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Walker AR, Venetis CA, Opdahl S, Chambers GM, Jorm LR, Vajdic CM. Estimating the impact of bias in causal epidemiological studies: the case of health outcomes following assisted reproduction. Hum Reprod 2024; 39:869-875. [PMID: 38509860 PMCID: PMC11063565 DOI: 10.1093/humrep/deae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
Researchers interested in causal questions must deal with two sources of error: random error (random deviation from the true mean value of a distribution), and bias (systematic deviance from the true mean value due to extraneous factors). For some causal questions, randomization is not feasible, and observational studies are necessary. Bias poses a substantial threat to the validity of observational research and can have important consequences for health policy developed from the findings. The current piece describes bias and its sources, outlines proposed methods to estimate its impacts in an observational study, and demonstrates how these methods may be used to inform debate on the causal relationship between medically assisted reproduction (MAR) and health outcomes, using cancer as an example. In doing so, we aim to enlighten researchers who work with observational data, especially regarding the health effects of MAR and infertility, on the pitfalls of bias, and how to address them. We hope that, in combination with the provided example, we can convince readers that estimating the impact of bias in causal epidemiologic research is not only important but necessary to inform the development of robust health policy and clinical practice recommendations.
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Affiliation(s)
- Adrian R Walker
- Centre for Big Data Research in Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Christos A Venetis
- Centre for Big Data Research in Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
- Unit for Human Reproduction, 1st Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Signe Opdahl
- Centre for Big Data Research in Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Georgina M Chambers
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health and School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Louisa R Jorm
- Centre for Big Data Research in Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
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2
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Mondaca JM, Uzair ID, Castro Guijarro AC, Flamini MI, Sanchez AM. Molecular Basis of LH Action on Breast Cancer Cell Migration and Invasion via Kinase and Scaffold Proteins. Front Cell Dev Biol 2021; 8:630147. [PMID: 33614634 PMCID: PMC7893099 DOI: 10.3389/fcell.2020.630147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/24/2020] [Indexed: 11/13/2022] Open
Abstract
Breast cancer (BC) is a major public health problem affecting women worldwide. Approximately 80% of diagnosed cases are hormone-dependent breast cancers. These hormones are known to stimulate tumor development and progression. In this setting, tentative evidence suggests that luteinizing hormone (LH) may also play a role in tumors. In BC cells that express functional LH receptors (LHR), this hormone regulates cell migration and invasion by controlling several kinases that activate actin cytoskeletal proteins. In this article, we show that LH induces phosphorylation of paxillin and its translocation toward the plasmatic membrane, where focal adhesion complexes are assembled. This process is triggered via a rapid extra-gonadal LHR signaling to Src/FAK/paxillin, which results in the phosphorylation/activation of the nucleation promoter factors cortactin and N-WASP. As a consequence, Arp2/3 complexes induce actin polymerization, essential to promote cell adhesion, migration, and invasion, thus enhancing metastatic spread of tumoral cells. Our findings provide relevant information about how gonadotrophins exert their action in BC. This information helps us understand the extragonadal effects of LH on BC metastasis. It may provide new perspectives for therapeutic treatment, especially for women with high serum levels of gonadotrophins.
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Affiliation(s)
- Joselina Magali Mondaca
- Laboratorio de Transducción de Señales y Movimiento Celular, Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Cuyo, Mendoza, Argentina
| | - Ivonne Denise Uzair
- Laboratorio de Transducción de Señales y Movimiento Celular, Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Cuyo, Mendoza, Argentina
| | - Ana Carla Castro Guijarro
- Laboratorio de Biología Tumoral, Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Cuyo, Mendoza, Argentina
| | - Marina Inés Flamini
- Laboratorio de Biología Tumoral, Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Cuyo, Mendoza, Argentina
| | - Angel Matias Sanchez
- Laboratorio de Transducción de Señales y Movimiento Celular, Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Cuyo, Mendoza, Argentina
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3
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Zhong Y, Wang Y, Huang J, Xu X, Pan W, Gao S, Zhang Y, Su M. Association of hCG and LHCGR expression patterns with clinicopathological parameters in ovarian cancer. Pathol Res Pract 2019; 215:748-754. [PMID: 30712886 DOI: 10.1016/j.prp.2019.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 12/01/2018] [Accepted: 01/05/2019] [Indexed: 01/14/2023]
Abstract
In addition to its critical role during pregnancy, human chorionic gonadotropin (hCG) has been shown to be expressed by various tumor types. Recent studies have similarly documented the presence of the luteinizing hormone (LH)/hCG receptor (LHCGR) in a variety of nongonadal organs; however, its clinicopathological significance in ovarian cancer remains unclear. The present study used a combination of immunohistochemical, real-time PCR, and western blot analyses to examine hCG and LHCGR expression in normal and cancerous tissues collected from patients with epithelial ovarian cancer (EOC). hCG and LHCGR expression levels were resultantly shown to be significantly increased and decreased in cancerous versus normal (or benign) ovarian tissues, respectively (P < 0.05), and both expression pattern changes were associated with more advanced tumor stages and a higher rate of metastasis. Furthermore, patients with tumors with high or low levels of hCG and LHCGR, respectively, experienced a worse overall survival (OS) rate than those with low hCG or high LHCGR expression levels (P < 0.05). In fact, hCG and LHCGR expression levels were independent prognostic factors of patient OS (P < 0.05) for EOC. Collectively, these findings indicate that hCG and LHCGR expression pattern changes are associated with EOC occurrence and progression. Thus, hCG and LHCGR represent promising potential targets to improve the diagnosis, treatment, and prognosis of patients with EOC.
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Affiliation(s)
- Yuanyuan Zhong
- Department of Obstetrics and Gynecology; Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China
| | - Yingying Wang
- Laboratory of Immunology, Nantong University, China; Nantong University, Nantong, Jiangsu 226001, China
| | - Jianfei Huang
- Department of Pathology; Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China
| | - Xiangyu Xu
- Department of Obstetrics and Gynecology; Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China
| | - Weidong Pan
- Department of Obstetrics and Gynecology; Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China
| | - Sainan Gao
- Department of Obstetrics and Gynecology; Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China
| | - Yuquan Zhang
- Department of Obstetrics and Gynecology; Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China.
| | - Min Su
- Department of Obstetrics and Gynecology; Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China.
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4
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Doroszko M, Chrusciel M, Stelmaszewska J, Slezak T, Anisimowicz S, Plöckinger U, Quinkler M, Bonomi M, Wolczynski S, Huhtaniemi I, Toppari J, Rahman NA. GnRH antagonist treatment of malignant adrenocortical tumors. Endocr Relat Cancer 2019; 26:103-117. [PMID: 30400009 PMCID: PMC6215908 DOI: 10.1530/erc-17-0399] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 08/21/2018] [Indexed: 12/11/2022]
Abstract
Aberrantly expressed G protein-coupled receptors in tumors are considered as potential therapeutic targets. We analyzed the expressions of receptors of gonadotropin-releasing hormone (GNRHR), luteinizing hormone/chorionic gonadotropin (LHCGR) and follicle-stimulating hormone (FSHR) in human adrenocortical carcinomas and assessed their response to GnRH antagonist therapy. We further studied the effects of the GnRH antagonist cetrorelix acetate (CTX) on cultured adrenocortical tumor (ACT) cells (mouse Cα1 and Y-1, and human H295R), and in vivo in transgenic mice (SV40 T-antigen expression under inhibin α promoter) bearing Lhcgr and Gnrhr in ACT. Both models were treated with control (CT), CTX, human chorionic gonadotropin (hCG) or CTX+hCG, and their growth and transcriptional changes were analyzed. In situ hybridization and qPCR analysis of human adrenocortical carcinomas (n = 11-13) showed expression of GNRHR in 54/73%, LHCGR in 77/100% and FSHR in 0%, respectively. CTX treatment in vitro decreased cell viability and proliferation, and increased caspase 3/7 activity in all treated cells. In vivo, CTX and CTX+hCG (but not hCG alone) decreased ACT weights and serum LH and progesterone concentrations. CTX treatment downregulated the tumor markers Lhcgr and Gata4. Upregulated genes included Grb10, Rerg, Nfatc and Gnas, all recently found to be abundantly expressed in healthy adrenal vs ACT. Our data suggest that CTX treatment may improve the therapy of human adrenocortical carcinomas by direct action on GNRHR-positive cancer cells inducing apoptosis and/or reducing gonadotropin release, directing tumor cells towards a healthy adrenal gene expression profile.
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Affiliation(s)
| | | | - Joanna Stelmaszewska
- Department of Reproduction and Gynecological EndocrinologyMedical University of Bialystok, Bialystok, Poland
| | - Tomasz Slezak
- Department of Biochemistry and Molecular BiologyUniversity of Chicago, Chicago, Illinois, USA
| | | | - Ursula Plöckinger
- Interdisciplinary Center of Metabolism: EndocrinologyDiabetes and Metabolism, Charité University Medicine Berlin, Berlin, Germany
| | - Marcus Quinkler
- Endocrinology in CharlottenburgBerlin, Germany
- Department of Clinical EndocrinologyCharité Campus Mitte, Charité University Medicine Berlin, Berlin, Germany
| | - Marco Bonomi
- Department of Clinical Sciences & Community HealthUniversity of Milan, Milan, Italy
| | - Slawomir Wolczynski
- Department of Reproduction and Gynecological EndocrinologyMedical University of Bialystok, Bialystok, Poland
| | - Ilpo Huhtaniemi
- Institute of BiomedicineUniversity of Turku, Turku, Finland
- Department of Surgery and CancerFaculty of Medicine, Imperial College London, London, U.K.
| | - Jorma Toppari
- Institute of BiomedicineUniversity of Turku, Turku, Finland
- Department of PediatricsTurku University Hospital, Turku, Finland
| | - Nafis A Rahman
- Institute of BiomedicineUniversity of Turku, Turku, Finland
- Department of Reproduction and Gynecological EndocrinologyMedical University of Bialystok, Bialystok, Poland
- Correspondence should be addressed to N Rahman:
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5
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Bhandari HM, Choudhary MK, Stewart JA. Complications of assisted reproductive technology treatment and the factors influencing reproductive outcome. ACTA ACUST UNITED AC 2018. [DOI: 10.1111/tog.12504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Harish M Bhandari
- Leeds Teaching Hospitals NHS Trust; Leeds Fertility; Seacroft Hospital; Leeds LS14 6UH UK
| | - Meenakshi K Choudhary
- Newcastle Fertility Centre at Life; International Centre for Life; Newcastle upon Tyne NE1 4EP UK
| | - Jane A Stewart
- Newcastle Fertility Centre at Life; International Centre for Life; Newcastle upon Tyne NE1 4EP UK
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Marlicz W, Poniewierska-Baran A, Rzeszotek S, Bartoszewski R, Skonieczna-Żydecka K, Starzyńska T, Ratajczak MZ. A novel potential role of pituitary gonadotropins in the pathogenesis of human colorectal cancer. PLoS One 2018; 13:e0189337. [PMID: 29494614 PMCID: PMC5832186 DOI: 10.1371/journal.pone.0189337] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 01/29/2018] [Indexed: 12/18/2022] Open
Abstract
Background Colorectal cancer (CRC) is a leading cause of death in the western world, and its incidence increases with patient age. It is also known that with age there occur changes in the levels of certain hormones, including an increase in the secretion of pituitary gonadotropins (PtGs) as a result of the loss of gonadal hormone feedback. We recently reported that functional PtG receptors are expressed in human lung cancer cells, rhabdomyosarcoma cells, and malignant hematopoietic stem cells. Findings Here we report for the first time that the receptors for follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are expressed in primary tumor samples isolated from CRC patients as well as in the established human CRC cell lines HTC116 and HTB37. Moreover, we also report that PtGs stimulate chemotaxis, adhesion, and proliferation of these cell lines. Conclusions Our results suggest that PtGs play an important and underappreciated role in CRC pathogenesis, and we call for further studies to better define their role in gastrointestinal malignancies and their direct effect on putative CRC cancer stem cells.
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Affiliation(s)
- Wojciech Marlicz
- Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland
- * E-mail: (WM); (AP)
| | - Agata Poniewierska-Baran
- Department of Physiology, Pomeranian Medical University in Szczecin, Szczecin, Poland
- Department of Immunology, Faculty of Biology, University of Szczecin, Szczecin, Poland
- * E-mail: (WM); (AP)
| | - Sylwia Rzeszotek
- Department of Histology and Embryology, Pomeranian Medical University, Szczecin, Poland
| | - Rafał Bartoszewski
- Department of Biology and Pharmaceutical Botany, Medical University of Gdansk, Gdansk, Poland
| | | | - Teresa Starzyńska
- Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland
| | - Mariusz Z. Ratajczak
- Stem Cell Institute, James Graham Brown Cancer Center, University of Louisville, Louisville, United States of America
- Department of Regenerative Medicine, Warsaw Medical University, Warsaw, Poland
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7
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Sanchez AM, Flamini MI, Zullino S, Russo E, Giannini A, Mannella P, Naccarato AG, Genazzani AR, Simoncini T. Regulatory Actions of LH and Follicle-Stimulating Hormone on Breast Cancer Cells and Mammary Tumors in Rats. Front Endocrinol (Lausanne) 2018; 9:239. [PMID: 29867771 PMCID: PMC5964138 DOI: 10.3389/fendo.2018.00239] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 04/26/2018] [Indexed: 02/05/2023] Open
Abstract
Gonadotrophins are mainly known to influence the body through the formation of gonadal steroids. However, receptors for luteinizing hormone (LH) and follicular-stimulating hormone (FSH) are present in a set of extra-gonadal tissues in humans and animals, but their functional relevance is uncertain. In this article, we present experimental evidence that, in T-47D breast cancer (BC) cells, FSH, and LH alter the expression of genes involved in adhesion, motility, and invasion through the activation of their receptors. Using miniarray technology we also found that LH influences the expression of a broad set of genes involved in cancer biology in T-47D cells. Interestingly, the regulatory actions of FSH and LH depend on the modality of exposure, with significant differences between pre-pubertal-like vs. post-menopausal-like amounts of gonadotrophins, but not after intermittent administration, representative of fertile life. We also studied the modulation of the circulating levels of gonadotrophins in an in vivo rat model of BC progression and observed a direct correlation with the extent of cancer growth. These results support the hypothesis that gonadotrophins may have direct effects on extra-gonadal tissues. They also highlight that gonadotrophins could potentially contribute to BC progression, particularly in post-menopausal women who typically have higher gonadotrophin levels. This research may ultimately lead to testing the use of gonadotrophin-modulating drugs in BC patients.
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Affiliation(s)
- Angel Matias Sanchez
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Laboratorio de Transducción de Señales y Movimiento Celular, Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina
- *Correspondence: Angel Matias Sanchez, ; Tommaso Simoncini,
| | - Marina Ines Flamini
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Laboratorio de Biología Tumoral, Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina
| | - Sara Zullino
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Eleonora Russo
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Giannini
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paolo Mannella
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Antonio Giuseppe Naccarato
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Andrea Riccardo Genazzani
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Tommaso Simoncini
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- *Correspondence: Angel Matias Sanchez, ; Tommaso Simoncini,
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Porcaro AB, Siracusano S, de Luyk N, Corsi P, Sebben M, Tafuri A, Processali T, Inverardi D, Cacciamani G, Mattevi D, Cerruto MA, Brunelli M, Ghimenton C, Monaco C, Artibani W. Simultaneous Measurements of Follicle Stimulating Hormone and Total Testosterone and Associations in Clinically Localized Prostate Cancer. Curr Urol 2017; 10:174-181. [PMID: 29234259 PMCID: PMC5704728 DOI: 10.1159/000447177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 11/07/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To evaluate the potential relations of simultaneous measurements of basal levels of follicle stimulating hormone (FSH) and total testosterone (TT) in clinically localized prostate cancer (PCa). MATERIALS AND METHODS The study included 126 patients who had simultaneous measurements of prostate specific antigen (PSA), FSH, and TT before undergoing radical prostatectomy for clinically localized PCa. Correlations and independent associations between clinical and pathological factors were investigated by statistical methods. RESULTS The tumor volume (TV) was directly correlated to PSA and TT which was inversely related to FSH. Moreover, it was independently associated with both PSA and TT. In a multivariate linear regression model, FSH and TV were simultaneous independent factors associated with TT, and the association was inverse in the former and direct in the latter. In the patient population, the subset with FSH levels above the third quartile was related to lower median levels of TT that were associated with high grade cancer showing a lower TV. In localized PCa, basal levels of TT were associated with tumor parameters and inversely related to FSH levels, and the subset FSH levels above the third quartile were related to lower TT levels that were associated with high grade cancers showing a lower tumor load. CONCLUSION Preoperative TT was associated with tumor parameters and inversely related to FSH levels. Patient with increased FSH levels was related to lower levels of TT, which was associated with high grade cancer.
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Affiliation(s)
- Antonio B. Porcaro
- Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Salvatore Siracusano
- Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Nicolò de Luyk
- Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Paolo Corsi
- Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Marco Sebben
- Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alessandro Tafuri
- Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Tania Processali
- Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Davide Inverardi
- Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Giovanni Cacciamani
- Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Daniele Mattevi
- Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Maria A. Cerruto
- Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Matteo Brunelli
- Department of Pathology, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Claudio Ghimenton
- Department of Pathology, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Carmelo Monaco
- Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Walter Artibani
- Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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9
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Sanchez AM, Flamini MI, Russo E, Casarosa E, Pacini S, Petrini M, Genazzani AR, Simoncini T. LH and FSH promote migration and invasion properties of a breast cancer cell line through regulatory actions on the actin cytoskeleton. Mol Cell Endocrinol 2016; 437:22-34. [PMID: 27502036 DOI: 10.1016/j.mce.2016.08.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 07/19/2016] [Accepted: 08/05/2016] [Indexed: 02/07/2023]
Abstract
Reproductive hormones influence breast cancer development and progression. While the actions of sex steroids in this setting are established, tentative evidence suggests that follicle-stimulating hormone (FSH) and luteinizing hormone (LH) may also play a role, yet this remains elusive. We here identify that T-47D breast cancer cells express functional receptors for FSH and LH, and that these hormones regulate breast cancer cell motility and invasion through the control of the actin cytoskeleton and the formation of cortical actin aggregates and focal adhesion complexes. Such actions are mediated by the cytoskeletal controllers Moesin and focal adhesion kinase (FAK). Moesin is recruited rapidly by FSH and LH through a signaling cascade requiring the G protein Gα13 and the Rho-associated kinase, ROCK-2. FSH and LH activate FAK via a Gαi/β and c-Src-dependent signaling cascade. Both cascades involve signaling to phosphatidylinositol-3 kinase and Akt. FSH and LH receptors and the related signaling intermediates are necessary for the actions of gonadotrophins on breast cancer cell cytoskeletal rearrangement, migration and invasion. These findings provide original information on the actions of gonadotrophins on breast cancer cells and may have clinical implications for the use of drugs that modulate gonadotrophins in breast cancer patients.
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Affiliation(s)
- Angel Matias Sanchez
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56100, Italy; Institute of Medicine and Experimental Biology of Cuyo (IMBECU), CCT-CONICET Mendoza, National University of Cuyo, Parque General San Martin s/n, Mendoza, CP:5500, Argentina
| | - Marina Ines Flamini
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56100, Italy; Institute of Medicine and Experimental Biology of Cuyo (IMBECU), CCT-CONICET Mendoza, National University of Cuyo, Parque General San Martin s/n, Mendoza, CP:5500, Argentina
| | - Eleonora Russo
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56100, Italy
| | - Elena Casarosa
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56100, Italy
| | - Simone Pacini
- Division of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56100, Italy
| | - Mario Petrini
- Division of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56100, Italy
| | - Andrea Riccardo Genazzani
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56100, Italy
| | - Tommaso Simoncini
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56100, Italy.
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10
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Wang Y, Cai KQ, Smith ER, Yeasky TM, Moore R, Ganjei-Azar P, Klein-Szanto AJ, Godwin AK, Hamilton TC, Xu XX. Follicle Depletion Provides a Permissive Environment for Ovarian Carcinogenesis. Mol Cell Biol 2016; 36:2418-30. [PMID: 27354067 PMCID: PMC5007791 DOI: 10.1128/mcb.00202-16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 05/07/2016] [Accepted: 06/23/2016] [Indexed: 12/17/2022] Open
Abstract
We modeled the etiology of postmenopausal biology on ovarian cancer risk using germ cell-deficient white-spotting variant (Wv) mice, incorporating oncogenic mutations. Ovarian cancer incidence is highest in peri- and postmenopausal women, and epidemiological studies have established the impact of reproductive factors on ovarian cancer risk. Menopause as a result of ovarian follicle depletion is thought to contribute to higher cancer risk. As a consequence of follicle depletion, female Wv mice develop ovarian tubular adenomas, a benign epithelial tumor corresponding to surface epithelial invaginations and papillomatosis frequently found in postmenopausal human ovaries. Lineage tracing using MISR2-Cre indicated that the tubular adenomas that developed in Wv mice were largely derived from the MISR2 lineage, which marked only a fraction of ovarian surface and oviduct epithelial cells in wild-type tissues. Deletion of p27, either heterozygous or homozygous, was able to convert the benign tubular adenomas into more proliferative tumors. Restricted deletion of p53 in Wv/Wv mice by either intrabursal injection of adenoviral Cre or inclusion of the MISR2-Cre transgene also resulted in augmented tumor growth. This finding suggests that follicle depletion provides a permissive ovarian environment for oncogenic transformation of epithelial cells, presenting a mechanism for the increased ovarian cancer risk in postmenopausal women.
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Affiliation(s)
- Ying Wang
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida, USA Department of Cell Biology, University of Miami School of Medicine, Miami, Florida, USA
| | - Kathy Qi Cai
- Ovarian Cancer Programs, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Elizabeth R Smith
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida, USA Department of Cell Biology, University of Miami School of Medicine, Miami, Florida, USA
| | - Toni M Yeasky
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida, USA Department of Cell Biology, University of Miami School of Medicine, Miami, Florida, USA
| | - Robert Moore
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida, USA Department of Cell Biology, University of Miami School of Medicine, Miami, Florida, USA
| | - Parvin Ganjei-Azar
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida, USA Department of Pathology, University of Miami School of Medicine, Miami, Florida, USA
| | - Andres J Klein-Szanto
- Ovarian Cancer Programs, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Andrew K Godwin
- Ovarian Cancer Programs, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Thomas C Hamilton
- Ovarian Cancer Programs, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Xiang-Xi Xu
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida, USA Department of Cell Biology, University of Miami School of Medicine, Miami, Florida, USA
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11
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Valdelièvre C, Sonigo C, Comtet M, Simon C, Eskenazi S, Grynberg M. [Impact of gonadotropins in women suffering from cancer]. Bull Cancer 2016; 103:282-8. [PMID: 26917466 DOI: 10.1016/j.bulcan.2016.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 03/23/2015] [Indexed: 12/21/2022]
Abstract
The role of gonadotropins in the genesis of malignant diseases, in particular gynecologic cancers, is still controversial. The production of ovarian steroids, as a consequence of FSH and LH actions, may constitute a bias to draw reliable conclusions. Over the past decades, the use of exogenous gonadotropins has markedly increased in cancer patients, candidates for fertility preservation, and in survivors facing infertility as a consequence of gonadotoxic treatments. In gynecologic cancers, high serum estradiol levels may be problematic and can therefore be overcome by specific protocols of ovarian stimulation. However, exogenous gonadotropin administration in cancer patients should systematically be included in a multidisciplinary approach. The present article discusses the possible role of gonadotropins as tumorigenic factors and the use of exogenous gonadotropins in females suffering from cancer.
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Affiliation(s)
- Constance Valdelièvre
- Hôpital Jean-Verdier, service de médecine de la reproduction, avenue du 14-Juillet, 93140 Bondy, France
| | - Charlotte Sonigo
- Hôpital Jean-Verdier, service de médecine de la reproduction, avenue du 14-Juillet, 93140 Bondy, France; Université Paris XIII, 93000 Bobigny, France
| | - Marjorie Comtet
- Hôpital Jean-Verdier, service de médecine de la reproduction, avenue du 14-Juillet, 93140 Bondy, France
| | - Cynthia Simon
- Hôpital Jean-Verdier, service de médecine de la reproduction, avenue du 14-Juillet, 93140 Bondy, France
| | - Sarah Eskenazi
- Hôpital Jean-Verdier, service de médecine de la reproduction, avenue du 14-Juillet, 93140 Bondy, France
| | - Michaël Grynberg
- Hôpital Jean-Verdier, service de médecine de la reproduction, avenue du 14-Juillet, 93140 Bondy, France; Université Paris XIII, 93000 Bobigny, France; Université Paris-Diderot, unité Inserm U1133, 75013 Paris, France.
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12
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Pawlikowski M, Jaranowska M, Pisarek H, Kubiak R, Fuss-Chmielewska J, Winczyk K. Ectopic expression of follicle-stimulating hormone receptors in thyroid tumors. Arch Med Sci 2015; 11:1314-7. [PMID: 26788096 PMCID: PMC4697062 DOI: 10.5114/aoms.2015.56357] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 12/30/2013] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION In normal conditions follicle-stimulating hormone receptors (FSHR) are expressed in the ovary and the testis. They can also be expressed in gonadal tumors. However, recently we have found FSHR immunostaining in pituitary adenomas, adrenal tumors and neuroendocrine tumors (carcinoids). The aim of this study was to determine whether the same occurs in thyroid tumors. MATERIAL AND METHODS Thirty-six samples of surgically excised thyroids were examined. Follicle-stimulating hormone receptors immunostaining was performed on paraffin sections using the rabbit anti-human FSHR polyclonal antibody raised against a 1-190 amino acid sequence from the human FSHR (sc-13935, Santa Cruz). RESULTS Normal thyroid follicles do not show immunopositivity for FSHR. The same concerns the majority of benign lesions, diagnosed as hyperplasia nodularis or thyroid adenomas. However, positive FSHR immunostaining in some follicles was observed. In all but one thyroid cancer (15 papillary, 10 follicular cancers and one case of anaplastic thyroid cancer) 10-100% of tumor cells exhibit positive FSHR immunostaining. In about 40% of samples FSHR immunoreactivity can be observed also in the endothelia of intrathyroidal blood vessels. This immunopositivity was more frequent in the samples of thyroid cancers (13/27) than in benign lesions (2/9). CONCLUSIONS Ectopic positive FSHR immunostaining is also present in thyroid cancers, and, to a lesser degree, in benign lesions but not in the normal thyroid epithelium.
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Affiliation(s)
- Marek Pawlikowski
- Department of Immunoendocrinology, Chair of Endocrinology, Medical University of Lodz, Lodz, Poland
| | - Maria Jaranowska
- Department of Neuroendocrinology, Chair of Laboratory Medicine, Medical University of Lodz, Lodz, Poland
| | - Hanna Pisarek
- Department of Neuroendocrinology, Chair of Laboratory Medicine, Medical University of Lodz, Lodz, Poland
| | - Robert Kubiak
- Department of Pathology of Tumors, Chair of Oncology, Medical University of Lodz, Lodz, Poland
| | - Julita Fuss-Chmielewska
- Department of Neuroendocrinology, Chair of Laboratory Medicine, Medical University of Lodz, Lodz, Poland
| | - Katarzyna Winczyk
- Department of Neuroendocrinology, Chair of Laboratory Medicine, Medical University of Lodz, Lodz, Poland
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Cai KQ, Wang Y, Smith ER, Smedberg JL, Yang DH, Yang WL, Xu XX. Global deletion of Trp53 reverts ovarian tumor phenotype of the germ cell-deficient white spotting variant (Wv) mice. Neoplasia 2015; 17:89-100. [PMID: 25622902 PMCID: PMC4309726 DOI: 10.1016/j.neo.2014.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 11/07/2014] [Accepted: 11/12/2014] [Indexed: 01/01/2023] Open
Abstract
White spotting variant (Wv) mice are spontaneous mutants attributed to a point mutation in the c-Kit gene, which reduces the tyrosine kinase activity to around 1% and affects the development of melanocytes, mast cells, and germ cells. Homozygous mutant mice are sterile but can live nearly a normal life span. The female Wv mice have a greatly reduced ovarian germ cell and follicle reserve at birth, and the remaining follicles are largely depleted soon after the females reach reproductive stage at around 7 weeks of age. Consequently, ovarian epithelial tumors develop in 100% of Wv females by 3 to 4 months of age. These tumors, called tubular adenomas, are benign but can become invasive in older Wv mice. We tested if additional genetic mutation(s) could convert the benign ovarian epithelial tumors to malignant tumors by crossing the Wv mutant into the Trp53 knockout background. Surprisingly, we found that global deletion of Trp53 suppressed the development of ovarian tubular adenomas in Wv mice. The ovaries of Wv/Wv; Trp53 (−/−) mice were covered by a single layer of surface epithelium and lacked excessive epithelial proliferation. Rather, the ovaries contained a small number of follicles. The presence of ovarian follicles and granulosa cells, as indicated by Pgc7 and inhibin-alpha expression, correlated with the absence of epithelial lesions. A reduction of Pten gene dosage, as in Wv/Wv; Pten (+/−) mice, produced a similar, though less dramatic, phenotype. We conclude that deletion of Trp53 prolongs the survival of ovarian follicles in Wv mice and consequently prevents the proliferation of ovarian epithelial cells and development of ovarian tubular adenomas. The results suggest that various cell types within the ovary communicate and mutually modulate, and an intact tissue environment is required to ensure homeostasis of ovarian surface epithelial cells. Especially, the current finding emphasizes the importance of ovarian follicles in suppressing the hyperplastic growth of ovarian epithelial cells, dominating over the loss of p53.
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Affiliation(s)
- Kathy Qi Cai
- Ovarian Cancer Program, Fox Chase Cancer Center, Philadelphia, PA 19111
| | - Ying Wang
- Sylvester Comprehensive Cancer Center, Department of Cell Biology, University of Miami Miller School of Medicine, Miami, FL 33136; Department of Medicine, University of California at San Diego, La Jolla, CA 92093
| | - Elizabeth R Smith
- Sylvester Comprehensive Cancer Center, Department of Cell Biology, University of Miami Miller School of Medicine, Miami, FL 33136
| | | | - Dong-Hua Yang
- Ovarian Cancer Program, Fox Chase Cancer Center, Philadelphia, PA 19111
| | - Wan-Lin Yang
- Ovarian Cancer Program, Fox Chase Cancer Center, Philadelphia, PA 19111
| | - Xiang-Xi Xu
- Sylvester Comprehensive Cancer Center, Department of Cell Biology, University of Miami Miller School of Medicine, Miami, FL 33136.
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Zhao J, Li Y, Zhang Q, Wang Y. Does ovarian stimulation for IVF increase gynaecological cancer risk? A systematic review and meta-analysis. Reprod Biomed Online 2015; 31:20-9. [PMID: 26003452 DOI: 10.1016/j.rbmo.2015.03.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 03/19/2015] [Accepted: 03/20/2015] [Indexed: 12/12/2022]
Abstract
The aim of this study was to evaluate whether ovarian stimulation for IVF increases the risk of gynaecological cancer, including ovarian, endometrial, cervical and breast cancers, as an independent risk factor. A systematic review and meta-analysis was conducted. Clinical trials that examined the association between ovarian stimulation for IVF and gynaecologic cancers were included. The outcomes of interest were incidence rate of gynaecologic cancers. Twelve cohort studies with 178,396 women exposed to IVF were included; 10 studies were used to analyse ovarian (167,640 women) and breast (151,702 women) cancers, and six studies were identified in the analysis of endometrial (116,672 women) and cervical cancer (114,799 women). Among these studies, 175 ovarian, 48 endometrial, 502 cervical and 866 cases of breast cancer were reported. The meta-analysis found no significant association between ovarian stimulation for IVF and increased ovarian, endometrial, cervical and breast cancer risk (odds ratio [OR] 1.06, 95% confidence interval [CI] 0.85 to 1.32; OR 0.97, 95% CI 0.58 to 1.63; OR 0.43, 95% CI 0.30 to 0.60; OR 0.69, 95% CI 0.63 to 0.76, respectively). Ovarian stimulation for IVF, therefore, does not increase the gynaecologic cancer risk, whether hormone-dependent endometrial and breast cancer or non-hormone-dependent ovarian and cervical cancer.
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Affiliation(s)
- Jing Zhao
- Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanping Li
- Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Qiong Zhang
- Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yonggang Wang
- Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
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15
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Pawlikowski M, Fuss-Chmielewska J, Jaranowska M, Pisarek H, Kubiak R, Winczyk K. Expression of follicle stimulating hormone receptors (FSHR) in thyroid tumours - a marker of malignancy? Thyroid Res 2015; 8:1. [PMID: 25685198 PMCID: PMC4328168 DOI: 10.1186/s13044-015-0014-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 01/23/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In normal conditions FSHR are expressed in granulosa cells of the ovary and Sertoli cells of the testis. They can be expressed also in gonadal tumours. However, recently the expression of FSHR was found in tumoral cells and intra-tumoral blood vessels of many other tumours, including thyroid tumours. Aim of this study was to see whether the expression of FSHR can be useful in the differentiation of benign and malignant thyroid lesions. METHODS 44 samples of surgically excised thyroids were immunostained with anti- FSHR antibody raised against 1-190 amino acid sequence from the human FSHR. RESULTS Non-neoplastic thyroid follicles (i.e. the follicles situated outside the tumour) do not show the immunostaining for FSHR. The same concerns the majority of follicular adenomas. In contrast, 87.5% of follicular cancers, the same percentage of papillary cancers and all the examined undifferentiated cancers showed the FSHR immunopositivity of tumoral cells. A tendency towards the higher frequency of FSHR - positive blood vessels also concerns malignant thyroid tumours. CONCLUSIONS The ectopic FSHR immunostaining seems to be useful to differentiate malignant from benign lesions, especially follicular cancers from follicular adenomas. However, the further studies on larger material are needed.
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Affiliation(s)
- Marek Pawlikowski
- />Department of Immunoendocrinology, Chair of Endocrinology, Medical University of Lodz, Lodz, Poland
| | - Julita Fuss-Chmielewska
- />Department of Neuroendocrinology, Chair of Laboratory Medicine, Medical University of Lodz, Lodz, Poland
| | - Maria Jaranowska
- />Department of Neuroendocrinology, Chair of Laboratory Medicine, Medical University of Lodz, Lodz, Poland
| | - Hanna Pisarek
- />Department of Neuroendocrinology, Chair of Laboratory Medicine, Medical University of Lodz, Lodz, Poland
| | - Robert Kubiak
- />Department of Pathology of Tumors, Chair of Oncology, Medical University of Lodz, Lodz, Poland
| | - Katarzyna Winczyk
- />Department of Neuroendocrinology, Chair of Laboratory Medicine, Medical University of Lodz, Lodz, Poland
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16
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Sabaa BME. Pathological conditions predisposing to infertility and gynaecological neoplasia. World J Obstet Gynecol 2014; 3:28-34. [DOI: 10.5317/wjog.v3.i2.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Revised: 03/04/2013] [Accepted: 04/11/2013] [Indexed: 02/05/2023] Open
Abstract
Some of the conditions long blamed for female factor infertility are now acknowledged as well established risk factors of gynecological neoplasia. This realization has lead to the proposition that infertility might be a risk factor for the development of several types of gynecological neoplasms. This review addresses different conditions that play a role in both infertility and gynaecological neoplasia. An intricate interplay between growth factors and hormonal factors (estrogens and progestins, androgens and gonadotropins) is said to link the state of infertility to some gynecological tumors. The relation between endometriosis -as one of the well established causes of female infertility - and ovarian cancer is well known. Endometriosis has been particularly related to endometrioid and clear-cell ovarian carcinomas. Another evidence for this association is embodied in finding endometriotic lesions adjacent to ovarian cancers. The polycystic ovary syndrome (PCOS), one of the most prevalent endocrine disorders and a long studied cause of female infertility increases the risk of endometrial carcinoma. The link between PCOS and endometrial carcinoma seems to be endometrial hyperplasia. PCOS-associated endometrial carcinoma tends to present at a younger age and early stage, with lower grade and lower risk of metastasis. Turner’s syndrome and other types of ovarian dysgenesis constitute a rare cause of infertility and are known to confer a definite risk of germ cell tumors. There seems to be a link between infertility and an increased risk of gynecological neoplasia. Hence, it is important to assess the risk of malignancy in each category of infertile patients so as to provide optimal and timely intervention.
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17
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Smith ER, Wang Y, Xu XX. Development of a mouse model of menopausal ovarian cancer. Front Oncol 2014; 4:36. [PMID: 24616881 PMCID: PMC3935315 DOI: 10.3389/fonc.2014.00036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 02/12/2014] [Indexed: 01/08/2023] Open
Abstract
Despite significant understanding of the genetic mutations involved in ovarian epithelial cancer and advances in genomic approaches for expression and mutation profiling of tumor tissues, several key questions in ovarian cancer biology remain enigmatic: the mechanism for the well-established impact of reproductive factors on ovarian cancer risk remains obscure; cell of origin of ovarian cancer continue to be debated; and the precursor lesion, sequence, or events in progression remain to be defined. Suitable mouse models should complement the analysis of human tumor tissues and may provide clues to these questions currently perplexing ovarian cancer biology. A potentially useful model is the germ cell-deficient Wv (white spotting variant) mutant mouse line, which may be used to study the impact of menopausal physiology on the increased risk of ovarian cancer. The Wv mice harbor a point mutation in c-Kit that reduces the receptor tyrosine kinase activity to about 1–5% (it is not a null mutation). Homozygous Wv mutant females have a reduced ovarian germ cell reservoir at birth and the follicles are rapidly depleted upon reaching reproductive maturity, but other biological phenotypes are minimal and the mice have a normal life span. The loss of ovarian function precipitates changes in hormonal and metabolic activity that model features of menopause in humans. As a consequence of follicle depletion, the Wv ovaries develop ovarian tubular adenomas, a benign epithelial tumor corresponding to surface epithelial invaginations and papillomatosis that mark human ovarian aging. Ongoing work will test the possibility of converting the benign epithelial tubular adenomas into neoplastic tumors by addition of an oncogenic mutation, such as of Tp53, to model the genotype and biology of serous ovarian cancer. Model based on the Wv mice may have the potential to gain biological and etiological insights into ovarian cancer development and prevention.
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Affiliation(s)
- Elizabeth R Smith
- Department of Cell Biology, Sylvester Comprehensive Cancer Center, University of Miami School of Medicine , Miami, FL , USA
| | - Ying Wang
- Department of Cell Biology, Sylvester Comprehensive Cancer Center, University of Miami School of Medicine , Miami, FL , USA
| | - Xiang-Xi Xu
- Department of Cell Biology, Sylvester Comprehensive Cancer Center, University of Miami School of Medicine , Miami, FL , USA ; Department of Obstetrics and Gynecology, University of Miami School of Medicine , Miami, FL , USA
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Disease control outcomes from analysis of pooled individual patient data from five comparative randomised clinical trials of degarelix versus luteinising hormone-releasing hormone agonists. Eur Urol 2014; 66:1101-8. [PMID: 24440304 DOI: 10.1016/j.eururo.2013.12.063] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 12/27/2013] [Indexed: 01/14/2023]
Abstract
BACKGROUND Studies comparing the gonadotropin-releasing hormone antagonist, degarelix, with luteinising hormone-releasing hormone (LHRH) agonists indicate differences in outcomes. OBJECTIVE To assess differences in efficacy and safety outcomes in a pooled analysis of trials comparing degarelix with LHRH agonists. DESIGN, SETTING, AND PARTICIPANTS Data were pooled from five prospective, phase 3 or 3b randomised trials (n=1925) of degarelix and leuprolide or goserelin in men requiring androgen deprivation therapy for the treatment of prostate cancer. Patients received either 3 mo (n=467) or 12 mo (n=1458) of treatment. INTERVENTION Men were randomised to receive degarelix (n=1266), leuprolide (n=201), or goserelin (n=458). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Unadjusted Kaplan-Meier analyses were supported by the Cox proportional hazards model, adjusted for disease-related baseline factors, to estimate hazard ratios (HRs) of efficacy and safety outcomes. The Fisher exact test compared crude incidences of adverse events. RESULTS AND LIMITATIONS Prostate-specific antigen (PSA) progression-free survival (PFS) was improved in the degarelix group (HR: 0.71; p=0.017). For patients with baseline PSA levels >20 ng/ml, the HR for PSA PFS was 0.74 (p=0.052). Overall survival (OS) was higher in the degarelix group (HR: 0.47; p=0.023). OS was particularly improved with degarelix in patients with baseline testosterone levels >2 ng/ml (HR: 0.36; p=0.006). In terms of disease-related adverse events, there were, overall, fewer joint-related signs and symptoms, musculoskeletal events, and urinary tract events in the degarelix group. CONCLUSIONS These data indicate clinical benefits with degarelix, including a significant improvement in PSA PFS and OS, as well as reduced incidence of joint, musculoskeletal, and urinary tract adverse events, compared with LHRH agonists.
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19
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Govindaraj V, Arya SV, Rao AJ. Differential action of glycoprotein hormones: significance in cancer progression. Discov Oncol 2013; 5:1-10. [PMID: 24129797 DOI: 10.1007/s12672-013-0164-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 10/02/2013] [Indexed: 01/16/2023] Open
Abstract
Growth of multicellular organisms depends on maintenance of proper balance between proliferation and differentiation. Any disturbance in this balance in animal cells can lead to cancer. Experimental evidence is provided to conclude with special reference to the action of follicle-stimulating hormone (FSH) on Sertoli cells, and luteinizing hormone (LH) on Leydig cells that these hormones exert a differential action on their target cells, i.e., stimulate proliferation when the cells are in an undifferentiated state which is the situation with cancer cells and promote only functional parameters when the cell are fully differentiated. Hormones and growth factors play a key role in cell proliferation, differentiation, and apoptosis. There is a growing body of evidence that various tumors express some hormones at high levels as well as their cognate receptors indicating the possibility of a role in progression of cancer. Hormones such as LH, FSH, and thyroid-stimulating hormone have been reported to stimulate cell proliferation and act as tumor promoter in a variety of hormone-dependent cancers including gonads, lung, thyroid, uterus, breast, prostate, etc. This review summarizes evidence to conclude that these hormones are produced by some cancer tissues to promote their own growth. Also an attempt is made to explain the significance of the differential action of hormones in progression of cancer with special reference to prostate cancer.
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20
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Bachelot A, Carré N, Mialon O, Matelot M, Servel N, Monget P, Ahtiainen P, Huhtaniemi I, Binart N. The permissive role of prolactin as a regulator of luteinizing hormone action in the female mouse ovary and extragonadal tumorigenesis. Am J Physiol Endocrinol Metab 2013; 305:E845-52. [PMID: 23921141 DOI: 10.1152/ajpendo.00243.2013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Transgenic female mice overexpressing the hCGβ subunit (hCGβ(+)) and producing elevated levels of luteinizing hormone (LH)/hCG bioactivity present as young adults with enhanced ovarian steroidogenesis, precocious puberty, and infertility. They subsequently develop pituitary prolactinomas, high circulating prolactin (PRL) levels, and marked mammary gland lobuloalveolar development followed by adenocarcinomas. None of these phenotypes appear in gonadectomized mice, indicating that the hCG-induced aberrations of ovarian function are responsible for the extragonadal phenotypes. PRL receptor-deficient (PRLR(-/-)) female mice are sterile, despite ovulating, due to a failure of embryo implantation, as a consequence of decreased ovarian LH receptor (Lhcgr) expression and inadequate corpus luteum formation and progesterone production. To study further the presumed permissive role of PRL in the maintenance of gonadal responsiveness to LH/hCG stimulation, we crossed the hCGβ(+) and PRLR(-/-) mice. The double-mutant hCGβ(+)/PRLR(-/-) females remained sterile with an ovarian phenotype similar to PRLR(-/-) mice, indicating that LH action, Lhcgr expression, and consequent luteinization are not possible without simultaneous PRL signaling. The high frequency of pituitary prolactinomas in PRLR(-/-) mice was not affected by transgenic hCGβ expression. In contrast, none of the hCGβ(+)/PRLR(-/-) females showed either mammary gland lobuloalveolar development or tumors, and the increased mammary gland Wnt-5b expression, possibly responsible for the tumorigenesis in hCGβ(+) mice, was absent in double-mutant mice. Hence, high LH/hCG stimulation is unable to compensate for missing PRL signaling in the maintenance of luteal function. PRL thus appears to be a major permissive regulator of LH action in the ovary and of its secondary extragonadal effects.
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MESH Headings
- Adenocarcinoma/genetics
- Adenocarcinoma/metabolism
- Adenocarcinoma/pathology
- Animals
- Carcinogenesis/metabolism
- Carcinogenesis/pathology
- Chorionic Gonadotropin, beta Subunit, Human/genetics
- Chorionic Gonadotropin, beta Subunit, Human/metabolism
- Corpus Luteum/metabolism
- Female
- Luteinizing Hormone/metabolism
- Mammary Glands, Animal/metabolism
- Mammary Glands, Animal/pathology
- Mammary Neoplasms, Animal/genetics
- Mammary Neoplasms, Animal/metabolism
- Mammary Neoplasms, Animal/pathology
- Mice
- Mice, Transgenic
- Ovary/metabolism
- Progesterone/metabolism
- Prolactin/blood
- Prolactin/metabolism
- Receptors, Prolactin/genetics
- Receptors, Prolactin/metabolism
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Affiliation(s)
- Anne Bachelot
- AP-HP, Endocrinology and Reproductive Medicine, Pitié-Salpêtrière Hospital, Paris, France
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Heublein S, Mayr D, Vrekoussis T, Friese K, Hofmann SS, Jeschke U, Lenhard M. The G-protein coupled estrogen receptor (GPER/GPR30) is a gonadotropin receptor dependent positive prognosticator in ovarian carcinoma patients. PLoS One 2013; 8:e71791. [PMID: 23951246 PMCID: PMC3739730 DOI: 10.1371/journal.pone.0071791] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 07/02/2013] [Indexed: 11/18/2022] Open
Abstract
Follicle stimulating hormone receptor (FSHR) and luteinizing hormone receptor (LHCGR) were demonstrated to impact upon survival of patients suffering from epithelial ovarian cancer (EOC). Though structure wise the G-protein coupled estrogen receptor (GPER/GPR30) is related to FSHR/LHCGR, its prognostic impact in EOC remains controversial. We recently found that FSHR negative patients represent a specific EOC subgroup that may behave differently in respect to both treatment response and prognosis. Hence, the current study aimed to analyze how GPER may interact with the FSHR/LHCGR system in EOC and whether the prognostic significance of GPER in EOC cases (n = 151) may be dependent on the FSHR/LHCGR immunophenotype of the tumor. Ovarian cancer cell lines were used to study how FSH and LH regulate GPER and whether GPER activation differentially affects in vitro cell proliferation in presence/absence of activated FSHR/LHCGR. In EOC tissue, GPER correlated with FSHR/LHCGR and was related to prolonged overall survival only in FSHR/LHCGR negative patients. Although GPER was found to be specifically induced by LH/FSH, GPER agonists (4-Hydroxy-Tamoxifen, G1) reduced EOC cell proliferation only in case of LH/FSH unstimulated pathways. To the same direction, only patients characterized as LHCGR/FSHR negative seem to gain from GPER in terms of survival. Our combined tissue and in vitro results support thus the hypothesis that GPER activation could be of therapeutic benefit in LHCGR/FSHR negative EOC patients. Further studies are needed to evaluate the impact of GPER activation on a clinical scheme.
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MESH Headings
- Antineoplastic Agents/pharmacology
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Carcinoma, Ovarian Epithelial
- Cell Line, Tumor
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Middle Aged
- Neoplasm Staging
- Neoplasms, Glandular and Epithelial/drug therapy
- Neoplasms, Glandular and Epithelial/genetics
- Neoplasms, Glandular and Epithelial/mortality
- Neoplasms, Glandular and Epithelial/pathology
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/mortality
- Ovarian Neoplasms/pathology
- Prognosis
- Receptor Cross-Talk/drug effects
- Receptors, Estrogen/agonists
- Receptors, Estrogen/genetics
- Receptors, Estrogen/metabolism
- Receptors, FSH/genetics
- Receptors, FSH/metabolism
- Receptors, G-Protein-Coupled/agonists
- Receptors, G-Protein-Coupled/genetics
- Receptors, G-Protein-Coupled/metabolism
- Receptors, LH/genetics
- Receptors, LH/metabolism
- Retrospective Studies
- Selective Estrogen Receptor Modulators/pharmacology
- Signal Transduction
- Survival Analysis
- Tamoxifen/analogs & derivatives
- Tamoxifen/pharmacology
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Affiliation(s)
- Sabine Heublein
- Department of Obstetrics and Gynaecology, Campus Innenstadt, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Doris Mayr
- Department of Pathology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Thomas Vrekoussis
- Department of Obstetrics and Gynaecology, Campus Innenstadt, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Klaus Friese
- Department of Obstetrics and Gynaecology, Campus Innenstadt, Ludwig-Maximilians-University of Munich, Munich, Germany
- Department of Pathology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Simone S. Hofmann
- Department of Obstetrics and Gynaecology, Campus Innenstadt, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynaecology, Campus Innenstadt, Ludwig-Maximilians-University of Munich, Munich, Germany
- * E-mail:
| | - Miriam Lenhard
- Department of Obstetrics and Gynaecology, Campus Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany
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22
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Zhou J, Chen Y, Huang Y, Long J, Wan F, Zhang S. Serum follicle-stimulating hormone level is associated with human epidermal growth factor receptor type 2 and Ki67 expression in post-menopausal females with breast cancer. Oncol Lett 2013; 6:1128-1132. [PMID: 24137476 PMCID: PMC3796423 DOI: 10.3892/ol.2013.1516] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 07/25/2013] [Indexed: 11/06/2022] Open
Abstract
The present study aimed to determine the association between levels of the gender hormones, follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone (P) and prolactin (PRL), and two breast cancer molecular markers, human epidermal growth factor receptor 2 (Her-2) and Ki67, in post-menopausal patients with breast cancer. A retrospective study of the serum hormone levels of FSH, LH, P and PRL and the expression status of Her-2 and Ki67 was performed using 187 post-menopausal females with breast cancer. Her-2+ breast cancer patients exhibited higher serum FSH levels compared with Her-2− patients (69.47±3.219 vs. 58.56±1.516 IU/l). The patients with high Ki67 expression [immunohistochemistry (IHC), 3+] displayed higher FSH (72.51±4.616 vs. 60.53±1.476 IU/l) and LH (32.33±1.916 vs. 26.98±0.8852 IU/l) levels than those with lower Ki67 expression. No correlation was identified between the FSH, LH, P and PRL hormone levels, tumor stages and lymphovascular invasion (LVI). In conclusion, a higher serum FSH level was identified in Her-2+ post-menopausal patients with breast cancer. Higher serum FSH and LH levels were also observed in breast cancer patients with high Ki67 expression. FSH and LH may function in the progression of breast cancer.
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Affiliation(s)
- Jun Zhou
- Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences of Zhejiang, Cancer Institute of Zhejiang University, Hangzhou, Zhejiang 310009, P.R. China ; Department of Surgery, The Women's Hospital of Zhejiang University, Hangzhou, Zhejiang 310006, P.R. China
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23
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Troppmann B, Kleinau G, Krause G, Gromoll J. Structural and functional plasticity of the luteinizing hormone/choriogonadotrophin receptor. Hum Reprod Update 2013; 19:583-602. [DOI: 10.1093/humupd/dmt023] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Matzkin ME, Yamashita S, Ascoli M. The ERK1/2 pathway regulates testosterone synthesis by coordinately regulating the expression of steroidogenic genes in Leydig cells. Mol Cell Endocrinol 2013; 370:130-7. [PMID: 23480967 PMCID: PMC3631444 DOI: 10.1016/j.mce.2013.02.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 02/04/2013] [Accepted: 02/22/2013] [Indexed: 10/27/2022]
Abstract
Adult mice with a Leydig cell specific deletion of MAPK kinase (MEK) 1 and 2 (Mek1(f)(/)(f);Mek2(-/-);Cre(+)) mice display Leydig cell hypoplasia and hypergonadotropic hypogonadism. We used radioimmunoassays and quantitative PCR to evaluate the function and expression of the Leydig cell genes involved in the conversion of cholesterol to testosterone (Star, Cyp11a1, Hsd3b6, Cyp17a1 and Hsd17b3), androgen metabolism (Srda1 and Dhrs9), and four transcription factors (Creb1, Nr5a1, Nr4a1 and Nr0b1) that regulate the expression of steroidogenic genes. We show that Star, Hsd3b6, Cyp17a1 and Hsd17b3 are downregulated in Ledyig cells of adult Mek1(f)(/)(f);Mek2(-/-);Cre(+) mice whereas Srda1 and Dhrs9 are upregulated and Creb1, Nr5a1, Nr4a1 and Nr0b1 are unchanged or upregulated. Functionally, all the downregulated genes but none of the upregulated genes contribute to the decrease in testosterone synthesis in Leydig cells of adult Mek1(f)(/)(f);Mek2(-/-);Cre(+) mice because they produce low testosterone and dihydrotestosterone when stimulated with hCG or when incubated with testosterone precursors such as progesterone or androstenedione.
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Affiliation(s)
- Maria Eugenia Matzkin
- Department of Pharmacology, Carver College of Medicine, The University of Iowa, Iowa City, Iowa
- Instituto de Biologia y Medicina Experimental (IBYME-CONICET), Buenos Aires, Argentina
| | - Soichi Yamashita
- Department of Pharmacology, Carver College of Medicine, The University of Iowa, Iowa City, Iowa
| | - Mario Ascoli
- Department of Pharmacology, Carver College of Medicine, The University of Iowa, Iowa City, Iowa
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25
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Porcaro AB, Migliorini F, Petrozziello A, Sava T, Romano M, Caruso B, Cocco C, Ghimenton C, Zecchinini Antoniolli S, Lacola V, Rubilotta E, Monaco C, Comunale L. Follicle-Stimulating Hormone and the Pituitary-Testicular-Prostate Axis at the Time of Initial Diagnosis of Prostate Cancer and Subsequent Cluster Selection of the Patient Population Undergoing Standard Radical Prostatectomy. Urol Int 2013; 90:45-55. [DOI: 10.1159/000343430] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 08/31/2012] [Indexed: 11/19/2022]
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26
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Cui J, Xu Y, Puett D. Microarray-based transcriptome profiling of ovarian cancer cells. Methods Mol Biol 2013; 1049:119-37. [PMID: 23913214 DOI: 10.1007/978-1-62703-547-7_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Transcriptome profiling is a powerful method for monitoring genes and their expression levels under a variety of conditions. Completion of the human genome and advances in high-throughput gene microarray instrumentation enables one to collect large amounts of data in a relatively short time. The challenge then becomes that of data analysis to identify patterns in expression changes and, from there, to relate the observed changes to functional compartments and pathways in cells, tissues, and organisms. Using cultured human ovarian cancer cells as an experimental model cellular system, we describe approaches that are used in analysis of the transcriptome, focusing on those genes encoding proteins and microRNAs. Coupled with other approaches described herein, one can also use the transcriptome to identify potential serum biomarkers, thus providing direction to what usually is a laborious search for low abundance proteins.
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Affiliation(s)
- Juan Cui
- Department of Biochemistry and Molecular Biology, University of Georgia, Athens, GA, USA
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27
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Siristatidis C, Sergentanis TN, Kanavidis P, Trivella M, Sotiraki M, Mavromatis I, Psaltopoulou T, Skalkidou A, Petridou ET. Controlled ovarian hyperstimulation for IVF: impact on ovarian, endometrial and cervical cancer—a systematic review and meta-analysis. Hum Reprod Update 2012; 19:105-23. [DOI: 10.1093/humupd/dms051] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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28
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New considerations for ADT in advanced prostate cancer and the emerging role of GnRH antagonists. Prostate Cancer Prostatic Dis 2012; 16:7-15. [PMID: 22751146 DOI: 10.1038/pcan.2012.25] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Androgen deprivation therapy (ADT) is first-line treatment for metastatic prostate cancer (PCa). Gonadotrophin-releasing hormone (GnRH) agonists are the most commonly used ADT but have several theoretical physiologic disadvantages (e.g. initial testosterone surge, potential microsurges upon repeat administration). Testosterone surge delays the intended serologic endpoint of testosterone suppression and may exacerbate clinical symptoms. GnRH antagonists were developed with a view toward overcoming these potential adverse physiologic events. This review evaluates GnRH agonists and antagonists, assessing the potential future role of antagonists in PCa and strategies to minimize ADT adverse events (AEs). Evidence was identified via PubMed search (by GnRH agent and other ADT-related terms), from review article bibliographies, and authors' therapy area knowledge, with articles included by author consensus. Degarelix shows similar efficacy to a GnRH agonist in achieving and maintaining castration, with faster onset and without testosterone surge/microsurges. Phase III data showed that, in the first treatment year, degarelix displayed a lower risk of PSA failure or death (composite endpoint), lower levels of the bone marker serum alkaline phosphatase (in baseline metastatic disease), and fewer musculoskeletal AEs than the agonist leuprolide. Also, crossing over from leuprolide to degarelix after 1 year reduced the risk of PSA failure or death. ADT displays an AE spectrum which can impact quality of life as well as causing significant morbidities. Strategies to improve ADT tolerability have become increasingly important including: a holistic management approach, improved diet and exercise, more specific monitoring to detect and prevent testosterone depletion toxicities, and intermittent ADT allowing hormonal recovery between treatment periods. Clinical studies suggest possible benefits of GnRH antagonists over agonists based on different mechanisms of action. GnRH antagonists should now be considered as an alternative first-line ADT option in advanced PCa. Intermittent ADT and a holistic treatment approach are promising strategies to improve ADT tolerability.
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29
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Porcaro AB, Migliorini F, Petrozziello A, Sava T, Romano M, Caruso B, Cocco C, Ghimenton C, Zecchinini Antoniolli S, Lacola V, Rubilotta E, Monaco C, Comunale L. Investigative clinical study on prostate cancer part VI: Follicle-stimulating hormone and the pituitary-testicular-prostate axis at the time of initial diagnosis and subsequent cluster selection of the patient population. Urol Int 2011; 88:150-7. [PMID: 22205171 DOI: 10.1159/000334596] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 10/17/2011] [Indexed: 11/19/2022]
Abstract
AIM To evaluate the physiopathology of follicle-stimulating hormone (FSH) along the pituitary-testicular-prostate axis at the time of initial diagnosis of prostate cancer in relation to the available clinical variables and to the subsequent cluster selection of the patient population. PATIENTS AND METHODS The study included 98 patients who were diagnosed with prostate cancer. Age, percentages of positive cores (P+) at transrectal ultrasound scan biopsy, biopsy Gleason score (bGS), luteinizing hormone (LH), FSH, total testosterone, free testosterone (FT) and prostate-specific antigen (PSA) were the continuous clinical variables. All patients had not previously received hormonal manipulations. FSH correlation and multiple linear analyses were computed in the population. The FSH/PSA ratio was computed and then ranked for clustering the population as groups A (0.13≤FSH/PSA≤0.57), B (0.57<FSH/PSA≤1.61) and C (1.61<FSH/PSA≤19.4). The model was assessed by simple linear and multiple linear regression analysis and differences between the groups were assessed by analysis of variance. RESULTS In the patient population, FSH correlated to LH (p < 0.0001), FT (p = 0.007) and age (p = 0.004). FSH was independently predicted by both LH (p < 0.0001) and PSA (p = 0.04). PSA predicted FSH/PSA A (p < 0.0001), B (p < 0.0001) and C (p = 0.04). On multiple regression analysis, FSH/PSA A was predicted by PSA (p < 0.0001), P+ (p = 0.03) and bGS (p = 0.04); FSH/PSA B by LH (p = 0.002) and PSA (p < 0.0001); FSH/PSA C by LH (p < 0.0001) and PSA (p < 0.0001). Moreover, FSH/PSA A, B and C differed for mean values of FSH (p < 0.0001), LH (p < 0.0001), PSA (p < 0.0001) and PSA/FT ratio (p < 0.0001). FSH/PSA clusters showed features of decreasing aggressive disease as the FSH/PSA ratio progressed from A to C. CONCLUSION At the diagnosis of prostate cancer and along the pituitary-testis-prostate axis in a patient population FSH significantly correlated to LH, FT and age, and FSH was independently and significantly predicted by both LH and PSA. Because of the independent prediction of PSA by FSH, the prostate cancer population at diagnosis was clustered and ranked according to the FSH/PSA ratio in groups A, B and C. Also, the predictive model of PSA on FSH for the different groups proved to be effective at selecting potential prognostic clusters in which the risk of progression might be assessed as low (group C), intermediate (group B) and high (group A). The FSH/PSA model might be considered as a tool for prostate cancer study and for use in individualized, risk-adapted approaches. However, confirmatory studies are needed.
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Affiliation(s)
- Antonio B Porcaro
- Department of Urology, University Integrated Hospitals, Civil Major Hospital, Verona, Italy.
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30
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Abstract
During the last two decades a large number of genetically modified mouse lines with altered gonadotropin action have been generated. These mouse lines fall into three categories: the lack-of-function mice, gain-of-function mice, and the mice generated by breeding the abovementioned lines with other disease model lines. The mouse strains lacking gonadotropin action have elucidated the necessity of the pituitary hormones in pubertal development and function of gonads, and revealed the processes from the original genetic defect to the pathological phenotype such as hypo- or hypergonadotropic hypogonadism. Conversely, the strains of the second group depict consequences of chronic gonadotropin action. The lines vary from those expressing constitutively active receptors and those secreting follicle-stimulating hormone (FSH) with slowly increasing amounts to those producing human choriogonadotropin (hCG), amount of which corresponds to 2000-fold luteinizing hormone (LH)/hCG biological activity. Accordingly, the phenotypes diverge from mild anomalies and enhanced fertility to disrupted gametogenesis, but eventually chronic, enhanced and non-pulsatile action of both FSH and LH leads to female and male infertility and/or hyper- and neoplasias in most of the gonadotropin gain-of-function mice. Elevated gonadotropin levels also alter the function of several extra-gonadal tissues either directly or indirectly via increased sex steroid production. These effects include promotion of tumorigenesis in tissues such as the pituitary, mammary and adrenal glands. Finally, the crossbreedings of the current mouse strains with other disease models are likely to uncover the contribution of gonadotropins in novel biological systems, as exemplified by the recent crossbreed of LHCG receptor deficient mice with Alzheimer disease mice.
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Affiliation(s)
- Hellevi Peltoketo
- Institute of Reproductive and Developmental Biology, Imperial College London, DuCane Road, London, W12 0NN, UK.
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31
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Cui J, Eldredge JB, Xu Y, Puett D. MicroRNA expression and regulation in human ovarian carcinoma cells by luteinizing hormone. PLoS One 2011; 6:e21730. [PMID: 21765906 PMCID: PMC3134471 DOI: 10.1371/journal.pone.0021730] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 06/07/2011] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND MicroRNAs have been widely-studied with regard to their aberrant expression and high correlation with tumorigenesis and progression in various solid tumors. With the major goal of assessing gonadotropin (luteinizing hormone, LH) contributions to LH receptor (LHR)-positive ovarian cancer cells, we have conducted a genome-wide transcriptomic analysis on human epithelial ovarian cancer cells to identify the microRNA-associated cellular response to LH-mediated activation of LHR. METHODS Human ovarian cancer cells (SKOV3) were chosen as negative control (LHR-) and stably transfected to express functional LHR (LHR+), followed by incubation with LH (0-20 h). At different times of LH-mediated activation of LHR the cancer cells were analyzed by a high-density Ovarian Cancer Disease-Specific-Array (DSA, ALMAC™), which profiled ∼ 100,000 transcripts with ∼ 400 non-coding microRNAs. FINDINGS In total, 65 microRNAs were identified to exhibit differential expression in either LHR expressing SKOV3 cells or LH-treated cells, a few of which have been found in the genomic fragile regions that are associated with abnormal deletion or amplification in cancer, such as miR-21, miR-101-1, miR-210 and miR-301a. By incorporating the dramatic expression changes observed in mRNAs, strong microRNA/mRNA regulatory pairs were predicted through statistical analyses coupled with collective computational prediction. The role of each microRNA was then determined through a functional analysis based on the highly-confident microRNA/mRNA pairs. CONCLUSION The overall impact on the transcriptome-level expression indicates that LH may regulate apoptosis and cell growth of LHR+ SKOV3 cells, particularly by reducing cancer cell proliferation, with some microRNAs involved in regulatory roles.
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Affiliation(s)
- Juan Cui
- Department of Biochemistry and Molecular Biology, University of Georgia, Athens, Georgia, United States of America
| | - Joanna B. Eldredge
- Department of Biochemistry and Molecular Biology, University of Georgia, Athens, Georgia, United States of America
| | - Ying Xu
- Department of Biochemistry and Molecular Biology, University of Georgia, Athens, Georgia, United States of America
- Institute of Bioinformatics, University of Georgia, Athens, Georgia, United States of America
- College of Computer Science and Technology, Jilin University, Changchun, Jilin, China
| | - David Puett
- Department of Biochemistry and Molecular Biology, University of Georgia, Athens, Georgia, United States of America
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32
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Cui J, Miner BM, Eldredge JB, Warrenfeltz SW, Dam P, Xu Y, Puett D. Regulation of gene expression in ovarian cancer cells by luteinizing hormone receptor expression and activation. BMC Cancer 2011; 11:280. [PMID: 21711548 PMCID: PMC3141782 DOI: 10.1186/1471-2407-11-280] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2010] [Accepted: 06/28/2011] [Indexed: 11/10/2022] Open
Abstract
Background Since a substantial percentage of ovarian cancers express gonadotropin receptors and are responsive to the relatively high concentrations of pituitary gonadotropins during the postmenopausal years, it has been suggested that receptor activation may contribute to the etiology and/or progression of the neoplasm. The goal of the present study was to develop a cell model to determine the impact of luteinizing hormone (LH) receptor (LHR) expression and LH-mediated LHR activation on gene expression and thus obtain insights into the mechanism of gonadotropin action on ovarian surface epithelial (OSE) carcinoma cells. Methods The human ovarian cancer cell line, SKOV-3, was stably transfected to express functional LHR and incubated with LH for various periods of time (0-20 hours). Transcriptomic profiling was performed on these cells to identify LHR expression/activation-dependent changes in gene expression levels and pathways by microarray and qRT-PCR analyses. Results Through comparative analysis on the LHR-transfected SKOV-3 cells exposed to LH, we observed the differential expression of 1,783 genes in response to LH treatment, among which five significant families were enriched, including those of growth factors, translation regulators, transporters, G-protein coupled receptors, and ligand-dependent nuclear receptors. The most highly induced early and intermediate responses were found to occupy a network impacting transcriptional regulation, cell growth, apoptosis, and multiple signaling transductions, giving indications of LH-induced apoptosis and cell growth inhibition through the significant changes in, for example, tumor necrosis factor, Jun and many others, supportive of the observed cell growth reduction in in vitro assays. However, other observations, e.g. the substantial up-regulation of the genes encoding the endothelin-1 subtype A receptor, stromal cell-derived factor 1, and insulin-like growth factor II, all of which are potential therapeutic targets, may reflect a positive mediation of ovarian cancer growth. Conclusion Overall, the present study elucidates the extensive transcriptomic changes of ovarian cancer cells in response to LH receptor activation, which provides a comprehensive and objective assessment for determining new cancer therapies and potential serum markers, of which over 100 are suggested.
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Affiliation(s)
- Juan Cui
- Department of Biochemistry and Molecular Biology, University of Georgia, Athens, GA 30602, USA
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33
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Yoffou PH, Edjekouane L, Meunier L, Tremblay A, Provencher DM, Mes-Masson AM, Carmona E. Subtype specific elevated expression of hyaluronidase-1 (HYAL-1) in epithelial ovarian cancer. PLoS One 2011; 6:e20705. [PMID: 21695196 PMCID: PMC3112150 DOI: 10.1371/journal.pone.0020705] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 05/08/2011] [Indexed: 12/31/2022] Open
Abstract
Background Epithelial ovarian cancer (EOC) is morphologically heterogeneous being classified as serous, endometrioid, clear cell, or mucinous. Molecular genetic analysis has suggested a role for tumor suppressor genes located at chromosome 3p in serous EOC pathogenesis. Our objective was to evaluate the expression of HYAL1, located at chromosome 3p21.3, in these EOC subtypes, and to investigate its correlation with the expression of steroid hormone receptors. Methodology/Principal Findings We determined the mRNA expression of HYAL1, estrogen receptor (ER)-α, ERβ and progesterone receptor (PR) in EOC tumor samples and cell lines using quantitative RT-PCR. We also examined the expression of these genes in a publicly available microarray dataset. HYAL-1 enzyme activity was measured in EOC cell lines and in plasma samples from patients. We found that HYAL1 mRNA expression was elevated in clear cell and mucinous EOC tissue samples, but not in serous and endometrioid samples, normal ovaries or benign tumors. Similar results were obtained by two different techniques and with tissue sample cohorts from two independent institutions. Concordantly, HYAL1 mRNA levels and enzymatic activity were elevated only in EOC cell lines derived from clear cell and mucinous subtypes. We also showed that HYAL1 mRNA was inversely correlated to that of ERα specifically in clear cell and mucinous EOCs. Additionally, ectopic expression of ERα in a clear cell EOC cell line (ER- and PR-negative) induced 50% reduction of HYAL1 mRNA expression, supporting a role of ERα in HYAL1 gene regulation. Significantly, HYAL-1 activity was also high in the plasma of patients with these EOC subtypes. Conclusions/Significance This is the first report showing high HYAL-1 levels in EOC and demonstrating HYAL1 gene repression by ERα. Our results identify Hyaluronidase-1 as a potential target/biomarker for clear cell and mucinous EOCs and especially in tumors with low ERα levels.
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MESH Headings
- Adenocarcinoma, Clear Cell/blood
- Adenocarcinoma, Clear Cell/enzymology
- Adenocarcinoma, Clear Cell/pathology
- Adenocarcinoma, Mucinous/blood
- Adenocarcinoma, Mucinous/enzymology
- Adenocarcinoma, Mucinous/pathology
- Biomarkers, Tumor/blood
- Carcinoma, Ovarian Epithelial
- Cell Line, Tumor
- Culture Media, Conditioned
- Estrogen Receptor alpha/genetics
- Estrogen Receptor alpha/metabolism
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Hyaluronoglucosaminidase/genetics
- Hyaluronoglucosaminidase/metabolism
- Neoplasms, Glandular and Epithelial/blood
- Neoplasms, Glandular and Epithelial/classification
- Neoplasms, Glandular and Epithelial/enzymology
- Neoplasms, Glandular and Epithelial/genetics
- Ovarian Neoplasms/blood
- Ovarian Neoplasms/classification
- Ovarian Neoplasms/enzymology
- Ovarian Neoplasms/genetics
- Receptors, Progesterone/genetics
- Receptors, Progesterone/metabolism
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Affiliation(s)
| | - Lydia Edjekouane
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
| | - Liliane Meunier
- Centre de recherche du Centre hospitalier de l'Université de Montréal/Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - André Tremblay
- Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada
- Department of Biochemistry, University of Montreal, Montreal, Quebec, Canada
- Research Center, Centre hospitalier universitaire Ste-Justine, Montreal, Quebec, Canada
| | - Diane Michèle Provencher
- Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal/Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - Anne-Marie Mes-Masson
- Department of Medicine, University of Montreal, Montreal, Quebec, Canada
- Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal/Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - Euridice Carmona
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
- Department of Medicine, University of Montreal, Montreal, Quebec, Canada
- * E-mail:
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