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Park H, Lee DH, You JH, Seok J, Lim JY, Kim GJ. Increased Hepatocyte Growth Factor Secretion by Placenta-Derived Mesenchymal Stem Cells Improves Ovarian Function in an Ovariectomized Rat Model via Vascular Remodeling by Wnt Signaling Activation. Cells 2023; 12:2708. [PMID: 38067136 PMCID: PMC10705748 DOI: 10.3390/cells12232708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/16/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
The vascular network contributes to the development of follicles. However, the therapeutic mechanism between vascular remodeling and ovarian functions is still unclear. Therefore, we demonstrated whether increased HGF by placenta-derived mesenchymal stem cells (PD-MSCs) improves ovarian function in an ovariectomized rat model via vascular remodeling by Wnt signaling activation. We established a half-ovariectomized rat model in which damaged ovaries were induced by ovariectomy of half of each ovary, and PD-MSCs (5 × 105 cells) were transplanted by intravenous injection. Three weeks after transplantation, rats in all groups were sacrificed. We examined the secretion of HGF by PD-MSCs through culture medium. The vascular structure in injured ovarian tissues was restored to a greater extent in the PD-MSC transplantation (Tx) group than in the nontransplantation (NTx) group (* p < 0.05). The expression of genes related to Wnt signaling (e.g., LRP6, GSK3β, β-catenin) was significantly increased in the Tx group compared to the NTx group (* p < 0.05). However, the expression of genes related to vascular permeability (e.g., Asef, ERG3) was significantly decreased in the Tx group compared to the NTx group (* p < 0.05). Follicular development was improved in the Tx group compared to the NTx group (* p < 0.05). Furthermore, to evaluate vascular function, we cocultivated PD-MSCs after human umbilical vein endothelial cells (HUVECs) with lipopolysaccharide (LPS), and we analyzed the vascular formation assay and dextran assay in HUVECs. Cocultivation of PD-MSCs with injured HUVECs enhanced vascular formation and decreased endothelial cell permeability (* p < 0.05). Also, cocultivation of PD-MSCs with explanted ovarian tissues improved follicular maturation compared to cocultivation of the Wnt inhibitor-treated PD-MSCs with explanted ovarian tissues. Therefore, HGF secreted by PD-MSCs improved ovarian function in rats with ovarian dysfunction by decreasing vascular permeability via Wnt signaling.
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Affiliation(s)
- Hyeri Park
- Department of Bioinspired Science, CHA University, Seongnam-si 13488, Gyeonggi-do, Republic of Korea
- PLABiologics Co., Ltd., Seongnam-si 13522, Gyeonggi-do, Republic of Korea
| | - Dae Hyun Lee
- Department of Bioinspired Science, CHA University, Seongnam-si 13488, Gyeonggi-do, Republic of Korea
- PLABiologics Co., Ltd., Seongnam-si 13522, Gyeonggi-do, Republic of Korea
| | - Jun Hyeong You
- Department of Bioinspired Science, CHA University, Seongnam-si 13488, Gyeonggi-do, Republic of Korea
| | - Jin Seok
- Department of Bioinspired Science, CHA University, Seongnam-si 13488, Gyeonggi-do, Republic of Korea
| | - Ja-Yun Lim
- Department of Clinical Laboratory Science, Hyejeon College, Hongsung-gun 32244, Chungnam-do, Republic of Korea
| | - Gi Jin Kim
- Department of Bioinspired Science, CHA University, Seongnam-si 13488, Gyeonggi-do, Republic of Korea
- PLABiologics Co., Ltd., Seongnam-si 13522, Gyeonggi-do, Republic of Korea
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Geng T, Zheng M, Wang Y, Reseland JE, Samara A. An artificial intelligence prediction model based on extracellular matrix proteins for the prognostic prediction and immunotherapeutic evaluation of ovarian serous adenocarcinoma. Front Mol Biosci 2023; 10:1200354. [PMID: 37388244 PMCID: PMC10301747 DOI: 10.3389/fmolb.2023.1200354] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/31/2023] [Indexed: 07/01/2023] Open
Abstract
Background: Ovarian Serous Adenocarcinoma is a malignant tumor originating from epithelial cells and one of the most common causes of death from gynecological cancers. The objective of this study was to develop a prediction model based on extracellular matrix proteins, using artificial intelligence techniques. The model aimed to aid healthcare professionals to predict the overall survival of patients with ovarian cancer (OC) and determine the efficacy of immunotherapy. Methods: The Cancer Genome Atlas Ovarian Cancer (TCGA-OV) data collection was used as the study dataset, whereas the TCGA-Pancancer dataset was used for validation. The prognostic importance of 1068 known extracellular matrix proteins for OC were determined by the Random Forest algorithm and the Lasso algorithm establishing the ECM risk score. Based on the gene expression data, the differences in mRNA abundance, tumour mutation burden (TMB) and tumour microenvironment (TME) between the high- and low-risk groups were assessed. Results: Combining multiple artificial intelligence algorithms we were able to identify 15 key extracellular matrix genes, namely, AMBN, CXCL11, PI3, CSPG5, TGFBI, TLL1, HMCN2, ESM1, IL12A, MMP17, CLEC5A, FREM2, ANGPTL4, PRSS1, FGF23, and confirm the validity of this ECM risk score for overall survival prediction. Several other parameters were identified as independent prognostic factors for OC by multivariate COX analysis. The analysis showed that thyroglobulin (TG) targeted immunotherapy was more effective in the high ECM risk score group, while the low ECM risk score group was more sensitive to the RYR2 gene-related immunotherapy. Additionally, the patients with low ECM risk scores had higher immune checkpoint gene expression and immunophenoscore levels and responded better to immunotherapy. Conclusion: The ECM risk score is an accurate tool to assess the patient's sensitivity to immunotherapy and forecast OC prognosis.
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Affiliation(s)
- Tianxiang Geng
- Department of Biomaterials, FUTURE, Center for Functional Tissue Reconstruction, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Mengxue Zheng
- Laboratory of Reproductive Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yongfeng Wang
- Department of Obstetrics and Gynecology, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Janne Elin Reseland
- Department of Biomaterials, FUTURE, Center for Functional Tissue Reconstruction, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Athina Samara
- Department of Biomaterials, FUTURE, Center for Functional Tissue Reconstruction, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Kırlangıç MM, Sahin E, Eraslan Sahin M, Madendag Y, Col Madendag I, Ak M, Karakas E, Muhtaroglu S. Severe Intrahepatic Cholestasis Pregnancy Is Associated With Maternal Endothelial Dysfunction: A Case-Control Study. Cureus 2022; 14:e32276. [DOI: 10.7759/cureus.32276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 12/12/2022] Open
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Taşcı Y, Fındık RB, Pekcan MK, Kaplan O, Celebier M. UPLC-Q-TOF/MS based Untargeted Metabolite and Lipid Analysis on Premature Ovarian Insufficiency Plasma Samples. CURR PHARM ANAL 2021. [DOI: 10.2174/1573412916666200102112339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Metabolomics is one of the main areas to understand cellular process at molecular
level by analyzing metabolites. In recent years metabolomics has emerged as a key tool to understand
molecular basis of diseases, to find diagnostic and prognostic biomarkers and develop new
treatment opportunities and drug molecules.
Objective:
In this study, untargeted metabolite and lipid analysis were performed to identify potential
biomarkers on premature ovarian insufficiency plasma samples. 43 POI subject plasma samples were
compared with 32 healthy subject plasma samples.
Methods:
Plasma samples were pooled and extracted using chloroform:methanol:water (3:3:1 v/v/v)
mixture. Agilent 6530 LC/MS Q-TOF instrument equipped with ESI source was used for analysis. A
C18 column (Agilent Zorbax 1.8 μM, 50 x 2.1 mm) was used for separation of the metabolites and lipids.
XCMS, an “R software” based freeware program, was used for peak picking, grouping and comparing
the findings. Isotopologue Parameter Optimization (IPO) software was used to optimize XCMS parameters.
The analytical methodology and data mining process were validated according to the literature.
Results:
83 metabolite peaks and 213 lipid peaks were found to be in semi-quantitatively and statistically
different (fold change >1.5, p <0.05) between the POI plasma samples and control subjects.
Conclusion:
According to the results, two groups were successfully separated through principal component
analysis. Among the peaks, phenyl alanine, decanoyl-L-carnitine, 1-palmitoyl lysophosphatidylcholine
and PC(O-16:0/2:0) were identified through auto MS/MS and matched with human metabolome
database and proposed as plasma biomarker for POI and monitoring the patients in treatment period.
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Affiliation(s)
- Yasemin Taşcı
- University of Health Sciences, Zekai Tahir Burak Women’s Health Research Hospital, Ankara,Turkey
| | - Rahime Bedir Fındık
- University of Health Sciences, Zekai Tahir Burak Women’s Health Research Hospital, Ankara,Turkey
| | - Meryem Kuru Pekcan
- University of Health Sciences, Zekai Tahir Burak Women’s Health Research Hospital, Ankara,Turkey
| | - Ozan Kaplan
- Department of Analytical Chemistry, Faculty of Pharmacy, Hacettepe University, Ankara,Turkey
| | - Mustafa Celebier
- Department of Analytical Chemistry, Faculty of Pharmacy, Hacettepe University, Ankara,Turkey
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Davis NL, Tolfrey K, Jenney M, Elson R, Stewart C, Moss AD, Cornish JM, Stevens MCG, Crowne EC. Combined resistance and aerobic exercise intervention improves fitness, insulin resistance and quality of life in survivors of childhood haemopoietic stem cell transplantation with total body irradiation. Pediatr Blood Cancer 2020; 67:e28687. [PMID: 33044779 DOI: 10.1002/pbc.28687] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/01/2020] [Accepted: 08/21/2020] [Indexed: 01/17/2023]
Abstract
PURPOSE To investigate the effects of a supervised combined resistance and aerobic training programme on cardiorespiratory fitness, body composition, insulin resistance and quality of life (QoL) in survivors of childhood haematopoietic stem cell transplantation (HSCT) with total body irradiation (TBI). PARTICIPANTS HSCT/TBI survivors (n = 20; 8 females). Mean (range) for age at study and time since HSCT/TBI was 16.7 (10.9-24.5) and 8.4 (2.3-16.0) years, respectively. METHODS After a 6-month run-in, participants undertook supervised 45- to 60-minute resistance and aerobic training twice weekly for 6 months, with a 6-month follow-up. The following assessments were made at 0, 6 (start of exercise programme), 12 (end of exercise programme) and 18 months: Body composition via dual energy X-ray absorptiometry, homeostatic model assessment of insulin resistance (HOMA-IR), cardiorespiratory fitness (treadmill-based peak rate of oxygen uptake (VO2 peak) test), QoL questionnaires (36-Item Short Form Health Survey (SF-36) and Minneapolis-Manchester Quality of Life Instrument (MMQL). RESULTS Results expressed as mean (standard deviation) or geometric mean (range). There were significant improvements in VO2 peak (35.7 (8.9) vs 41.7 (16.1) mL/min/kg, P = 0.05), fasted plasma insulin (16.56 (1.48-72.8) vs 12.62 (1.04-54.97) mIU/L, P = 0.03) and HOMA-IR (3.65 (0.30-17.26) vs 2.72 (0.22-12.89), P = 0.02) after the exercise intervention. There were also significant improvements in the SF-36 QoL general health domain (69.7 (14.3) vs 72.7 (16.0), P = 0.001) and the MMQL school domain (69.1 (25.2) vs (79.3 (21.6), P = 0.03) during the exercise intervention. No significant changes were observed in percentage body fat, fat mass or lean mass. CONCLUSION The supervised 6-month combined resistance and aerobic exercise programme significantly improved cardiorespiratory fitness, insulin resistance and QoL in childhood HSCT/TBI survivors, with no change in body composition, suggesting a metabolic training effect on muscle. These data support a role for targeted physical rehabilitation services in this group at high risk of diabetes and cardiovascular disease.
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Affiliation(s)
- Nikki L Davis
- Department of Paediatric Endocrinology and Diabetes, Level 6 UHBristol Education Centre, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
| | - Keith Tolfrey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Meriel Jenney
- Department of Paediatric Oncology, Children's Hospital for Wales, Cardiff, UK
| | - Ruth Elson
- Department of Paediatric Oncology, Bristol Royal Hospital for Children, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
| | - Claire Stewart
- Stem cells, Ageing and Molecular Physiology Unit, Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, Merseyside, UK
| | - Andrew D Moss
- Stem cells, Ageing and Molecular Physiology Unit, Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, Merseyside, UK
| | - Jacqueline M Cornish
- Department of Paediatric Oncology, Bristol Royal Hospital for Children, Bristol, UK
| | - Michael C G Stevens
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, UK
| | - Elizabeth C Crowne
- Department of Paediatric Endocrinology and Diabetes, Level 6 UHBristol Education Centre, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
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Giordano Imbroll M, Gruppetta M. A current perspective into young female sex hormone replacement: a review. Expert Rev Endocrinol Metab 2020; 15:405-414. [PMID: 32893689 DOI: 10.1080/17446651.2020.1816820] [Citation(s) in RCA: 3] [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] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Hormone replacement in females with hypogonadism is advocated to address the various clinical aspects of estrogen deficiency. AREAS COVERED This article focuses on hormone replacement in young females with hypogonadism, including a rationale as to why hormone replacement in such patients differs from treatment in postmenopausal females, a summary of symptoms encountered by females with hypogonadism and a comprehensive discussion of the various treatment options available, specifically focusing on the latest advances in the subject. A Medline search was conducted using different combinations of relevant keywords, giving preference to recent publications. EXPERT OPINION Whilst traditionally oral contraceptive pills (containing ethynyl estradiol) were commonly used as a form of hormone replacement, it is now increasingly recognized that this is not the optimal treatment option. Physiological hormone replacement with transdermal estradiol is found to be superior. Evidence suggests that micronized progesterone may be associated with fewer side effects, although its effect on endometrial protection is not yet proven. Synthetic progestins confer varying degrees of androgenic and thromboembolic properties which should be kept in mind when prescribing individualized treatment. Further studies in different sub-cohorts of female patients with hypogonadism might help address the specific needs of individual patients.
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Affiliation(s)
- Miriam Giordano Imbroll
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Mater Dei Hospital , Msida, Malta
- Department of Medicine, Mater Dei Hospital , Msida, Malta
| | - Mark Gruppetta
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Mater Dei Hospital , Msida, Malta
- Department of Medicine, Mater Dei Hospital , Msida, Malta
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Ovayolu A, Karaman E, Turgut A, Cekici Y, Ortabag T, Chiara Rapisarda AM, Noventa M, Cianci A. Endothelial cell-specific-molecule-1 (endocan) levels in women with premature ovarian insufficiency: a prospective comparative study. J OBSTET GYNAECOL 2020; 41:637-641. [PMID: 32808833 DOI: 10.1080/01443615.2020.1789952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
There is an increased risk of cardiovascular disease in women with premature ovarian insufficiency (POI). A relationship between cardiovascular disease and endocan levels has been shown. Endocan is a marker that is prominent in many diseases caused by endothelial dysfunction and can be measured in the blood. POI is also associated with endothelial dysfunction. The causes of POI include chromosomal and genetic defects, autoimmune processes, chemotherapy, radiation, infections and surgery, but many are unidentified (idiopathic). This study aimed to evaluate serum endocan levels in women with idiopathic POI. The blood for analysis was obtained at the early follicular phase of the menstrual cycle and endocan levels were measured using a commercially available enzyme-linked immunosorbent assay kit. There were 38 patients with idiopathic POI in the study group and 39 healthy subjects in the control group. The median ages of the women were not significantly different between the groups 34 [7] years vs. 34 [7] years, respectively (p = .862). The median endocan level was not different in the POI and control group 769 [727] vs. 1077 [403] pg/mL, respectively (p = .603). Endocan is not associated with the cardiovascular diseases risk linked with endothelial dysfunction in idiopathic POI. Clinical trial number: NCT03932877 (Clinicaltrials.gov)IMPACT STATEMENTWhat is already known on this subject? There is an increased risk of cardiovascular disease in premature ovarian insufficiency (POI) due to the decreased level of oestrogen, which is linked with endothelial dysfunction.What do the results of this study add? This study showed that endocan is not associated with the cardiovascular disease risk linked with endothelial dysfunction in idiopathic POI.What are the implications of these findings for clinical practice and/or further research? A marker to be used to predict the risk of cardiovascular disease in patients with POI could facilitate in improving the quality of life of these patients. Moreover, advantageous and easy-to-measure markers are needed in larger sample studies to better understand the cardiovascular diseases risk in POI.
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Affiliation(s)
- Ali Ovayolu
- Department of Obstetrics and Gynecology, Cengiz Gokcek Public Hospital, Gaziantep, Turkey
| | - Erbil Karaman
- Department of Gynecology and Obstetrics, Faculty of Medicine, Yuzuncu Yıl University, Van, Turkey
| | - Abdulkadir Turgut
- Department of Obstetrics and Gynecology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Yusuf Cekici
- Department of Cardiology, Doctor Ersin, Aslan Research and Training Hospital, Gaziantep, Turkey
| | - Tulay Ortabag
- Public Health Nursing Department, School of Nursing, Hasan Kalyoncu University, Sahinbey, Turkey
| | | | - Marco Noventa
- Department of Women and Children's health, Clinic of Gynecology and Obstetrics, University of Padua, Padua, Italy
| | - Antonio Cianci
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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Gordon JL, Rubinow DR, Watkins L, Hinderliter AL, Caughey MC, Girdler SS. The Effect of Perimenopausal Transdermal Estradiol and Micronized Progesterone on Markers of Risk for Arterial Disease. J Clin Endocrinol Metab 2020; 105:dgz262. [PMID: 31838497 PMCID: PMC7096310 DOI: 10.1210/clinem/dgz262] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 12/13/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND The arterial effects of hormone therapy remain controversial. This study tested the effects of transdermal estradiol plus intermittent micronized progesterone (TE + IMP) in healthy perimenopausal and early postmenopausal women on several mechanisms involved in the pathophysiology of arterial disease. METHODS Healthy perimenopausal and early postmenopausal women, ages 45 to 60 years, were enrolled in this randomized, double-blind, placebo-controlled trial. Women were randomized to receive TE (0.1 mg/day) + IMP (200 mg/day for 12 days) or identical placebo patches and pills for 12 months. Outcomes included: change in stress reactivity composite z-score (combining inflammatory, cortisol, and hemodynamic responses to a standardized psychological laboratory stressor); flow-mediated dilation (FMD) of the brachial artery (an index of vascular endothelial function); baroreflex sensitivity; and metabolic risk (presence of the metabolic syndrome or insulin resistance), all assessed at baseline and at months 6 and 12. RESULTS Of 172 women enrolled, those assigned to TE + IMP tended to have higher resting baroreflex sensitivity than those assigned to placebo across the 6- and 12-month visits. Although treatment groups did not differ in terms of the other prespecified outcomes, a significant treatment-by-age interaction was found for FMD and stress reactivity such that an age-related decrease in FMD and increase in stress reactivity were seen among women assigned to placebo but not those assigned to TE + IMP. Women on TE + IMP also had lower resting diastolic blood pressure, lower levels of low-density lipoprotein cholesterol, and higher baroreflex sensitivity during stress testing. CONCLUSIONS TE + IMP tended to improve cardiac autonomic control and prevented age-related changes in stress reactivity and endothelial function among healthy perimenopausal and early postmenopausal women.
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Affiliation(s)
- Jennifer L Gordon
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - David R Rubinow
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lana Watkins
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, North Carolina
| | - Alan L Hinderliter
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Melissa C Caughey
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Susan S Girdler
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Yalamudi K. Study of Comparison between Autonomic Dysfunction and Dyslipidemia in Healthy Postmenopausal Women. J Midlife Health 2017; 8:103-109. [PMID: 28983156 PMCID: PMC5625573 DOI: 10.4103/jmh.jmh_67_15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: Obesity, physical inactivity, and altered estrogen levels play an important role in contributing to disease risk profile and autonomic dysfunction in healthy postmenopausal women. This study was conducted to test the correlation between autonomic dysfunction and dyslipidemia in healthy postmenopausal women. Materials and Methods: This study was carried out on sixty healthy postmenopausal women before the age of 65 years, without any gross systemic disease. The following five autonomic functional tests were performed on the study group: heart rate response to deep breathing, heart rate response to Valsalva maneuver, heart rate response to standing up from supine position, blood pressure response to sustained hand grip, and blood pressure response to standing up from supine position. Fasting lipid profile of the study group was tested. Results and Conclusion: In the present study, autonomic dysfunction was found in 67% of healthy postmenopausal women. Among the sixty female healthy postmenopausal women included in the study, 68% were found to have dyslipidemia. In our study, there is a statistically significant correlation between autonomic dysfunction and dyslipidemia in healthy postmenopausal women. In these healthy postmenopausal women with increased serum cholesterol, serum low-density lipoprotein, and serum triglycerides, there was autonomic dysfunction which is statistically significant. There is no statistical significance on comparing serum high-density lipoprotein cholesterol with autonomic dysfunction in healthy postmenopausal women.
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Affiliation(s)
- Kavyach Yalamudi
- Department of General Medicine, Newlife Hospitals, Khammam, Telangana State, India
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Catamero D, Noonan K, Richards T, Faiman B, Manchulenko C, Devine H, Bertolotti P, Gleason C, Board A. Distress, Fatigue, and Sexuality: Understanding and Treating Concerns and Symptoms in Patients With Multiple Myeloma. Clin J Oncol Nurs 2017; 21:7-18. [DOI: 10.1188/17.cjon.s5.7-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Luisi S, Orlandini C, Regini C, Pizzo A, Vellucci F, Petraglia F. Premature ovarian insufficiency: from pathogenesis to clinical management. J Endocrinol Invest 2015; 38:597-603. [PMID: 25596661 DOI: 10.1007/s40618-014-0231-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 12/16/2014] [Indexed: 10/24/2022]
Abstract
Premature ovarian insufficiency (POI) represents a condition characterized by the absence of normal ovarian function due to an incipient (by 3-10 years) ovarian aging. In most of the women affected there are no signs or symptoms that precede the interruption of menstruation and the onset of POI and the majority of women have a normal history of menarche, regular menstrual cycles and normal fertility. The possible genetic role in the development of POI has been largely demonstrated and many genes have been involved; on the other hand, ovary is not protected immunologically and the detection of autoantibodies directed against various ovarian targets strongly support the hypothesis of an autoimmune etiology. In approximately 5-10% of women with a diagnosis of POI with a normal karyotype, a spontaneous pregnancy could occur even if the recovery of ovarian function is temporary and poorly predictable. Embryo donation and adoption are other alternatives that should be considered. POI and subsequent loss of reproductive capacity is a devastating condition and a difficult diagnosis for women to accept so it requires an individualized and a multidisciplinary approach. Hormonal replacement therapy (HRT) should be commenced as soon as possible to prevent and to contrast the onset of the symptoms related to hypoestrogenism and to improve the quality of life for these women.
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Affiliation(s)
- S Luisi
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Policlinico "Le Scotte" Viale Bracci, 53100, Siena, Italy.
| | - C Orlandini
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Policlinico "Le Scotte" Viale Bracci, 53100, Siena, Italy
| | - C Regini
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Policlinico "Le Scotte" Viale Bracci, 53100, Siena, Italy
| | - A Pizzo
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Policlinico "Le Scotte" Viale Bracci, 53100, Siena, Italy
| | - F Vellucci
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Policlinico "Le Scotte" Viale Bracci, 53100, Siena, Italy
| | - F Petraglia
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Policlinico "Le Scotte" Viale Bracci, 53100, Siena, Italy
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Epistasis between polymorphisms in ACVR2B and ADAMTS19 is associated with premature ovarian failure. Menopause 2015; 22:212-6. [DOI: 10.1097/gme.0000000000000285] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Shufelt C, Waldman T, Wang E, Merz CNB. Female-Specific Factors for IHD: Across the Reproductive Lifespan. Curr Atheroscler Rep 2015; 17:481. [DOI: 10.1007/s11883-014-0481-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Souza HCD, Tezini GCSV. Autonomic Cardiovascular Damage during Post-menopause: the Role of Physical Training. Aging Dis 2013; 4:320-8. [PMID: 24307965 DOI: 10.14336/ad.2013.0400320] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 08/20/2013] [Accepted: 08/28/2013] [Indexed: 12/23/2022] Open
Abstract
Menopause is part of the aging process and is characterized by the natural cessation of menstruation; during this time, the production of ovarian hormones, especially estrogen, is sharply reduced. This reduction can cause symptoms and disorders that affect most women and can interfere with their quality of life. Women are also more susceptible to cardiovascular diseases during this period, considering that these ovarian hormones would be associated with a protective effect on the cardiovascular system, by acting at various levels, contributing to the body homeostasis. Among several effects on the cardiovascular system, the ovarian hormones seem to play an important role in the autonomic control of heart rate and blood pressure. A reduction in ovarian hormones causes an autonomic imbalance and increases the risk of cardiovascular diseases. In fact, this increased risk is justified by the key role the autonomic nervous system plays in all cardiac regulatory mechanisms, exerting a tonic and reflexive influence on the main variables of the cardiovascular system. The autonomic system controls various cardiovascular parameters, such as the modulation of heart rate and blood pressure, myocardial contractility and venous capacitance, directly participating in the regulation of cardiac output. Over the years, the standard treatment for menopause symptoms and disorders has been hormone replacement therapy (HRT). However, many studies have indicated the risks of HRT, which justify the need for new non-pharmacological therapies. To this end, physical training, mainly aerobic, has been applied with excellent results on the cardiovascular autonomic nervous system, as it reduces the risk of cardiac diseases and improves the survival rate with direct beneficial effects on the quality of life of these women during the aging process.
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Affiliation(s)
- Hugo C D Souza
- Exercise Physiology Laboratory of the Department of Biomechanics, Medicine and Rehabilitation, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Pyun JA, Kim S, Cha DH, Kwack K. Epistasis between IGF2R and ADAMTS19 polymorphisms associates with premature ovarian failure. Hum Reprod 2013; 28:3146-54. [PMID: 24014609 DOI: 10.1093/humrep/det365] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Do single nucleotide polymorphisms (SNPs) or synergistic interactions between SNPs and diplotypes within the insulin-like growth factor 2 receptor (IGF2R) and ADAM metallopeptidase with thrombospondin type 1 motif, 19 (ADAMTS19), contribute to premature ovarian failure (POF)? SUMMARY ANSWER Synergistic interactions were detected between SNPs, including a non-synonymous SNP, and diplotypes within IGF2R and ADAMTS19 which may contribute to POF; however, there was no correlation with POF in a single SNP model after Bonferroni correction. WHAT IS KNOWN ALREADY IGF2R regulates free IGF2 level, which is involved in steroidogenesis in bovine granulosa cells. ADAMTS19 expression is higher in the murine embryonic ovary than in the embryonic testis during sexual differentiation, and an ADAMTS19 SNP (rs246246) showed a possible association with POF in a genome-wide association study in Caucasian women. STUDY DESIGN, SIZE, DURATION This study analyzed interactions between SNPs and diplotypes within IGF2R and ADAMTS19 as well as SNPs within the two genes. In Stage I, a total of 120 patients with POF and 152 female controls were recruited. All patients were diagnosed with POF at the CHA hospital in Seoul, Korea, and were recruited between 1994 and 2004. The 152 controls were recruited from Chungju, Korea, as part of another study that was conducted from April 2002 to March 2004. For Stage II, we obtained genotype data for an additional 1641 female controls, recruited in Ansung and Ansan from 2001 to 2008, from the Korean Genome Epidemiology Study (KoGES). PARTICIPANTS/MATERIALS, SETTING, METHODS In Stage I, the GoldenGate assay with VeraCode technology was used to genotype SNPs in IGF2R and ADAMTS19. In Stage II, we obtained genotype data for IGF2R and ADAMTS19 using Affymetrix Genome-Wide Human SNP array 5.0 and imputed data by the IMPUTE program from the KoGES. To identify POF-associated SNPs, logistic regression analysis in an additive model was performed using the PLINK tool. Synergistic interactions between SNPs and diplotypes within IGF2R and ADAMTS19 were analyzed by logistic regression analysis in three alternative models. MAIN RESULTS AND THE ROLE OF CHANCE In Stage I, 13 combinations of SNPs showed significant synergistic interactions after Bonferroni correction [the strongest association had odds ratio (OR) = 5.77, 95% confidence interval (CI): 2.26-14.75, P = 0.00025]. In Stage II and combined analyses, two and four combinations, respectively, of the significant results in Stage I showed significant synergistic interactions after Bonferroni correction. For interactions between diplotypes in block 2 of IGF2R and block 3 of ADAMTS19 in Stage I, we found 17 synergistic interactions with P < 0.0001, but there was no significant interaction after Bonferroni correction. In Stage II and combined analyses, we found that three and seven combinations in the same blocks, respectively, showed significant synergistic interactions after Bonferroni correction (strongest association: OR = 4.12, 95% CI: 2.22-7.62, P = 6.74E-06). LIMITATIONS, REASONS FOR CAUTION The sample size for patients with POF in this study was small but, compared with recent reports describing associations between SNPs and POF and considering the low prevalence of POF (1%), the sample size is considered to be reasonable. These results should be confirmed in large-scale studies involving different ethnic groups. WIDER IMPLICATIONS OF THE FINDINGS Our results may ultimately provide predictive markers for women at a high risk of POF. STUDY FUNDING/COMPETING INTERESTS This study was supported by grants from Basic Science Research Program through the National Research Foundation of Korea (NRF), which is funded by the Ministry of Education (2009-0093821, 2011-0010637). There are no competing interests.
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Affiliation(s)
- J-A Pyun
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 463-836, Republic of Korea
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16
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Rah H, Jeon YJ, Lee WS, Jung YW, Choi DH, Kwon H, Kim JH, Shin JE, Kim NK. Association of nitric oxide synthase gene polymorphisms (−786T>C, 4a4b, 894G>T) with primary ovarian insufficiency in Korean women. Maturitas 2013. [DOI: 10.1016/j.maturitas.2012.10.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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17
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Michalakis K, Coppack SW. Primary ovarian insufficiency: Relation to changes in body composition and adiposity. Maturitas 2012; 71:320-5. [DOI: 10.1016/j.maturitas.2011.12.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2011] [Revised: 12/21/2011] [Accepted: 12/24/2011] [Indexed: 11/27/2022]
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18
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Nicholls C, Li H, Wang JQ, Liu JP. Molecular regulation of telomerase activity in aging. Protein Cell 2011; 2:726-38. [PMID: 21976062 DOI: 10.1007/s13238-011-1093-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2011] [Accepted: 08/30/2011] [Indexed: 11/25/2022] Open
Abstract
The process of aging is mitigated by the maintenance and repair of chromosome ends (telomeres), resulting in extended lifespan. This review examines the molecular mechanisms underlying the actions and regulation of the enzyme telomerase reverse transcriptase (TERT), which functions as the primary mechanism of telomere maintenance and regulates cellular life expectancy. Underpinning increased cell proliferation, telomerase is also a key factor in facilitating cancer cell immortalization. The review focuses on aspects of hormonal regulations of telomerase, and the intracellular pathways that converge to regulate telomerase activity with an emphasis on molecular interactions at protein and gene levels. In addition, the basic structure and function of two key telomerase enzyme components-the catalytic subunit TERT and the template RNA (TERC) are discussed briefly.
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Affiliation(s)
- Craig Nicholls
- Molecular Signalling Laboratory, Murdoch Childrens Research Institute, Parkville, Victoria 3052, Australia
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19
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Rubinow DR, Girdler SS. Hormones, heart disease, and health: individualized medicine versus throwing the baby out with the bathwater. Depress Anxiety 2011; 28:E1-E15. [PMID: 21648024 DOI: 10.1002/da.20833] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
It is increasingly axiomatic that depression has widespread adverse physiological effects and, conversely, that a variety of physiological systems impact the risk for developing depression. This convergence of depression and altered physiology is particularly dramatic during midlife--a time during which reproductive failure presages dramatic increases in prevalence of both heart disease and depression. The potentially meaningful and illuminating links between estrogen deficiency, cardiovascular disease (CVD), and depression have largely been obscured, first by assertions, subsequently repudiated, that the perimenopause was not a time of increased risk of depression, and more recently by the denegration of hormone replacement therapy by initial reports of the Women's Health Initiative. Increasingly, however, research has led to unavoidable conclusions that CVD and depression share common, mediating pathogenic processes and that these same processes are dramatically altered by the presence or absence of estrogen (E2). This review summarizes data supporting these contentions with the intent of placing depression and estrogen therapy in their proper physiologic context.
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Affiliation(s)
- David R Rubinow
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina 27599. USA
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20
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Rubinow DR, Girdler SS. Hormones, heart disease, and health: individualized medicine versus throwing the baby out with the bathwater. Depress Anxiety 2011; 28:282-96. [PMID: 21456038 DOI: 10.1002/da.20810] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
It is increasingly axiomatic that depression has widespread adverse physiological effects, and conversely that a variety of physiological systems impact the risk for developing depression. This convergence of depression and altered physiology is particularly dramatic during midlife-a time during which reproductive failure presages dramatic increases in prevalence of both heart disease and depression. The potentially meaningful and illuminating links between estrogen (E2) deficiency, cardiovascular disease (CVD), and depression have largely been obscured, first by assertions, subsequently repudiated that the perimenopause was not a time of increased risk of depression, and more recently by the denegration of hormone replacement therapy by initial reports of the Women's Health Initiative. Increasingly, however, research has led to unavoidable conclusions that CVD and depression share common and mediating pathogenic processes and that these same processes are dramatically altered by the presence or absence of E2. This review summarizes data supporting this contention with the intent of placing depression and E2 therapy in their proper physiologic context.
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Affiliation(s)
- David R Rubinow
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA
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21
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Abstract
Cardiovascular disease is the leading cause of morbidity and mortality for both men and women in the USA. However, there are differences between the sexes in age-dependent onset, severity, symptoms and outcomes. Basic research into the causes of sex-dependent differences in cardiovascular disease is ongoing and includes investigation into genetic variation in expression and distribution of receptors for the sex steroids; specificity of natural and synthetic ligands that activate the sex steroid receptors; and intracellular mechanisms that are activated by the receptors in all components of the vessel wall and blood elements, which integrate to regulate vascular tone, vascular repair and remodeling in health and disease. In this era of personalized medicine, basic research into mechanisms of sex differences in vascular function will result in improved prevention, detection and treatment of cardiovascular disease in both men and women.
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Affiliation(s)
- V M Miller
- Departments of Surgery & Physiology & Biomedical Engineering, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
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22
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Abstract
Premature ovarian failure (POF) is a syndrome characterised by amenorrhoea, hypoestrogenism and hypergonadotropinism before the age of 40. It is a disorder affecting approximately 1% of women <40 years, 1/1,000 women by the age of 30 and 1/10,000 women by the age of 20. POF is not merely an early menopause. Up to 50% of the patients with POF will have intermittent and unpredictable ovarian function which may persist for some years. Heterogeneity of POF is also reflected by the variety of possible causes, including autoimmunity, toxics, drugs, radiation, infectious as well as genetic defects. HRT remains the cornerstone of treatment and the only proven method of achieving pregnancy in these patients is by ovum donation.
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Affiliation(s)
- Arif Kokcu
- IVF Center, Department of Obstetrics and Gynecology, School of Medicine, University of Ondokuz Mayis, Samsun, Turkey.
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23
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Arain FA, Kuniyoshi FH, Abdalrhim AD, Miller VM. Sex/gender medicine. The biological basis for personalized care in cardiovascular medicine. Circ J 2009; 73:1774-82. [PMID: 19729858 DOI: 10.1253/circj.cj-09-0588] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Sex differences in morbidity and mortality associated with cardiovascular disease have been recognized by the medical community for decades. Investigation into the underlying biological basis of these differences was largely neglected by the scientific community until a report released by the Institute of Medicine in the United States in 2001 "Exploring the Biological Contributions to Human Health: Does Sex Matter?" Recommendations from this report included the need for more accurate use of the terms "sex" and "gender", better tools and resources to study the biological basis of sex differences, integration of findings from different levels of biological organization and continued synergy between basic and clinical researchers. Ten years after the Institute's report, this review evaluates some of the sex differences in cardiovascular disease, reviews new approaches to study sex differences and emphasizes areas where further research is required. In the era of personalized medicine, the study of the biological basis of sex differences promises to optimize preventive, diagnostic and therapeutic strategies for cardiovascular disease in men and women, but will require diligence by the scientific and medical communities to remember that sex does matter.
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Affiliation(s)
- Faisal A Arain
- Department of General Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA
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24
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Miller VM, Black DM, Brinton EA, Budoff MJ, Cedars MI, Hodis HN, Lobo RA, Manson JE, Merriam GR, Naftolin F, Santoro N, Taylor HS, Harman SM. Using basic science to design a clinical trial: baseline characteristics of women enrolled in the Kronos Early Estrogen Prevention Study (KEEPS). J Cardiovasc Transl Res 2009; 2:228-39. [PMID: 19668346 PMCID: PMC2721728 DOI: 10.1007/s12265-009-9104-y] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Accepted: 04/27/2009] [Indexed: 12/24/2022]
Abstract
Observational and epidemiological studies suggest that menopausal hormone therapy (MHT) reduces cardiovascular disease (CVD) risk. However, results from prospective trials showed neutral or adverse effects most likely due to differences in participant demographics, such as age, timing of initiation of treatment, and preexisting cardiovascular disease, which reflected in part the lack of basic science information on mechanisms of action of hormones on the vasculature at the time clinical trials were designed. The Kronos Early Estrogen Replacement Study (KEEPS) is a prospective, randomized, controlled trial designed, using findings from basic science studies, to test the hypothesis that MHT when initiated early in menopause reduces progression of atherosclerosis. KEEPS participants are younger, healthier, and within 3 years of menopause thus matching more closely demographics of women in prior observational and epidemiological studies than women in the Women's Health Initiative hormone trials. KEEPS will provide information relevant to the critical timing hypothesis for MHT use in reducing risk for CVD.
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Affiliation(s)
- V M Miller
- Medical Science 4-62, College of Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.
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25
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Abstract
Increased arterial stiffness and wave reflection have been identified as cardiovascular disease risk factors. In light of significant sex differences and the moderate heritability of vascular function measures, we hypothesized that variation in the genes coding for estrogen receptors alpha (ESR1) and beta (ESR2) and aromatase (CYP19A1) is associated with aortic stiffness and pressure wave reflection as measured by noninvasive arterial tonometry. 1261 unrelated Framingham Offspring Study participants who attended the 7th examination cycle (mean age 62±10 years, 52% women) and had arterial tonometry and genotyping data were included in the study. ANCOVA was used to assess the association of polymorphisms with forward wave amplitude, augmented pressure, augmentation index, carotid-femoral pulse wave velocity, and mean arterial pressure with adjustment for potential confounders. In the sex-pooled analysis, those homozygous for the minor allele at any of four ESR1 variants that were in strong linkage disequilibrium ((TA)n, rs2077647, rs2234693 and rs9340799) had on average 18% higher augmented pressure and 16% greater augmentation index compared to carriers of one or two major alleles (p=0.0002–0.01). A similar magnitude of association was detected in those homozygous for the common allele at two ESR2 SNPs (p=0.007–0.02). Our results are consistent with the hypothesis that variation in ESR1 and ESR2, but not CYP19A1, is associated with increased wave reflection, which may contribute to previously demonstrated associations between these variants and adverse clinical events. Our findings will need to be replicated in additional cohorts.
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26
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Antonicelli R, Olivieri F, Morichi V, Urbani E, Mais V. Prevention of cardiovascular events in early menopause: A possible role for hormone replacement therapy. Int J Cardiol 2008; 130:140-6. [DOI: 10.1016/j.ijcard.2008.03.051] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2006] [Revised: 02/18/2008] [Accepted: 03/29/2008] [Indexed: 11/28/2022]
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Abstract
Gonadal dysfunction and fertility problems are adverse effects of cancer treatment or may be associated with specific malignancies. This review focuses on these problems in the young cancer survivors, where methods of protecting or restoring endocrine function and fertility need to be considered. In females, treatment adverse effects can result in infertility, but premature ovarian failure (POF) is probably relevant for more female cancer survivors, affecting also those who do not wish post-treatment parenthood. POF affects present and future health, especially through oestrogen deficiency symptoms and an increased risk of developing osteoporosis. A lower risk of developing POF has been considered in young females than in older due to a larger pool of oocytes. However, a recent long-term follow-up study reported a prevalence of POF in young females with Hodgkin's lymphoma of 37% showing that young age at time of treatment only delays the development of POF. In male gonads, germ cells are much more sensitive to irradiation and chemotherapy than Leydig cells. Thus, infertility is a more common adverse effect than hypogonadism. Some malignancies are particular relevant. Persistent azoospermia was formerly common after treatment for Hodgkin's lymphoma, but currently, most patients recover spermatogenesis. Modern treatment of childhood acute lymphoblastic leukemia is also unlikely to cause infertility. Norwegian testicular cancer survivors diagnosed in 1980-1994 who attempted conception had an overall 15-year actuarial post-treatment paternity rate of 71% (range 48-92% depending on the treatment). However, the rate was significantly higher among men diagnosed in1989-1994 (over 80%) than in 1980-1988 (about 63%). Patients at risk for hypogonadism and infertility should be defined prior to treatment, and available methods for gonadal preservation should maximally be utilised. During follow-up, oncologists should routinely address these issues.
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Affiliation(s)
- Marianne Brydøy
- Department of Oncology, Haukeland University Hospital, Bergen, Norway.
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28
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Mouridsen H, Keshaviah A, Coates AS, Rabaglio M, Castiglione-Gertsch M, Sun Z, Thürlimann B, Mauriac L, Forbes JF, Paridaens R, Gelber RD, Colleoni M, Smith I, Price KN, Goldhirsch A. Cardiovascular Adverse Events During Adjuvant Endocrine Therapy for Early Breast Cancer Using Letrozole or Tamoxifen: Safety Analysis of BIG 1-98 Trial. J Clin Oncol 2007; 25:5715-22. [DOI: 10.1200/jco.2007.12.1665] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Previous analyses of adjuvant studies of aromatase inhibitors versus tamoxifen, including the Breast International Group (BIG) 1-98 study, have suggested a small numerical excess of cardiac adverse events (AEs) on aromatase inhibitors, a reduction in the incidence of hypercholesterolemia on tamoxifen, and significantly higher incidence of thromboembolic AEs on tamoxifen. The purpose of the present study is to provide detailed updated information on these AEs in BIG 1-98. Patients and Methods Eight thousand twenty-eight postmenopausal women with receptor-positive early breast cancer were randomly assigned (double-blind) between March 1998 and May 2003 to receive 5 years of adjuvant endocrine therapy with letrozole, tamoxifen, or a sequence of these agents. Seven thousand nine hundred sixty-three patients who actually received therapy are included in this safety analysis, which focuses on cardiovascular events. AE recording ceased 30 days after therapy completion (or after switch on the sequential arms). Results Baseline comorbidities were balanced. At a median follow-up time of 30.1 months, we observed similar overall incidence of cardiac AEs (letrozole, 4.8%; tamoxifen, 4.7%), more grade 3 to 5 cardiac AEs on letrozole (letrozole, 2.4%; tamoxifen, 1.4%; P = .001)—an excess only partially attributable to prior hypercholesterolemia—and more overall (tamoxifen, 3.9%; letrozole, 1.7%; P < .001) and grade 3 to 5 thromboembolic AEs on tamoxifen (tamoxifen, 2.3%; letrozole, 0.9%; P < .001). There was no significant difference between tamoxifen and letrozole in incidence of hypertension or cerebrovascular events. Conclusion The present safety analysis, limited to cardiovascular AEs in BIG 1-98, documents a low overall incidence of cardiovascular AEs, which differed between treatment arms.
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Affiliation(s)
- Henning Mouridsen
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Aparna Keshaviah
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Alan S. Coates
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Manuela Rabaglio
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Monica Castiglione-Gertsch
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Zhuoxin Sun
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Beat Thürlimann
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Louis Mauriac
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - John F. Forbes
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Robert Paridaens
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Richard D. Gelber
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Marco Colleoni
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Ian Smith
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Karen N. Price
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Aron Goldhirsch
- From the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Harvard School of Public Health; Frontier Science and Technology Research Foundation, Boston, MA; IBCSG Coordinating Center and Inselspital; Swiss Group for Clinical Cancer Research, Bern; Senology Center of Eastern Switzerland, Kantonsspital, St Gallen; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
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Christin-Maitre S. The role of hormone replacement therapy in the management of premature ovarian failure. ACTA ACUST UNITED AC 2007; 4:60-1. [DOI: 10.1038/ncpendmet0699] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2007] [Accepted: 10/19/2007] [Indexed: 12/21/2022]
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Vilodre LC, Moretto M, Kohek MBDF, Spritzer PM. Falência ovariana prematura: aspectos atuais. ACTA ACUST UNITED AC 2007; 51:920-9. [DOI: 10.1590/s0004-27302007000600005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2006] [Accepted: 06/27/2007] [Indexed: 11/21/2022]
Abstract
A falência ovariana prematura (FOP) acomete aproximadamente 1:1000 mulheres antes dos 30 anos, 1:250 em torno dos 35 anos e de 1:100 aos 40 anos. Manifesta-se como amenorréia primária ou amenorréia secundária, não podendo ser considerada definitiva em todas as pacientes, uma vez que a concepção espontânea pode ocorrer em até 5-10% das FOP. Na maioria dos casos apresenta-se na forma esporádica, pois apenas 5% apresentam história familial. Entre as causas conhecidas estão as alterações cromossômicas, dos genes ligados ao cromossomo X e cromossomos autossômicos, doenças autoimunes, alterações tóxicas e iatrogênicas. Com relativa freqüência, a causa etiológica não é obtida, sendo então denominada de idiopática. O diagnóstico da FOP é feito baseado na história clínica e níveis elevados do hormônio folículo estimulante (FSH), sendo posteriormente investigadas as causas mais específicas. O manejo clínico visa o suporte emocional, o tratamento hormonal com estrogênios e progestogênios, a abordagem da infertilidade e a prevenção de co-morbidades como a osteoporose e potencial maior risco cardiovascular.
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Affiliation(s)
| | | | | | - Poli Mara Spritzer
- Hospital de Clinicas de Porto Alegre; Universidade Federal do Rio Grande do Sul
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Bibliography. Current world literature. Diabetes and the endocrine pancreas II. Curr Opin Endocrinol Diabetes Obes 2007; 14:329-57. [PMID: 17940461 DOI: 10.1097/med.0b013e3282c3a898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kimura S, Matsumoto T, Matsuyama R, Shiina H, Sato T, Takeyama KI, Kato S. Androgen receptor function in folliculogenesis and its clinical implication in premature ovarian failure. Trends Endocrinol Metab 2007; 18:183-9. [PMID: 17442585 DOI: 10.1016/j.tem.2007.04.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2006] [Revised: 03/07/2007] [Accepted: 04/05/2007] [Indexed: 01/19/2023]
Abstract
The action of estrogen in the female reproductive organs is well known in terms of the expression pattern and gene regulation of the estrogen receptor (ER). The significance of ERs in female reproduction is undisputed. The role of the androgen receptor (AR) is less clear. Clinical hyperandrogenism, a typical feature of polycystic ovary syndrome (PCOS), highlights pathological androgen production by the ovary. By contrast, the physiological impact of androgen action in female reproductive organs remains elusive. Androgens affect folliculogenesis in a variety of experimental approaches and ARs are expressed in developing follicles. Recent observations have discovered that inactivation of ARs in female mice results in premature ovarian failure (POF), indicating that normal folliculogenesis requires AR-mediated androgen action. Moreover, these results imply that POF might be caused by impairment of AR-mediated androgen action.
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Affiliation(s)
- Shuhei Kimura
- Institute of Molecular and Cellular Biosciences, University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-0032, Japan
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Abstract
OBJECTIVES To present an updated review on the etiology, consequences and management of premature ovarian failure. DESIGN A search of the English language literature using the Cochrane Library database and Medline 1966-2006, with a hand search of the references. CONCLUSION Premature ovarian failure is defined as the occurrence of amenorrhea, hypergonadotropinemia and estrogen deficiency in women under the age of 40 years, with the prevalence being 0.9-1.2%. In the majority of cases, the etiology is unknown, but known causes include chemotherapy, radiotherapy, surgery, genetic disorders, particularly involving the X chromosome, associations with autoimmune diseases, infections, smoking and other toxins. The three critical issues of management in these women are the effect of the diagnosis on the psychological health of the patient, the consequent infertility and the long- and short-term effects of estrogen deficiency arising from ovarian decline. Promising methods of screening for premature ovarian failure are being developed.
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Affiliation(s)
- T A Nippita
- Department of Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards, and The University of Sydney, Australia
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Jeanes H, Newby D, Gray GA. Cardiovascular risk in women: the impact of hormone replacement therapy and prospects for new therapeutic approaches. Expert Opin Pharmacother 2007; 8:279-88. [PMID: 17266463 DOI: 10.1517/14656566.8.3.279] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Cardiovascular disease (CVD) is the main cause of death in women. Observational studies of hormone replacement therapy (HT) and data from women with premature ovarian failure have provided support for the principle that estrogen confers protection against the development of CVD in premenopausal women. However, randomised, controlled trials investigating HT in postmenopausal women have failed to demonstrate a benefit of HT in the primary or secondary prevention of CVD. Nevertheless, HT may be effective if targeted at younger perimenopausal women. Research aimed at investigation of the cellular mechanisms of estrogen may result in the discovery of new therapeutic targets that may be able to harness the potential beneficial effects of estrogens in the cardiovascular system. An improved understanding of the distinct processes in the clinical presentation and progress of CVD in women will help develop new targets and enhance the use of current established drugs.
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Affiliation(s)
- Helen Jeanes
- University of Edinburgh, Centre for Cardiovascular Science, Room E3.24, Queens Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, Scotland, UK.
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Christin-Maitre S, Pasquier M, Donadille B, Bouchard P. L’insuffisance ovarienne prématurée. ANNALES D'ENDOCRINOLOGIE 2006; 67:557-66. [PMID: 17194965 DOI: 10.1016/s0003-4266(06)73007-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Premature ovarian failure (POF) is defined by at least four months of amenorrhea with elevated gonadotropins (usually above 40 UI/L) detected on two occasions a few weeks apart, in a woman before the age of 40. It occurs in 1 out of 10,000 in women below the age of 20, 1/1,000 below 30 and 1% in women before the age of 40. In 80% of POF cases, the etiology is unknown, except for Turner syndrome. The different etiologies identified are 1) iatrogenic following chemotherapy and/or radiotherapy, 2) autoimmune, 3) viral, 4) genetic (RFSH, FOXL2, FRAXA, BMP15, GDF9, GALT, 17 hydroxylase...). Management of these patients includes hormone replacement therapy in order to avoid an increase in cardiovascular risk and osteoporosis related to hypoestrogenism. Infertility is common, as only 3 to 10% of the patients will have natural conception. When fertility is desired, women with POF should be oriented towards oocyte donation centers. Research is currently performed in order to identify new genes involved in POF.
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Affiliation(s)
- S Christin-Maitre
- EA1533 Génétique de la reproduction, Université Paris VI, Service d'Endocrinologie de la Reproduction, Hôpital Saint-Antoine, Assistance Publique, Hôpitaux de Paris, 75012 Paris, France.
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Affiliation(s)
- Wei Shen
- Department of Traditional Chinese Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
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