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Peltier MR, Verplaetse TL, Altemus M, Zakiniaeiz Y, Ralevski EA, Mineur YS, Gueorguieva R, Picciotto MR, Cosgrove KP, Petrakis I, McKee SA. The role of neurosteroids in posttraumatic stress disorder and alcohol use disorder: A review of 10 years of clinical literature and treatment implications. Front Neuroendocrinol 2024; 73:101119. [PMID: 38184208 PMCID: PMC11185997 DOI: 10.1016/j.yfrne.2023.101119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 12/08/2023] [Accepted: 12/31/2023] [Indexed: 01/08/2024]
Abstract
Rates of alcohol use disorder (AUD) are increasing in men and women and there are high rates of concurrent posttraumatic stress disorder (PTSD) and AUD. AUD and PTSD synergistically increase symptomatology and negatively affect treatment outcomes; however, there are very limited pharmacological treatments for PTSD/AUD. Neurosteroids have been implicated in the underlying neurobiological mechanisms of both PTSD and AUD and may be a target for treatment development. This review details the past ten years of research on pregnenolone, progesterone, allopregnanolone, pregnanolone, estradiol, testosterone and dehydroepiandrosterone/dehydroepiandrosterone-sulfate (DHEA/DHEA-S) in the context of PTSD and AUD, including examination of trauma/alcohol-related variables, such as stress-reactivity. Emerging evidence that exogenous pregnenolone, progesterone, and allopregnanolone may be promising, novel interventions is also discussed. Specific emphasis is placed on examining the application of sex as a biological variable in this body of literature, given that women are more susceptible to both PTSD diagnoses and stress-related alcohol consumption.
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Affiliation(s)
- MacKenzie R Peltier
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; VA Connecticut Healthcare System, Mental Health Service, West Haven, CT 06516, USA; National Center for PTSD, Clinical Neuroscience Division, West Haven, CT 06516, USA.
| | | | - Margaret Altemus
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; VA Connecticut Healthcare System, Mental Health Service, West Haven, CT 06516, USA
| | - Yasmin Zakiniaeiz
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA
| | - Elizabeth A Ralevski
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; VA Connecticut Healthcare System, Mental Health Service, West Haven, CT 06516, USA
| | - Yann S Mineur
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA
| | - Ralitza Gueorguieva
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; Department of Biostatistics, School of Public Health, Yale University, New Haven, CT, USA
| | - Marina R Picciotto
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA
| | - Kelly P Cosgrove
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; National Center for PTSD, Clinical Neuroscience Division, West Haven, CT 06516, USA; Department of Radiology and Biomedical Imaging, School of Medicine, Yale University, New Haven, CT, USA
| | - Ismene Petrakis
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; VA Connecticut Healthcare System, Mental Health Service, West Haven, CT 06516, USA; National Center for PTSD, Clinical Neuroscience Division, West Haven, CT 06516, USA
| | - Sherry A McKee
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA
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2
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Torres Irizarry VC, Feng B, Yang X, Patel N, Schaul S, Ibrahimi L, Ye H, Luo P, Carrillo-Sáenz L, Lai P, Kota M, Dixit D, Wang C, Lasek AW, He Y, Xu P. Estrogen signaling in the dorsal raphe regulates binge-like drinking in mice. Transl Psychiatry 2024; 14:122. [PMID: 38413577 PMCID: PMC10899193 DOI: 10.1038/s41398-024-02821-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 02/29/2024] Open
Abstract
Estrogens promote binge alcohol drinking and contribute to sex differences in alcohol use disorder. However, the mechanisms are largely unknown. This study aims to test if estrogens act on 5-hydroxytryptamine neurons in the dorsal raphe nucleus (5-HTDRN) to promote binge drinking. We found that female mice drank more alcohol than male mice in chronic drinking in the dark (DID) tests. This sex difference was associated with distinct alterations in mRNA expression of estrogen receptor α (ERα) and 5-HT-related genes in the DRN, suggesting a potential role of estrogen/ERs/5-HT signaling. In supporting this view, 5-HTDRN neurons from naïve male mice had lower baseline firing activity but higher sensitivity to alcohol-induced excitation compared to 5-HTDRN neurons from naïve female mice. Notably, this higher sensitivity was blunted by 17β-estradiol treatment in males, indicating an estrogen-dependent mechanism. We further showed that both ERα and ERβ are expressed in 5-HTDRN neurons, whereas ERα agonist depolarizes and ERβ agonist hyperpolarizes 5-HTDRN neurons. Notably, both treatments blocked the stimulatory effects of alcohol on 5-HTDRN neurons in males, even though they have antagonistic effects on the activity dynamics. These results suggest that ERs' inhibitory effects on ethanol-induced burst firing of 5-HTDRN neurons may contribute to higher levels of binge drinking in females. Consistently, chemogenetic activation of ERα- or ERβ-expressing neurons in the DRN reduced binge alcohol drinking. These results support a model in which estrogens act on ERα/β to prevent alcohol-induced activation of 5-HTDRN neurons, which in return leads to higher binge alcohol drinking.
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Affiliation(s)
- Valeria C Torres Irizarry
- Division of Endocrinology, Department of Medicine, The University of Illinois at Chicago, Chicago, IL, 60612, USA
- Department of Physiology and Biophysics, The University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Bing Feng
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, 70808, USA
| | - Xiaohua Yang
- Division of Endocrinology, Department of Medicine, The University of Illinois at Chicago, Chicago, IL, 60612, USA
- Guangdong Laboratory of Lingnan Modern Agriculture and Guangdong Province Key Laboratory of Animal Nutritional Regulation, National Engineering Research Center for Breeding Swine Industry, College of Animal Science, South China Agricultural University, 483 Wushan Road, Tianhe District, 510642, Guangzhou, Guangdong, China
| | - Nirali Patel
- Division of Endocrinology, Department of Medicine, The University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Sarah Schaul
- Division of Endocrinology, Department of Medicine, The University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Lucas Ibrahimi
- Division of Endocrinology, Department of Medicine, The University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Hui Ye
- Division of Endocrinology, Department of Medicine, The University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Pei Luo
- Division of Endocrinology, Department of Medicine, The University of Illinois at Chicago, Chicago, IL, 60612, USA
- Guangdong Laboratory of Lingnan Modern Agriculture and Guangdong Province Key Laboratory of Animal Nutritional Regulation, National Engineering Research Center for Breeding Swine Industry, College of Animal Science, South China Agricultural University, 483 Wushan Road, Tianhe District, 510642, Guangzhou, Guangdong, China
| | - Leslie Carrillo-Sáenz
- Division of Endocrinology, Department of Medicine, The University of Illinois at Chicago, Chicago, IL, 60612, USA
- Department of Physiology and Biophysics, The University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Penghua Lai
- Division of Endocrinology, Department of Medicine, The University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Maya Kota
- Division of Endocrinology, Department of Medicine, The University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Devin Dixit
- Division of Endocrinology, Department of Medicine, The University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Chunmei Wang
- Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Amy W Lasek
- Center for Alcohol Research in Epigenetics and Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60612, USA
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VI, 23298, USA
| | - Yanlin He
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, 70808, USA.
| | - Pingwen Xu
- Division of Endocrinology, Department of Medicine, The University of Illinois at Chicago, Chicago, IL, 60612, USA.
- Department of Physiology and Biophysics, The University of Illinois at Chicago, Chicago, IL, 60612, USA.
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3
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Strzelecki AM, Gipson CD, Childs E, Weafer J. Preliminary evidence of increased alcohol use associated with ethinyl estradiol levels in women using oral contraceptives. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 9:100194. [PMID: 37954868 PMCID: PMC10632661 DOI: 10.1016/j.dadr.2023.100194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023]
Abstract
Alcohol use is highly prevalent in young adult women and rates of alcohol use disorder are rising rapidly in this population. Further, emerging evidence suggests that circulating levels of ovarian hormones influence alcohol consumption, with increased consumption associated with higher estradiol and lower progesterone levels. However, less is known about the influence of synthetic hormones (contained in oral contraceptive (OC) pills) on alcohol use. The current study examined the influence of OC pill phase, ethinyl estradiol (EE) levels, and progestin levels on self-reported alcohol consumption in healthy female drinkers. Young adult female drinkers using OCs (N = 21) reported alcohol use across one OC pill pack using the Timeline Followback and provided blood samples during both pill phases to measure synthetic hormone levels. We compared alcohol use between OC pill phases (active vs. inactive) using linear mixed effects models for repeated measures and examined correlations between alcohol use and EE and progestin levels. Results showed that women with higher EE levels reported increased alcohol consumption (r = 0.56, p = 0.01) and binge drinking (r = 0.45, p = 0.04) in the active pill phase. Progestin levels and pill phase were not significantly associated with alcohol consumption. These findings provide preliminary data suggesting increased levels of EE from OC pills are associated with excessive alcohol consumption in women. Further research is needed to determine if EE plays a causal role in increased alcohol consumption. This line of research could inform female-specific AUD prevention and treatment strategies among the large subpopulation of women using hormonal contraceptives.
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Affiliation(s)
| | - Cassandra D. Gipson
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - Emma Childs
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Jessica Weafer
- Department of Psychology, University of Kentucky, Lexington, KY, United States
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, United States
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4
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Maher EE, White AM, Craig A, Khatri S, Kendrick PT, Matocha ME, Bondy EO, Pallem N, Breakfield G, Botkins M, Sweatt O, Griffin WC, Kaplan B, Weafer JJ, Beckmann JS, Gipson CD. Synthetic contraceptive hormones occlude the ability of nicotine to reduce ethanol consumption in ovary-intact female rats. Drug Alcohol Depend 2023; 252:110983. [PMID: 37778097 DOI: 10.1016/j.drugalcdep.2023.110983] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/03/2023]
Abstract
Rates of tobacco and alcohol use in women are rising, and women are more vulnerable than men to escalating tobacco and alcohol use. Many women use hormonal birth control, with the oral contraceptive pill being the most prevalent. Oral contraceptives contain both a progestin (synthetic progesterone) and a synthetic estrogen (ethinyl estradiol; EE) and are contraindicated for women over 35 years who smoke. Despite this, no studies have examined how synthetic contraceptive hormones impact this pattern of polysubstance use in females. To address this critical gap in the field, we treated ovary-intact female rats with either sesame oil (vehicle), the progestin levonorgestrel (LEVO; contained in formulations such as Alesse®), or the combination of EE+LEVO in addition to either undergoing single (nicotine or saline) or polydrug (nicotine and ethanol; EtOH) self-administration (SA) in a sequential use model. Rats preferred EtOH over water following extended EtOH drinking experience as well as after nicotine or saline SA experience, and rats undergoing only nicotine SA (water controls) consumed more nicotine as compared to rats co-using EtOH and nicotine. Importantly, this effect was occluded in groups treated with contraceptive hormones. In the sequential use group, both LEVO alone and the EE+LEVO combination occluded the ability of nicotine to decrease EtOH consumption. Interestingly, demand experiments suggest an economic substitute effect between nicotine and EtOH. Together, we show that chronic synthetic hormone exposure impacts nicotine and EtOH sequential use, demonstrating the crucial need to understand how chronic use of different contraceptive formulations alter patterns of polydrug use in women.
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Affiliation(s)
- Erin E Maher
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Ashley M White
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Ashley Craig
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Shailesh Khatri
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Percell T Kendrick
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Mary E Matocha
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Emma O Bondy
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Nikhil Pallem
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Grace Breakfield
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Madison Botkins
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Olivia Sweatt
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - William C Griffin
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Brent Kaplan
- Department of Family and Community Medicine, University of Kentucky, Lexington, KY, USA
| | - Jessica J Weafer
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Joshua S Beckmann
- Department of Psychology, University of Kentucky, Lexington, KY, USA.
| | - Cassandra D Gipson
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA.
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5
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Fucic A, Mantovani A, Vena J, Bloom MS, Sincic N, Vazquez M, Aguado-Sierra J. Impact of endocrine disruptors from mother's diet on immuno-hormonal orchestration of brain development and introduction of the virtual human twin tool. Reprod Toxicol 2023; 117:108357. [PMID: 36863570 DOI: 10.1016/j.reprotox.2023.108357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/19/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
Diet has long been known to modify physiology during development and adulthood. However, due to a growing number of manufactured contaminants and additives over the last few decades, diet has increasingly become a source of exposure to chemicals that has been associated with adverse health risks. Sources of food contaminants include the environment, crops treated with agrochemicals, inappropriate storage (e.g., mycotoxins) and migration of xenobiotics from food packaging and food production equipment. Hence, consumers are exposed to a mixture of xenobiotics, some of which are endocrine disruptors (EDs). The complex interactions between immune function and brain development and their orchestration by steroid hormones are insufficiently understood in human populations, and little is known about the impact on immune-brain interactions by transplacental fetal exposure to EDs via maternal diet. To help to identify the key data gaps, this paper aims to present (a) how transplacental EDs modify immune system and brain development, and (b) how these mechanisms may correlate with diseases such as autism and disturbances of lateral brain development. Attention is given to disturbances of the subplate, a transient structure of crucial significance in brain development. Additionally, we describe cutting edge approaches to investigate the developmental neurotoxicity of EDs, such as the application of artificial intelligence and comprehensive modelling. In the future, highly complex investigations will be performed using virtual brain models constructed using sophisticated multi-physics/multi-scale modelling strategies based on patient and synthetic data, which will enable a greater understanding of healthy or disturbed brain development.
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Affiliation(s)
- A Fucic
- Institute for Medical Research and Occupational Health, Ksaverska C 2, Zagreb, Croatia.
| | - A Mantovani
- Istituto Superiore di Sanità, Department of Food Safety, Nutrition and Veterinary Public Health, Rome, Italy
| | - J Vena
- Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - M S Bloom
- Global and Community Health, George Mason University, 4400 University Dr., Fairfax, VA, USA
| | - N Sincic
- Medical School, University of Zagreb, Salata 3, Croatia
| | - M Vazquez
- Barcelona Supercomputing Center, Plaça Eusebi Güell, 1-3, Barcelona 08034, Spain
| | - J Aguado-Sierra
- Barcelona Supercomputing Center, Plaça Eusebi Güell, 1-3, Barcelona 08034, Spain
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6
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Ellington K, Link T, Saccomano SJ. Menopause: A primary care perspective. Nurse Pract 2022; 47:16-23. [PMID: 35044348 DOI: 10.1097/01.npr.0000806384.48601.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Menopause signifies permanent cessation of ovarian function and the end of a woman's reproductive potential. Menopausal transition plays a major role in many symptoms common in middle age and may contribute to chronic conditions and disorders of aging. An evidence-based plan of care improves outcomes, enhancing quality of life.
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7
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Donat-Vargas C, Guerrero-Zotano Á, Casas A, Baena-Cañada JM, Lope V, Antolín S, Garcia-Saénz JÁ, Bermejo B, Muñoz M, Ramos M, de Juan A, Jara Sánchez C, Sánchez-Rovira P, Antón A, Brunet J, Gavilá J, Salvador J, Arriola Arellano E, Bezares S, Fernández de Larrea-Baz N, Pérez-Gómez B, Martín M, Pollán M. Trajectories of alcohol consumption during life and the risk of developing breast cancer. Br J Cancer 2021; 125:1168-1176. [PMID: 34483338 PMCID: PMC8505448 DOI: 10.1038/s41416-021-01492-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/10/2021] [Accepted: 07/08/2021] [Indexed: 12/26/2022] Open
Abstract
Background Whether there are lifetime points of greater sensitivity to the deleterious effects of alcohol intake on the breasts remains inconclusive. Objective To compare the influence of distinctive trajectories of alcohol consumption throughout a woman’s life on development of breast cancer (BC). Methods 1278 confirmed invasive BC cases and matched (by age and residence) controls from the Epi-GEICAM study (Spain) were used. The novel group-based trajectory modelling was used to identify different alcohol consumption trajectories throughout women’s lifetime. Results Four alcohol trajectories were identified. The first comprised women (45%) with low alcohol consumption (<5 g/day) throughout their life. The second included those (33%) who gradually moved from a low alcohol consumption in adolescence to a moderate in adulthood (5 to <15 g/day), never having a high consumption; and oppositely, women in the third trajectory (16%) moved from moderate consumption in adolescence, to a lower consumption in adulthood. Women in the fourth (6%) moved from a moderate alcohol consumption in adolescence to the highest consumption in adulthood (≥15 g/day), never having a low alcohol consumption. Comparing with the first trajectory, the fourth doubled BC risk (OR 2.19; 95% CI 1.27, 3.77), followed by the third (OR 1.44; 0.96, 2.16) and ultimately by the second trajectory (OR 1.17; 0.86, 1.58). The magnitude of BC risk was greater in postmenopausal women, especially in those with underweight or normal weight. When alcohol consumption was independently examined at each life stage, ≥15 g/day of alcohol consumption in adolescence was strongly associated with BC risk followed by consumption in adulthood. Conclusions The greater the alcohol consumption accumulated throughout life, the greater the risk of BC, especially in postmenopausal women. Alcohol consumption during adolescence may particularly influence BC risk.
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Affiliation(s)
- Carolina Donat-Vargas
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Ana Casas
- Medical Oncology Unit, Hospital Virgen del Rocío, Sevilla, Spain
| | - José Manuel Baena-Cañada
- Medical Oncology Unit, Hospital Puerta del Mar, Cádiz, Spain.,Instituto de Investigación en Biomedicina de Cádiz (INiBICA), Cádiz, Spain
| | - Virginia Lope
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Silvia Antolín
- Medical Oncology Unit, Complejo Hospitalario Universitario, A Coruña, Spain
| | | | - Begoña Bermejo
- Medical Oncology Unit, Hospital Clínico, Valencia, Spain
| | - Montserrat Muñoz
- Medical Oncology Unit, Hospital Clinic i Provincial, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics, Institut d'Investigacions Biomèdiques Pi i Sunyer-IDIBAPS, Barcelona, Spain
| | - Manuel Ramos
- Medical Oncology Unit, Centro Oncológico de Galicia, A Coruña, Spain
| | - Ana de Juan
- Medical Oncology Unit, Hospital Marqués de Valdecilla, Santander, Spain
| | - Carlos Jara Sánchez
- Medical Oncology Unit/Departamento Especialidades Médicas, Hospital Universitario Fundación Alcorcón/Universidad Rey Juan Carlos, Madrid, Spain
| | | | - Antonio Antón
- Medical Oncology Unit, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Joan Brunet
- Medical Oncology Department, Institut Català d'Oncologia, IDIBGi, Girona, Spain.,Medical Sciences Department, Universitat de Girona, Girona, Spain
| | - Joaquín Gavilá
- Medical Oncology Unit, Instituto Valenciano de Oncología, Valencia, Spain
| | - Javier Salvador
- Medical Oncology Unit, Hospital Virgen del Rocío, Sevilla, Spain
| | | | - Susana Bezares
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain
| | - Nerea Fernández de Larrea-Baz
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Beatriz Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Miguel Martín
- Medical Oncology Unit, Instituto de Investigación Sanitaria Gregorio Marañón/Universidad Complutense, Madrid, Spain.,Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
| | - Marina Pollán
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain. .,National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain. .,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain.
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8
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Abstract
Globally, more than 2 million new cases of breast cancer are reported annually. The United States alone has more than 496,000 new cases every year. The worldwide prevalence is approximately 6.8 million cases. Although many risk factors for breast cancer are not modifiable, understanding the role of the factors that can be altered is critical. Alcohol consumption is a modifiable factor. Studies of alcohol in relation to breast cancer incidence have included hundreds of thousands of women. Evidence is consistent that intake, even intake of less than 10–15 grams per day, is associated with increased risk of this disease. In addition, evidence, although less extensive, shows that possible early indicators of risk, such as benign breast disease and increased breast density, are associated with alcohol consumption. Evidence is less strong for differences based on geographic region, beverage type, drinking pattern, or breast cancer subtype. Some studies have examined the association between alcohol and recurrence or survival after a breast cancer diagnosis. These findings are less consistent. Public awareness of alcohol as a risk factor for breast cancer is low, and public health measures to increase that awareness are warranted.
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Affiliation(s)
- Jo L Freudenheim
- School of Public Health and Health Professions, University at Buffalo, Buffalo, New York
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9
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Xiao Q, James P, Breheny P, Jia P, Park Y, Zhang D, Fisher JA, Ward MH, Jones RR. Outdoor light at night and postmenopausal breast cancer risk in the NIH-AARP diet and health study. Int J Cancer 2020; 147:2363-2372. [PMID: 32488897 DOI: 10.1002/ijc.33016] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/21/2020] [Accepted: 04/03/2020] [Indexed: 12/24/2022]
Abstract
Circadian disruption may play a role in breast carcinogenesis. Previous studies reported relationships between outdoor light at night (LAN) and the breast cancer risk, but their findings are mixed. There is also a need to examine LAN and breast cancer incidence according to different individual and environmental characteristics to identify subpopulations at greater risk associated with LAN exposure. We studied residential outdoor LAN estimated from satellite imagery at baseline (1996) in relation to postmenopausal breast cancer incidence over ~16 years of follow-up in 186 981 postmenopausal women including 12 318 incident postmenopausal breast cancer cases in the NIH-AARP Diet and Health Study. We used Cox proportional hazards models to estimate hazard ratios (HR) and two-sided 95% confidence intervals (CI) of the relationship between quintiles of LAN and postmenopausal breast cancer risk, overall and by hormone receptor status and cancer stage. We found that when compared to women in the lowest quintile of baseline LAN, those in the highest quintile had a 10% increase in postmenopausal breast cancer risk (HR (95% CI), 1.10 (1.02, 1.18), P-trend, .002). The association appeared to be stronger for estrogen receptor (ER) positive breast cancer (1.12 [1.02, 1.24], .007) than for ER-negative cancer (1.07 [0.85, 1.34], .66). Our findings also suggested that the relationship between LAN and breast cancer risk may differ by individual characteristics, such as smoking, alcohol drinking, sleep duration and BMI, and neighborhood environment. In conclusion, our study suggests that higher outdoor LAN exposure may be a risk factor for postmenopausal breast cancer.
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Affiliation(s)
- Qian Xiao
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Patrick Breheny
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Peng Jia
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China.,International Initiative on Spatial Lifecourse Epidemiology, Hong Kong, China
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St Louis, St. Louis, Missouri, USA
| | - Dong Zhang
- Department of Health and Human physiology, College of Liberal Arts and Sciences, University of Iowa, Iowa City, Iowa, USA
| | - Jared A Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
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10
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van der Berg C, Venter G, van der Westhuizen FH, Erasmus E. Development and validation of LC-ESI-MS/MS methods for quantification of 27 free and conjugated estrogen-related metabolites. Anal Biochem 2019; 590:113531. [PMID: 31805274 DOI: 10.1016/j.ab.2019.113531] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/27/2019] [Accepted: 11/30/2019] [Indexed: 10/25/2022]
Abstract
An imbalance in the estrogen metabolism has been associated with an increased risk of breast cancer development. Evaluation of the estrogen biotransformation capacity requires monitoring of various estrogen metabolites. Up to now, only some estrogen metabolites could be measured in urine. However, in order to offer tailor made nutritional support or therapies, a complete estrogen metabolite profile is required in order to identify specific deficiencies in this pathway for each patient individually. Here, we focused on this need to quantify as many as possible of the estrogen-related metabolites excreted in urine. The method was developed to quantify 27 estrogen-related metabolites in small urine quantities. This entailed sample clean-up with a multi-step solid phase extraction procedure, derivatisation of the metabolites in the less water-soluble fraction through dansylation, and analyses using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The metabolites accurately quantified by the method devised included parent estrogens, hydroxylated and methylated forms, metabolites of the 16α-hydroxyestrogen pathway, sulphate and glucuronide conjugated forms, precursors and a related steroid hormone. This method was validated and enabled quantification in the high picograms and low nanograms per millilitre range. Finally, analyses of urine samples confirmed detection and quantification of each of the metabolites.
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Affiliation(s)
- Carien van der Berg
- Human Metabolomics, North-West University (Potchefstroom Campus), Potchefstroom, 2531, South Africa.
| | - Gerda Venter
- Human Metabolomics, North-West University (Potchefstroom Campus), Potchefstroom, 2531, South Africa
| | | | - Elardus Erasmus
- Human Metabolomics, North-West University (Potchefstroom Campus), Potchefstroom, 2531, South Africa.
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Damayanthi HDWT, Moy FM, Abdullah KL, Dharmaratne SD. Handgrip Strength and Its Associated Factors among Community-dwelling Elderly in Sri Lanka: A Cross-sectional Study. Asian Nurs Res (Korean Soc Nurs Sci) 2018; 12:231-236. [PMID: 30193884 DOI: 10.1016/j.anr.2018.08.008] [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] [Received: 12/06/2017] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 01/28/2023] Open
Abstract
PURPOSE Low muscle strength is central to geriatric physical disabilities and mortality. The purpose of the present study was to examine handgrip strength (HGS) and its associated factors among community-dwelling older people in Sri Lanka. METHODS A cross-sectional study was conducted in the Kandy district using multistage sampling. A total of 999 older people were recruited, with a female preponderance. Data were collected using interviewer-administered questionnaires on demographic characteristics, depression, and physical activity. Anthropometric measurements including weight, height, mid-upper arm circumference, calf circumference, and HGS were recorded. Complex sample general linear model was used to examine the association between HGS and its associated factors. RESULTS The mean highest HGS of the study group was 12.56 kg (95% confidence interval: 11.94-13.19). Male older people had a higher HGS (17.02, 95% confidence interval: 15.55-18.49 kg) than females (10.59, 95% confidence interval: 10.12-11.06 kg). For both men and women, older age was associated with lower HGS, while mid-upper arm circumference was associated with better HGS. Diabetes mellitus, vegetarian diet, and alcohol consumption were associated with HGS for women only. CONCLUSION Men had a higher HGS compared with women. Age, mid-upper arm circumference, diabetes mellitus, vegetarian diet, and alcohol consumption were factors associated with HGS among community-dwelling older people in Kandy district, Sri Lanka. HGS can be used as a feasible strategy to improve health status of older people by community health nurses.
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Affiliation(s)
- Hewaratne D W T Damayanthi
- Department of Nursing Sciences, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Foong-Ming Moy
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Kathijah L Abdullah
- Department of Nursing Sciences, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Samath D Dharmaratne
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka; Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, United States; Department of Health Metric Sciences, School of Medicine, University of Washington, Seattle, United States
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12
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Houghton LC, Sisti JS, Hankinson SE, Xie J, Xu X, Hoover RN, Eliassen AH, Ziegler RG. Estrogen Metabolism in Premenopausal Women Is Related to Early Life Body Fatness. Cancer Epidemiol Biomarkers Prev 2018; 27:585-593. [PMID: 29511040 PMCID: PMC5932230 DOI: 10.1158/1055-9965.epi-17-0595] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 10/04/2017] [Accepted: 02/19/2018] [Indexed: 12/15/2022] Open
Abstract
Background: Estrogen metabolism in premenopausal women may be related to early life body fatness.Methods: Premenopausal women participating in the Nurses' Health Study II recalled their body fatness at ages 5, 10, and 20 years using a validated 9-level pictogram. Fifteen estrogens and estrogen metabolites (EM) were measured using LC/MS-MS in luteal phase urines from 603 women ages 32-54 years. Geometric means of individual EM, metabolic pathway groups, and pathway ratios were examined by body fatness categories using linear mixed models.Results: Body fatness at each age was inversely associated with adult concentrations of all EM combined, parent estrogens (estrone, estradiol), and the 2-hydroxylation pathway. Women in the top (vs. bottom) category of body fatness at age 10 had 21% lower levels of all EM (Ptrend = 0.003), 24% lower parent estrogens (Ptrend = 0.002), and 36% lower 2-pathway (Ptrend = 0.0003). Body fatness at age 10 was inversely associated with 2-catechols (35% lower, Ptrend = 0.0004) and 2-methylated catechols (30% lower, Ptrend = 0.002). After adjusting for premenopausal body mass index (BMI), these associations remained inverse but were attenuated; only parent estrogens remained statistically significant (21% lower, Ptrend = 0.01). Body fatness at ages 5 and 20 were similarly, but more weakly, associated with estrogen pathways.Conclusions: Estimates of body fatness during early life were inversely associated with premenopausal levels of all EM combined, parent estrogens, and 2-pathway estrogen metabolites. These relationships were not fully explained by adult BMI.Impact: These findings inform investigations of diseases linked to early life body fatness and estrogen metabolism. Cancer Epidemiol Biomarkers Prev; 27(5); 585-93. ©2018 AACR.
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Affiliation(s)
- Lauren C Houghton
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York.
| | - Julia S Sisti
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Susan E Hankinson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
| | | | - Xia Xu
- Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Robert N Hoover
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Regina G Ziegler
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
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Playdon MC, Coburn SB, Moore SC, Brinton LA, Wentzensen N, Anderson G, Wallace R, Falk RT, Pfeiffer R, Xu X, Trabert B. Alcohol and oestrogen metabolites in postmenopausal women in the Women's Health Initiative Observational Study. Br J Cancer 2017; 118:448-457. [PMID: 29235567 PMCID: PMC5808032 DOI: 10.1038/bjc.2017.419] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/25/2017] [Accepted: 10/26/2017] [Indexed: 12/31/2022] Open
Abstract
Background: Alcohol consumption is associated with an increased risk of several cancers. Potential mechanisms include altered oestrogen metabolism. Parent oestrogens metabolise into alternate pathways of oestrogen metabolites that may have variable effects on cancer pathogenesis. We examined associations of alcohol consumption with circulating oestrogen/oestrogen metabolites in postmenopausal women in the Women’s Health Initiative (WHI)-Observational Study (OS). Methods: We conducted a cross-sectional analysis of prediagnosis ovarian/endometrial cancer case-control data within WHI-OS (N=1864). Alcohol consumption was measured by validated food frequency questionnaire. Fasting serum parent oestrogens/oestrogen metabolites were assayed using liquid chromatography tandem mass-spectrometry. Geometric mean analyte concentrations (GM, pmol l−1) were calculated by alcohol category using inverse-probability weighted linear regression, adjusting for venepuncture age/year, race, smoking, body mass index, years since menopause, oral contraceptive duration, caffeine intake, and physical activity. Results: There was evidence for a positive association between alcohol consumption and oestrone, oestradiol and 2-hydroxylation oestrogen metabolite concentrations among menopausal hormone therapy (MHT) users. We observed an association between liquor consumption and parent oestrogens among non-MHT users, who consumed larger doses of liquor than MHT users. Conclusions: Among postmenopausal women, the association between alcohol intake and parent oestrogen, but not oestrogen metabolite concentrations, may be influenced by MHT and type of alcohol.
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Affiliation(s)
- Mary C Playdon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6909 Medical Centre Drive, Rockville, MD 20850, USA
| | - Sally B Coburn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6909 Medical Centre Drive, Rockville, MD 20850, USA
| | - Steven C Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6909 Medical Centre Drive, Rockville, MD 20850, USA
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6909 Medical Centre Drive, Rockville, MD 20850, USA
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6909 Medical Centre Drive, Rockville, MD 20850, USA
| | - Garnet Anderson
- Public Health Sciences Division, University of Washington, 1100 Fairview Ave. N, M3-C102, Seattle, WA 98109, USA
| | - Robert Wallace
- College of Public Health, The University of Iowa, 145 N. Riverside drive, 100 CPHB, Iowa City, IA 52242, USA
| | - Roni T Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6909 Medical Centre Drive, Rockville, MD 20850, USA
| | - Ruth Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6909 Medical Centre Drive, Rockville, MD 20850, USA
| | - Xia Xu
- Hormone Analysis Unit, Protein Characterization Laboratory, Cancer Research Technology Program, Leidos Biomedical Research Inc., P.O. Box B, Frederick, MD 21702-1201, USA
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6909 Medical Centre Drive, Rockville, MD 20850, USA
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Mani S. Microbiota and Breast Cancer. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2017; 151:217-229. [DOI: 10.1016/bs.pmbts.2017.07.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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