Estrogen negative feedback on gonadotropin secretion: evidence for a direct pituitary effect in women

CONTEXT

Studies in humans and animals indicate that estrogen negative feedback occurs at the level of the hypothalamus, but it is unclear whether estrogen also exerts an inhibitory effect directly at the pituitary.

OBJECTIVES

The aim of the study was to determine whether estrogen has a direct negative feedback effect at the pituitary and whether this varies with aging.

DESIGN AND SETTING

A GnRH antagonist and graded doses of GnRH were used to isolate pituitary responsiveness before and after estrogen administration in Clinical Research Center studies at an academic medical center.

SUBJECTS

Subjects were healthy postmenopausal women aged 48-56 yr (n = 8) or 70-75 yr (n= 8).

INTERVENTIONS

A suppressive dose of the NAL-GLU GnRH antagonist was administered, followed by graded doses of GnRH before and after 1 month of estrogen administration.

RESULTS

LH and FSH responses to GnRH decreased after estrogen administration (P = 0.01 and P = 0.0001, respectively). The ratio of FSH to LH amplitudes decreased in response to estrogen (P = 0.04) indicating a greater sensitivity of FSH than LH to inhibition by estrogen. The inhibitory effect of estrogen on FSH was attenuated with aging (P = 0.02), but was maintained for LH (P = 0.4).

CONCLUSIONS

Studies that control for endogenous GnRH and estradiol demonstrate a direct pituitary site of estrogen negative feedback on LH and FSH responsiveness to GnRH in women. The effect of estrogen on FSH responsiveness is greater than on LH and is attenuated with aging. These studies indicate that estrogen negative feedback occurs directly at the pituitary and contributes to the differential regulation of FSH and LH secretion.

Kupfer-type immunological synapse characteristics do not predict anti-brain tumor cytolytic T-cell function in vivo

To analyze the in vivo structure of antigen-specific immunological synapses during an effective immune response, we established brain tumors expressing the surrogate tumor antigen ovalbumin and labeled antigen-specific anti-glioma T cells using specific tetramers. Using these techniques, we determined that a significant number of antigen-specific T cells were localized to the brain tumor and surrounding brain tissue and a large percentage could be induced to express IFNgamma when exposed to the specific ovalbumin-derived peptide epitope SIINFEKL. Detailed morphological analysis of T cells immunoreactive for tetramers in direct physical contact with tumor cells expressing ovalbumin indicated that the interface between T cells and target tumor cells displayed various morphologies, including Kupfer-type immunological synapses. Quantitative analysis of adjacent confocal optical sections was performed to determine if the higher frequency of antigen-specific antiglioma T cells present in animals that developed an effective antitumor immune response could be correlated with a specific immunological synaptic morphology. Detailed in vivo quantitative analysis failed to detect an increased proportion of immunological synapses displaying the characteristic Kupfer-type morphology in animals mounting a strong and effective antitumor immune response as compared with those experiencing a clinically ineffective response. We conclude that an effective cytolytic immune response is not dependent on an increased frequency of Kupfer-type immunological synapses between T cells and tumor cells.

Compartment Syndrome and Patient-Controlled Analgesia in Children – Analgesic Complication or Early Warning System?

We present two cases of children who developed compartment syndrome after upper limb fractures. Morphine patient-controlled analgesia was used in a bolus-only mode for analgesia (bolus 20 μg/kg, five minute lockout and hourly limit of 150 μg/kg). An increase in patient-controlled analgesia use was observed up to 12 hours before the decision was made to proceed to fasciotomy but neither child exceeded the hourly limit or had an excessive increase in pain scores. Clinical risk factors for compartment syndrome should be identified and appropriate monitoring instituted. A subtle increase in patient-controlled analgesia use may be an early indicator of impending compartment syndrome before classical signs such as reporting of pain, pallor, paraesthesiae, paralysis and pulselessness develop. These cases and review of the literature suggest techniques which may assist earlier diagnosis of compartment syndrome include setting a more conservative hourly limit of morphine patient-controlled analgesia such as 80 to 100 μg/kg/hour and graphing of patient-controlled analgesia demands and boluses, pain scores at rest and pain scores with passive flexion and extension of digits. These practices could identify trends that pain or analgesia requirement is increasing leading to earlier diagnosis of compartment syndrome.

Phytoestrogens from Psoralea corylifolia reveal estrogen receptor-subtype selectivity

The seed of Psoralea corylifolia L. (PCL), a well-known traditional Chinese medicine, has been applied as a tonic or an aphrodisiac agent and commonly used as a remedy for bone fracture, osteomalacia and osteoporosis in China. In our study, the estrogen receptor subtype-selective activities of the extracts and compounds derived from PCL were analyzed using the HeLa cell assay. The different fractions including petroleum ether, CH(2)Cl(2) and EtOAc fractions of the EtOH extract of PCL showed significant activity in activating either ERalpha or ERbeta whereas the n-BuOH fraction showed no estrogenic activity. Further chromatographic purification of the active fractions yielded seven compounds including the two coumarins isopsoralen and psoralen, the four flavonoids isobavachalcone, bavachin, corylifol A and neobavaisoflavone, and the meroterpene phenol, bakuchiol. In reporter gene assay, the two coumarins (10(-8)-10(-5)M) acted as ERalpha-selective agonists while the other compounds (10(-9)-10(-6)M) activated both ERalpha and ERbeta. The estrogenic activities of all compounds could be completely suppressed by the pure estrogen antagonist, ICI 182,780, suggesting that the compounds exert their activities through ER. Only psoralen and isopsoralen as ERalpha agonists promoted MCF-7 cell proliferation significantly. Although all the compounds have estrogenic activity, they may exert different biological effects. In conclusion, both ER subtype-selective and nonselective activities in compounds derived from PCL suggested that PCL could be a new source for selective estrogen-receptor modulators.

Impaired wound healing in mouse models of diabetes is mediated by TNF-alpha dysregulation and associated with enhanced activation of forkhead box O1 (FOXO1)

AIMS/HYPOTHESIS

The role of TNF-alpha in impaired wound healing in diabetes was examined by focusing on fibroblasts.

METHODS

Small excisional wounds were created in the db/db mice model of type 2 diabetes and normoglycaemic littermates, and in a streptozotocin-induced type 1 diabetes mouse model and control mice. Fibroblast apoptosis was measured by the TUNEL assay, proliferation by detection of proliferating cell nuclear antigen, and forkhead box O1 (FOXO1) activity by DNA binding and nuclear translocation. TNF-alpha was specifically inhibited by pegsunercept.

RESULTS

Diabetic wounds had increased TNF-alpha, fibroblast apoptosis, caspase-3/7 activity and activation of the pro-apoptotic transcription factor FOXO1, and decreased proliferating cell nuclear antigen positive fibroblasts (p < 0.05). TNF-alpha inhibition improved healing in the diabetic mice and increased fibroblast density. This may be explained by a decrease in fibroblast apoptosis and increased proliferation when TNF-alpha was blocked (p < 0.05). Although decreased fibroblast proliferation and enhanced FOXO1 activity were investigated in type 2 diabetes, they may also be implicated in type 1 diabetes. In vitro, TNF-alpha enhanced mRNA levels of gene sets related to apoptosis and Akt and p53 but not mitochondrial or cell-cycle pathways. FOXO1 small interfering RNA reduced gene sets that regulate apoptosis, Akt, mitochondrial and cell-cycle pathways. TNF-alpha also increased genes involved in inflammation, cytokine, Toll-like receptor and nuclear factor-kB pathways, which were significantly reduced by FOXO1 knockdown.

CONCLUSIONS/INTERPRETATION

These studies indicate that TNF-alpha dysregulation in diabetic wounds impairs healing, which may involve enhanced fibroblast apoptosis and decreased proliferation. In vitro, TNF-alpha induced gene sets through FOXO1 that regulate a number of pathways that could influence inflammation and apoptosis.

Irritant and adjuvant effects of gaseous formaldehyde on the ovalbumin-induced hyperresponsiveness and inflammation in a rat model

BACKGROUND

Formaldehyde (FA) is a common indoor air pollutant that can cause asthma in people experiencing long-term exposure. While FA and other man-made chemicals contribute to the stimulation of asthma in the general population, the underlying molecular pathogenesis of this relationship is not yet well understood.

OBJECTIVE

To explore FA as an irritant for the onset of asthma and as an adjuvant for the induction of allergy.

METHODS

In the present study, 40 Wistar rats in five experimental groups were exposed to: (i) saline; (ii) ovalbumin (OVA); (iii) OVA + FA at 417 ppb; (iv) OVA + FA at 2500 ppb; and (v) FA at 2500 ppb. Current and prior occupational exposure limits in China were established at 417 ppb and 2500 ppb, respectively. Gaseous FA was administrated to the animals for 6 h/day before and during OVA immunization or saline treatment. Measured outcomes included in situ lung function analysis, cytokine measurement, and histological changes in the rat lungs.

RESULTS

The airway reactivity, lung histological changes, pulmonary interleukin-4 secretion, and eosinophil infiltration in the OVA and FA exposed rats were significantly higher after gaseous FA exposures of 417 and 2500 ppb. While FA exposure alone did not induce significant structural changes to the airway, and the rate of inflammatory cell infiltration was the same as for the control group, pulmonary levels of interferon-gamma were significantly elevated in the exposed rats.

CONCLUSIONS

FA may be an irritant as well as serve as an adjuvant for the onset of asthma or asthma-like symptoms.

Comparative structural and hemodynamic analysis of vascular trees

The availability of detailed three-dimensional images of vascular trees from mammalian organs provides a wealth of essential data for understanding the processes and mechanisms of vascular patterning. Using this detailed geometric data requires the ability to compare individual representations of vascular trees in statistically meaningful ways. This article provides some comparisons of geometry and also of simulated hemodynamics, enabling the identification of similarities and differences among 10 individual specimens (5 placenta specimens and 5 lung specimens). Similar comparisons made with a series of models (starting with the simplest and increasing in complexity) enable the identification of essential features that are needed to account for the patterns and function of vascular arborization.

Neuronostatin is co-expressed with somatostatin and mobilizes calcium in cultured rat hypothalamic neurons

Neuronostatin (NST) is a newly identified peptide of 13-amino acids encoded by the somatostatin (SST) gene. Using a rabbit polyclonal antiserum against the human NST, neuronostatin-immunoreactive (irNST) cells comparable in number and intensity to somatostatin immunoreactive (irSST) cells were detected in the hypothalamic periventricular nucleus. Fewer and/or less intensely labeled irNST cells were noted in other regions such as the hippocampus, cortex, amygdala, and cerebellum. Double-labeling hypothalamic sections with NST- and SST-antiserum revealed an extensive overlapping of irNST and irSST cells in the periventricular nucleus. Pre-absorption of the NST-antiserum with NST (1 microg/ml) but not with SST (1 microg/ml) abrogated irNST and vice versa. The activity of NST on dissociated and cultured hypothalamic neurons was assessed by the Ca(2+) imaging method. NST (10, 100, 1000 nM) concentration-dependently elevated intracellular Ca(2+) concentrations [Ca(2+)](i) in a population of hypothalamic neurons with two distinct profiles: (1) a fast and transitory increase in [Ca(2+)](i), and (2) an oscillatory response. Whereas, SST (100 nM) reduced the basal [Ca(2+)](i) in 21 of 61 hypothalamic neurons examined; an increase was not observed in any of the cells. Optical imaging with a slow-responding voltage sensitive dye DiBAC(4)(3) showed that NST (100 nM) depolarized or hyperpolarized; whereas, SST (100 nM) hyperpolarized a population of hypothalamic neurons. The result shows that NST and SST, though derived from the same precursor protein, exert different calcium mobilizing effects on cultured rat hypothalamic neurons, resulting in diverse cellular activities.

Loss of HBsAg antigen during treatment with entecavir or lamivudine in nucleoside-naïve HBeAg-positive patients with chronic hepatitis B

This retrospective analysis was conducted to describe the characteristics of nucleoside-naïve hepatitis B e antigen (HBeAg)-positive patients with chronic hepatitis B, who achieved hepatitis B surface antigen (HBsAg) loss during entecavir or lamivudine therapy. HBeAg-positive adults with chronic hepatitis B, elevated serum alanine aminotransferase, and compensated liver disease were randomized to double-blind treatment for up to 96 weeks with entecavir 0.5 mg/day or lamivudine 100 mg/day. HBsAg and hepatitis B virus (HBV) DNA were measured at regular intervals during and off-treatment follow-up. Through a maximum duration of 96 weeks on-treatment and 24 weeks off-treatment, HBsAg loss was confirmed in 18/354 (5.1%) patients treated with entecavir and 10/355 (2.8%) patients treated with lamivudine. Among the 28 patients with confirmed HBsAg loss, 27 (96%) achieved HBV DNA <300 copies/mL, and 27 (96%) achieved confirmed HBeAg loss. All entecavir recipients with HBsAg loss had HBV DNA <300 copies/mL. Caucasian patients, and those infected with HBV genotype A or D, were significantly more likely to lose HBsAg. This retrospective analysis of data from a randomized, global phase three trial shows that confirmed loss of HBsAg occurred in 5% of nucleoside-naïve HBeAg-positive patients treated with entecavir, and that HBsAg loss is associated with sustained off-treatment suppression of HBV DNA.

A longitudinal Raman microspectroscopic study of osteoporosis induced by spinal cord injury

INTRODUCTION

A longitudinal study was established to investigate bone compositional information in spinal cord injury (SCI) rat model.

METHODS

Raman spectroscopy was applied to detect the distal femur and humeri of SCI, sham-operated (SO), and age-matched control (CON) male Sprague-Dawley (SD) rats at first, second, third, and fifth weeks after surgery. One-way ANOVA and Tukey's HSD post hoc multiple comparison tests were used to analyze the longitudinal data of mineral to matrix ratio and carbonate substitution.

RESULTS

Relative mineral decrease was found in SCI group by more than 20% in femur and approximately 12% in humeri compared with CON group. No significant changes in carbonate substitution were observed.

CONCLUSIONS

Severe bone loss in the early stage of SCI was confirmed by a continuous decrease of the mineral to collagen matrix ratio. The decrease in the humeri suggested hormone level variations might participate in the etiology of SCI-induced osteoporosis.

VARS2 V552V Variant as a Prognostic Marker in Patients with Early Breast Cancer

Purpose: The present study analyzed the polymorphisms of DNA repair genes and their impact on survival of patients with early breast cancer.Patients and methods: A total of 240 patients with surgically resected early invasive ductal breast cancer were enrolled in the present study, where patients who underwent neoadjuvant treatment were excluded. The genomic DNA was extracted from paraffin-embedded tumor-free tissue or blood, and thirteen single nucleotide polymorphisms of 12 DNA repair genes were determined using the Sequenom Mass array system.Results: Among the target SNPs, VARS2 rs2074511 and POLE rs5744857 were found to correlate with relapse-free survival (RFS) after curative surgery in the log-rank test. There was no difference in the clinical and tumor characteristics according to the genotypes of these two coding variants except for the higher incidence of positive ER in patients with the GG genotype of POLE rs5744857 (p = 0.025). Multivariate analysis showed that the GG genotype of VARS2 V552V (rs2301717) was marginally associated with a better RFS than the combined AA and AG genotype (HR = 0.298; 95% CI = 0.089-0.995; p = 0.049). However, there was no significant association with overall survival.Conclusion: VARS2 V552V may be considered as a prognostic factor of survival in patients with early breast cancer.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6055.

Study of the Effect of Micro-Environment Stresses on Breast Tumor Initiating Cells by In Vitro Cell Tracking

Increasing clinical as well as experimental evidence supports the existence of a small population of tumor initiating cells (TIC) that possesses enhanced self-renewal capacity, and the ability to form tumors upon transplantation. These TIC, which highly resemble normal stem cells, are believed to be responsible for tumor initiation and propagation. Evidence also suggests that TIC reside in unique micro-environment which may account for their resistance to traditional chemo- and radiotherapy. Understanding the effect of micro-environment on TIC will have dramatic implications for breast cancer prevention, treatment, and drug development.It is known that tumor micro-environment is characterized by various degrees of chemical imbalance, including oxygen depletion (hypoxia), lactic acidosis, glucose deprivation and high oxidative stresses caused by elevated reactive oxygen species (ROS) [1]. These physiological stresses have significant clinical impact and are often related to poor patient prognosis [2]. Interestingly, recent studies revealed that there are molecular connections between physiological stress regulated transcription factors and pathways known to control stem cell function [3], suggesting that the micro-environment stresses may either promote TIC cell transformation or proliferation [4]. However, despite these molecular level findings, direct evidence on the effect of physiological stresses on the proliferation and differentiation of TIC is still missing.We use in vitro live cell tracking to study the influence of micro-environment on TIC. Primary cultured cells are prepared from breast cancer surgery specimen. They are cultured in suspension in serum free medium as mammospheres which have been demonstrated to be highly enriched with TIC [5]. Various physiological stresses are mimicked by growing cells in tissue culture incubators with 2% O2 (hypoxia), acidic medium (pH 6.7) with 25mM lactic acid, glucose deprivation condition by using glucose free DMEM medium, high ROS condition with 100uM H2O2. Cells are also infected with lentivirus to express H2B-GFP to label the cell nuclei so that they can be tracked by fluorescence imaging. Experiments are carried out in a full environmental controlled (CO2, O2, temperature, humidity) chamber and monitored by confocal imaging over prolonged time up to 96 hours. Since mammosphere cells grow in 3D instead of monolayer, they were scanned by confocal to reconstruct the 3D structure. We also developed computer programs for 3D segmentation to separate each cell, so that each cell within the mammosphere can be labeled and monitored individually. Such system allows us to draw a lineage tree for all the cells in the final mammosphere and detect the active dividing cells (which represent the differentiated cells) and the cells which reenter the quiescent status (which represent the progenitor cells), and hence allow us to study the effect of various micro-environment stresses on them.1. Vaupel, P., Semin Radiat Oncol, 2004. 14(3): p. 198-206.2. Schwickert, G., et al., Cancer Res, 1995. 55(21): p. 4757-9.3. Keith, B. and M.C. Simon, Cell, 2007. 129(3): p. 465-72.4. Li, Z., et al., Cancer Cell, 2009. 15(6): p. 501-13.5. Ponti, D., et al., Cancer Res, 2005. 65(13): p. 5506-11.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1163.