Intracellular actions of steroid hormones and their therapeutic value, including the potential of radiohalosteroids against ovarian cancer

The biological activities of steroid hormones are effected via intracellular receptors. The receptors are part of a ligand-activated family of transcription regulator proteins that are critical for steroid-regulated cell differentiation. With recombinant cDNA technology, yeast and cultured animal cells can be made to express mammalian cDNA steroid receptors from cDNA clones that contain deletions and substitutions. Among the leading problems addressed in these models is the characterization of sequences that promote association or interaction with other transcription regulating molecules, including oncogene products. Recently it has been found that heat shock proteins may serve not only to stabilize the receptor proteins but also to precondition the activation imparted by ligand binding. Aberrant receptor proteins can be found in ovarian cancer. Whether aberrant receptor proteins are associated with transformation in general or with a variable clinical response to steroidal or anti-steroidal therapy is not known. Even after chemotherapy, steroid receptors are expressed in the metastases of ovarian cancers seen clinically, and they may have potential uses for localization and treatment of receptor-rich cancers. Radioligand pharmaceuticals appropriate for imaging or for site-directed radiocytotoxicity can be sequestered to the nuclei of receptor-rich cancers. Initial clinical imaging and therapy trials with such pharmaceuticals have been approved and begun. In the use of halogenated estrogen radiopharmaceuticals, liver metabolism and enterohepatic recirculation are important considerations. Ascites prolongs retention of a radiohalogenated estrogen in the abdominal cavity. Distant metastases have been localized with [123I]-estrogen in breast cancer patients in pre-operative procedures. Receptor-mediated cytotoxicity occurs when estrogen receptor radioligand pharmaceuticals that are Auger electron emitters are used in vitro.

Estradiol-induced changes in progesterone secretion by rabbit corpora lutea are associated with quantitative ultrastructural changes in luteal cells

In this study, we examined changes in luteal cell structure that accompany estradiol-altered progesterone production by the rabbit corpus luteum. To stimulate progesterone production, polydimethylsiloxane (Silastic) capsules containing 17 beta-estradiol were inserted sc into superovulated New Zealand White rabbits. Luteal progesterone production, assessed by measurement of progesterone in peripheral serum, was high after the estradiol-filled capsules were inserted, declined within 24 h after the capsules were removed, and increased within 32 h after reinsertion of the capsules. Stereological analyses at the light microscopic level revealed that the number of luteal cells and the volume of an average luteal cell did not differ significantly between estradiol-stimulated and estradiol-deprived rabbits over the time period employed. In contrast, stereological analyses at the electron microscopic level demonstrated that the surface areas of smooth endoplasmic reticulum and inner mitochondrial membrane declined with estradiol deprivation, but were restored by reimposition of estradiol stimulation. These changes in the surface area per cell of smooth endoplasmic reticulum and inner mitochondrial membrane were strongly correlated (r = 0.94 and r = 0.88, respectively) with changes in progesterone concentrations in peripheral serum. Changes in the surface area of lipid droplets per luteal cell also occurred, but were inversely correlated (r = -0.87) with progesterone levels. No significant changes were seen in the surface areas per cell of outer mitochondrial membrane or rough endoplasmic reticulum. These results demonstrate that estradiol stimulation and deprivation cause reversible quantitative changes in the rabbit luteal cell organelles known to be directly involved in progesterone biosynthesis. This leads to the conclusion that the steroidogenic activity of the luteal cell is tightly coupled to its subcellular structure.

Estrogen-mediated mitochondrial cholesterol transport and metabolism to pregnenolone in the rabbit luteinized ovary

We investigated the mechanisms of luteotropic actions of estradiol on steroidogenesis. To this end, we examined, in vitro, the metabolism of cholesterol from endogenous or exogenous sources for pregnenolone production in rabbit luteinized ovarian cell mitochondria isolated from pseudopregnant animals in various states of stimulation by estradiol. We found that estradiol-mediated regulation of mitochondrial cholesterol metabolism for pregnenolone production differs from the mechanisms of regulation reported for steroidogenic protein/polypeptide hormones in the following respects: 1) in the estradiol-sensitive, luteinized-ovary, rabbit model, temporary blockage of cytochrome P-450 cholesterol side-chain cleavage enzyme by aminoglutethimide treatment in vivo has no effect on mitochondrial pregnenolone production in vitro after the aminoglutethimide is removed, indicating no additional capacity for upstream cholesterol storage; 2) preincubating mitochondria at 37 degrees C fails to increase subsequent pregnenolone synthesis in response to the addition of isocitrate; and 3) exogenously added cholesterol does not readily enter the steroidogenic pool of cholesterol unless the endogenous cholesterol pool is first depleted. These new observations indicate that estradiol increases the usable steroidogenic cholesterol pool in rabbit ovarian mitochondria. Also, 1) they are consistent with a putative requirement for the participation of one or more estrogen-sensitive protein factors to enhance cholesterol trafficking to the inner mitochondrial membrane, and 2) they complement the observation of estrogen-dependent expression of steroidogenic acute regulatory protein in rabbit luteal tissue.

Binding of radiolabeled estrogens by human cells in vitro: implications to the development of a new diagnostic and therapeutic modality in the treatment of malignancies with estrogen receptors

An in vitro technique was employed to demonstrate the binding of Auger electron-emitting nuclide-labeled estrogenic compounds by a variety of human cell types. Human granulosa cells, endometrium, and MCF-7 breast cancer cells were incubated with either 16 alpha-[I125]-iodoestradiol-17 beta or 16 alpha-[I123]-iodoestradiol-17 beta in vitro. Autoradiographic techniques were subsequently utilized and revealed that binding of these estrogenic compounds by all three types of cells did occur and that this binding was inhibited by excess unlabeled estradiol. Histologic examination was not able to demonstrate nuclear-specific binding in all instances, however. These compounds are potentially useful in both diagnostic and therapeutic settings and this study is the first to provide such data from human tissue.

Detection of the HER-2/neu proto-oncogene protein p185erbB2 by a novel monoclonal antibody (MAB-145ww) in breast cancer membranes from oestrogen and progesterone receptor assays

Amplification of the proto-oncogene HER-2/neu and/or overexpression of the transmembrane protein p185erbB2 that it encodes occur in approximately 30% of human breast and gynaecological cancers seen clinically and are strongly associated with an unfavourable outcome. We report on the use of a new monoclonal antibody (Mab-145ww) together with immunoblotting for detection of p185erbB2 in membranes that remain after routine processing of breast cancer tissue for steroid receptor assays. Human breast cancer cell lines SKBR3 and MCF-7 were used as high and low controls, respectively, for p185erbB2 expression. Mab-145ww was detected p185erbB2 in more than half of the breast cancer specimens; the expression was intense in SKBR3 cells, but only faint in MCF-7 cells. These results demonstrate that routine processing of cancer tissue for steroid receptor status can include providing a preparation with which to assess p185erbB2 expression and, thus, can provide information potentially useful for the clinical management of individual cancer patients.

Estradiol-induced changes in rabbit luteal cell progestin production and cholesterol and cholesterol ester content

Estradiol deprivation in vivo causes accumulation of cholesterol and cholesterol ester in the corpora lutea of pseudo-pregnant rabbits within 24 hours. These accumulations occur concomitantly with an abrupt cessation of progestin production. Retreatment with estradiol restores progestin production and can block further increases in cholesterol accumulation (per mg total tissue protein). Ample quantities of precursor cholesterol ester and cholesterol substrate are present in corpora lutea when progestin falls because of estradiol deprivation. We conclude therefore that the gonadotropic action of estradiol is, in part, because of its stimulation of cholesterol conversion to progestins.

The glutathione cycle is the creative reaction of life and cancer. Cancer causes oncogenes and not vice versa

Life is definable as a chemical reaction which obeys exponential growth and dies if reversed. Such a reaction must be the commencement of all life so that every evolved form of it inherits these characteristics. As no single reaction known has these two features, life must be a combination of two or more reactions which whilst obeying all the classical laws of physics and chemistry assume an exponential form and effectively act as being irreversible. The reactions of glutathione--oxidation and reduction--when combined in sequence as a cyclical process fulfill these criteria. The cyclic changes of glutathione from reduced to oxidised to reduced forms must therefore be the reaction which creates life and is responsible for cancer's growth. 434 mHz electromagnetic radiation stimulates cancer growth rate by forcing this cycle into activity. Proof of this hypothesis is the long-term control of cancer in 11 patients treated with oxidised glutathione and 434 mHz radiation. Genetic material does not contain any energy system with exponential form, neither is it self-replicating. Genetic material will only reproduce if placed within an immortal cell in which all controls of the glutathione system have been lost, as in a cancer cell. Oncogenes must be the product of cancer and not the reverse.

Estrogen increases precursor for pregnenolone synthesis with temperature-sensitive occupancy of P-450scc in mitochondria of rabbit corpus luteum

To examine the mechanism of estrogen's direct stimulation of steroidogenesis in the rabbit corpus luteum, we tested the hypothesis that the effect of estrogen on progestin production occurs at the site of processing of the precursor for pregnenolone (i.e. cholesterol) in the mitochondrion. For this purpose, we manipulated a model of estrogen stimulation by 1) removing sc estradiol-filled polydimethylsiloxane capsules from superovulated rabbits on day 9 of pseudopregnancy or 2) leaving the capsules in place to preserve a chronic estrogen stimulus. In the estrogen-deprived rabbits, the serum progesterone level fell precipitously in vivo within 24 h, but in rabbits with chronic estrogen stimulation, serum progesterone levels remained high. Our results show that the loss in progestin production caused by estrogen deprivation could not be attributed to loss of the mitochondrial cytochrome P-450 side-chain cleavage enzyme (P-450scc), a common rate-limiting step in progestin synthesis in many steroidogenic tissues. In addition, we confirmed that there was no loss in the catalytic activity of this enzyme. Treatment with aminoglutethimide in vivo followed by electron paramagnetic resonance spectroscopic analysis of mitochondria (prepared in aminoglutethimide-free buffers) showed that incubation of isolated mitochondria at 37 C and pH 6.2 caused an increased high spin state (g = 8.2 signal) and a concomitant decreased low spin state. This shift from low to high spin states, which is indicative of cholesterol-P-450scc complex formation, occurred in the luteal mitochondria from both estrogen-deprived and estrogen-stimulated rabbits. In further studies to localize estrogen's regulatory point, we determined that the initial (first minute) rate of production of pregnenolone (per mg protein or per U P-450scc) from endogenous precursor proceeded equally fast in mitochondria from estrogen-deprived and those from estrogen-stimulated rabbits. However, the rapid pregnenolone production in the estrogen-deprived group lasted for a shorter time and, after 30 min, yielded less pregnenolone per mg protein or per U P-450scc than did mitochondria from estrogen-stimulated rabbits. Addition of 25-hydroxycholesterol did not increase the initial rate of pregnenolone formation, indicating that precursor availability is not limiting during the initial period. In aggregate, these observations suggest that the effect of estrogen on progestin production in the rabbit corpus luteum is not regulation of the movement of cholesterol to the catalytic site on the inner mitochondrial membrane, even though this is a step in the regulation of protein hormone-stimulated steroidogenesis.(ABSTRACT TRUNCATED AT 400 WORDS)

Some characteristics of the glutathione cycle revealed by ionising and non-ionising electromagnetic radiation

The cyclic reaction of GSH-->GSSG-->GSH (designated R(exp) or R(e)) obeys the three specific features of life by producing energy in exponential quantities relative to time, is in effect irreversible and is inherited from generation to generation. In multicellular life, this reaction produces the energy for mitosis and is kept in controlled inactivity until needed to maintain perfection of form and function by energising mitosis. The immediate control of Re appears to be feedback process-dependent on the concentration of GSSG. Ultra high-frequency electromagnetic radiation of 434 MHz (UHF) will change Re from inactive to active and, in so doing, it causes resonance and/or fluorescence of the glutathione cycle which changes its radiosensitivity. Re is the primary direct target of ionising radiation and produces the energy for mitosis. Clinical observations suggest that, in the normal cell, Re is inactive and is not killed by 3 x 2700 rads or 6 x 1650 rads yet, when active, its sensitivity value (DO) is approximately 160 rads. Using the standard radiobiological equation of response to ionising radiation, it can be deduced that radiosensitive cancers have two or three Re units active per cell and radioresistance increases in proportion to the number of potentially active Re units per cell. Re appears to be the main cause of cancers' increased conductivity of electricity compared with normal tissue. In cancer therapy, UHF is the best radiosensitiser ever discovered (up to two or more decades). Re is also intelligent compared with non-exponential reactions but cannot be the basis of intellectual brain functions which must be based on non-electrical chemical processes.

The fundamental chemistry of life. An attempt to define and identify the basic reaction responsible for life's creation and evolution

All natural growth follows exponential characteristics which vary from a simple exponential equation (non-solid cancer, bacteria) to complex Gompertzian functions describing solid cancer and multicellular organisms. Like all chemical processes the reagents (energy sources of food) react during life to produce vital energy, but in addition also create the next generation of life. This latter reaction is unique in that a simple proportional increase in the reagents creates an exponential increase in products: it is the sole invariable criterion of all life. The target of combined ionising and non-ionising radiations in cancer cells appears to be identical with this fundamental exponential chemical reaction. Identification of this target as a system of anaerobic glycolysis suggests that life's first reaction is a unique one whereby a simple proportional increase in available glucose causes an exponential proportional increase in energy which is available solely for reproduction.

Correlation of cervicovaginal fluid volume with serum estradiol levels and total follicular volume during human gonadotropin stimulation

During the normal menstrual cycle the volume of cervicovaginal fluid (CVF), as determined by the patient at home using a simple volumetric aspirating pipette, increases significantly over several days prior to the luteinizing hormone (LH) surge and decreases characteristically shortly after ovulation. The present study was undertaken to test the hypothesis that self-determined measurements of CVF volume would correlate positively with serum estradiol (E2) levels and with total follicular volume (TFV) in cycles stimulated with exogenous gonadotropins. Consequently, 20 infertility patients, undergoing human menopausal gonadotropin (hMG)-stimulated cycles, were asked to measure daily CVF. Routine serum E2 determinations and vaginal follicular ultrasound studies were performed up to and including the day of human chorionic gonadotropin (hCG) administration (designated day 0). The mean daily CVF volume (+/- SD) increased from 0.1 +/- 0.01 ml on day -6 to 0.7 +/- 0.40 ml on day -1 and then decreased to 0.6 +/- 0.40 ml on day 0. On day 0, 7 of 20 cycles (35%) demonstrated a decrease in CVF, which ranged from 0.1 to 1.0 ml (mean, 0.42 ml). The mean daily CVF correlated positively (correlation coefficient = r) with the mean daily serum E2 (r = 0.89) and with the mean daily TFV (r = 0.88). The mean daily correlation of TFV for E2 was r = 0.98. The correlation between CVF and E2 of individuals ranged from r = 0.38 to r = 0.99 and the correlation between CVF and TFV ranged from r = 0.12 to r = 1.0, while the individual correlations of E2 to TFV ranged from r = 0.60 to r = 0.99.(ABSTRACT TRUNCATED AT 250 WORDS)

Rapid vascular escape of arterially injected 16 alpha-radioiodo,17 beta-estradiol

PURPOSE

We undertook this study because confirmation of a rapid vascular escape and slow release back into the circulatory system suggests that arterial injection of radiohalogenated steroid receptor ligands might provide an efficacious route of administration for imaging or treatment of receptor-rich malignant tumors in peripheral tissues.

METHODS AND MATERIALS

We injected radiolabeled 16 alpha-iodo,17 beta-estradiol ([I]-E), an estrogen receptor ligand, into the femoral artery of swine in a solution that contained [125I]-E in a known ratio to [99mTc]-labeled red blood cells. Fractions of femoral venous blood were collected at short intervals during 10 min. We looked for changes in the ratio of the radiolabels. [99mTc]-labeled red blood cells are known to remain in the vascular system for an hour or more.

RESULTS

After passage of the injectate through the capillary bed of the swine leg, a dramatic decrease of the initial 125I:99mTc ratio to only 10% was observed in the femoral venous blood. This ratio increased gradually during the next 10 min to approximately 30% of that in the injectate, indicating that a significant portion (approximately 90%) of the [125I]-E was initially trapped in the limb and then slowly re-entered the vascular system. To obtain visual confirmation of the rapid vascular escape of iodo-estrogen, we injected either an imageable form of [I]-E (123I]-E) or [99mTc]-labeled red blood cells into the dorsal aorta of superovulated rabbits, whose smaller size allowed whole-body imaging. The biodistributions of these radiopharmaceuticals were surveyed continuously by real-time planar gamma imaging. Within 2 min after the injection of [123I]-E, the outlines of the circulatory system were entirely lost; however, some estrogen receptor-rich tissues (the ovaries) as well as some non-target tissues, for example, the lower leg extremities, yielded well-defined images. In contrast, after intra-arterial injection of [99mTc]-labeled red blood cells, the circulatory system remained sharply defined for the duration of the study (40 min).

CONCLUSION

A large fraction of [I]-E escapes from the vascular system during the first pass through an organ or limb, without regard to the estrogen receptor content of the tissue.

Immunocytochemical identification of estrogen receptor in ovarian carcinomas. Localization with monoclonal estrophilin antibodies compared with biochemical assays

Estrogen receptor (estrophilin) has been identified in ovarian carcinomas by a variety of physicochemical methods. Since these methods require disruption of the tissue, they do not provide any anatomic information about the cellular distribution and location of receptor. The authors have used monoclonal estrophilin antibodies and an indirect immunoperoxidase technique to study the immunocytochemical localization of estrogen receptor in 43 tissue samples of ovarian carcinoma from 27 patients. The immunocytochemical findings were compared with the results of conventional estrogen receptor assays of cytosolic and nuclear extracts prepared from adjacent pieces of ovarian carcinoma. Exclusively nuclear localization of estrogen receptor was observed with the immunocytochemical technique in all of the 25 tumor samples which had a cytosolic estrogen receptor content, determined by either the dextran-coated charcoal or hydroxylapatite techniques, greater than 700 fmoles/gm wet weight of tissue. Only 3 of 16 tumor samples with cytosolic estrophilin concentrations of less than 700 fmoles/gm wet weight displayed nuclear staining for estrogen receptor; two of these three were metastases from receptor-rich primaries. Specific cytoplasmic staining for estrogen receptor was not observed. These results indicate that many ovarian carcinomas have estrogen receptor, predominantly localized in the nucleus, which is similar to tissues of the female genital tract (vagina, cervix, endometrium, fallopian tube) and breast carcinoma.

Limitations of qualitative serum beta-HCG assays in the diagnosis of ectopic pregnancy

Seventy-four patients had ectopic pregnancies proven by surgery. Three of them had a serum beta-HCG test for pregnancy that was reported as negative (less than 25-35 mIU/ml). We sought a threshold for positive in the serum beta-HCG test that would maximize its usefulness in diagnosing ectopic pregnancy. Sera from 52 of the patients were available for reanalysis. Quantitative values of beta-HCG were determined. Lowering the threshold for positive from 25-35 to 10 mIU/ml might increase the test's sensitivity without sacrificing specificity but would still not ensure detection of all ectopic pregnancies. Of 445 cases of ectopic pregnancy described in the literature, 6 had serum beta-HCG values reported as negative. In the published reports and in our own cases, clinical histories and histologies indicated that a nonviable ectopic pregnancy can be expected to have an associated serum concentration of beta-HCG that may be below the sensitivity of detection even with current, commercially available quantitative tests.