Plasminogen activators, plasminogen activator inhibitor, and fibronectin in human granulosa cells and follicular fluid related to oocyte maturation and intrafollicular gonadotropin levels

Ovulation: Parallels With Inflammatory Processes

The midcycle surge of LH sets in motion interconnected networks of signaling cascades to bring about rupture of the follicle and release of the oocyte during ovulation. Many mediators of these LH-induced signaling cascades are associated with inflammation, leading to the postulate that ovulation is similar to an inflammatory response. First responders to the LH surge are granulosa and theca cells, which produce steroids, prostaglandins, chemokines, and cytokines, which are also mediators of inflammatory processes. These mediators, in turn, activate both nonimmune ovarian cells as well as resident immune cells within the ovary; additional immune cells are also attracted to the ovary. Collectively, these cells regulate proteolytic pathways to reorganize the follicular stroma, disrupt the granulosa cell basal lamina, and facilitate invasion of vascular endothelial cells. LH-induced mediators initiate cumulus expansion and cumulus oocyte complex detachment, whereas the follicular apex undergoes extensive extracellular matrix remodeling and a loss of the surface epithelium. The remainder of the follicle undergoes rapid angiogenesis and functional differentiation of granulosa and theca cells. Ultimately, these functional and structural changes culminate in follicular rupture and oocyte release. Throughout the ovulatory process, the importance of inflammatory responses is highlighted by the commonalities and similarities between many of these events associated with ovulation and inflammation. However, ovulation includes processes that are distinct from inflammation, such as regulation of steroid action, oocyte maturation, and the eventual release of the oocyte. This review focuses on the commonalities between inflammatory responses and the process of ovulation.

Cellular and molecular mechanisms of the preovulatory follicle differenciation and ovulation: What do we know in the mare relative to other species

Terminal follicular differentiation and ovulation are essential steps of reproduction. They are induced by the increase in circulating LH, and lead to the expulsion from the ovary of oocytes ready to be fertilized. This review summarizes our current understanding of cellular and molecular pathways that control ovulation using a broad mammalian literature, with a specific focus to the mare, which is unique in some aspects of ovarian function in some cases. Essential steps and key factors are approached. The first part of this review concerns LH, receptors and signaling, addressing the description of the equine gonadotropin and cloning, signaling pathways that are activated following the binding of LH to its receptors, and implication of transcription factors which better known are CCAAT-enhancer-binding proteins (CEBP) and cAMP response element-binding protein (CREB). The second and major part is devoted to the cellular and molecular actors within follicular cells during preovulatory maturation. We relate to 1) molecules involved in vascular permeability and vasoconstriction, 2) involvement of neuropeptides, such as kisspeptin, neurotrophins and neuronal growth factor, neuropeptide Y (NPY), 3) the modification of steroidogenesis, steroids intrafollicular levels and enzymes activity, 4) the local inflammation, with the increase in prostaglandins synthesis, and implication of leukotrienes, cytokines and glucocorticoids, 5) extracellular matrix remodelling with involvement of proteases, antiproteases and inhibitors, as well as relaxin, and finaly 6) the implication of oxytocine, osteopontin, growth factors and reactive oxygen species. The third part describes our current knowledge on molecular aspect of in vivo cumulus-oocyte-complexe maturation, with a specific focus on signaling pathways, paracrine factors, and intracellular regulations that occur in cumulus cells during expansion, and in the oocyte during nuclear and cytoplasmic meiosis resumption. Our aim was to give an overall and comprehensive map of the regulatory mechanisms that intervene within the preovulatory follicle during differentiation and ovulation.

A novel ovary-specific and ovulation-associated variant of epoxide hydrolase 2

Ovulation is a complex process initiated by the surge of the pituitary luteinizing hormone (LH) that provokes the expression of specific genes. We report herein the isolation and characterization of an ovulation-associated, ovary-specific novel isoform of epoxide hydrolase 2 (Ephx2), Ephx2C. This variant is exclusively expressed in the granulosa cells of preovulatory mouse ovarian follicles. The LH-induced expression of Ephx2C is mediated by the protein kinase A and partially by the protein kinase C signaling pathways. The involvement of p38 kinase has also been demonstrated.

Effects of plasmin on sperm-oocyte interactions during in vitro fertilization in the pig

The present study was undertaken to examine the effect of plasmin on sperm viability and sperm-oocyte interaction during in vitro fertilization in the pig. Porcine sperm, which were washed in Dulbecco's PBS were re-suspended and incubated in fertilization medium (mTBM; modified Tris-buffered medium) containing 0, 0.1, 1.0, 10.0 or 100.0ng/mL of plasmin. Sperm viability was not affected by plasmin treatment. Addition of plasmin in doses ranging from 0.1 to 100.0ng/mL for 2, 4 or 6h to washed boar sperm resulted in enhancement of acrosome reaction (AR) compared with untreated cells. The concentration of 0.1ng/mL plasmin (95+/-18 sperm/oocyte) had no effect on sperm binding, whereas 1.0ng/mL (123+/-21 sperm/oocyte), 10.0ng/mL (124+/-16 sperm/oocyte) and 100.0ng/mL (124+/-15 sperm/oocyte) of plasmin increased sperm binding compared with the control (83+/-15 sperm/oocyte). The zona pellucida solubility (zona dissolution time) was less in medium with 1.0ng/mL (123+/-24s), 10.0ng/mL (99+/-15s) or 100.0ng/mL (95+/-19s) plasmin compared with control (176+/-27s). When pig oocytes and sperm were co-incubated in various concentrations of plasmin for 6h, the penetration rate was greater in medium with 1.0ng/mL plasmin (77.5+/-3.1%) compared with the control. However, there were no differences in the polyspermic rates and mean number of sperm (MNS)/oocyte between the groups treated with plasmin and control. These results suggest that plasmin might play a role in events related to fertilization.

Vascular endothelial growth factor plays more than an angiogenic role in the female reproductive system

Although the most well-known function of vascular endothelial growth factor is its angiogenic activity, it plays more than a simple angiogenic role in the female reproductive system as it is involved in a number of key events in the course of the ovulatory cycle. The modulation of vascular endothelial growth factor expression varies in different reproductive tissues, probably related to its various functions at these different sites.

Cytochrome p450-dependent lipid metabolism in preovulatory follicles

Estrogen biosynthesis and proteolysis are both important processes involved in ovarian follicular development, which may be influenced by cytochrome P450 (CYP)-dependent fatty acid metabolites. However, CYP-dependent lipid metabolism has not been characterized with respect to follicular maturation in vivo. Therefore, follicular fluid was collected in the hours before and after the LH surge in pigs, and concentrations of epoxy, hydroxy, and dihydroxy lipids were measured by liquid chromatography tandem mass spectrometry. Arachidonate oxidation and epoxyeicosatrienoic acid hydrolysis to dihydroxyeicosatrienoic acids (DHETs) were also assessed in thecal and granulosa tissue fractions, and the expression of CYP epoxygenases was evaluated by immunoblots using available antisera. To evaluate soluble epoxide hydrolase (sEH) expression, the porcine sEH was cloned from ovarian tissue, expressed and purified for antibody generation. The follicular fluid oxylipin concentrations ranged from 1-150 nm depending on the compound and estrous stage. The follicular fluid concentrations of CYP-dependent oxylipins increased at estrus, as did sEH expression; however, significant changes in epoxides were not observed, and the 11,12-DHET peak was delayed. The ratio of 14,15-DHET:11,12-DHET across all samples correlated with the log of follicular fluid estradiol concentrations (P < 0.01). Epoxygenase activities were similar in theca and granulosa, varying little with follicular development, whereas the decline of a single CYP2J isoform at ovulation was observed by immunoblots. The sEH activity was higher in granulosa than in theca. Finally, the dynamic changes in follicular CYP-dependent arachidonic acid metabolites and their modulatory function in vascular models suggest roles for these metabolites in follicular maturation, which may include regulation of estradiol biosynthesis and preovulatory remodeling of the follicular wall that should be fully explored in future studies.

Differences in the implantation rates of rat embryos developed in vivo and in vitro: possible role for plasminogen activators

OBJECTIVE

To assess the participation of urokinase-type (uPA) and tissue-type (tPA) plasminogen activators in embryo development and implantation.

DESIGN

The study was set to compare the activities of PAs in embryos developed in vivo and in vitro and their implantation rates. Endometrial PA activity was studied as well.

SETTING

University laboratories.

PATIENT(S)

None.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Plasminogen activator activity in embryos.

RESULT(S)

Whereas tPA activity in in vivo-developed embryos decreased from the zygote to the blastocyst stages, it did not change in embryos developed in vitro. The activity of uPA was lowest in two-cell-stage embryos, both in vivo and in vitro, and increased as embryos developed into blastocysts. The activity of uPA in the in vitro-developed embroys was lower in all developmental stages as compared with those developed in vivo. Whereas endometrial tPA activity did not change during the preimplantation period, uPA activity increased gradually toward the time of implantation. The implantation rate of the in vitro-developed embryos was much lower than that of those developed in vivo.

CONCLUSION(S)

Taken together, these data indicate that in vitro embryo development leads to lower PA activities as compared with in vivo development. The increased activity of uPA toward the blastocyst stage supports uPA's role in the implantation process. Moreover, the rise in endometrial uPA might also indicate its importance in this process.

The influence of hormone replacement therapy on skin ageing: a pilot study

OBJECTIVES

We studied the effect of hormonal treatment on skin ageing in menopausal women.

METHODS

Twenty-four patients (45-68 years; mean age, 54.9 years) without hormone treatment for at least 6 months were included. Patients were assigned to three therapy groups: 1, oestrogen only (Estraderm TTS 50) (n=6); 2, transdermal oestrogen and progesterone (Estraderm TTS 50 and 0.4 mg progesterone vaginal suppository) (n=7); and 3, oral oestrogen and progesterone (2 mg Progynova and 0.4 mg progesterone vaginal suppository) (n=8). One group without therapy was included as a control group (n=3). Treatment was continued for 6 months. Three patients, one from group 2 and two from group 3, discontinued therapy before the study endpoint. The following skin parameters were measured at monthly intervals during treatment: skin surface lipids, epidermal skin hydration, skin elasticity and skin thickness. Concomitant clinical evaluation included a subjective clinical evaluation form, a patient questionnaire and laboratory tests for oestradiol, progesterone and follicle stimulating hormone.

RESULTS

Mean levels of epidermal skin moisture, elasticity and skin thickness were improved at the end of treatment based on both subjective and objective evaluation in patients with hormone replacement therapy (HRT). Skin surface lipids were increased during combined HRT, which may reflect stimulatory effects of the progestagen component on sebaceous gland activity, while oestrogen alone has a sebum-suppressive action. In the HRT groups, the questionnaire for climacteric complaints demonstrated significant improvements, while laboratory tests showed increases in oestradiol and progesterone and decreases in FSH.

CONCLUSIONS

HRT with the mentioned regimes significantly improved parameters of skin ageing.

Purification of follicular regulatory protein: possible plasminogen identity

A partially purified protein (the SR fraction) of porcine and human origin has been extensively characterized as Follicular Regulatory Protein (FRP). In the current study, 1A8D5, one of several monoclonal antibodies raised against FRP, was used to further purify the protein. The monoclonal antibody cross-reacted only with porcine plasminogen, a key fibrinolytic proenzyme. A commercial polyclonal antibody for human plasminogen confirmed the relationship between plasminogen and bands of the SR fraction of the porcine follicular fluid. Sequencing of the N-terminal amino acids (54 kd) of the SR fraction indicated that it shared 100% identity with the short form of porcine plasminogen chain A and 93% identity to human plasminogen. Moreover, we demonstrated that this purified protein from human follicular fluid inhibited aromatase activity of granulosa cells, a key biological property of FRP. Given that plasminogen possesses most of the proposed properties of the protein termed FRP, we conclude that FRP is likely plasminogen itself or a plasminogen-related protein and not a novel protein.

The vascular endothelial growth factor/fms-like tyrosine kinase system in human ovary during the menstrual cycle and early pregnancy

In human ovaries, angiogenesis is known to be associated with the development of follicles and the formation of the corpus luteum (CL). A complex vascular network is formed within the thecal cell layer during follicular growth, and rapid neovascularization occurs toward the granulosa cell layer after ovulation. Vascular endothelial growth factor (VEGF) is a multifunctional cytokine, stimulating endothelial cell growth and enhancing microvascular permeability. A specific receptor for VEGF, fms-like tyrosine kinase (Flt-1), is expressed in vascular endothelial cells that mediates the action of VEGF. We examined the localization and expression of VEGF and Flt-1, using an immunohistochemical technique and RT-PCR analysis, in human follicles and corpora lutea during the normal menstrual cycle and early pregnancy. We measured concentrations of VEGF in extracts of human CL using an enzyme-linked immunosorbent assay during the luteal phase and early pregnancy. Immunostaining for VEGF was observed in granulosa cells from small antral follicles to preovulatory follicles. The staining was detected in thecal cells from medium-sized to preovulatory follicles. The intensity of the staining was gradually increased as a follicle grew. Flt-1 was localized in granulosa and thecal cells of preovulatory follicles as well as in endothelial cells. In the human CL, the intense staining for VEGF was observed in granulosa and thecal lutein cells, especially in the midluteal phase. The immunostaining for Flt-1 was faint in endothelial cells in the CL, whereas it was distinct in granulosa and thecal lutein cells. The concentrations of VEGF in lutein extracts were high in the early and midluteal phases and tended to decrease toward the late luteal phase. During early pregnancy, a measurable amount of VEGF was detected. RT-PCR analysis demonstrated that messenger ribonucleic acids encoding VEGF121, VEGF165, and Flt-1 were expressed in the CL. These results suggest that VEGF might have an autocrine role in the ovulatory process and luteal function as well as a paracrine role in angiogenesis.

Fibronectin concentrations correlate with ovarian follicular size and estradiol values in equine follicular fluid

The amounts of total protein, albumin, fibronectin, alpha 2-macroglobulin (alpha 2-M), immunoglobulin G, ceruloplasmin and antithrombin were determined in fluids collected from 53 preovulatory equine follicles and compared with the contents of estradiol-17 beta, progesterone and androstenedione, with follicle size and the amounts of the equivalent proteins in normal equine plasma. The concentration of fibronectin and the fibronectin/albumin ratios increased significantly with follicle size and with follicular estradiol levels. The alpha 2-M levels and alpha 2-M/albumin ratios correlated with follicle size but not with hormone content. Both fibronectin and alpha 2-M were present in lower amounts in follicular fluid compared with plasma while the other proteins were present in similar amounts. Among the proteins evaluated, there was a positive correlation between the amount of the protein in the follicular fluid and the molecular weight of the protein.

Treatment of skin aging with topical estrogens

BACKGROUND

The coincidence of climacteric symptoms and the beginning of skin aging suggests that estrogen deficiency may be a common and important factor in the perimenopausal woman. Often hormones have been considered important in endogenous aging of the skin, but their role has not been clearly defined. Therefore, we investigated, whether topical treatment of the skin with estrogen could reverse some of the changes in the aging skin.

MATERIAL AND METHODS

The effects of 0.01% estradiol and 0.3% estriol compounds were compared in 59 preclimacteric women with skim aging symptoms. Monthly determinations of estrodiol (E2), follicle-stimulating hormone (FSH), and prolactin (PRL) were done and the monthly clinical monitoring was supplemented by measurements of skin hydration by corneometry and profilometry. In 10 patients, skin biopsies were taken for immunohistochemical determination of collagen types I and III.

RESULTS

After treatment for 6 months, elasticity and firmness of the skin had markedly improved and the wrinkle depth and pore sizes had decreased by 61 to 100% in both groups. Furthermore, skin moisture had increased and the measurement of wrinkles using skin profilometry, revealed significant, or even highly significant, decreases of wrinkle depth in the estradiol and the estriol groups, respectively. On immunohistochemistry, significant increases of Type III collagen labeling were combined with increased numbers of collagen fibers at the end of the treatment period. As to hormone levels, only those of PRL had increased significantly and no systemic hormonal side effects were noted.

Hemostatic profile of bovine ovarian follicular fluid

The hemostatic profile of bovine ovarian follicular fluid was evaluated and the levels of procoagulant, fibrinolytic, and inhibitory activity compared with plasma. The results of the prothrombin time assay and the presence of fibrinogen along with factor VII and factor X activity indicate that bovine follicular fluid possesses components of the "extrinsic" or "tissue factor" coagulation system. The absence of factor VIII:C activity, along with the extremely low levels of factors IX and XI, indicates that there is not a functional "intrinsic" coagulation pathway. The fluid derived from large follicles exhibited increased levels of factors VII and X activity and a shorter prothrombin time compared with fluid obtained from the less mature small follicles. Similar alterations in the levels of the inhibitory proteins antithrombin III and alpha 2-macroglobulin were observed. Overall the amount of antithrombin III was similar to that in plasma, the levels of fibrinogen and factor X were approximately 2-fold lower, and the levels of factor VII and factor X were approximately 10-fold lower than in plasma. The fibrinolytic activity in follicular fluid was greater than the procoagulant or inhibitory activity. Plasminogen activator activity was 5-fold higher, while both plasminogen and antiplasmin values were similar to plasma levels.

Increased insulin sensitivity and fibrinolytic capacity after dietary intervention in obese women with polycystic ovary syndrome

In overweight women with polycystic ovary syndrome (PCOS), increased insulin resistance has been observed. Since abdominal obesity is associated with impaired fibrinolytic capacity and elevated levels of plasminogen activator inhibitor (PAI-1) and since PAI-1 seems to be related to insulin resistance, we investigated the possible effects of dietary intervention on lipids, fibrinolysis, coagulation, and insulin sensitivity in obese PCOS women. Nine women aged 22 to 39 years (median weight, 97 kg) ate a protein-rich very-low-calorie diet (VLCD) (Nutrilett, Nycomed Pharma, Oslo, Norway; 421 kcal/d) for 4 weeks (part 1). After significant reductions of body fat (13%, P < .01), two of nine women achieved regular menstruation and became pregnant. Six of the remaining women continued on a conventional low-calorie diet (1,000 to 1,500 kcal/d) for the next 20 weeks (part 2), during which time they were generally able to preserve the body fat loss obtained in part 1 of the study. During part 1, significant reductions of total serum cholesterol (29%, P = .001) and fasting triglyceride ([TG] 31%, P < .05) levels were observed, as well as significant reductions of fasting glucose (6%, P < .05) and insulin (20%, P < .05). Insulin sensitivity (glucose disposal rate [GDR]) was increased by 93% (P < .05). After finishing part 2, insulin sensitivity was still significantly increased (86%, P < .05) and PAI-1 activity was significantly reduced (54%, P < .05). Moreover, overall fibrinolytic activity was significantly improved (serum D-dimer concentration increased by 75%, P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Bovine ovarian follicular fluid vitronectin content is influenced by the follicle size

Vitronectin was quantified in the follicular fluid aspirated from bovine follicles with diameters of 3 to 15 mm (as determined by ultrasonography) using a specific enzyme-linked immunosorbent assay (ELISA) validated for bovine vitronectin. The primary antibody was raised in rabbit against vitronectin purified from bovine plasma. Vitronectin quantified in serial dilutions of bovine plasma and ovarian follicular fluid was highly correlated with the volume of each sample assayed. In addition, known amounts of purified bovine vitronectin added to samples of plasma or follicular fluid were accurately recovered. Follicular fluid concentrations of vitronectin were positively correlated with the follicle diameter (r = 0.8; P < 0.01). These data indicate that bovine follicular fluid concentration of vitronectin is influenced by the stage of follicular development.

Purification of a 240 kDa protein from serum and follicular fluid of water buffalo and its identification as haptoglobin

The fluids from healthy growing follicles of water buffalo were previously found free of the polypeptides H (M(r) 36,000) and L (M(r) 21,000) which were instead detected in fluids from atretic follicles and blood. Here we report evidence that these two polypeptides, as selected from serum by specific anti-L antibodies, are the subunits of an oligomeric protein. The protein was purified from serum or follicular fluid, and its molecular weight (240 kDa), isoelectric point (6.5), and amino acid composition were determined. The NH2-terminal sequences of the subunits L and H were analyzed: 100% and 90% homology with alpha and beta chains of bovine haptoglobin, respectively, was found. Thus, haptoglobin can be used as a novel molecular marker to assess the physiological state of the blood-follicle barrier or discriminate between atretic and healthy follicles.

Ovulation as a tissue remodelling process. Proteolysis and cumulus expansion

Ovulation, recurring every midcycle of the mammalian female and triggered by a surge of luteinizing hormone (LH) released from the pituitary, is an essential prerequisite for fertilization and subsequent embryonic development. Here we shall describe two of the biological components of the ovulatory response, cumulus expansion (frequently denoted as cumulus maturation) and the rupture of follicular wall, both crucial for the release of a fertilizable ovum. The role of a proteolytic cascade and its regulation by eicosanoids will be emphasized in relation to follicle rupture. The new data implicating cumulus maturation as an essential step for the release of the ovum and the apparent mediatory role of interleukin-1 in this process will be presented. LH/hCG stimulates, in the preovulatory follicles, a cascade of proteolytic enzymes, including plasminogen activator (PA), plasmin and matrix metalloproteinase 1 (MMP-1). These enzymes bring about the degradation of perifollicular matrix and, most notably, the decomposition of the meshwork of collagen fibers which provides the strength to follicular wall. Furthermore, pharmacological blockage of any of these enzymes resulted in inhibition of follicle rupture. LH/hCG stimulates, in addition, an increase in ovarian production of eicosanoids. These include prostaglandins, obtained from arachidonic acid via the cyclooxygenase pathway and leukotrienes, the products of lipoxygenase. Previous studies from our and other laboratories have demonstrated the ability of inhibitors of cyclooxygenase and of lipoxygenases to suppress ovulation in several mammalian species. MK-886, which inhibits the translocation of 5-lipoxygenase (5-LO) from the cytosol and its binding to the membranal 5-LO activating enzyme, suppressed dose-dependently follicular rupture from the treated ovary. Zymographic analysis of ovarian extracts from PMSG/hCG-stimulated rats revealed a band of collagenolytic activity at 52kD, corresponding to human MMP-1 and at 72kD, corresponding to human MMP-2. Both activities were markedly stimulated by administration of hCG and were significantly inhibited by indomethacin, NDGA or MK-886. Thus, eicosanoids seem to mediate LH stimulation of follicular collagenase. Interleukin-1 (IL-1) has been recently implicated in ovulation. The ability of an IL-1 receptor antagonist (ra) to block ovulation in vivo and in vitro has been demonstrated recently. Morphological examination of the ovulatory follicles failing to ovulate suggests that this effect is exerted by inhibiting cumulus oophorus expansion and detachment from mural granulosa cells. In vitro, IL-1ra attenuated the action of hCG and FSH on cumulus expansion and follicular hyaluronic acid synthesis. Thus, IL-1 seems to mediate and/or facilitate gonadotropin action on cumulus expansion, and hence on ovulation.

New treatment of atrophic acne scars by iontophoresis with estriol and tretinoin

BACKGROUND

Common treatment of atrophic acne scars consists of invasive methods such as dermabrasion, chemopeeling, or implantation of bovine collagen. In our study a new noninvasive treatment method consisting of local iontophoresis is demonstrated. Local iontophoresis was performed with either estriol--a mainly topically active estrogen--or with tretinoin.

PATIENTS AND METHODS

Eighteen women were treated with estriol iontophoresis twice weekly for a period of 3 months. In addition to photographic and clinical documentation of the skin, venous blood for determination of serum levels of prolactin and estradiol according to standard radioimmunoassay methods was obtained monthly. Tretinoin iontophoresis was performed according to the same time schedule in 28 patients (19 women and 9 men) with atrophic acne scars.

RESULTS

Improvement of acne scars was observed in 93% of patients treated with tretinoin iontophoresis and in 100% of the group treated with estriol iontophoresis. No hormonal changes were noted in the estrogen group. Side effects involving the skin appeared in the tretinoin group in 4 cases and consisted of increased dryness and of retinoid dermatitis.

CONCLUSION

Both treatments were shown to be clinically effective in decreasing acne scars and persistence of effects. This promising new therapeutic approach may thus replace invasive treatment methods in many patients.

Development and influence of an endogenous serum luteinizing hormone surge after ovulation induction in stimulated cycles

The aim of this study was to investigate whether the endogenous serum luteinizing hormone (LH) discharge in stimulated cycles--either simultaneously with or shortly after exogenous human chorionic gonadotropin (hCG) administration--is influenced by serum steroid hormones and follicle stimulating hormone (FSH). We also tested whether the LH discharge affects intrafollicular hormone metabolism and oocyte fertilization. In a group of 46 women with tubal pathology who were undergoing in vitro fertilization (IVF), follicular fluids were collected during oocyte retrieval. In addition blood samples were drawn daily, starting at cycle day 7 until the day of oocyte retrieval. LH, FSH, estradiol, progesterone, testosterone and prolactin were determined in all samples of serum and follicular fluid. Oocyte maturation was classified according to the morphology of the oocyte corona-cumulus complex. Of the 46 women studied, 15 showed no LH surge (group A) and 31 developed an endogenous LH surge (group B). Serum samples showed no significant differences between the two groups in follicular phase estradiol, progesterone, testosterone and prolactin. Only levels of serum FSH showed a significant difference between groups A and B (p < 0.0005). In follicular fluid samples LH (p < 0.05) and FSH levels (p < 0.005) were significantly different. Fertilization rate and cleavage rate, however, did not differ significantly. The late endogenous LH surge occurring simultaneously with or shortly after hCG application for ovulation induction did not affect intrafollicular steroid metabolism, oocyte maturation, fertilization rate or cleavage rate.

Treatment of skin ageing symptoms in perimenopausal females with estrogen compounds. A pilot study

A wide range of somatic symptoms of the perimenopausal female is due to the decrease of estrogen at that age. Minor attention has been paid hitherto to the involvement of estrogens in female skin ageing symptoms. In our study, the ageing skin of the face of perimenopausal females was treated with a 0.3% estriol cream (8 patients) or with a 0.01% estradiol cream (10 patients) for 6 months. Dermatologic follow-up was performed monthly. At each follow-up venous blood for radioimmuno assay determination of prolactin (PRL), follicle stimulating hormone (FSH) and estradiol (E2) was sampled. In addition, prior to and after 3 and 6 months of treatment, gynecological examinations for climacteric symptoms, mammary and colposcopic investigations and vaginal smears for cytology were performed. Both treatment groups showed improvement of the various skin ageing symptoms at the end of treatment. The effects of the group treated with topical estriol were slightly superior with regard to their extent and onset. No hormonal side effects were noted either clinically or by hormone monitoring. According to these preliminary results, local estrogen treatment appears to be a promising new approach for the treatment of skin ageing in perimenopausal females. However, for minimizing the risk of systemic hormonal side effects, concentrations and size of application field should be limited.

Gene regulation of interleukin-1 beta, interleukin-1 receptor type I, and plasminogen activator inhibitor-1 and -2 in human granulosa-luteal cells

OBJECTIVE

To investigate the regulation of messenger ribonucleic acid (mRNA) levels of interleukin-1 beta (IL-1 beta), interleukin-1 (IL-1) receptor type 1, and plasminogen activator (PA) inhibitor-1 and -2 in cumulus cells, granulosa-luteal cells, and macrophage-depleted granulosa-luteal cells obtained from human preovulatory follicles.

DESIGN

Prospective longitudinal study.

SETTING, PATIENTS

Patients undergoing assisted reproductive technologies (ART) in the Department of Gynecology and Obstetrics, Stanford University, Stanford, California.

INTERVENTIONS

Cumulus cells and granulosa-luteal cells were collected by ultrasound-guided transvaginal aspiration at the time of ART.

MAIN OUTCOME MEASURES

Northern blot analysis of mRNA levels of IL-1 beta, IL-1 receptor type 1, PA inhibitor-1 and -2 in cumulus cells, granulosa-luteal cells and macrophage-depleted granulosa-luteal cells, and indirect immunocytochemical analysis of the IL-1 system and macrophages in granulosa-luteal cell preparations were performed.

RESULTS

Interleukin-1 beta mRNA levels in uncultured cumulus cells were less than those of uncultured granulosa-luteal cells with no differences in IL-1 receptor type 1 mRNA levels between these two cell types. Granulosa-luteal cell IL-1 receptor type 1 mRNA levels were expressed constitutively throughout 24 hours of culture with no effect by hCG, whereas IL-1 beta mRNA levels increased within 6 hours, and then remained elevated for 24 hours with no effect by hCG. Interleukin-1 beta significantly increased granulosa-luteal cell mRNA levels of IL-1 beta (over twofold), IL-1 receptor type 1 (over twofold), PA inhibitor-1 (approximately 1.4-fold), and PA inhibitor-2 (approximately 1.6-fold). In contrast, IL-1 beta had no effect on IL-1 beta and IL-1 receptor type 1 mRNA levels in macrophage-depleted granulosa-luteal cells. Granulosa-luteal cells, not macrophages, account for the majority of the immunocytochemical staining for IL-1 beta and IL-1 receptor type 1 in follicular aspirates.

CONCLUSIONS

These studies suggest that the IL-1 system is regulated in human granulosa-luteal cells during the periovulatory period. Furthermore, the augmentation of PA inhibitor-1 and -2 mRNA levels by IL-1 beta suggests a potential role for IL-1 beta in remodeling of the human ovary during the periovulatory period.

When applied to facial skin, does estrogen ointment have systemic effects?

We examined cytological vaginal smears of 17 women before and after three months of dermal estrogen (1 g of 0.01% estradiol ointment or 0.3% estriol ointment once daily), applied to the face for dermatological indications. The mean age was 57.1 +/- 7.6 years (range from 46 to 66). Seven women had estrogenic smears (more than 10% superficial cells) before therapy. Nine women were treated with 0.01% estradiol ointment and 8 were treated with 0.3% estriol ointment. Both groups had gynecological examinations including cervical and vaginal smears before and after treatment and also monthly measurements of serum follicle-stimulating hormone, prolactin and estradiol levels. Serum hormone levels and the appearance of vaginal smears showed no significant change during treatment.

Lung capillary endothelial cells produce and secrete urokinase-type plasminogen activator

Bovine lung capillary endothelial cells (BLuEC) were isolated, and their ability to produce plasminogen activator (PA) in vitro was demonstrated. BLuEC secreted more than 10 times as much as urokinase-type PA (u-PA) as did bovine aortic, hepatic capillary and adrenal capillary endothelial cells, and lung fibroblasts. BLuEC secreted u-PA on both sides of the cell layer, the luminal surface, and the basic surface attached to the basement membrane. u-PA mRNA was detected in BLuEC by Northern blotting, but not in endothelial cells from other tissues and fibroblasts. These results suggest that BLuEC may contribute not only to the patency of lung vessels but also to the maintenance of alveolar functions through the production and secretion of u-PA.