋亡细胞百分数增高 ,术后 60d达到新的平衡。大豆黄酮、尼尔雌醇干预组与健康组比较 ,早期凋亡细胞无明显改变。结论　雌激素替代和大豆黄酮可通过减少凋亡细胞而保护鼻黏膜免受雌激素缺乏的损害     

甲萘威对雌性大鼠血清雌激素水平及抗氧化系统功能的影响

目的观察甲萘威对雌性大鼠的生殖毒性并初步探讨其机制。方法雌性SD大鼠经口染毒甲萘威,剂量为0、1.028、5.140、25.704mg·kg-1·d-1。阴道脱落细胞涂片法观察大鼠动情周期的变化;放射免疫法测定其血清雌二醇(E2)、孕酮(P4)水平;分光光度法测定其血清超氧化物歧化酶(SOD)、谷胱甘肽硫转移酶(GST)的活力以及丙二醛(MDA)、谷胱甘肽(GSH)的含量。结果各剂量甲萘威染毒组大鼠动情周期数明显低于对照组。染毒后15d大鼠动情各期出现变化,与对照组的差异有统计学意义(P<0.05,P<0.01)。25.704mg·kg-1·d-1组大鼠体重增长明显低于对照组。各剂量染毒组大鼠的多个脏器系数均明显降低。25.704mg·kg-1·d-1组大鼠血清中E2水平为(19.93±2.21)nmoll,1.028mg·kg-1·d-1组大鼠P4水平为(1.21±0.40)nmoll,与对照组[(28.76±6.12)、(0.63±0.39)nmolL]的差异均有统计学意义(P<0.05)。随染毒剂量增高,大鼠SOD活力在卵巢先降后升,在血清中略升后下降;MDA含量则呈在卵巢中渐升高、在血清中略升后降低趋势;GSH含量和GST活力在卵巢中呈先降后升趋势,但在血清中,GSH含量呈下降趋势,GST活力先上升后下降。结论甲萘威可致雌性大鼠动情周期紊乱及雌激素水平改变,对大鼠的抗氧化系统产生一定影响。     

Endogenous urinary steroids in premenopausal women with uterine leiomyomas.

OBJECTIVES: To study the effect of endogenous steroids on the presence of uterine leiomyomas. METHODS: Urine samples of 27 premenopausal women with leiomyomas and 25 age-matched healthy premenopausal women were collected. The concentration of estrogens and androgens in the urine samples of the two groups were determined using a gas chromatography mass spectrometer and the two groups were compared. To study metabolic changes in patients indirectly, the concentration ratios of precursor metabolite to product metabolite of the two groups were also compared. RESULTS: Urinary concentrations of 17beta-estradiol, 5-androstene-3beta, 16beta, 17beta, triol, 11-keto-ethiocholanolone, 11beta-hydroxy-androsterone, 11beta-hydroxy-etiocholanolone, THS, THA, THE, alpha-cortol and beta-cortol were significantly higher in patients than in controls. The concentration ratios of 17beta-estradiol/estrone and 11/beta-hydroxy-ethiocholanolone/11beta-hydroxy-androsterone increased in patients. CONCLUSIONS: The presence of uterine leiomyomas correlates with an increase in urinary concentrations of estrogens and androgens, and it appears to be caused by a decrease in patients' metabolism of steroids.     

宫颈腺癌的研究进展

宫颈腺癌是宫颈癌的一种特殊病理类型,较鳞癌少见.近年来,宫颈腺癌的发病率及其在宫颈癌中所占比例不断上升,且发病趋于年轻化,预后比同期鳞癌差.此外,宫颈腺癌卵巢转移率高于鳞癌,对放、化疗的敏感性显著低于鳞癌,这些均对宫颈腺癌的诊治有重要影响.从宫颈腺癌致病因素(雌激素、孕激素与人乳头瘤病毒)、卵巢转移高危因素及卵巢保留以及放化疗进展3个热点问题着手,简述近年来宫颈腺癌的研究进展.