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Barth C, de Lange AMG. Towards an understanding of women's brain aging: the immunology of pregnancy and menopause. Front Neuroendocrinol 2020; 58:100850. [PMID: 32504632 DOI: 10.1016/j.yfrne.2020.100850] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/23/2020] [Accepted: 05/20/2020] [Indexed: 02/06/2023]
Abstract
Women are at significantly greater risk of developing Alzheimer's disease and show higher prevalence of autoimmune conditions relative to men. Women's brain health is historically understudied, and little is therefore known about the mechanisms underlying epidemiological sex differences in neurodegenerative diseases, and how female-specific factors may influence women's brain health across the lifespan. In this review, we summarize recent studies on the immunology of pregnancy and menopause, emphasizing that these major immunoendocrine transition phases may play a critical part in women's brain aging trajectories.
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Affiliation(s)
- Claudia Barth
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Ann-Marie G de Lange
- Department of Psychology, University of Oslo, Oslo, Norway; Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
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102
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Koenig MD, Klikuszowian E, O'Brien KO, Pauls H, Steffen A, DeMartelly V, Ruchob R, Welke L, Hemphill N, LaBomascus B, Pezley L, McLeod A, Hirsch B, Ferrans CE, Tussing-Humphreys L. Prepregnancy Obesity Is Not Associated with Iron Utilization during the Third Trimester. J Nutr 2020; 150:1397-1404. [PMID: 32221605 PMCID: PMC7269726 DOI: 10.1093/jn/nxaa065] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/09/2019] [Accepted: 02/25/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND An adequate maternal iron supply is crucial for maternal red blood cell (RBC) expansion, placental and fetal growth, and fetal brain development. Obese women may be at risk for poor iron status in pregnancy due to proinflammatory-driven overexpression of hepcidin leading to decreased iron bioavailability. OBJECTIVE The objective of this study was to determine the impact of prepregnancy (PP) obesity on third-trimester maternal iron utilization. DESIGN Using the stable isotope 57Fe, we measured iron utilization in the third trimester in PP obese [BMI (in kg/m2): ≥30] and nonobese (BMI: 18.5-29.9) women. We also assessed iron status, hepcidin, inflammation, erythropoietin, dietary iron intake, and gestational weight gain. Descriptive and inferential statistical tests (e.g., Student t test, Pearson correlation) were used for data analysis. RESULTS Fifty pregnant women (21 PP obese, 29 PP nonobese) were included. Mean age was 27.6 ± 6.8 y and mean gestational age at time of 57Fe administration was 32.7 ± 0.7 wk. Anemia (hemoglobin <11 g/dL for non-black and <10.2 g/dL for black women) affected 38% of women (43% PP obese compared with 35% PP nonobese; P = 0.55). Women with PP obesity had significantly higher C-reactive protein (8.5 compared with 3.4 mg/L, P = 0.0007) and total body iron corrected for inflammation (6.0 compared with 4.3 mg/kg, P = 0.04) compared with the nonobese women. There was no difference in serum hepcidin or iron utilization between the PP BMI groups. CONCLUSION This is the first study to assess the impact of PP obesity on maternal iron utilization. We found no difference in iron utilization in the third trimester of pregnancy in women with and without PP obesity. Despite higher frequency of anemia, women with PP obesity had less depleted body iron stores, suggesting some degree of iron sequestration. This finding should be followed up and extended to understand effects on fetal iron bioavailability.
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Affiliation(s)
- Mary Dawn Koenig
- Department of Women, Children and Family Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Elizabeth Klikuszowian
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kimberly O O'Brien
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Heather Pauls
- Department of Women, Children and Family Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Alana Steffen
- Department of Women, Children and Family Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Victoria DeMartelly
- Department of Women, Children and Family Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Rungnapa Ruchob
- Department of Women, Children and Family Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Lauren Welke
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Nefertiti Hemphill
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Bazil LaBomascus
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Lacey Pezley
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Andrew McLeod
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Bruni Hirsch
- Department of Women, Children and Family Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Carol Estwing Ferrans
- Department of Women, Children and Family Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Lisa Tussing-Humphreys
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA,Address correspondence to LT-H (e-mail: )
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103
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Nielsen JH, Birukov A, Jensen RC, Kyhl HB, Jørgensen JS, Andersen MS, Glintborg D. Blood pressure and hypertension during pregnancy in women with polycystic ovary syndrome: Odense Child Cohort. Acta Obstet Gynecol Scand 2020; 99:1354-1363. [DOI: 10.1111/aogs.13914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/07/2020] [Accepted: 05/10/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Julie Hougård Nielsen
- Department of Endocrinology and Metabolism Odense University Hospital Odense Denmark
| | - Anna Birukov
- Charité – Universitätsmedizin BerlinCorporate member of Freie Universität BerlinHumboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
- Department of Gynecology and Obstetrics Odense University Hospital Odense Denmark
- Experimental and Clinical Research Center, a joint cooperation between Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité‐Universitätsmedizin Berlin Berlin Germany
- German Center for Cardiovascular Research (DZHK) Berlin Germany
- Department of Molecular Epidemiology German Institute of Human Nutrition Potsdam‐Rehbrücke Nuthetal Germany
| | - Richard Christian Jensen
- Department of Endocrinology and Metabolism Odense University Hospital Odense Denmark
- Department of Environmental Medicine University of Southern Denmark Odense Denmark
| | - Henriette Boye Kyhl
- Odense Child Cohort Hans Christian Andersen Children’s HospitalOdense University Hospital Odense Denmark
- OPEN Patient data Explorative Network (OPEN) University of Southern Denmark Odense Denmark
| | - Jan Stener Jørgensen
- Department of Gynecology and Obstetrics Odense University Hospital Odense Denmark
| | | | - Dorte Glintborg
- Department of Endocrinology and Metabolism Odense University Hospital Odense Denmark
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104
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Sánchez-Ferrer ML, Arense-Gonzalo JJ, Prieto-Sánchez MT, Alfosea-Marhuenda E, Gómez-Carrascosa I, Iniesta MA, Mendiola J, Torres-Cantero AM. Does the anogenital distance change across pregnancy? Reprod Biomed Online 2020; 41:527-533. [PMID: 32586732 DOI: 10.1016/j.rbmo.2020.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/28/2020] [Accepted: 05/11/2020] [Indexed: 01/03/2023]
Abstract
RESEARCH QUESTION Does the length of the anogenital distance (AGD), an anthropometric biomarker of fetal androgen exposure, change across pregnancy? It has been suggested that AGD remains stable during adulthood with no changes across the menstrual cycle. No studies, however, have been carried out during pregnancy, during which women are exposed to important hormonal and anthropometric variations. DESIGN A cohort study of 186 singleton pregnant women recruited in the first trimester of pregnancy. Measurements from the anterior clitoral surface to the upper verge of the anus (AGDAC), and from the posterior fourchette to the upper verge of the anus (AGDAF) and body mass index (BMI) were obtained in each trimester. Generalized linear model for repeated measures was carried out to assess differences in AGDs and BMI across the three trimesters of the pregnancy. RESULTS In crude analyses, AGDAC was progressively and significantly longer as the pregnancy developed (first trimester: 87.69 ± 13.14mm; second trimester: 89.69 ± 13.47mm; third trimester: 91.95 ± 13.25 mm; P < 0.001), whereas AGDAF did not significantly change throughout pregnancy (first trimester: 28.37 ± 6.94 mm; second trimester: 28.09 ± 7.66 mm; third trimester: 28.94 ± 6.7 mm). In the multivariable mixed-effect models for fixed effect (trimester) and time-covariate (BMI), AGDs did not show significant associations with trimesters of pregnancy when BMI was included in the model. CONCLUSIONS Our results suggest that AGDAF and AGDAC, when adjusted by BMI, do not change throughout gestation despite maternal anthropometric variations during pregnancy. AGDAF may be a meaningful measurement at any time during pregnancy without considering BMI. Therefore, maternal AGDAF may be used as a prenatal biomarker of the mother's in-uteru hormonal exposure even during pregnancy.
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Affiliation(s)
- María L Sánchez-Ferrer
- Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, El Palmar Murcia 30120, Spain; Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar Mucia 30120, Spain
| | - Julian J Arense-Gonzalo
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar Mucia 30120, Spain; Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Espinardo Murcia 30100, Spain
| | - María T Prieto-Sánchez
- Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, El Palmar Murcia 30120, Spain; Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar Mucia 30120, Spain.
| | - Emilia Alfosea-Marhuenda
- Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, El Palmar Murcia 30120, Spain
| | - Inmaculada Gómez-Carrascosa
- Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, El Palmar Murcia 30120, Spain
| | - Miguel A Iniesta
- Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, El Palmar Murcia 30120, Spain
| | - Jaime Mendiola
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar Mucia 30120, Spain; Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Espinardo Murcia 30100, Spain
| | - Alberto M Torres-Cantero
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar Mucia 30120, Spain; Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Espinardo Murcia 30100, Spain; Department of Preventive Medicine, 'Virgen de la Arrixaca' University Clinical l Hospital, Murcia Murcia 30003, Spain; Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
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105
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Huang S, Tang Z, Wang Y, Chen D, Li J, Zhou C, Lu X, Yuan Y. Comparative profiling of exosomal miRNAs in human adult peripheral and umbilical cord blood plasma by deep sequencing. Epigenomics 2020; 12:825-842. [DOI: 10.2217/epi-2019-0213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: To assess differential expression profiles of miRNAs in exosomes derived from human peripheral blood (PB) and umbilical cord blood (UCB). Materials & methods: Small RNA sequencing was performed to characterize the miRNA expression in plasma exosomes processed from UCB of five healthy newborns and PB of five normal adult volunteers, and differentially expressed miRNAs were further analyzed. Results: A total of 65 exosomal miRNAs, including 46 upregulated and 19 downregulated, showed differential expression between UCB and PB. Target genes of these miRNAs were mainly enriched in signaling pathways associated with pregnancy, cancers, cell mobility and nervous system. Conclusion: Exosomal miRNAs may have essential roles in the biological functions of UCB, suggesting the therapeutic and biomarker potentials of exosomes in UCB.
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Affiliation(s)
- Sirui Huang
- School of Life Science & Biopharmacology, Guangdong Pharmaceutical University, Number 280 Outer Ring East Road, Higher Education Mega Center, Guangzhou, Guangdong 510006,PR China
| | - Zhenlin Tang
- School of Life Science & Biopharmacology, Guangdong Pharmaceutical University, Number 280 Outer Ring East Road, Higher Education Mega Center, Guangzhou, Guangdong 510006,PR China
| | - Yuheng Wang
- School of Life Science & Biopharmacology, Guangdong Pharmaceutical University, Number 280 Outer Ring East Road, Higher Education Mega Center, Guangzhou, Guangdong 510006,PR China
| | - Danliang Chen
- Department of Gynecology and Obstetrics, the First Affiliated Hospital of Jinan University, Number 613 Huangpu Avenue, Guangzhou, Guangdong 510630, PR China
| | - Jinhua Li
- School of Life Science & Biopharmacology, Guangdong Pharmaceutical University, Number 280 Outer Ring East Road, Higher Education Mega Center, Guangzhou, Guangdong 510006,PR China
| | - Chang Zhou
- School of Life Science & Biopharmacology, Guangdong Pharmaceutical University, Number 280 Outer Ring East Road, Higher Education Mega Center, Guangzhou, Guangdong 510006,PR China
| | - Xin Lu
- School of Life Science, South China Normal University, Number 55 Zhongshan Avenue, Guangzhou, Guangdong 510631, PR China
| | - Yin Yuan
- School of Life Science & Biopharmacology, Guangdong Pharmaceutical University, Number 280 Outer Ring East Road, Higher Education Mega Center, Guangzhou, Guangdong 510006,PR China
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106
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Kaur H, Merchant M, Haque MM, Mande SS. Crosstalk Between Female Gonadal Hormones and Vaginal Microbiota Across Various Phases of Women's Gynecological Lifecycle. Front Microbiol 2020; 11:551. [PMID: 32296412 PMCID: PMC7136476 DOI: 10.3389/fmicb.2020.00551] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 03/13/2020] [Indexed: 01/02/2023] Open
Abstract
Functional equilibrium between vaginal microbiota and the host is important for maintaining gynecological and reproductive health. Apart from host genetics, infections, changes in diet, life-style and hygiene status are known to affect this delicate state of equilibrium. More importantly, the gonadal hormones strongly influence the overall structure and function of vaginal microbiota. Several studies have attempted to understand (a) the composition of vaginal microbiota in specific stages of women's reproductive cycle as well as in menopause (b) their association with gonadal hormones, and their potential role in manifestation of specific health conditions (from the perspective of cause/consequence). However, a single study that places, in context, the structural variations of the vaginal microbiome across the entire life-span of women's reproductive cycle and during various stages of menopause is currently lacking. With the objective to obtain a holistic overview of the community dynamics of vaginal micro-environment 'across' various stages of women's reproductive and post-reproductive life-cycle, we have performed a meta-analysis of approximately 1,000 vaginal microbiome samples representing various stages of the reproductive cycle and menopausal states. Objectives of this analysis included (a) understanding temporal changes in vaginal community taxonomic structure and composition as women pass through various reproductive and menopausal stages (b) exploring correlations between the levels of female sex hormones with vaginal microbiome diversity (c) analyzing changes in the pattern of community diversity in cases of dysbiotic conditions such as bacterial vaginosis, and viewing the analyzed changes in the context of a healthy state. Results reveal interesting temporal trends with respect to vaginal microbial community diversity and its pattern of correlation with host physiology. Results indicate significant differences in alpha-diversity and overall vaginal microbial community members in various reproductive and post-reproductive phases. In addition to reinforcing the known influence/role of gonadal hormones in maintaining gynecological health, results indicate how hormonal level perturbations cause/contribute to imbalances in vaginal microbiota. The nature of resulting dysbiotic state and its influence on vaginal health is also analyzed and discussed. Results also suggest that elevated vaginal microbial diversity in pregnancy does not necessarily indicate a state of bacterial infection. The study puts forward a hormone-level driven microbiome diversity hypothesis for explaining temporal patterns in vaginal microbial diversity during various stages of women's reproductive cycle and at menopause.
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Affiliation(s)
| | | | | | - Sharmila S. Mande
- Bio-Sciences R&D Division, TCS Research, Tata Consultancy Services, Pune, India
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107
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Day DB, Collett BR, Barrett ES, Bush NR, Swan SH, Wang C, Sathyanarayana S. Prenatal sex hormones and behavioral outcomes in children. Psychoneuroendocrinology 2020; 113:104547. [PMID: 31901731 PMCID: PMC7759302 DOI: 10.1016/j.psyneuen.2019.104547] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/12/2019] [Accepted: 12/12/2019] [Indexed: 01/07/2023]
Abstract
Abnormal sex hormone levels in utero have been associated with child behavioral problems, but it is unclear if normal variation in prenatal sex hormones is associated with subsequent behavior in childhood. We assessed maternal sex hormones, including serum estrone (E1), estradiol (E2), estriol (E3), free testosterone (FT), and total testosterone (TT), during early pregnancy (gestational week 6-21 (mean = 11.1)) and evaluated child behavior at ages 4-5 using the Behavioral Assessment System for Children (BASC-2) and Social Responsiveness Scale (SRS-2) in 404 mother/child pairs (211 girls, 193 boys) within The Infant Development and Environment Study, a multi-site pregnancy cohort study. Associations between hormones and composite scores were evaluated using multiple linear regressions in both sexes combined, and separate models assessed effect modification by sex with the addition of interaction terms. A 10-fold increase in maternal FT or TT was associated in both sexes with a 4.3-point (95 % CI: 0.5, 8.2) or 4.4-point (0.8, 8.0) higher BASC-2 internalizing composite T score, respectively. In addition, a 10-fold increase in FT or TT was associated with a 3.8-point (0.04, 7.5) or 4.0-point (0.5, 7.5) higher behavioral symptoms index composite score. In models evaluating effect modification by sex, a 10-fold increase in E1 was associated with a 4.3-point (1.2, 7.4) decrease in adaptive skills composite score in girls only (interaction p = 0.04). We observed associations between testosterone and internalizing behaviors and behavioral symptoms index in both sexes, as well as a female-specific association between E1 and adaptive skills. Sex hormones during pregnancy may play a key role in influencing later-life behavior, and additional studies should further examine different periods of susceptibility to hormonal signals.
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Affiliation(s)
- Drew B Day
- Seattle Children's Research Institute, Seattle, WA, United States.
| | - Brent R Collett
- Seattle Children’s Research Institute, Seattle, WA,University of Washington, Seattle, WA
| | | | - Nicole R Bush
- University of California, San Francisco, San Francisco, CA
| | - Shanna H Swan
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - Christina Wang
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA
| | - Sheela Sathyanarayana
- Seattle Children’s Research Institute, Seattle, WA,University of Washington, Seattle, WA
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108
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Abstract
Prolactinomas are the most common pituitary tumors and pathological hyperprolactinemia. Therefore, women harboring prolactinomas frequently present infertility due to the gonadal axis impairment. The gold-standard treatment is dopamine agonist (DA) which can reverse hyperprolactinemia and hypogonadism, and promote tumor shrinkage in the majority of cases. Therefore, reports of pregnancy in such cohort become more common. In this scenario, bromocriptine is still the DA of choice due to its shorter half-life and larger experience as compared to cabergoline. In DA resistant cases, transsphenoidal pituitary surgery is indicated. However, potential risks of DA-induced pregnancies include fetal exposition and symptomatic tumor growth. Dopamine agonist should be discontinued as soon as pregnancy is confirmed in microprolactinomas and intrasellar macroprolactinomas (MAC). Concerning expansive/invasive MAC, DA maintenance should be considered. Periodically clinical evaluation should be performed during pregnancy, being sellar imaging indicated if tumor symptomatic growth is suspected. In such cases, if DA treatment fails, neurosurgery is indicated.
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Affiliation(s)
- Andrea Glezer
- Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clinicas, University of Sao Paulo Medical School, Rua Dr. Enéas de Carvalho Aguiar, no 155, 8° andar, bloco 3 (Endocrinologia), São Paulo, SP, 05403-000, Brazil
| | - Marcello D Bronstein
- Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clinicas, University of Sao Paulo Medical School, Rua Dr. Enéas de Carvalho Aguiar, no 155, 8° andar, bloco 3 (Endocrinologia), São Paulo, SP, 05403-000, Brazil.
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109
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Ganmaa D, Enkhmaa D, Baatar T, Uyanga B, Gantsetseg G, Helde TT, McElrath TF, Cantonwine DE, Bradwin G, Falk RT, Hoover RN, Troisi R. Maternal Pregnancy Hormone Concentrations in Countries with Very Low and High Breast Cancer Risk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E823. [PMID: 32012981 PMCID: PMC7037832 DOI: 10.3390/ijerph17030823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/07/2020] [Accepted: 01/20/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Breast cancer rates in Asia are much lower than in Europe and North America. Within Asia, rates are lower in Mongolia than in neighboring countries. Variation in pregnancy exposure to endogenous hormone concentrations may explain the differences, but data are lacking. METHODS We measured maternal serum progesterone, prolactin, estradiol and estrone concentrations in the second half of pregnancy in a cross-sectional study of urban (n = 143-194 depending on the analyte) and rural (n = 150-193) Mongolian women, and U.S. women from Boston (n = 66-204). Medical records provided information on maternal and perinatal factors. Geometric mean hormones were estimated from standard linear models with the log-hormone as the dependent variable and country as the independent variable adjusted for maternal and gestational age at blood draw. RESULTS Mean concentrations of prolactin (5722 vs. 4648 uIU/mL; p < 0.0001) and estradiol (17.7 vs. 13.6 ng/mL; p < 0.0001) were greater in Mongolian than U.S. women, while progesterone (147 vs. 201 ng/mL; p < 0.0001) was lower. Mean hormone concentrations were similar in rural and urban Mongolian women. Results were generally similar, with additional adjustment for gravidity, parity, height, body mass index at blood draw, education and alcohol use during pregnancy, and when stratified by offspring sex or parity. CONCLUSIONS Mongolian women had greater concentrations of prolactin and estrogen and lower concentrations of progesterone than U.S. women, while hormone concentrations were similar in rural and urban Mongolian pregnancies. IMPACT These data do not support the hypothesis that estrogen concentrations in pregnant women are lower in Mongolian compared with Caucasian women.
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Affiliation(s)
- Davaasambuu Ganmaa
- Channing Division Network of Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School and Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
- Mongolian Health Initiative, Ulaanbaatar 13312, Mongolia; (B.U.); (G.G.)
| | - Davaasambuu Enkhmaa
- Maternal and Child Health Research Center, Ulaanbaatar 16060, Mongolia; (D.E.); (T.B.)
| | - Tsedmaa Baatar
- Maternal and Child Health Research Center, Ulaanbaatar 16060, Mongolia; (D.E.); (T.B.)
| | - Buyanjargal Uyanga
- Mongolian Health Initiative, Ulaanbaatar 13312, Mongolia; (B.U.); (G.G.)
| | - Garmaa Gantsetseg
- Mongolian Health Initiative, Ulaanbaatar 13312, Mongolia; (B.U.); (G.G.)
| | - Thomas T. Helde
- Information Management Services, Inc., Rockville, MD 20850, USA;
| | - Thomas F. McElrath
- Harvard Medical School, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, MA 02115, USA; (T.F.M.); (D.E.C.)
| | - David E. Cantonwine
- Harvard Medical School, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, MA 02115, USA; (T.F.M.); (D.E.C.)
| | - Gary Bradwin
- Clinical and Epidemiologic Research Laboratory, Boston Children’s Hospital, Boston, MA 02115, USA;
| | - Roni T. Falk
- Epidemiology and Biostatistics Program, Division of Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA; (R.T.F.); (R.N.H.)
| | - Robert N. Hoover
- Epidemiology and Biostatistics Program, Division of Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA; (R.T.F.); (R.N.H.)
| | - Rebecca Troisi
- Epidemiology and Biostatistics Program, Division of Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA; (R.T.F.); (R.N.H.)
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110
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Lacham-Kaplan O, Camera DM, Hawley JA. Divergent Regulation of Myotube Formation and Gene Expression by E2 and EPA during In-Vitro Differentiation of C2C12 Myoblasts. Int J Mol Sci 2020; 21:E745. [PMID: 31979341 PMCID: PMC7037418 DOI: 10.3390/ijms21030745] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 12/21/2022] Open
Abstract
Estrogen (E2) and polyunsaturated fatty acids (n-3PUFA) supplements independently support general wellbeing and enhance muscle regeneration in-vivo and myotube formation in-vitro. However, the combined effect of E2 and n-3PUFA on myoblast differentiation is not known. The purpose of the study was to identify whether E2 and n-3PUFA possess a synergistic effect on in-vitro myogenesis. Mouse C2C12 myoblasts, a reliable model to reiterate myogenic events in-vitro, were treated with 10nM E2 and 50μM eicosapentaenoic acid (EPA) independently or combined, for 0-24 h or 0-120 h during differentiation. Immunofluorescence, targeted qPCR and next generation sequencing (NGS) were used to characterize morphological changes and differential expression of key genes involved in the regulation of myogenesis and muscle function pathways. E2 increased estrogen receptor α (Erα) and the expression of the mitogen-activated protein kinase 11 (Mapk11) within 1 h of treatment and improved myoblast differentiation and myotube formation. A significant reduction (p < 0.001) in myotube formation and in the expression of myogenic regulatory factors Mrfs (MyoD, Myog and Myh1) and the myoblast fusion related gene, Tmem8c, was observed in the presence of EPA and the combined E2/EPA treatment. Additionally, EPA treatment at 48 h of differentiation inhibited the majority of genes associated with the myogenic and striated muscle contraction pathways. In conclusion, EPA and E2 had no synergistic effect on myotube formation in-vitro. Independently, EPA inhibited myoblast differentiation and overrides the stimulatory effect of E2 when used in combination with E2.
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Affiliation(s)
- Orly Lacham-Kaplan
- Exercise and Nutrition Research Program, Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne 3000, Australia;
| | - Donny M. Camera
- Department of Health and Medical Sciences, Swinburne University of Technology, Melbourne 3122, Australia;
| | - John A. Hawley
- Exercise and Nutrition Research Program, Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne 3000, Australia;
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111
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Prolactin, Estradiol and Testosterone Differentially Impact Human Hippocampal Neurogenesis in an In Vitro Model. Neuroscience 2020; 454:15-39. [PMID: 31930958 PMCID: PMC7839971 DOI: 10.1016/j.neuroscience.2019.12.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 12/20/2022]
Abstract
Human hippocampal progenitor cells (HPCs) and tissue express classical sex hormone receptors. Prolactin does not impact human HPCs maintained in a proliferative state. Prolactin increases neuronal differentiation of human HPCs only in the short term. Estradiol and testosterone both increase the cell density of proliferating HPCs. Estradiol and testosterone have no observed effect on differentiating HPCs.
Previous studies have indicated that sex hormones such as prolactin, estradiol and testosterone may play a role in the modulation of adult hippocampal neurogenesis (AHN) in rodents and non-human primates, but so far there has been no investigation of their impact on human hippocampal neurogenesis. Here, we quantify the expression levels of the relevant receptors in human post-mortem hippocampal tissue and a human hippocampal progenitor cell (HPC) line. Secondly, we investigate how these hormones modulate hippocampal neurogenesis using a human in vitro cellular model. Human female HPCs were cultured with biologically relevant concentrations of either prolactin, estradiol or testosterone. Bromodeoxyuridine (BrdU) incorporation, immunocytochemistry (ICC) and high-throughput analyses were used to quantify markers determining cell fate after HPCs were either maintained in a proliferative state or allowed to differentiate in the presence of these hormones. In proliferating cells, estrogen and testosterone increased cell density but had no clear effect on markers of proliferation or cell death to account for this. In differentiating cells, a 3-day treatment of prolactin elicited a transient effect, whereby it increased the proportion of microtubule-associated protein 2 (MAP2)-positive and Doublecortin (DCX)-positive cells, but this effect was not apparent after 7-days. At this timepoint we instead observe a decrease in proliferation. Overall, our study demonstrates relatively minor, and possibly short-term effects of sex hormones on hippocampal neurogenesis in human cells. Further work will be needed to understand if our results differ to previous animal research due to species-specific differences, or whether it relates to limitations of our in vitro model.
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Anatomy and Physiology of the Breast during Pregnancy and Lactation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1252:3-7. [PMID: 32816256 DOI: 10.1007/978-3-030-41596-9_1] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
The mature breast is located within the anterior thoracic wall, lying atop the pectoralis major muscle. Pubertal changes lead to incomplete development of the breast , a process which is only completed during pregnancy . The incomplete breast consists mostly of adipose tissue but also lactiferous units called lobes. These eventually drain into the lactiferous ducts and then into the lactiferous sinus and then to the nipple-areolar complex. During pregnancy , the breast undergoes both anatomic and physiologic changes to prepare for lactation. During the first trimester, the ductal system expands and branches out into the adipose tissue in response to the increase of estrogen. Elevated levels of estrogen also cause a decrease in adipose tissue and ductal proliferation and elongation. Estrogen also stimulates the pituitary gland which leads to elevated levels of prolactin. By the twentieth week of gestation, mammary glands are sufficiently developed to produce components of milk due to prolactin stimulation. Milk production is inhibited by high estrogen and progesterone levels and colostrum is produced during this time. In the third trimester and then rapidly after birth, these levels decrease, allowing for milk production and eventual let-down to allow for breastfeeding. Most pregnancies cause the areola to darken, the breast to increase in size, and the Montgomery glands to become more prominent. Post-lactational involution occurs at the cessation of milk production caused by a decline in prolactin.
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Majhi PD, Sharma A, Roberts AL, Daniele E, Majewski AR, Chuong LM, Black AL, Vandenberg LN, Schneider SS, Dunphy KA, Jerry DJ. Effects of Benzophenone-3 and Propylparaben on Estrogen Receptor-Dependent R-Loops and DNA Damage in Breast Epithelial Cells and Mice. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:17002. [PMID: 31939680 PMCID: PMC7015622 DOI: 10.1289/ehp5221] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
BACKGROUND Endocrine-disrupting chemicals have been shown to have broad effects on development, but their mutagenic actions that can lead to cancer have been less clearly demonstrated. Physiological levels of estrogen have been shown to stimulate DNA damage in breast epithelial cells through mechanisms mediated by estrogen-receptor alpha (ERα). Benzophenone-3 (BP-3) and propylparaben (PP) are xenoestrogens found in the urine of >96% of U.S. OBJECTIVES We investigated the effect of BP-3 and PP on estrogen receptor-dependent transactivation and DNA damage at concentrations relevant to exposures in humans. METHODS In human breast epithelial cells, DNA damage following treatment with 17β-estradiol (E2), BP-3, and PP was determined by immunostaining with antibodies against γ-H2AX and 53BP1. Estrogenic responses were determined using luciferase reporter assays and gene expression. Formation of R-loops was determined with DNA: RNA hybrid-specific S9.6 antibody. Short-term exposure to the chemicals was also studied in ovariectomized mice. Immunostaining of mouse mammary epithelium was performed to quantify R-loops and DNA damage in vivo. RESULTS Concentrations of 1μM and 5μM BP-3 or PP increased DNA damage similar to that of E2 treatment in a ERα-dependent manner. However, BP-3 and PP had limited transactivation of target genes at 1μM and 5μM concentrations. BP-3 and PP exposure caused R-loop formation in a normal human breast epithelial cell line when ERα was introduced. R-loops and DNA damage were also detected in mammary epithelial cells of mice treated with BP-3 and PP. CONCLUSIONS Acute exposure to xenoestrogens (PP and BP-3) in mice induce DNA damage mediated by formation of ERα-dependent R-loops at concentrations 10-fold lower than those required for transactivation. Exposure to these xenoestrogens may cause deleterious estrogenic responses, such as DNA damage, in susceptible individuals. https://doi.org/10.1289/EHP5221.
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Affiliation(s)
- Prabin Dhangada Majhi
- Department of Veterinary & Animal Sciences, University of Massachusetts, Amherst, Massachusetts, USA
- Department of Botany, Ravenshaw University, Cuttack, Odisha, India
| | - Aman Sharma
- Department of Veterinary & Animal Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Amy L. Roberts
- Department of Veterinary & Animal Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Elizabeth Daniele
- Department of Veterinary & Animal Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Aliza R. Majewski
- Department of Veterinary & Animal Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Lynn M. Chuong
- Department of Veterinary & Animal Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Amye L. Black
- Department of Veterinary & Animal Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Laura N. Vandenberg
- Department of Environmental Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Sallie S. Schneider
- University of Massachusetts Medical School, Baystate Campus, Springfield, Massachusetts, USA
- Pioneer Valley Life Sciences Institute, Springfield, Massachusetts, USA
| | - Karen A. Dunphy
- Department of Veterinary & Animal Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - D. Joseph Jerry
- Department of Veterinary & Animal Sciences, University of Massachusetts, Amherst, Massachusetts, USA
- Pioneer Valley Life Sciences Institute, Springfield, Massachusetts, USA
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Shugg T, Egly C, Stamatkin CW, Patil AS, Tisdale JE, Overholser BR. Progesterone Metabolites Inhibit the Human Ether-a-go-go-Related Gene and Predict QT Interval Length. J Clin Pharmacol 2019; 60:648-659. [PMID: 31829451 PMCID: PMC10170396 DOI: 10.1002/jcph.1563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/12/2019] [Indexed: 11/08/2022]
Abstract
A decrease in the human ether-a-go-go-related gene (hERG/KCNH2)-related channel has been linked to intrauterine fetal death. The formation of cytochrome P450 (CYP) 3A-mediated progesterone metabolites, 6-beta-hydroxy-progesterone (6β-OHP) and 16α-hydroxy-progesterone (16α-OHP), is variable among adults and differs from fetal metabolism. The primary objective of this study was to assess the potential for progesterone metabolites to inhibit hERG-related current and predict QTc intervals. Whole-cell voltage-clamp electrophysiology was performed on human embryonic kidney 293 cells stably expressing hERG exposed to progesterone or metabolites. Both 6β-OHP and 16α-OHP positively shifted the voltage dependence of activation relative to vehicle from -4.0 ± 0.8 to -0.3 ± 0.8 mV, P < .01; and 1.0 ± 0.6 mV, P < .01, respectively. In addition, 6β-OHP decreased maximal outward tail currents from 49.4 ± 4.9 to 32.5 ± 4.1 pA/pF, P < 0.01, and reduced the expression of fully glycosylated hERG by 42%. Healthy female subjects were administered progesterone 400 mg orally for 7 days, ibutilide 0.003 mg/kg was infused, and serial electrocardiograms and blood samples collected. Relationships between rate-corrected QT intervals (QTcI) with circulating hormones and metabolites were assessed. The 6β-OHP and 16α-OHP metabolites were independent predictors of QTcI intervals prior to and following ibutilide administration. In conclusion, the progesterone metabolites formed via CYP3A cause inhibitory effects on hERG channels and predict QTcI intervals in healthy women pretreated with progesterone. Further study into maternal and fetal exposure to these metabolites and potential to prolong cardiac repolarization is warranted.
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Affiliation(s)
- Tyler Shugg
- Department of Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette, Indiana, USA
| | - Christian Egly
- Department of Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette, Indiana, USA
| | - Chris W Stamatkin
- Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Department of Pediatrics, Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Avinash S Patil
- Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Center for Personalized Obstetric Medicine, Valley Perinatal Services, Phoenix, Arizona, USA
| | - James E Tisdale
- Department of Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette, Indiana, USA.,Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Brian R Overholser
- Department of Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette, Indiana, USA.,Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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115
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Borba VV, Zandman-Goddard G, Shoenfeld Y. Exacerbations of autoimmune diseases during pregnancy and postpartum. Best Pract Res Clin Endocrinol Metab 2019; 33:101321. [PMID: 31564626 DOI: 10.1016/j.beem.2019.101321] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Autoimmune diseases represent a complex heterogeneous group of disorders that occur as a results of immune homeostasis dysregulation and loss of self-tolerance. Interestingly, more than 80% of the cases are found among women at reproductive age. Normal pregnancy is associated with remarkable changes in the immune and endocrine signaling required to tolerate and support the development and survival of the placenta and the semi-allogenic fetus in the hostile maternal immune system environment. Gravidity and postpartum represent an extremely challenge period, and likewise the general population, women suffering from autoimmune disorders attempt pregnancy. Effective preconception counseling and subsequent gestation and postpartum follow-up are crucial for improving mother and child outcomes. This comprehensive review provides information about the different pathways modulating autoimmune diseases activity and severity, such as the influence hormones, microbiome, infections, vaccines, among others, as well as updated recommendations were needed, in order to offer those women better medical care and life quality.
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Affiliation(s)
- Vânia Vieira Borba
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
| | - Gisele Zandman-Goddard
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Department of Medicine C, Wolfson Medical Center, Tel Aviv, Israel
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Russia.
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116
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Gogos A, Ney LJ, Seymour N, Van Rheenen TE, Felmingham KL. Sex differences in schizophrenia, bipolar disorder, and post-traumatic stress disorder: Are gonadal hormones the link? Br J Pharmacol 2019; 176:4119-4135. [PMID: 30658014 PMCID: PMC6877792 DOI: 10.1111/bph.14584] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 11/13/2018] [Accepted: 11/25/2018] [Indexed: 12/30/2022] Open
Abstract
In this review, we describe the sex differences in prevalence, onset, symptom profiles, and disease outcome that are evident in schizophrenia, bipolar disorder, and post-traumatic stress disorder. Women with schizophrenia tend to exhibit less disease impairment than men. By contrast, women with post-traumatic stress disorder are more affected than men. The most likely candidates to explain these sex differences are gonadal hormones. This review details the clinical evidence that oestradiol and progesterone are dysregulated in these psychiatric disorders. Notably, existing data on oestradiol, and to a lesser extent, progesterone, suggest that low levels of these hormones may increase the risk of disease development and worsen symptom severity. We argue that future studies require a more inclusive, considered analysis of gonadal steroid hormones and the intricacies of the interactions between them, with methodological rigour applied, to enhance our understanding of the roles of steroid hormones in psychiatric disorders. LINKED ARTICLES: This article is part of a themed section on The Importance of Sex Differences in Pharmacology Research. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.21/issuetoc.
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Affiliation(s)
- Andrea Gogos
- Hormones in Psychiatry LaboratoryFlorey Institute of Neuroscience and Mental HealthParkvilleVictoriaAustralia
| | - Luke J. Ney
- School of Medicine (Psychology)University of TasmaniaSandy BayTasmaniaAustralia
| | - Natasha Seymour
- Hormones in Psychiatry LaboratoryFlorey Institute of Neuroscience and Mental HealthParkvilleVictoriaAustralia
- Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleVictoriaAustralia
| | - Tamsyn E. Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of PsychiatryUniversity of MelbourneParkvilleVictoriaAustralia
- Centre for Mental Health, School of Health Sciences, Faculty of Health, Arts and DesignSwinburne UniversityMelbourneVictoriaAustralia
| | - Kim L. Felmingham
- School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
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Andersen MS, Jensen RC, Schmedes AV, Brandslund I, Kyhl HB, Jensen TK, Glintborg D. Third trimester cortisol status is associated with offspring sex and polycystic ovary syndrome status: Odense Child Cohort. Fertil Steril 2019; 112:764-772. [DOI: 10.1016/j.fertnstert.2019.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/06/2019] [Accepted: 05/07/2019] [Indexed: 12/15/2022]
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118
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Morrison KE, Cole AB, Thompson SM, Bale TL. Brexanolone for the treatment of patients with postpartum depression. Drugs Today (Barc) 2019; 55:537-544. [PMID: 31584571 PMCID: PMC8033597 DOI: 10.1358/dot.2019.55.9.3040864] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
On March 19, 2019, the United States Food and Drug Administration (FDA) approved Zulresso (brexanolone) for intravenous use for the treatment of postpartum depression (PPD) in adult women. The decision was based on three recent clinical trials following an FDA priority review and breakthrough therapy designation. Brexanolone is now available through a restricted process called the Zulresso Risk Evaluation and Mitigation Strategy Program that requires the drug to be administered by a healthcare provider in a certified healthcare facility. Brexanolone represents an important new treatment option to address treatment-resistant depressive symptoms. In this article, we discuss the current critical need for PPD treatments, the mechanisms of brexanolone action, and the efficacy and drug safety studies that led to FDA approval. Additionally, we discuss some limitations of the current formulation, specific populations of women that might benefit from this treatment, and how new drugs on the horizon may increase the ability to treat PPD in a variety of patient populations.
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Affiliation(s)
- K E Morrison
- Departments of Pharmacology and Psychiatry and Center for Epigenetic Research in Child Health and Brain Development, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - A B Cole
- Department of Physiology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - S M Thompson
- Department of Physiology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - T L Bale
- Departments of Pharmacology and Psychiatry and Center for Epigenetic Research in Child Health and Brain Development, University of Maryland School of Medicine, Baltimore, Maryland, USA.
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119
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Smeeth DM, Dima D, Jones L, Jones I, Craddock N, Owen MJ, Rietschel M, Maier W, Korszun A, Rice JP, Mors O, Preisig M, Uher R, Lewis CM, Thuret S, Powell TR. Polygenic risk for circulating reproductive hormone levels and their influence on hippocampal volume and depression susceptibility. Psychoneuroendocrinology 2019; 106:284-292. [PMID: 31039525 PMCID: PMC6597945 DOI: 10.1016/j.psyneuen.2019.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 04/04/2019] [Accepted: 04/09/2019] [Indexed: 12/13/2022]
Abstract
Altered reproductive hormone levels have been associated with the pathophysiology of depressive disorders and this risk may be imparted by their modulatory effect upon hippocampal structure and function. Currently it is unclear whether altered levels of reproductive hormones are causally associated with hippocampal volume reductions and the risk of depressive disorders. Here, we utilize genome-wide association study (GWAS) summary statistics from a GWAS focusing on reproductive hormones, consisting of 2913 individuals. Using this data, we generated polygenic risk scores (PRS) for estradiol, progesterone, prolactin and testosterone in the European RADIANT cohort consisting of 176 postpartum depression (PPD) cases (100% female, mean age: 41.6 years old), 2772 major depressive disorder (MDD) cases (68.6% female, mean age: 46.9 years old) and 1588 control participants (62.5% female, mean age: 42.4 years old), for which there was also a neuroimaging subset of 111 individuals (60.4% female, mean age: 50.0 years old). Only the best-fit PRS for estradiol showed a significant negative association with hippocampal volume, as well as many of its individual subfields; including the molecular layer and granule cell layer of the dentate gyrus, subiculum, CA1, CA2/3 and CA4 regions. Interestingly, several of these subfields are implicated in adult hippocampal neurogenesis. When we tested the same estradiol PRS for association with case-control status for PPD or MDD there was no significant relationship observed. Here, we provide evidence that genetic risk for higher plasma estradiol is negatively associated with hippocampal volume, but this does not translate into an increased risk of MDD or PPD. This work suggests that the relationship between reproductive hormones, the hippocampus, and depression is complex, and that there may not be a clear-cut pathway for etiology or risk moderation.
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Affiliation(s)
- Demelza M Smeeth
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Danai Dima
- Department of Psychology, School of Arts and Social Sciences, City, University of London, London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lisa Jones
- Institute of Health & Society, University of Worcester, Worcester, UK
| | - Ian Jones
- MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - Nick Craddock
- MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - Michael J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - Marcella Rietschel
- Department of Psychiatry, University of Bonn, Bonn, Germany; Division of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim, Germany
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Ania Korszun
- Barts and The London Medical School, Queen Mary University of London, London, UK
| | - John P Rice
- Department of Psychiatry, Washington University, St. Louis, Missouri, USA
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Martin Preisig
- University Hospital Center and University of Lausanne, Lausanne, Switzerland
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Cathryn M Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sandrine Thuret
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Timothy R Powell
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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120
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Mossa F, Latham KE, Ireland JJ, Veiga-Lopez A. Undernutrition and hyperandrogenism during pregnancy: Role in programming of cardiovascular disease and infertility. Mol Reprod Dev 2019; 86:1255-1264. [PMID: 31347224 DOI: 10.1002/mrd.23239] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 07/02/2019] [Indexed: 12/17/2022]
Abstract
Maternal nutritional status programs the development of several systems in female offspring, with effects that depend on the severity, duration, and window of development when the nutritional perturbation is imposed. On the basis of the developmental origins of health and disease concept, we hypothesize that gestational low caloric intake may induce maternal subclinical hyperandrogenism during early pregnancy and compromise cardiovascular health and fertility in the female offspring. To examine this possibility, a literature search for human and animal studies was conducted using two electronic databases, PubMed and Cochrane until April 2019 to address the following questions: (a) Do androgens have a developmental role in cardiovascular and ovarian development? (b) Is excess maternal testosterone linked to cardiovascular disease and infertility? and (c) Could early pregnancy undernutrition enhance maternal androgen production and compromise health and fertility in female offspring? The observations reviewed, establish a potential causative link between maternal undernutrition and subclinical hyperandrogenism with hypertension and reduced ovarian reserve in the progeny. Further studies in appropriate models are needed to better understand whether low energy intake and subclinical maternal hyperandrogenism during early pregnancy can negatively affect the health of the female offspring.
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Affiliation(s)
- Francesca Mossa
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - Keith E Latham
- Department of Animal Science, Reproductive and Developmental Sciences Program, Michigan State University, East Lansing, Michigan
| | - James J Ireland
- Department of Animal Science, Reproductive and Developmental Sciences Program, Michigan State University, East Lansing, Michigan
| | - Almudena Veiga-Lopez
- Department of Animal Science, Reproductive and Developmental Sciences Program, Michigan State University, East Lansing, Michigan
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121
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Taylor CM, Pritschet L, Yu S, Jacobs EG. Applying a Women's Health Lens to the Study of the Aging Brain. Front Hum Neurosci 2019; 13:224. [PMID: 31333434 PMCID: PMC6625223 DOI: 10.3389/fnhum.2019.00224] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 06/18/2019] [Indexed: 11/15/2022] Open
Abstract
A major challenge in neuroscience is to understand what happens to a brain as it ages. Such insights could make it possible to distinguish between individuals who will undergo typical aging and those at risk for neurodegenerative disease. Over the last quarter century, thousands of human brain imaging studies have probed the neural basis of age-related cognitive decline. "Aging" studies generally enroll adults over the age of 65, a historical precedent rooted in the average age of retirement. A consequence of this research tradition is that it overlooks one of the most significant neuroendocrine changes in a woman's life: the transition to menopause. The menopausal transition is marked by an overall decline in ovarian sex steroid production-up to 90% in the case of estradiol-a dramatic endocrine change that impacts multiple biological systems, including the brain. Despite sex differences in the risk for dementia, the influence that biological sex and sex hormones have on the aging brain is historically understudied, leaving a critical gap in our understanding of the aging process. In this Perspective article, we highlight the influence that endocrine factors have on the aging brain. We devote particular attention to the neural and cognitive changes that unfold in the middle decade of life, as a function of reproductive aging. We then consider emerging evidence from animal and human studies that other endocrine factors occurring earlier in life (e.g., pregnancy, hormonal birth control use) also shape the aging process. Applying a women's health lens to the study of the aging brain will advance knowledge of the neuroendocrine basis of cognitive aging and ensure that men and women get the full benefit of our research efforts.
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Affiliation(s)
- Caitlin M. Taylor
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
- The Sage Center for the Study of the Mind, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Laura Pritschet
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Shuying Yu
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Emily G. Jacobs
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
- Neuroscience Research Institute, University of California, Santa Barbara, Santa Barbara, CA, United States
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Dixson BJW, Kennedy-Costantini S, Lee AJ, Nelson NL. Mothers are sensitive to men's beards as a potential cue of paternal investment. Horm Behav 2019; 113:55-66. [PMID: 30978339 DOI: 10.1016/j.yhbeh.2019.04.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/27/2019] [Accepted: 04/08/2019] [Indexed: 12/29/2022]
Abstract
Mating strategy theories assert that women's preferences for androgen dependent traits in men are stronger when the costs of reduced paternal investment are lowest. Past research has shown that preferences for facial masculinity are stronger among nulliparous and non-pregnant women than pregnant or parous women. In two studies, we examine patterns in women's preferences for men's facial hair - likely the most visually conspicuous and sexually dimorphic of men's secondary sexual traits - when evaluating men's masculinity, dominance, age, fathering, and attractiveness. Two studies were conducted among heterosexual pregnant women, mothers, non-contractive and contraceptive users. Study 1 used a between-subjects sample (N = 2103) and found that mothers had significantly higher preferences for beards when judging fathering than all other women. Pregnant women and mothers also judged beards as more masculine and older, but less attractive, than non-contractive and contraceptive users. Parous women judged beards higher for age, masculinity and fathering, but lower for attractiveness, than nulliparous women. Irrespective of reproductive status, beards were judged as looking more dominant than clean-shaven faces. Study 2 used a within-subjects design (N = 53) among women surveyed during pregnancy and three months post-partum. Judgments of parenting skills were higher for bearded stimuli during pregnancy among women having their first baby, whereas among parous women parenting skills judgments for bearded stimuli were higher post-partum. Our results suggest that mothers are sensitive to beardedness as a masculine secondary sexual characteristic that may denote parental investment, providing evidence that women's mate preferences could reflect sexual selection for direct benefits.
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Affiliation(s)
- Barnaby J W Dixson
- School of Psychology, The University of Queensland, St. Lucia, Brisbane 4072, QLD, Australia.
| | | | | | - Nicole L Nelson
- School of Psychology, The University of Queensland, St. Lucia, Brisbane 4072, QLD, Australia
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Grossi E, Parisi F, Duca P, Savasi VM. Maternal estradiol and progesterone concentrations among singleton spontaneous pregnancies during the first trimester. J Endocrinol Invest 2019; 42:633-638. [PMID: 30324258 DOI: 10.1007/s40618-018-0961-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 09/24/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pregnancy hormonal milieu represents a crucial determinant of fetal outcome. We aim to determine 17β-estradiol (E2) and progesterone (PGT) concentrations in spontaneous pregnancies during the first trimester. In addition, we aim to determine E2 concentrations as a function of gestational age (GA) and PGT. METHODS Between November 2015 and March 2017, 104 healthy women of at least 18 years undergoing medical consultation for voluntary interruption of pregnancy were enrolled in an observational study at University Hospital ASST Fatebenefratelli Sacco, Milan, Italy. Only singleton pregnancies between 5+0 and 13+6 weeks of gestation were eligible. First trimester ultrasound scans were performed for dating and one fasting venous blood sample was collected for E2 and PGT determinations. RESULTS E2 and PGT concentrations steadily increased according to GA. The correlation between E2 on a logarithmic scale and PGT concentrations was expressed by the following equation, explaining 12.6% of E2 variance: logE2 = 2.57 + 0.1 × PGT, (r = 0.34, p < 0.001). By performing a multivariable linear regression analysis adjusted for variables significantly correlated with E2 concentrations, we obtained a model explaining the 53.5% of E2 variance. The final equation to determine E2 concentrations among Caucasian women was: logE2 = 1.96 + 0.01 × GA + 0.004 × PGT. CONCLUSIONS Gestational week-specific reference intervals are reported for maternal E2 and PGT concentrations during early pregnancy, further providing a model for E2 assessment in this period. This will represent a starting point for further evaluations between twin and ART pregnancies, as well as to potentially improve pregnancy outcome and future health of the offspring.
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Affiliation(s)
- E Grossi
- Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli Sacco, Hospital "L. Sacco", University of Milan, via GB Grassi 74, 20157, Milan, Italy.
- Centre for Fetal Research Giorgio Pardi, University of Milan, Milan, Italy.
| | - F Parisi
- Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli Sacco, Hospital "L. Sacco", University of Milan, via GB Grassi 74, 20157, Milan, Italy
- Centre for Fetal Research Giorgio Pardi, University of Milan, Milan, Italy
| | - P Duca
- Medical Statistics, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli Sacco, Hospital "L. Sacco", via GB Grassi 74, 20157, Milan, Italy
| | - V M Savasi
- Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli Sacco, Hospital "L. Sacco", University of Milan, via GB Grassi 74, 20157, Milan, Italy
- Centre for Fetal Research Giorgio Pardi, University of Milan, Milan, Italy
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Wang H, Du H, Yang J, Jiang H, O K, Xu L, Liu S, Yi J, Qian X, Chen Y, Jiang Q, He G. PFOS, PFOA, estrogen homeostasis, and birth size in Chinese infants. CHEMOSPHERE 2019; 221:349-355. [PMID: 30641376 DOI: 10.1016/j.chemosphere.2019.01.061] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 05/22/2023]
Abstract
Laboratory studies have suggested that perfluoroalkyl substances (PFASs) could affect fetal growth by disrupting estrogen homeostasis, but there are limited data for human. For this, 424 mother-infant pairs were selected from a cohort established in Hebei Province of North China in 2013. Two typical PFASs, perfluorooctyl sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA), and three typical estrogens, estrone (E1), β-estradiol (E2), and estriol (E3), were measured in cord serum. After adjusted for important covariates, serum PFOS was positively related to E1 and E3, but negatively related to E2. Serum PFOA was positively related to serum E1 and negatively related to head circumference at birth. Serum E2 was negatively related to head circumference, body weight, and body length at birth and serum E3 was positively related to body weight. Serum E3 mediated the relationship between serum PFOS and body weight. There were sex-specific differences for the associations between PFOS/PFOA and estrogens/birth size. These findings suggested that exposure to PFASs could affect estrogen homeostasis and fetal growth during pregnancy and that estrogens might mediate the association between exposure to PFASs and fetal growth.
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Affiliation(s)
- Hexing Wang
- School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Hongyi Du
- School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Jiaqi Yang
- School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Hong Jiang
- School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Karmin O
- Department of Animal Science, Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, Manitoba, R3T2N2, Canada
| | - Linji Xu
- Maternal and Child Health Care Hospital of Tangshan Municipality, Tangshan, 063000, Hebei province, China
| | - Shuping Liu
- Maternal and Child Health Care Hospital of Tangshan Municipality, Tangshan, 063000, Hebei province, China
| | - Jianping Yi
- Maternal and Child Health Care Hospital of Tangshan Municipality, Tangshan, 063000, Hebei province, China
| | - Xu Qian
- School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, K1G5Z3, Canada
| | - Qingwu Jiang
- School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Gengsheng He
- School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China.
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Petersenn S, Christ-Crain M, Droste M, Finke R, Flitsch J, Kreitschmann-Andermahr I, Luger A, Schopohl J, Stalla G. Pituitary Disease in Pregnancy: Special Aspects of Diagnosis and Treatment? Geburtshilfe Frauenheilkd 2019; 79:365-374. [PMID: 31000881 PMCID: PMC6461462 DOI: 10.1055/a-0794-7587] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/14/2018] [Accepted: 11/10/2018] [Indexed: 02/06/2023] Open
Abstract
The diagnosis and treatment of pituitary disease in pregnancy represents a special clinical challenge. Not least because there is very little data on the treatment of pregnant patients with pituitary disorders. A selective search of the literature was carried out with the aim of compiling evidence about the diagnosis and treatment of pituitary disease in pregnancy. The search covered the databases PubMed/MEDLINE including PubMed Central and also used the Livivo (ZB MED) search engine. Recent studies were evaluated for recommendations about the care of pregnant patients with hormone-inactive and hormone-active pituitary adenomas (prolactinoma, acromegaly and Cushing's disease), pituitary insufficiency, pituitary apoplexy and hypophysitis. The most well-established forms of treatment are for prolactinoma, due to the incidence of this disease and its impact on fertility. When pregnancy has been confirmed, prolactinoma treatment with dopamine agonists should be paused. Although microprolactinomas rarely increase significantly in size after the administration of dopamine agonists is discontinued, symptomatic tumor growth of macroprolactinomas can occur. In such cases, treatment with dopamine agonists can be resumed. If the primary tumor is large and the risk that it will continue to grow is high, it may be necessary to continue medical treatment from the start of pregnancy. If one of the partners has a pituitary disorder, it is often still possible for many couples to achieve their wish of having children if they receive medical support to plan and the pregnancy is carefully monitored. Given the complexity of pituitary disease, pregnant patients with pituitary disorders should be cared for and treated by a multidisciplinary team in centers specializing in the diagnosis and treatment of pituitary disease.
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Affiliation(s)
- Stephan Petersenn
- ENDOC Praxis für Endokrinologie, Andrologie und medikamentöse Tumortherapie, Hamburg, Germany
| | - Mirjam Christ-Crain
- Endokrinologie, Diabetologie & Metabolismus. Universitätsspital Basel, Basel, Switzerland
| | - Michael Droste
- Endokrinologie, Diabetologie, Hormonanalytik. MEDICOVER MVZ, Oldenburg, Germany
| | - Reinhard Finke
- Praxis an der Kaisereiche (üBAG), Berlin-Friedenau, Germany
| | - Jörg Flitsch
- Klinik und Poliklinik für Neurochirurgie, Kopf- und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | | | - Anton Luger
- Universitätsklinik für Innere Medizin III, Klinische Abteilung für Endokrinologie & Stoffwechsel, Medizinische Universität Wien, Wien, Austria
| | - Jochen Schopohl
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München, Germany
| | - Günter Stalla
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München, Germany.,Medicover Neuroendokrinologie, München, Germany
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Barrett ES, Mbowe O, Thurston SW, Butts S, Wang C, Nguyen R, Bush N, Redmon JB, Sheshu S, Swan SH, Sathyanarayana S. Predictors of Steroid Hormone Concentrations in Early Pregnancy: Results from a Multi-Center Cohort. Matern Child Health J 2019; 23:397-407. [PMID: 30659461 PMCID: PMC6397082 DOI: 10.1007/s10995-018-02705-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objectives To identify factors predicting maternal sex steroid hormone concentrations in early pregnancy. Methods The Infant Development and the Environment Study recruited healthy pregnant women from academic medical centers in four US cities. Gold standard liquid chromatography-tandem mass spectrometry was used to measure maternal sex steroids concentrations (total testosterone [TT], free testosterone [FT], estrone [E1], estradiol [E2], and estriol [E3] concentrations) in serum samples from 548 women carrying singletons (median = 11.7 weeks gestation). Women completed questionnaires on demographic and lifestyle characteristics. Results In multivariable linear regression analyses, hormone concentrations varied in relation to maternal age, body mass index (BMI), race, and parity. Older mothers had significantly lower levels of most hormones; for every year increase in maternal age, there was a 1-2% decrease in E1, E2, TT, and FT. By contrast, each unit increase in maternal BMI was associated 1-2% lower estrogen (E1, E2, E3) levels, but 1-2% higher androgen (TT, FT) concentrations. Hormone concentrations were 4-18% lower among parous women, and for each year elapsed since last birth, TT and FT were 1-2% higher (no difference in estrogens). Androgen concentrations were 18-30% higher among Black women compared to women of other races. Fetal sex, maternal stress, and lifestyle factors (including alcohol and tobacco use) were not related to maternal steroid concentrations. Conclusions for Practice Maternal demographic factors predict sex steroid hormone concentrations during pregnancy, which is important given increasing evidence that the prenatal endocrine environment shapes future risk of chronic disease for both mother and offspring.
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Affiliation(s)
- Emily S Barrett
- Department of Epidemiology, Rutgers School of Public Health, 170 Frelinghuysen Road, Piscataway, NJ, 08854, USA.
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA.
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
| | - Omar Mbowe
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Sally W Thurston
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Samantha Butts
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Christina Wang
- Clinical and Translational Science Institute, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Los Angeles, CA, USA
| | - Ruby Nguyen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Nicole Bush
- Departments of Psychiatry and Pediatrics, University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | - J Bruce Redmon
- Department of Medicine, University of Minnesota School of Medicine, Minneapolis, MN, USA
| | - Sukrita Sheshu
- Department of Epidemiology, Rutgers School of Public Health, 170 Frelinghuysen Road, Piscataway, NJ, 08854, USA
| | - Shanna H Swan
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington, Seattle, WA, USA
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
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Cornish R, Staff AC, Boyd A, Lawlor DA, Tretli S, Bradwin G, McElrath TF, Hyer M, Hoover RN, Troisi R. Maternal reproductive hormones and angiogenic factors in pregnancy and subsequent breast cancer risk. Cancer Causes Control 2019; 30:63-74. [PMID: 30506491 PMCID: PMC6438198 DOI: 10.1007/s10552-018-1100-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 11/22/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE Breast cancer risk associated with pregnancy characteristics may be mediated by maternal hormones or angiogenic factors. METHODS We conducted a prospective breast cancer case-control study among women in the Avon Longitudinal Study of Parents and Children (ALSPAC) and Norwegian Mother and Child Cohort Study (MoBa) related to maternal pregnancy prolactin (n = 254 cases and 374 controls), placental growth factor (PlGF, n = 252 and 371), soluble fms-like tyrosine kinase-1 (sFlt-1, n = 118 and 240) and steroid hormone concentrations (ALSPAC only, n = 173 and 171). Odds ratios (OR) and 95% confidence intervals (CI) for a 1 SD change in analytes were estimated using unconditional logistic regression with matching factors (cohort, mother's birth year, serum/plasma, blood collection timing) and gestational age. RESULTS Breast cancer ORs (95% CI) were 0.85 (0.51-1.43) for estradiol, 0.86 (0.67-1.09) for testosterone, 0.89 (0.71-1.13) for androstenedione, 0.97 (0.71-1.34) for hCG, 0.93 (0.75, 1.15) for prolactin, 1.00 (0.78-1.27) for PlGF and 1.91 (1.00-3.65 ALSPAC) and 0.94 (0.73-1.21 MoBa) for sFlt-1, and were similar adjusting for potential confounders. Results were similar by blood collection timing, parity, age at first birth or diagnosis, and time between pregnancy and diagnosis. CONCLUSION These data do not provide strong evidence of associations between maternal hormones or angiogenic factors with subsequent maternal breast cancer risk.
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Affiliation(s)
- Rosie Cornish
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Anne Cathrine Staff
- Division of Obstetrics and Gynecology, Oslo University Hospital and University of Oslo, P.O. Box 4956, Nydalen, 0424, Oslo, Norway
| | - Andy Boyd
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Debbie A Lawlor
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- NIHR Bristol Biomedical Research Centre, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Steinar Tretli
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, P.O. Box 5313, Majorstuen, 0304, Oslo, Norway
| | - Gary Bradwin
- Clinical and Epidemiologic Research Laboratory, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Thomas F McElrath
- Department of Obstetrics and Gynecology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA
| | - Marianne Hyer
- Information Management Services, 6110 Executive Blvd # 310, Rockville, MD, 20852, USA
| | - Robert N Hoover
- Epidemiology and Biostatistics Program, Division of Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Rebecca Troisi
- Epidemiology and Biostatistics Program, Division of Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
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128
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Swaen GMH, Boffetta P, Zeegers M. Impact of changes in human reproduction on the incidence of endocrine-related diseases. Crit Rev Toxicol 2018; 48:789-795. [PMID: 30590970 DOI: 10.1080/10408444.2018.1541073] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The incidence rates of a wide range of diseases and conditions have increased over the last decades. There is controversy over the origin of these increases, whether they are caused by exposure to compounds thought to have an effect on the endocrine system, the "endocrine disruption theory", or whether some other factor is responsible. In this analysis, the authors take a closer look at the role that changes in reproductive factors have played in this respect. They apply the relative risks of age at first pregnancy and parity or family size to a set of Dutch demographic data from 1955 and 2015 and calculate the percentage of disease increase explained. The decrease in parity over the last decades explains an increase of 26% in testicular cancer. The combination of decrease in parity and increase in maternal age at first pregnancy explains an increase of 34% in hypospadias prevalence. This combination of decreased parity and increased maternal age at pregnancy explains an increase of 24% in childhood obesity prevalence. The authors further point to a perhaps even more profound effect of the trend toward smaller families. This trend has led to an estimated doubling of the proportion of children born from subfertile couples. Since children born from subfertile couples are more likely to be preterm or of low birth weight, the incidence of these conditions must have increased as well. Low birth weight and preterm delivery are risk factors for a wide range of diseases and conditions. The changes in human reproduction over the last decades have had a profound impact on the incidence of a range of diseases and conditions in the next generation and thus provide a sound explanation for a substantial portion of the reported increases. Key messages The incidence rates of a wide range of diseases and conditions have increased in the Western societies over the last decades. Many have argued that these increases are attributable to compounds thought to have effects on the human endocrine system: the endocrine disruption theory This analysis shows, however, that human reproductive factors such as maternal age at first pregnancy and parity explain substantial proportions of the reported increases.
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Affiliation(s)
- Gerard M H Swaen
- a CAPHRI Research Institute and Department of Complex Genetics , Maastricht University , Maastricht , The Netherlands
| | - Paolo Boffetta
- b Tisch Cancer Institute , Icahn School of Medicine at Mount Sinai , New York City , NY , USA
| | - Maurice Zeegers
- a CAPHRI Research Institute and Department of Complex Genetics , Maastricht University , Maastricht , The Netherlands
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Zhao H, Li J, Zhou Y, Zhu L, Zheng Y, Xia W, Li Y, Xiang L, Chen W, Xu S, Cai Z. Investigation on Metabolism of Di(2-Ethylhexyl) Phthalate in Different Trimesters of Pregnant Women. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2018; 52:12851-12858. [PMID: 30257557 DOI: 10.1021/acs.est.8b04519] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Di(2-ethylhexyl) phthalate (DEHP) is a widely used plasticizer but shows diverse toxicity. To investigate the time- and maternal age-differences in metabolism process of DEHP in pregnant women, three urine samples were collected from each pregnant woman ( n = 847) at the first (T1, mean 13.04 gestational weeks), the second (T2, mean 23.63 gestational weeks) and the third time point (T3, mean 35.91 gestational weeks), respectively. Four metabolites of DEHP were analyzed in 2541 urine samples (847 × 3) by using ultra-high performance liquid chromatography coupled with triple quadrupole mass spectrometry. The level of urinary mono(2-ethylhexyl) phthalate (MEHP) had a decreasing trend across the pregnancy periods. The geometric mean concentrations of mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) and mono(2-ethyl-5-carboxypentyl) phthalate (MECPP) were significantly decreased in T2 than T1, and recovered slightly in T3. The transformation rate of MEHP to MEHHP in T3 was significantly higher than those in other two time points. The transformation rate of MEHHP to MEOHP in T2 and T3 was significantly higher than that in T1, indicating the oxidation was more efficient in late pregnancy compared with early and middle pregnancy. The percentages of oxidation products MEHHP and MECPP were higher in the higher-age group compared with the lower-age group in the second trimester samples. It is therefore concluded that DEHP metabolism may be influenced by the pregnancy stage and maternal age. The findings may benefit the risk assessment and toxicity evaluation of DEHP.
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Affiliation(s)
- Hongzhi Zhao
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry , Hong Kong Baptist University , Hong Kong SAR , China
| | - Jiufeng Li
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry , Hong Kong Baptist University , Hong Kong SAR , China
| | - Yanqiu Zhou
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry , Hong Kong Baptist University , Hong Kong SAR , China
| | - Lin Zhu
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry , Hong Kong Baptist University , Hong Kong SAR , China
| | - Yuanyuan Zheng
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry , Hong Kong Baptist University , Hong Kong SAR , China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health , Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health , Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Li Xiang
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry , Hong Kong Baptist University , Hong Kong SAR , China
| | - Wei Chen
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry , Hong Kong Baptist University , Hong Kong SAR , China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health , Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Zongwei Cai
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry , Hong Kong Baptist University , Hong Kong SAR , China
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Glintborg D, Jensen RC, Bentsen K, Schmedes AV, Brandslund I, Kyhl HB, Bilenberg N, Andersen MS. Testosterone Levels in Third Trimester in Polycystic Ovary Syndrome: Odense Child Cohort. J Clin Endocrinol Metab 2018; 103:3819-3827. [PMID: 30060213 DOI: 10.1210/jc.2018-00889] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 07/24/2018] [Indexed: 02/13/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism. In pregnancy, testosterone levels may be higher in women with PCOS compared with controls. AIMS To compare total testosterone (TT), free testosterone (FT), and sex hormone-binding globulin (SHBG) levels in third-trimester pregnant women with PCOS and controls and to establish reference ranges for TT, FT, and SHBG in PCOS and controls. METHODS The study was part of the prospective study, Odense Child Cohort. PCOS was diagnosed by questionnaires and/or patient records. Fasting blood samples were collected at gestational week 28 and plasma TT was measured by liquid chromatography-tandem mass spectrometry in women with PCOS (n = 145) and in women without PCOS (controls, n = 1341). RESULTS Levels of TT (mean, 2.4 vs 2.0 nmol/L) and FT (mean, 0.005 vs 0.004 nmol/L) were higher, whereas SHBG levels (mean, 447 vs 477 nmol/L) were lower in women with PCOS vs controls (all P < 0.001). Reference intervals for TT, FT, and SHBG in women with PCOS and controls were overlapping, and partitioning of reference intervals was an ambiguous decision. In multiple regression analyses, TT and FT levels were positively associated with PCOS status and BMI and inversely associated with age and parity. Offspring sex did not predict maternal TT and FT. CONCLUSIONS TT and FT levels were higher in third-trimester pregnant women with PCOS compared with controls. Separate reference interval for FT in women with PCOS should be considered.
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Affiliation(s)
- Dorte Glintborg
- Department of Endocrinology and Metabolism, Odense University, Odense C, Denmark
| | - Richard Christian Jensen
- Department of Endocrinology and Metabolism, Odense University, Odense C, Denmark
- Department of Environmental Medicine, Odense University Hospital, Odense C, Denmark
| | - Kristian Bentsen
- Department of Endocrinology and Metabolism, Odense University, Odense C, Denmark
| | | | - Ivan Brandslund
- Department of Biochemistry and Immunology, Lillebaelt Hospital, Vejle, Denmark
- Institute of Regional Health Research, University of Southern Denmark (SDU), Odense C, Denmark
| | - Henriette Boye Kyhl
- Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense C, Denmark
- Odense Patient Data Exploratory Network (OPEN), University of Southern Denmark, Odense C, Denmark
| | - Niels Bilenberg
- Child and Adolescent Psychiatric Department, Odense, Mental Health Hospital and University Clinic, Region of Southern Denmark, Odense C, Denmark
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Ku CW, Allen JC, Lek SM, Chia ML, Tan NS, Tan TC. Serum progesterone distribution in normal pregnancies compared to pregnancies complicated by threatened miscarriage from 5 to 13 weeks gestation: a prospective cohort study. BMC Pregnancy Childbirth 2018; 18:360. [PMID: 30185145 PMCID: PMC6126027 DOI: 10.1186/s12884-018-2002-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 08/28/2018] [Indexed: 11/20/2022] Open
Abstract
Background Progesterone is a critical hormone in early pregnancy. A low level of serum progesterone is associated with threatened miscarriage. We aim to establish the distribution of maternal serum progesterone in normal pregnancies compared to pregnancies complicated by threatened miscarriage from 5 to 13 weeks gestation. Methods This is a single centre, prospective cohort study of 929 patients. Women from the Normal Pregnancy [NP] cohort were recruited from antenatal clinics, and those in the Threatened Miscarriage [TM] cohort were recruited from emergency walk-in clinics. Women with multiple gestations, missed, incomplete or inevitable miscarriage were excluded from the study. Quantile regression was used to characterize serum progesterone levels in the NP and TM cohorts by estimating the 10th, 50th and 90th percentiles from 5 to 13 weeks gestation. Pregnancy outcome was determined at 16 weeks of gestation. Subgroup analysis within the TM group compared progesterone levels of women who subsequently miscarried with those who had ongoing pregnancies at 16 weeks of gestation. Results Median serum progesterone concentration demonstrated a linearly increasing trend from 57.5 nmol/L to 80.8 nmol/L from 5 to 13 weeks gestation in the NP cohort. In the TM cohort, median serum progesterone concentration increased from 41.7 nmol/L to 78.1 nmol/L. However, median progesterone levels were uniformly lower in the TM cohort by approximately 10 nmol/L at every gestation week. In the subgroup analysis, median serum progesterone concentration in women with ongoing pregnancy at 16 weeks gestation demonstrated a linearly increasing trend from 5 to 13 weeks gestation. There was a marginal and non-significant increase in serum progesterone from 19.0 to 30.3 nmol/L from 5 to 13 weeks gestation in women who eventually had a spontaneous miscarriage. Conclusions Serum progesterone concentration increased linearly with gestational age from 5 to 13 weeks in women with normal pregnancies. Women with spontaneous miscarriage showed a marginal and non-significant increase in serum progesterone. This study highlights the pivotal role of progesterone in supporting an early pregnancy, with lower serum progesterone associated with threatened miscarriage and a subsequent complete miscarriage at 16 weeks gestation. Electronic supplementary material The online version of this article (10.1186/s12884-018-2002-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chee Wai Ku
- Department of Obstetrics and Gynecology, KK Women's and Children's Hospital, Singapore, 100 Bukit Timah Road, Singapore, 229899, Singapore.
| | - John C Allen
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Sze Min Lek
- Department of Obstetrics and Gynecology, KK Women's and Children's Hospital, Singapore, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Ming Li Chia
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Nguan Soon Tan
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore.,Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore
| | - Thiam Chye Tan
- Department of Obstetrics and Gynecology, KK Women's and Children's Hospital, Singapore, 100 Bukit Timah Road, Singapore, 229899, Singapore.,Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
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132
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Lazorwitz A, Coleman-Minahan K, Teal SB, Guiahi M. Ongoing Etonogestrel Contraceptive Implant Use Throughout Pregnancy. J Adolesc Health 2018; 63:363-364. [PMID: 30076014 DOI: 10.1016/j.jadohealth.2018.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/23/2018] [Accepted: 03/22/2018] [Indexed: 10/28/2022]
Abstract
Case reports of pregnancies with inadvertent etonogestrel contraceptive implant exposure in the first-trimester have not demonstrated teratogenic risks or adverse pregnancy outcomes. We report the clinical observations of a 15-year-old nulligravida who continued her etonogestrel contraceptive implant throughout pregnancy and delivery, without any adverse maternal or neonatal outcomes. The patient then continued her contraceptive implant as a reliable postpartum contraceptive method. Although her favorable outcomes are consistent with available pharmacologic literature, more data is needed regarding maintenance of a contraceptive implant during a desired pregnancy.
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Affiliation(s)
- Aaron Lazorwitz
- University of Colorado Anschutz Medical Campus, Department of Obstetrics and Gynecology, Division of Family Planning, Aurora, Colorado.
| | - Kate Coleman-Minahan
- University of Colorado Anschutz Medical Campus, College of Nursing, Aurora, Colorado.
| | - Stephanie B Teal
- University of Colorado Anschutz Medical Campus, Department of Obstetrics and Gynecology, Division of Family Planning, Aurora, Colorado.
| | - Maryam Guiahi
- University of Colorado Anschutz Medical Campus, Department of Obstetrics and Gynecology, Division of Family Planning, Aurora, Colorado.
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133
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Smy L, Straseski JA. Measuring estrogens in women, men, and children: Recent advances 2012-2017. Clin Biochem 2018; 62:11-23. [PMID: 29800559 DOI: 10.1016/j.clinbiochem.2018.05.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 05/22/2018] [Indexed: 12/11/2022]
Abstract
The measurement of estrogens is important for diagnosing and monitoring the health of women, men, and children. For example, for postmenopausal women or women undergoing treatment for breast cancer with aromatase inhibitors, the measurement of extremely low concentrations of estrogens in serum, especially estradiol, is problematic but essential for proper medical care. Achieving superb analytical sensitivity and specificity has been and continues to be a challenge for the clinical laboratory, but is a challenge that is being taken seriously. Focusing on publications from 2012 to 2017, this review will provide an overview of recent research in the development of methods to accurately and precisely measure estrogens, including a variety of estrogen metabolites. Additionally, the latest in clinical research involving estrogen measurement in women, men, and children will be presented to provide an update on the association of estrogens with diseases or conditions such as breast cancer, precocious puberty, infertility, and pregnancy. This research update will provide context as to why estrogen measurement is important and why laboratories are working hard to support the recommendations made by the Endocrine Society regarding estrogen measurement.
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Affiliation(s)
- Laura Smy
- Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT 84108, USA
| | - Joely A Straseski
- Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT 84108, USA.
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134
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Yao Y, Li H, Ding J, Xia Y, Wang L. Progesterone impairs antigen-non-specific immune protection by CD8 T memory cells via interferon-γ gene hypermethylation. PLoS Pathog 2017; 13:e1006736. [PMID: 29155896 PMCID: PMC5714395 DOI: 10.1371/journal.ppat.1006736] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 12/04/2017] [Accepted: 11/05/2017] [Indexed: 12/11/2022] Open
Abstract
Pregnant women and animals have increased susceptibility to a variety of intracellular pathogens including Listeria monocytogenes (LM), which has been associated with significantly increased level of sex hormones such as progesterone. CD8 T memory(Tm) cell-mediated antigen-non-specific IFN-γ responses are critically required in the host defense against LM. However, whether and how increased progesterone during pregnancy modulates CD8 Tm cell-mediated antigen-non-specific IFN-γ production and immune protection against LM remain poorly understood. Here we show in pregnant women that increased serum progesterone levels are associated with DNA hypermethylation of IFN-γ gene promoter region and decreased IFN-γ production in CD8 Tm cells upon antigen-non-specific stimulation ex vivo. Moreover, IFN-γ gene hypermethylation and significantly reduced IFN-γ production post LM infection in antigen-non-specific CD8 Tm cells are also observed in pregnant mice or progesterone treated non-pregnant female mice, which is a reversible phenotype following demethylation treatment. Importantly, antigen-non-specific CD8 Tm cells from progesterone treated mice have impaired anti-LM protection when adoptive transferred in either pregnant wild type mice or IFN-γ-deficient mice, and demethylation treatment rescues the adoptive protection of such CD8 Tm cells. These data demonstrate that increased progesterone impairs immune protective functions of antigen-non-specific CD8 Tm cells via inducing IFN-γ gene hypermethylation. Our findings thus provide insights into a new mechanism through which increased female sex hormone regulate CD8 Tm cell functions during pregnancy. Increased female sex hormones during pregnancy generate a temporary immune suppression status in the pregnant that protect the developing fetus from maternal rejection but renders the pregnant highly susceptible to various pathogens. However, molecular mechanisms underlying such an increased maternal susceptibility to pathogens during pregnancy remain to be further understood. Here we show in pregnant women that increased progesterone levels are associated with IFN-γ gene hypermethylation and reduced IFN-γ production in peripheral CD8 Tm cells. By using murine models of LM infection, for the first time we show a causal relationship between increased level of progesterone, a characteristic female sex hormone of pregnancy, and increased susceptibility to Listeria monocytogenes, an intracellular bacterium that endangers both the pregnant and the fetus. Such an impact on anti-listeria host defense is mediated through progesterone-induced IFN-γ gene hypermethylation in CD8 Tm cells, resulting in impaired IFN-γ production and reduced immune protection by antigen-non-specific CD8 Tm cells. This study provides new insights into molecular mechanisms underlying the increased susceptibility to intracellular pathogens during pregnancy.
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Affiliation(s)
- Yushi Yao
- McMaster Immunology Research Center, Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Hematology, Chinese PLA General Hospital, Beijing, China
| | - Hui Li
- Department of Clinical Nutrition, General Hospital of Chinese People's Armed Police Forces, Beijing, China
| | - Jie Ding
- Department of Hematology, Chinese PLA General Hospital, Beijing, China
| | - Yixin Xia
- Department of Obstetrics and Gynecology, General Hospital of Chinese People's Armed Police Forces, Beijing, China
| | - Lei Wang
- Department of Clinical Nutrition, General Hospital of Chinese People's Armed Police Forces, Beijing, China
- * E-mail:
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135
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Cohn BA, Cirillo PM, Hopper BR, Siiteri PK. Third Trimester Estrogens and Maternal Breast Cancer: Prospective Evidence. J Clin Endocrinol Metab 2017; 102:3739-3748. [PMID: 28973345 PMCID: PMC5630249 DOI: 10.1210/jc.2016-3476] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 07/25/2017] [Indexed: 01/07/2023]
Abstract
Context Full-term pregnancy is associated with a transient increase and life-time decrease in maternal breast cancer risk. Estrone (E1), estradiol (E2), and estriol (E3) are in high concentration during the third trimester. E1 and E2 metabolism produces carcinogenic intermediaries, and E3 metabolism does not. Objective We tested the hypothesis that higher E3 in pregnancy is protective while higher E1 plus E2 increases risk. Design Prospective case-cohort study (n = 620; 204 cases) nested in a 38-year follow-up of 15,528 pregnant women in the Child Health and Development Studies. We measured E1, E2, and E3 in archived third trimester serum and estimated associations with breast cancer. Setting Northern California Kaiser members receiving obstetric care from 1959 to 1967. Main Outcome Measure Breast cancer diagnosed through 1997. Results Doubling of E1+E2 was associated with greater risk [hazard ratio (HR), 1.7; 95% confidence interval (CI), 1.2 to 2.4]. In contrast, doubling of E3 or the E3/E1+E2 ratio was associated with protection (HR, 0.7; 95% CI, 0.5 to 1.0; HR, 0.6; 95% CI, 0.4 to 0.8, respectively). Associations were stronger for diagnoses within 15 years after delivery compared with 16 to 38 years (Pinteraction = 0.0002) for gravidas >27 years at delivery vs ≤27 (Pinteraction = 0.01) and for primiparas vs multiparas (Pinteraction = 0.02). Conclusions Relatively high third trimester E3 levels might protect parous women from breast cancer and E1 and E2 might enhance the risk. If findings are confirmed, third trimester pregnancy estrogens could help explain how parity affects breast cancer.
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Affiliation(s)
- Barbara A. Cohn
- Child Health and Development Studies, Public Health Institute, Berkeley, California 94709
| | - Piera M. Cirillo
- Child Health and Development Studies, Public Health Institute, Berkeley, California 94709
| | - Bill R. Hopper
- Child Health and Development Studies, Public Health Institute, Berkeley, California 94709
| | - Pentti K. Siiteri
- Child Health and Development Studies, Public Health Institute, Berkeley, California 94709
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136
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Velegrakis A, Sfakiotaki M, Sifakis S. Human placental growth hormone in normal and abnormal fetal growth. Biomed Rep 2017; 7:115-122. [PMID: 28804622 PMCID: PMC5526045 DOI: 10.3892/br.2017.930] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/31/2017] [Indexed: 01/05/2023] Open
Abstract
Human placental growth hormone (PGH), encoded by the growth hormone (GH) variant gene on chromosome 17, is expressed in the syncytiotrophoblast and extravillous cytotrophoblast layers of the human placenta. Its maternal serum levels increase throughout pregnancy, and gradually replaces the pulsatile secreted pituitary GH. PGH is also detectable in cord blood and in the amniotic fluid. This placental-origin hormone stimulates glyconeogenesis, lipolysis and anabolism in maternal organs, and influences fetal growth, placental development and maternal adaptation to pregnancy. The majority of these actions are performed indirectly by regulating maternal insulin-like growth factor-I levels, while the extravillous trophoblast involvement indicates a direct effect on placental development, as it stimulates trophoblast invasiveness and function via a potential combination of autocrine and paracrine mechanisms. The current review focuses on the role of PGH in fetal growth. In addition, the association of PGH alterations in maternal circulation and placental expression in pregnancy complications associated with abnormal fetal growth is briefly reviewed.
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Affiliation(s)
- Alexandros Velegrakis
- Department of Obstetrics and Gynecology, Venizelion General Hospital, Heraklion 71409, Greece
| | - Maria Sfakiotaki
- Department of Endocrinology, University Hospital of Heraklion, Heraklion 71201, Greece
| | - Stavros Sifakis
- Department of Obstetrics and Gynecology, University Hospital of Heraklion, Heraklion 71201, Greece
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137
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Fortner RT, Tolockiene E, Schock H, Oda H, Lakso HÅ, Hallmans G, Kaaks R, Toniolo P, Zeleniuch-Jacquotte A, Grankvist K, Lundin E. Early pregnancy sex steroids during primiparous pregnancies and maternal breast cancer: a nested case-control study in the Northern Sweden Maternity Cohort. Breast Cancer Res 2017; 19:82. [PMID: 28720108 PMCID: PMC5516370 DOI: 10.1186/s13058-017-0876-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/29/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Pregnancy and parity are associated with subsequent breast cancer risk. Experimental and epidemiologic data suggest a role for pregnancy sex steroid hormones. METHODS We conducted a nested case-control study in the Northern Sweden Maternity Cohort (1975-2007). Eligible women had provided a blood sample in the first 20 weeks of gestation during a primiparous pregnancy leading to a term delivery. The current study includes 223 cases and 417 matched controls (matching factors: age at and date of blood collection). Estrogen receptor (ER) and progesterone receptor (PR) status was available for all cases; androgen receptor (AR) data were available for 41% of cases (n = 92). Sex steroids were quantified by high-performance liquid chromatography tandem mass spectrometry. Odds ratios (ORs) and 95% confidence intervals were estimated using conditional logistic regression. RESULTS Higher concentrations of circulating progesterone in early pregnancy were inversely associated with ER+/PR+ breast cancer risk (ORlog2: 0.64 (0.41-1.00)). Higher testosterone was positively associated with ER+/PR+ disease risk (ORlog2: 1.57 (1.13-2.18)). Early pregnancy estrogens were not associated with risk, except for relatively high estradiol in the context of low progesterone (split at median, relative to low concentrations of both; OR: 1.87 (1.11-3.16)). None of the investigated hormones were associated with ER-/PR- disease, or with AR+ or AR+/ER+/PR+ disease. CONCLUSIONS Consistent with experimental models, high progesterone in early pregnancy was associated with lower risk of ER+/PR+ breast cancer in the mother. High circulating testosterone in early pregnancy, which likely reflects nonpregnant premenopausal exposure, was associated with higher risk of ER+/PR+ disease.
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Affiliation(s)
- Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120, Heidelberg, Germany.
| | - Eglé Tolockiene
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | - Helena Schock
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120, Heidelberg, Germany
| | - Husam Oda
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | - Hans-Åke Lakso
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
| | - Göran Hallmans
- Public Health and Clinical Medicine: Nutritional Research, Umeå University, Umeå, Sweden
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120, Heidelberg, Germany
| | - Paolo Toniolo
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
| | - Anne Zeleniuch-Jacquotte
- Department of Population Health and Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA
| | - Kjell Grankvist
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
| | - Eva Lundin
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
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138
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Ose J, Poole EM, Schock H, Lehtinen M, Arslan AA, Zeleniuch-Jacquotte A, Visvanathan K, Helzlsouer K, Buring JE, Lee IM, Tjønneland A, Dossus L, Trichopoulou A, Masala G, Onland-Moret NC, Weiderpass E, Duell EJ, Idahl A, Travis RC, Rinaldi S, Merritt MA, Trabert B, Wentzensen N, Tworoger SS, Kaaks R, Fortner RT. Androgens Are Differentially Associated with Ovarian Cancer Subtypes in the Ovarian Cancer Cohort Consortium. Cancer Res 2017; 77:3951-3960. [PMID: 28381542 PMCID: PMC5512110 DOI: 10.1158/0008-5472.can-16-3322] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 02/15/2017] [Accepted: 03/31/2017] [Indexed: 12/22/2022]
Abstract
Invasive epithelial ovarian cancer (EOC) is the most lethal gynecologic malignancy. The etiology of EOC remains elusive; however, experimental and epidemiologic data suggest a role for hormone-related exposures in ovarian carcinogenesis and risk factor differences by histologic phenotypes and developmental pathways. Research on prediagnosis androgen concentrations and EOC risk has yielded inconclusive results, and analyses incorporating EOC subtypes are sparse. We conducted a pooled analysis of 7 nested case-control studies in the Ovarian Cancer Cohort Consortium to investigate the association between pre-diagnosis circulating androgens [testosterone, free testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEAS)], sex hormone binding globulin (SHBG), and EOC risk by tumor characteristics (i.e., histology, grade, and stage). The final study population included 1,331 EOC cases and 3,017 matched controls. Multivariable conditional logistic regression was used to assess risk associations in pooled individual data. Testosterone was positively associated with EOC risk (all subtypes combined, ORlog2 = 1.12; 95% confidence interval 1.02-1.24); other endogenous androgens and SHBG were not associated with overall risk. Higher concentrations of testosterone and androstenedione associated with an increased risk in endometrioid and mucinous tumors [e.g., testosterone, endometrioid tumors, ORlog2 = 1.40 (1.03-1.91)], but not serous or clear cell. An inverse association was observed between androstenedione and high grade serous tumors [ORlog2 = 0.76 (0.60-0.96)]. Our analyses provide further evidence for a role of hormone-related pathways in EOC risk, with differences in associations between androgens and histologic subtypes of EOC. Cancer Res; 77(14); 3951-60. ©2017 AACR.
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Affiliation(s)
- Jennifer Ose
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Baden-Württemberg, Germany
- Department of Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Elizabeth M Poole
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Helena Schock
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Baden-Württemberg, Germany
| | - Matti Lehtinen
- Karolinska Institutet, Department of Laboratory Medicine, Huddinge, Sweden
| | - Alan A Arslan
- Department of Obstetrics and Gynecology, New York University School of Medicine; Perlmutter Cancer Center, New York University, New York, New York
- Department of Population Health and Environmental Medicine, New York University School of Medicine; Perlmutter Cancer Center, New York University, New York, New York
| | - Anne Zeleniuch-Jacquotte
- Department of Population Health and Environmental Medicine, New York University School of Medicine; Perlmutter Cancer Center, New York University, New York, New York
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kathy Helzlsouer
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - I-Min Lee
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Anne Tjønneland
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Laure Dossus
- INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, Villejuif, France
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Giovanna Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - N Charlotte Onland-Moret
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Eric J Duell
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Annika Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umea University, Umea, Sweden
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Sabina Rinaldi
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France
| | - Melissa A Merritt
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Shelley S Tworoger
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Baden-Württemberg, Germany
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Baden-Württemberg, Germany.
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