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Fan L, Zeng P, Wang X, Mo X, Ma Q, Zhou X, Yuan N, Liu Y, Xue Z, Huang J, Li X, Ding J, Chen J. Xiaoyao Pills, a Chinese patent medicine, treats mild and moderate depression: A randomized clinical trial combined with DNA methylation analysis. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 130:155660. [PMID: 38815407 DOI: 10.1016/j.phymed.2024.155660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/26/2024] [Accepted: 04/19/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Xiaoyao pills (XYP) is a commercial Chinese patent medicine used in the treatment of depression. However, the mechanisms underlying its therapeutic effects, as well as the patients who can benefit from XYP, have not been evaluated so far. OBJECTIVES To this end, we conducted a double-blinded, random, and placebo-controlled clinical trial of orally administered XYP in patients with depression. METHODS The 17-item Hamilton Depression Rating Scale (HAMD-17) scores were recorded at baseline, and every 2 weeks after the start of treatment. To further elucidate the epigenetic mechanism of XYP, we performed mRNA sequencing and genome-wide DNA methylation sequencing using peripheral blood leukocytes of patients and healthy. RESULTS XYP effectively alleviated the symptoms in patients with mild or moderate depressive disorders, particularly that of psychomotor retardation. XYP restored aberrant gene expression and DNA methylation patterns associated with depression, and the normalization of DNA methylation correlated with downregulation of several genes. In addition, altered DNA methylation levels in the XYP-treated samples were attributed to increased expression of the DNA methyltransferase DNMT1. CONCLUSIONS Our study provides new insights into the epigenetic mechanism underlying depression and the therapeutic effects of XYP, along with an experimental basis for using XYP in the treatment of depression. TRIAL REGISTRATION INFORMATION The name of the registry and number: U.S. CLINICAL TRIALS REGISTRY The link to the registration: ClinicalTrials.gov ISRCTN12746343 (https://www.isrctn.com/ISRCTN12746343). The name of the trial register is "Efficacy and safety of the Xiaoyao pill for improving the clinical symptoms of stagnation of liver qi (chi) and spleen deficiency". The clinical trial registration number is ISRCTN12746343.
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Affiliation(s)
- Lili Fan
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, China
| | - Pengguihang Zeng
- RNA Biomedical Institute, Sun Yat-Sen Memorial Hospital, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou 510080, China
| | - Xihong Wang
- College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xiaowei Mo
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, China
| | - Qingyu Ma
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, China
| | - Xuan Zhou
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, China
| | - Naijun Yuan
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, China
| | - Yueyun Liu
- College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Zhe Xue
- College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Junqing Huang
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, China
| | - Xiaojuan Li
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, China.
| | - Junjun Ding
- RNA Biomedical Institute, Sun Yat-Sen Memorial Hospital, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou 510080, China; Department of Histology and Embryology, Advanced Medical Technology Center, The First Affiliated Hospital, Zhongshan School of Medicine, Sun Yat-sen University, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou 511436, China; West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China.
| | - Jiaxu Chen
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, China; College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China.
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Nieland L, Mahjoum S, Grandell E, Breyne K, Breakefield XO. Engineered EVs designed to target diseases of the CNS. J Control Release 2023; 356:493-506. [PMID: 36907561 DOI: 10.1016/j.jconrel.2023.03.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/28/2023] [Accepted: 03/06/2023] [Indexed: 03/14/2023]
Abstract
Diseases of the central nervous system (CNS) are challenging to treat, mainly due to the blood-brain barrier (BBB), which restricts drugs in circulation from entering target regions in the brain. To address this issue extracellular vesicles (EVs) have gained increasing scientific interest as carriers able to cross the BBB with multiplex cargos. EVs are secreted by virtually every cell, and their escorted biomolecules are part of an intercellular information gateway between cells within the brain and with other organs. Scientists have undertaken efforts to safeguard the inherent features of EVs as therapeutic delivery vehicles, such as protecting and transferring functional cargo, as well as loading them with therapeutic small molecules, proteins, and oligonucleotides and targeting them to specific cell types for the treatment of CNS diseases. Here, we review current emerging approaches that engineer the EV surface and cargo to improve targeting and functional responses in the brain. We summarize existing applications of engineered EVs as a therapeutic delivery platform for brain diseases, some of which have been evaluated clinically.
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Affiliation(s)
- Lisa Nieland
- Department of Neurology, Molecular Neurogenetics Unit, Massachusetts General Hospital, Boston, MA 02129, USA; Harvard Medical School, Boston, MA 02115, USA; Department of Neurosurgery, Leiden University Medical Center, Leiden 2300 RC, the Netherlands.
| | - Shadi Mahjoum
- Department of Neurology, Molecular Neurogenetics Unit, Massachusetts General Hospital, Boston, MA 02129, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Emily Grandell
- Department of Neurology, Molecular Neurogenetics Unit, Massachusetts General Hospital, Boston, MA 02129, USA; Harvard Medical School, Boston, MA 02115, USA; Department of Bioengineering, Northeastern University, Boston, MA 02115, USA
| | - Koen Breyne
- Department of Neurology, Molecular Neurogenetics Unit, Massachusetts General Hospital, Boston, MA 02129, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Xandra O Breakefield
- Department of Neurology, Molecular Neurogenetics Unit, Massachusetts General Hospital, Boston, MA 02129, USA; Harvard Medical School, Boston, MA 02115, USA
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de Lucio Delgado A, Villegas Rubio JA, Riaño-Galán I, Pérez Gordón J. Effect of the Use of Gnrh Analogs in Low-Grade Cerebral Glioma. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010115. [PMID: 36670665 PMCID: PMC9856414 DOI: 10.3390/children10010115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/19/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023]
Abstract
Low-grade gliomas are the most common brain tumors in children. This tumor type presents a wide range of clinical, histological, and biological behaviors. In recent years, an association between estrogens and progesterone and the development of tumors has been suggested. A case of a 2-year-old girl is described with a low-grade brain tumor treated with chemotherapy and disease stabilization. The treatment with Decapeptyl® was initiated due to precocious puberty, and the tumor showed a decrease in its solid component-more than 50% of the initial size-three years after starting treatment. Several studies have described the influence of estrogen and progesterone on the development of gliomas, decreasing or increasing their expression in those tumors with greater aggressiveness, respectively. Despite the fact that the tumor-hormonal expression relationship in other tumor types has been evaluated, its role in the treatment of brain tumors remains unknown.
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Affiliation(s)
- Ana de Lucio Delgado
- Oncology Pediatric Department, Central University Hospital of Asturias, 33011 Oviedo, Spain
- Correspondence:
| | | | - Isolina Riaño-Galán
- Pediatric Endocrinology Department, Central University Hospital of Asturias, 33011 Oviedo, Spain
| | - Juan Pérez Gordón
- Pediatric Endocrinology Department, Central University Hospital of Asturias, 33011 Oviedo, Spain
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Svanström Röjvall A, Buchli C, Flöter Rådestad A, Martling A, Segelman J. Impact of Androgens on Sexual Function in Women With Rectal Cancer - A Prospective Cohort Study. J Sex Med 2021; 18:1374-1382. [PMID: 37057455 DOI: 10.1016/j.jsxm.2021.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/29/2021] [Accepted: 05/29/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Women treated for rectal cancer are at risk of sexual dysfunction and impaired ovarian androgen production. AIM To investigate a possible association between serum levels of endogenous androgens and sexual function in women with rectal cancer. METHODS Women diagnosed with stage I-III rectal cancer were consecutively included and prospectively followed with the Female Sexual Function Index (FSFI) questionnaire from baseline to 2 years postoperatively and blood samples for hormone analyses, baseline to 1 year. Androgens were measured with liquid chromatography-mass spectrometry and electrochemiluminescence. The associations between the 4 measured androgens (testosterone, free testosterone, androstenedione, and dehydroepiandrosterone sulphate) and sexual function were assessed with generalized least squares random effects regression analysis in sexually active women. OUTCOMES The primary outcome measure was the mean change observed in the FSFI total score when the serum androgen levels changed with one unit. Secondary outcomes were the corresponding mean changes in the FSFI domain scores: sexual desire, arousal, lubrication, orgasm, satisfaction, and pain/discomfort. RESULTS In the 99 participants, the median FSFI total score decreased from 21.9 (range 2.0 - 36.0) to 16.4 (3.5 - 34.5) and 11.5 (2.0 to 34.8) at 1 and 2-years follow-up. After adjustment for age, partner, psychological well-being, preoperative (chemo)radiotherapy, and surgery, total testosterone and androstenedione were significantly associated with FSFI total score (β-coefficients 3.45 (95% CI 0.92 - 5.97) and 1.39 (0.46 - 2.33) respectively). Testosterone was significantly associated with the FSFI-domains lubrication and orgasm, free testosterone with lubrication, androstenedione with all domains except desire and satisfaction, and dehydroepiandrosterone sulphate with none of the domains. STRENGTHS AND LIMITATIONS This is the first study investigating whether androgen levels are of importance for the impaired sexual function seen in women following rectal cancer treatment. The prospective design allows for repeated measures and the use of the FSFI for comparisons across studies. No laboratory data were collected at the 2-year follow-up, and the missing data could have further clarified the studied associations. CONCLUSION AND CLINICAL IMPLICATION Testosterone and androstenedione were associated with sexual function in female rectal cancer patients. The results are of interest for future intervention studies and contribute to the understanding of sexual problems, which is an essential component of the rehabilitation process in pelvic cancer survivors. Svanström Röjvall A, Buchli C, Flöter Rådestad A, et al. Impact of Androgens on Sexual Function in Women With Rectal Cancer - A Prospective Cohort Study. J Sex Med 2021;18:1374-1382.
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Affiliation(s)
- Annika Svanström Röjvall
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Department of Surgery, GI Oncology Unit, St Göran's Hospital, Stockholm, Sweden.
| | - Christian Buchli
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Department of Pelvic Cancer, GI Oncology and Colorectal Surgery Unit, Stockholm, Sweden
| | - Angelique Flöter Rådestad
- Department of Hereditary Cancer, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Anna Martling
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Department of Pelvic Cancer, GI Oncology and Colorectal Surgery Unit, Stockholm, Sweden
| | - Josefin Segelman
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Department of Surgery, Ersta Hospital, Stockholm, Sweden
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Fruzzetti F, Fidecicchi T. Hormonal Contraception and Depression: Updated Evidence and Implications in Clinical Practice. Clin Drug Investig 2021; 40:1097-1106. [PMID: 32980990 DOI: 10.1007/s40261-020-00966-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Hormonal contraceptives are used worldwide by more than 100 million women. Some studies have been published about the possible appearance of depressive symptoms when using hormonal contraceptives, but this link is still a matter of debate. The purpose of this review is to provide an update of the literature on this issue, and to investigate the possible explanations of this problem based on animal and human studies. The main pathway responsible for menstrual cycle-related mood changes is the γ-aminobutyric acid pathway, which is sensitive to changes in the levels of progesterone and of its metabolites, the neurosteroids. In particular, allopregnanolone is a potentiating neurosteroid with anxiolytic and anti-convulsant effects whose levels change during a normal menstrual cycle together with progesterone levels. Progestins have different effects on allopregnanolone, mainly owing to their diverse androgenicity. Moreover, they might affect brain structure and function, even though the meaning of these changes has yet to be clarified. It is important to define the groups of women in which negative mood disorders are more likely to occur. Adolescence is a critical period and this age-specific vulnerability is complex and likely bidirectional. Moreover, women with a history of mood affective disorders or premenstrual dysphoric syndrome are at a higher risk when taking contraceptives. In this review, we aim to provide clinicians with advice on how to approach these difficult situations.
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Affiliation(s)
- Franca Fruzzetti
- Department of Obstetrics and Gynecology, Pisa University Hospital of S. Chiara, Azienda Ospedaliera Universitaria, Via Roma 65, 56126, Pisa, Italy.
| | - Tiziana Fidecicchi
- Department of Obstetrics and Gynecology, Pisa University Hospital of S. Chiara, Azienda Ospedaliera Universitaria, Via Roma 65, 56126, Pisa, Italy
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Alam MA, Quamri MA, Sofi G. Understanding hormones in terms of humours ( Akhlat) in Unani system of medicine. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2020; 18:459-467. [PMID: 32857723 DOI: 10.1515/jcim-2020-0003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 04/19/2020] [Indexed: 06/11/2023]
Abstract
In Unani System of Medicine, humours (Akhlat) play a vital role in maintenance of health; imbalance of their proportion either qualitative or quantitative can cause disease. Akhlat refers to the body fluids under a wider perspective in the Unani Medicine, which also encompasses fluids designated as hormones by the Modern Medicine. Akhlat (humours) are those moist and fluid parts of the body which are produced after transformation and metabolism of the nutrition; they serve the function of growth, repair, produce energy, preservation of individual and the species. It is concerned with growth, multiplication, differentiation, and metabolic activities of different tissues and systems, and thereby maintains a correct physiological balance between them. Present paper is a review on the concept of Akhlat and an attempt to understand hormones.
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Affiliation(s)
- Md Anzar Alam
- Department of Moalajat, National Institute of Unani Medicine, Bangalore 560091, India
| | | | - Ghulamuddin Sofi
- Department of Ilmul Advia, National Institute of Unani Medicine, Bangalore 560091, India
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7
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Kong F, Wang J, Zhang C, Feng X, Zhang L, Zang H. Assessment of sexual activity and menopausal symptoms in middle-aged Chinese women using the Menopause Rating Scale. Climacteric 2019; 22:370-376. [PMID: 30612483 DOI: 10.1080/13697137.2018.1547702] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- F. Kong
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
| | - J. Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
| | - C. Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
- Department of Obstetrics and Gynecology, The Affiliated Zhongshan Hospital of Dalian University, Dalian, P.R. of China
| | - X. Feng
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
| | - L. Zhang
- Department of Pathology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
| | - H. Zang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
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8
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Segelman J, Buchli C, Svanström Röjvall A, Matthiessen P, Arver S, Bottai M, Ahlberg M, Jasuja R, Flöter-Rådestad A, Martling A. Effect of radiotherapy for rectal cancer on ovarian androgen production. Br J Surg 2018; 106:267-275. [PMID: 30277569 DOI: 10.1002/bjs.10980] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/26/2018] [Accepted: 07/14/2018] [Indexed: 01/13/2023]
Abstract
Abstract
Background
The impact of radiotherapy (RT) for rectal cancer on ovarian androgen production is unknown. The aim was to examine the effect of RT for rectal cancer on androgen levels in non-oophorectomized women and the association with female sexual desire.
Methods
This prospective cohort study included women who had surgery for rectal cancer with or without RT. Serum testosterone, free testosterone, androstenedione and dehydroepiandrosterone sulphate (DHEA-S) levels were assessed at baseline, after RT and 1 year after surgery. Sexual desire was assessed by means of the Female Sexual Function Index.
Results
Twenty-seven participants had surgery alone (RT– group) and 98 had preoperative RT and surgery (RT+ group). During the first year after surgery, median serum testosterone and free testosterone levels decreased from 0·6 (range 0·1–3·6) to 0·5 (0·1–2·3) nmol/l (P < 0·001) and from 9·1 (1·6–45·8) to 7·9 (1·4–22·7) pmol/l (P < 0·001) respectively in the RT+ group, but did not change in the RT– group. Longitudinal regression analysis confirmed a decrease in testosterone and free testosterone after RT. The adjusted change in androstenedione and DHEA-S was not significant in any group. The mean change in testosterone (odds ratio (OR) 2·74, 95 per cent c.i. 1·06 to 7·11; P = 0·038), free testosterone (OR 1·08, 1·02 to 1·15; P = 0·011), androstenedione (OR 1·52, 1·07 to 2·16; P = 0·019) and DHEA-S (OR 0·49, 0·27 to 0·89; P = 0·019) was related to change in sexual desire.
Conclusion
RT decreased levels of androgens predominantly derived from the ovaries, whereas androgens of mainly adrenal origin remained unchanged. Reduction in ovarian androgens may be associated with reduced sexual desire.
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Affiliation(s)
- J Segelman
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery, Ersta Hospital, Stockholm, Sweden
| | - C Buchli
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Division of Coloproctology, Karolinska University Hospital, Stockholm, Sweden
| | - A Svanström Röjvall
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery, St Göran Hospital, Stockholm, Sweden
| | - P Matthiessen
- Department of Surgery, School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - S Arver
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Andrology and Sexual Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - M Bottai
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - M Ahlberg
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Division of Coloproctology, Karolinska University Hospital, Stockholm, Sweden
| | - R Jasuja
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, and Function Promoting Therapies, Weston, Massachusetts, USA
| | - A Flöter-Rådestad
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Division of Obstetrics and Gynaecology, Karolinska University Hospital, Stockholm, Sweden
| | - A Martling
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Division of Coloproctology, Karolinska University Hospital, Stockholm, Sweden
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Sexual activity and function assessment in middle-aged Chinese women using the female sexual function index. Menopause 2018; 24:669-676. [PMID: 28072610 DOI: 10.1097/gme.0000000000000812] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To assess sexual activity, sexual function, and their correlation with vaginal maturation status among middle-aged Chinese women. METHODS A cross-sectional study with comparisons across age groups was carried out. In all, 120 women aged 45 to 60 years were recruited into three groups: 45 to 50 (youngest group), 51 to 55 (intermediate group), and 56 to 60 years old (eldest group). Sexual function was assessed through the Female Sexual Function Index (FSFI); vaginal maturation status was determined through the Vaginal Maturation Index (VMI) and pH value. Sexual activity was recorded with self-administered questionnaires. RESULTS Low sexual frequency was present in a higher proportion of women, but sexual distress was identified within a lower proportion of women in the eldest group. The total FSFI score was significantly lower in the eldest group than in the youngest and intermediate groups (P < 0.01 and 0.05, respectively); however, the domain score of sexual desire, arousal, and satisfaction was lower in the eldest group than in the youngest group (P < 0.01, 0.05, and 0.05) only. The domain score for lubrication was lower in the eldest group than in both the youngest and intermediate groups (P < 0.01 and 0.05), and the pain score was lower in both the intermediate and eldest groups than in the youngest group (P < 0.01 and 0.05). A lower VMI (P < 0.001) and a higher pH value (P < 0.01) were observed in the eldest group, compared with the youngest group. Moreover, VMI was positively correlated with the total FSFI score, the domain score for sexual desire, and lubrication (r = 0.26, 0.25, 0.34; P < 0.05, 0.05, 0.01), but the opposite associations were demonstrated for pH value (r = -0.47, -0.37, -0.38; P < 0.01, respectively), especially with vaginal pain (r = -0.44, P < 0.01). CONCLUSIONS Among middle-aged Chinese women, sexual desire is lower in 56 to 60-year-old women, compared with those aged 45 to 55 years, whereas vaginal dryness and dyspareunia become more prevalent with age. Importantly, sexual function is associated with vaginal maturation status in women at midlife.
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Kara A, Unal D, Simsek N, Yucel A, Yucel N, Selli J. Ultra-structural changes and apoptotic activity in cerebellum of post-menopausal-diabetic rats: a histochemical and ultra-structural study. Gynecol Endocrinol 2014; 30:226-31. [PMID: 24397360 DOI: 10.3109/09513590.2013.864270] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Diabetes mellitus (DM) is one of the most common and chronic diseases, especially in post-menopausal periods. Neuro-degeneration occurs more frequently in post-menopausal diabetics. Therefore, we investigated ovariectomized rats cerebellar cortex response to the estradiol deficiency and hyperglycemia. For the ovariectomy, the rats were bilaterally ovariectomized, and then DM induced by a single dose of Alloxan monohydrate injection in ovariectomy or/and diabetic groups. During light and electron microscopic examination, degenerated Purkinje cells membrane, swollen organelles, degenerated mitochondria, edema formation and vacuolization were seen in the ovariectomy and ovariectomy-diabetic groups sections. In addition, increased apoptotic activity was observed in the ovariectomy and ovariectomy-diabetic groups compared to the control group. We demonstrated that estradiol and insulin deficiency can affect the cerebellar cortex, which support the hypothesis that the execution of neuronal damages in post-menopausal diabetics. Also, diabetes and menopause are major risks factors for many disorders including nervous system and the number of post-menopausal-diabetics are increasing world-wide.
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Affiliation(s)
- Adem Kara
- Department of Histology and Embryology, Faculty of Veterinary Medicine
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11
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Marshall KM. Introduction to the interaction between gonadal steroids and the central nervous system. Curr Top Behav Neurosci 2011; 8:1-13. [PMID: 21644052 DOI: 10.1007/7854_2011_136] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
The sex steroids are frequently referred to as the gonadal steroids and are erroneously assumed to be exclusively linked to the ovaries in women or the testes in men and the functions of the reproductive tract. This chapter will provide an overview of some of the extragonadal effects of these hormones, focusing on the central nervous system, and the mechanisms of hormone action. Hormone synthesis and metabolism within the CNS will be discussed with particular focus on the role of aromatase. Sex steroids exert many of their effects via intracellular receptors and these genomic responses tend to be slow in onset, however, some responses to steroids occur more quickly and are mediated via membrane receptors and involve interactions with many different transduction pathways to produce a diverse array of responses. These complexities do pose challenges but also offer opportunity for novel approaches for therapeutic exploitation as the pharmacological tools with which to modulate systems become increasingly available.
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Affiliation(s)
- Kay M Marshall
- School of Pharmacy, University of Bradford, Bradford, BD7 1DP, UK.
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12
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Kocoska-Maras L, Zethraeus N, Rådestad AF, Ellingsen T, von Schoultz B, Johannesson M, Hirschberg AL. A randomized trial of the effect of testosterone and estrogen on verbal fluency, verbal memory, and spatial ability in healthy postmenopausal women. Fertil Steril 2011; 95:152-7. [DOI: 10.1016/j.fertnstert.2010.05.062] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 05/26/2010] [Accepted: 05/27/2010] [Indexed: 12/23/2022]
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Abstract
Although the effects of estrogen on sexual behavior in mammals are well known, its role on other types of behavior, including cognition, have only recently been recognized. This review summarizes work conducted in our laboratory and others with the aim of identifying the effects of estrogen on cognitive functions. The first section will briefly describe the neurobiology of estrogen. The second section will discuss the effects of estrogen on cognitive behaviors in mammals, as well as the physiological relevance of these effects and their applicability to human health and disease. The third section will detail the role of estrogen on working memory in humans and nonhuman primates, and in rodents. Finally, the concluding section will briefly describe the relationship between estrogen and the aging brain.
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Affiliation(s)
- Antonella Gasbarri
- a Department of Biomedical Sciences and Technologies, Faculty of Sciences of Education, University of L'Aquila, via Vetoio, 67100 L'Aquila, Italy.
| | - Assunta Pompili
- b Department of Biomedical Sciences and Technologies, Faculty of Sciences of Education, University of L'Aquila, via Vetoio, 67100 L'Aquila, Italy.
| | - Maria Clotilde Tavares
- c Department of Physiological Sciences, Laboratory of Neurosciences and Behavior, Center of Primatology, University of Brasília, Campus Asa Norte, CEP 70910-900 Brasília, DF, Brazil.
| | - Carlos Tomaz
- d Department of Physiological Sciences, Laboratory of Neurosciences and Behavior, Institute of Biology, University of Brasília, Campus Asa Norte, CEP 70910-900 Brasília, DF, Brazil.
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A randomized trial of the effect of estrogen and testosterone on economic behavior. Proc Natl Acad Sci U S A 2009; 106:6535-8. [PMID: 19366676 DOI: 10.1073/pnas.0812757106] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Existing correlative evidence suggests that sex hormones may affect economic behavior such as risk taking and reciprocal fairness. To test this hypothesis we conducted a double-blind randomized study. Two-hundred healthy postmenopausal women aged 50-65 years were randomly allocated to 4 weeks of treatment with estrogen, testosterone, or placebo. At the end of the treatment period, the subjects participated in a series of economic experiments that measure altruism, reciprocal fairness, trust, trustworthiness, and risk attitudes. There was no significant effect of estrogen or testosterone on any of the studied behaviors.
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15
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Accortt EE, Freeman MP, Allen JJB. Women and major depressive disorder: clinical perspectives on causal pathways. J Womens Health (Larchmt) 2009; 17:1583-90. [PMID: 19049352 DOI: 10.1089/jwh.2007.0592] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND AIMS Epidemiological data on the prevalence of mood disorders demonstrate that major depressive disorder (MDD) is approximately twice as common in women as in men and that its first onset peaks during the reproductive years. We aimed to review key social, psychological, and biological factors that seem strongly implicated in the etiology of major depression and to focus on sex-specific aspects of depression, such as the role of a woman's reproductive life cycle in depressive symptomatology. METHODS A review of the literature, from 1965 to present, was conducted. RESULTS An integrated etiological model best explains gender and sex differences in depression. Social, psychological, and biological variables must be simultaneously taken into account. These vulnerabilities include (but are not limited to) gender-specific roles in society, life stress such as trauma, a tendency toward ruminative coping strategies, and the effects of sex hormones and genetic factors. CONCLUSIONS To effectively treat MDD in women and to prevent the recurrence of illness in vulnerable women, clinicians must understand the sex-specific aspects of mood disorders over the longitudinal course of women's reproductive lives. A biopsychosocial approach should, therefore, be the main focus of future research and practice, to eventually result in an integrated etiological model of depression in women. Based on the prevalence of MDD in women, timely screening, diagnosis, and intervention should be public health priorities.
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16
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Nappi RE, Polatti F. Continuing Medical Education: The Use of Estrogen Therapy in Women's Sexual Functioning (CME). J Sex Med 2009; 6:603-16; quiz 618-9. [DOI: 10.1111/j.1743-6109.2008.01198.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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17
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Acute effect of intranasal estrogen on cerebral and cerebellar perfusion in postmenopausal women. Maturitas 2008; 59:72-82. [DOI: 10.1016/j.maturitas.2007.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2007] [Revised: 10/05/2007] [Accepted: 10/09/2007] [Indexed: 11/21/2022]
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18
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Archer DF, Hendrix S, Ferenczy A, Felix J, Gallagher JC, Rymer J, Skouby SO, den Hollander W, Stathopoulos V, Helmond FA. Tibolone histology of the endometrium and breast endpoints study: design of the trial and endometrial histology at baseline in postmenopausal women. Fertil Steril 2007; 88:866-78. [PMID: 17548089 DOI: 10.1016/j.fertnstert.2006.12.052] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2006] [Revised: 12/27/2006] [Accepted: 12/27/2006] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To address the endometrial safety of tibolone. DESIGN The Tibolone Histology of the Endometrium and Breast Endpoints Study (THEBES) is a randomized, double-blind, parallel-group trial of tibolone compared with continuous combined conjugated equine estrogen (CEE) and medroxyprogesterone acetate (MPA). SETTING Multi-country, multi-center ambulatory care setting. PATIENT(S) A total of 5,185 subjects were screened, and biopsies were obtained from 4,446 women. INTERVENTION(S) Participants were randomized in a 1:1:2 ratio, to tibolone (1.25 or 2.5 mg/d) or CEE-MPA. MAIN OUTCOME MEASURE(S) The one-sided 95% confidence intervals for the incidence of hyperplasia or cancer were evaluated for tibolone compared with CEE-MPA. RESULT(S) Endometrial biopsy results at baseline: atrophic (87.29%), inactive (0.25%), proliferative (6.12%), secretory (2.86%), menstrual type (0.40%), and hyperplasia (0.18%). Only subjects with atrophic or inactive endometrium were eligible for this study, and 3% of the women at screening either had no tissue (0.18%) or had an amount of tissue that was insufficient for diagnosis (2.72%). Three thousand two hundred forty postmenopausal women with a mean (+/-SD) age of 54.4 +/- 4.4 years and a mean time since menopause of 4.5 +/- 3.6 years were randomized. CONCLUSION(S) The Tibolone Histology of the Endometrium and Breast Endpoints Study is a prospective, randomized clinical trial, designed to provide evidence of the endometrial safety of tibolone compared with estrogen and progestogen. Screening endometrial histology shows a low prevalence of endometrial hyperplasia (0.18%) and no carcinoma.
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Affiliation(s)
- David F Archer
- Department of Obstetrics and Gynecology, Contraceptive Research and Development Program Clinical Research Center, Eastern Virginia Medical School, Norfolk, Virginia 23507, USA.
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Marceglia S, Priori A. Sex, genes, hormones and nigral neurodegeneration: two different Parkinson’s diseases in males and in females. FUTURE NEUROLOGY 2007. [DOI: 10.2217/14796708.2.5.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Evaluation of: Cantuti-Castelvetri I, Keller-McGandy C, Bouzou B et al.: Effects of gender on nigral gene expression and Parkinson disease. Neurobiol. Dis. 26(3), 606–614 (2007). Evidence from clinical, anatomical, neurophysiological, endocrinological and genetic studies demonstrates that Parkinson’s disease (PD) is a gender-specific pathology. The study by Cantuti-Castelvetri et al. points out the central role of sexual dimorphisms in gene expression for understanding the pathophysiology of gender differences in PD. They identified several genes differentially expressed in female and male PD patients. Their results support the hypothesis that PD in females and in males are two different pathologies possibly associated with specific therapies. Gender differences in PD could be seen in the wider perspective of gender medicine for neurological disorders and their results suggest that basic and clinical research should examine sex differences for both understanding the disease and optimizing treatments.
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Affiliation(s)
- Sara Marceglia
- Università di Milano, Dipartimento di Scienze Neurologiche, Fondazione IRCCS Ospedale Policlinico, via Francesco Sforza 35, 20122, Milano, Italy
| | - Alberto Priori
- Università di Milano, Dipartimento di Scienze Neurologiche, Fondazione IRCCS Ospedale Policlinico, via Francesco Sforza 35, 20122, Milano, Italy
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Takuma K, Matsuo A, Himeno Y, Hoshina Y, Ohno Y, Funatsu Y, Arai S, Kamei H, Mizoguchi H, Nagai T, Koike K, Inoue M, Yamada K. 17beta-estradiol attenuates hippocampal neuronal loss and cognitive dysfunction induced by chronic restraint stress in ovariectomized rats. Neuroscience 2007; 146:60-8. [PMID: 17320294 DOI: 10.1016/j.neuroscience.2007.01.017] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2006] [Revised: 01/03/2007] [Accepted: 01/13/2007] [Indexed: 10/23/2022]
Abstract
Several lines of evidence suggest that hormonal changes after menopause may play an important role in the incidence of cognitive dysfunction, and also in the development of Alzheimer's disease. In this study, we investigated the effect of estrogen on cognitive function in rats under different stress environment. Female rats were divided into four groups: two groups were ovariectomized (OVX) and two were sham-operated. One group each of OVX and sham rats was kept in a normal environment, and the other groups were assigned to a daily restraint stress (6 h/day) for 21 days from 2 months after the operation. Following the stress period, subjects were tested for performance in novel object recognition test and then used for morphological and neurochemical analyses. The OVX plus stress (OVX/stress) group showed a significant impairment of recognition of novel objects, compared with the other groups. The OVX/stress group also showed a marked decrease in the number of pyramidal cells of the CA3 region and levels of brain-derived neurotrophic factor mRNA in the hippocampus. We further examined the effect of estrogen against cognitive dysfunction and hippocampal changes of OVX/stress rats. Vehicle or 17beta-estradiol (E2) at 20 microg/day was s.c. administered to OVX/stress rats from 2 days before the stress period to the end of behavioral analysis through an implantable osmotic pump. Chronic E2 treatment decreased stress response and improved the cognitive and morphological impairments relative to vehicle group. These data have important implications for cognition enhancing effect of estrogen treatment in postmenopausal women.
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Affiliation(s)
- K Takuma
- Laboratory of Neuropsychopharmacology, Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan
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Koundi KL, Christodoulakos GE, Lambrinoudaki IV, Zervas IM, Spyropoulou A, Fexi P, Sakkas PN, Soldatos CR, Creatsas GC. Quality of life and psychological symptoms in Greek postmenopausal women: association with hormone therapy. Gynecol Endocrinol 2006; 22:660-8. [PMID: 17162707 DOI: 10.1080/09513590601010557] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Quality of life (QoL) in menopause is influenced by many parameters, including vasomotor symptoms, psychological status and culture. The aim of the present study was to examine the association of hormone therapy (HT) with QoL and psychological symptoms in Greek postmenopausal women. The study assessed 216 postmenopausal women (mean age 54.5 years) attending a university menopause clinic in Greece. Fifty-three were users of HT and 163 were not. QoL was evaluated by the Utian Quality of Life Scale (UQOL) and psychological symptoms were assessed by the Symptom Checklist-90-R (SCL-90-R). Women on HT were younger and more educated than women not using HT. Adjusting the analysis for the women's characteristics, HT users had better total UQOL scores than non-users (p < 0.05). Marital status and education had independent effects on QoL, with married and more educated women scoring higher (p < 0.05). Assessment of psychological symptomatology, after adjustment for sociodemographic variables across the different dimensions, revealed that HT users had better SCL-90-R scores than non-users for obsessionality, interpersonal sensitivity and for the general index (p < 0.05). Concluding, even though the impact of sociodemographic and lifestyle variables must be factored into the assessment of QoL, HT use is independently related to an improvement in the total score and in most domains of QoL, and has a significant positive effect on many aspects of psychological well-being in Greek postmenopausal women.
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Affiliation(s)
- Kalliopi L Koundi
- Athens University Medical School, Women's Mental Health Clinic, Department of Psychiatry, Eginition Hospital, Athens, Greece
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22
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Olsen L, Rasmussen HB, Hansen T, Bagger YZ, Tankó LB, Qin G, Christiansen C, Werge T. Estrogen receptor alpha and risk for cognitive impairment in postmenopausal women. Psychiatr Genet 2006; 16:85-8. [PMID: 16538187 DOI: 10.1097/01.ypg.0000194445.27555.71] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The estrogen receptor alpha (ESR1) gene has been implicated in the process of cognitive impairment in elderly women. In a paired case-control study, we tested whether two ESR1 gene polymorphisms (the XbaI and PvuII sites) are risk factors for cognitive impairment as measured by the six-item Orientation-Memory-Concentration test in postmenopausal Danish women. Hormone replacement therapy, age and executive cognitive ability were examined as covariates for ESR1 gene effects on cognitive impairment. The XbaI polymorphism showed a marginal effect on cognitive abilities (P=0.054) when adjusted for executive cognitive ability. Using a dominant genetic model for the X allele, we found an elevated risk (executive cognitive ability adjusted P=0.033) for cognitive impairment. Hormone replacement therapy also had a borderline effect on cognitive ability (P=0.049) and this effect was reflected in executive cognitive ability. These data support that the ESR1 gene variants affect cognitive functioning in postmenopausal women.
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Affiliation(s)
- Line Olsen
- Research Institute of Biological Psychiatry, Copenhagen University Hospital, Roskilde, Denmark
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23
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Tomei G, Ciarrocca M, Fortunato BR, Capozzella A, Rosati MV, Cerratti D, Tomao E, Anzelmo V, Monti C, Tomei F. Exposure to traffic pollutants and effects on 17-beta-estradiol (E2) in female workers. Int Arch Occup Environ Health 2006; 80:70-7. [PMID: 16680486 DOI: 10.1007/s00420-006-0105-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2005] [Accepted: 03/15/2006] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim of the study is to evaluate whether the occupational exposure to urban pollutants including endocrine disruptors (EDs) could cause alterations in plasma 17-beta-estradiol (E2) levels and related diseases (adverse pregnancy outcome and mental health disorders) in female traffic police compared to a control group. METHODS After excluding the subjects with the principal confounding factors, traffic police and controls were matched by age, years of police work, age of menarche, menstrual cycle day, body mass index (BMI), drinking habit, cigarette smoking habit, habitual intake of soy or liquorice in diet and habitual consumption of Italian coffee. Thirty-seven traffic police and 31 controls (seventh day; follicular phase of the ovarian cycle); 38 traffic police and 42 controls (14th day; ovulatory phase of the ovarian cycle); and 25 traffic police and 28 controls (21st day; lutheal phase of the ovarian cycle) were included in the study and then matched for the above-mentioned variables. RESULTS In follicular and in lutheal phases, mean E2 levels were significantly lower in traffic police compared to controls. The distribution of E2 values in traffic police and controls was significant in follicular, ovulatory and lutheal phases. In ovulatory phase, mean E2 levels were lower but not significant in traffic police compared to controls. An increase was found concerning mental health disorders referred to in the questionnaire items in traffic police compared to controls, although the difference was not significant. CONCLUSIONS Considering that the potential confounding effect of extraneous factors was controlled for by restricting the study population and by matching traffic police and controls on the above-mentioned variables, our results suggest that occupational exposure to urban pollutants, EDs included, might alter E2 plasma concentrations. E2 could be used in occupational set as an early biomarker of exposure to urban pollutants, valuable for the group, even before the onset of the related pathologies (adverse pregnancy outcome and mental health disorders).
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Affiliation(s)
- Gianfranco Tomei
- Department of Occupational Medicine, University of Rome "La Sapienza", Viale Regina Elena 336, 00161 Rome, Italy
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Nievas AF, Furegato ARF, Iannetta O, Santos JLF. Depressão no climatério: indicadores biopsicossociais. JORNAL BRASILEIRO DE PSIQUIATRIA 2006. [DOI: 10.1590/s0047-20852006000400003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Identificar a presença de sintomas depressivos em mulheres no climatério, analisando os indicadores biopsicossociais relacionados. MÉTODOS: Aplicaram-se o Questionário de Identificação e Contexto da Mulher no Climatério (ICMC) e o inventário de Beck a 30 mulheres em primeiro atendimento no Ambulatório Multidisciplinar do Climatério do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCRP/FMRP/USP). Os dados foram estatisticamente trabalhados por análise bivariada e multivariada. RESULTADOS: Observa-se que, de acordo com o inventário de Beck, foi identificada depressão em 14 das 30 mulheres atendidas no ambulatório no período de novembro de 2003 a dezembro de 2004. CONCLUSÃO: Os resultados mostraram que os sintomas depressivos estavam aumentados em mulheres na faixa dos 40 aos 49 anos, não-brancas, que tinham companheiro pertencente ao grupo biológico B ou C, que tinham problemas com o cônjuge, que vivenciaram hábito de beber, situação de óbito recentemente e/ou desemprego na família.
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Abstract
BACKGROUND In terms of clinical outcomes, women with schizophrenia seem to fare better then men, but appear more vulnerable to psychotic illness in the period after birth and menopause. As these vulnerable periods to psychosis are associated with estrogen withdrawal, this hormone has been proposed as a treatment for schizophrenia. OBJECTIVES To evaluate the clinical effects of estrogens alone or in combination with progesterone, as a sole treatment or as an adjunctive therapy, for the treatment of schizophrenia or schizophrenia-like illnesses. SEARCH STRATEGY Electronic searches of the Cochrane Schizophrenia Group's Register (October 2003) was supplemented with manual reference inspection of all identified studies. Authors of trials were contacted for further material and archive information. SELECTION CRITERIA All randomised clinical trials comparing estrogens with or without progesterone, as a sole or adjunctive treatment for people with schizophrenia or other similar serious, non-affective psychotic illness. DATA COLLECTION AND ANALYSIS We evaluated data independently and analysed on an intention to treat basis. For binary data we calculated the fixed effect relative risk (RR) and its 95% confidence interval (CI). For continuous non-skewed data, we calculated weighted mean differences. MAIN RESULTS All available evidence relates to women. Four studies (n=108) compared estrogen only with placebo. Short-term scores for general mental state showed no significant difference between groups (n=24, 1 RCT, WMD PANSS for 100mcg comparison -2.26 CI -15.4 to 10.9). Data from all four studies showed overall loss from the studies was low ( 5%), with no significant differences between groups (n=96, 4 RCTs, RR 0.95 CI 0.2 to 6.1). Skewed continuous data from two studies showed no clear differences in ratings of movement disorders. One medium-term unpublished study (n=14) compared estrogen and progesterone with placebo. Data at six months showed no difference between groups for total scores (n=9, WMD PANSS -25.3 CI -51 to 0.1). For negative symptoms, results favoured the estrogen and progesterone group (n=9, WMD PANSS negative subscale -9.0 CI -17 to -0.9). For loss to follow up there was no difference between groups (n=10, RR 0.33 CI 0.02 to 6.7). This trial used many cognitive tests and one visual retention test showed statistically significant differences favouring the treatment group: total scores (n=8, WMD -3.5 CI -5.7 to -1.3). AUTHORS' CONCLUSIONS Adjunctive estrogen with or without progesterone does not appear to offer convincing advantages over placebo. Before any more research is undertaken in this area, all completed and unpublished work should be made available in order to ensure that more trials are justified.
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Affiliation(s)
- W L Chua
- Bradford District Care Trust, City Mental Health Team, Horton Park Centre, 99 Horton Park Avenue, Bradford, West Yorkshire, UK BD7 3 EG.
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26
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Andrade TGCS, Nakamuta JS, Avanzi V, Graeff FG. Anxiolytic effect of estradiol in the median raphe nucleus mediated by 5-HT1A receptors. Behav Brain Res 2005; 163:18-25. [PMID: 15951031 DOI: 10.1016/j.bbr.2005.04.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2004] [Revised: 03/31/2005] [Accepted: 04/05/2005] [Indexed: 11/17/2022]
Abstract
Estrogen deficiency has been associated with stress, anxiety and depression. Estrogen receptors have been identified in the median raphe nucleus (MRN). This structure is the main source of serotonergic projections to the hippocampus, a forebrain area implicated in the regulation of defensive responses and in the resistance to chronic stress. There is evidence showing that estrogen modulates 5-HT1A receptor functions. In the MRN, somatodendritic 5-HT1A receptors control the activity of serotonergic neurones by negative feedback. The present study evaluated the effect of intra-MRN injection of estradiol benzoate (EB) (600 or 1200ng/0.2microl) on the performance of ovariectomised rats submitted to the elevated plus-maze test of anxiety and to the open-field test. Additionally, the same effect was evaluated with a previous intra-MRN injection of WAY 100635(100ng/0.2microl), an antagonist of 5-HT1A receptors. The results showed that both doses of EB increased the percentage of entries and the percentage of time spent into the open arms, suggestive of an anxiolytic effect. The highest dose of the drug also increased the number of entries into the enclosed arm and locomotion in the open field, indicating a stimulatory motor effect. WAY 100635 antagonised the effect of estradiol in the elevated plus-maze and in the open-field. The results show that estrogen receptors of the MRN are implicated in the regulation of anxiety-related behaviour. The results also support claims that the effect of estrogen involves a change in 5-HT1A receptor function.
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Affiliation(s)
- T G C S Andrade
- Department of Biological Science, UNESP, Avenida Dom Antonio, 2100, 19.806-900, Assis, São Paulo, Brazil.
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Jasienska G, Ziomkiewicz A, Górkiewicz M, Pajak A. Body mass, depressive symptoms and menopausal status: An examination of the “Jolly Fat” hypothesis. Womens Health Issues 2005; 15:145-51. [PMID: 15894200 DOI: 10.1016/j.whi.2005.02.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2004] [Revised: 12/29/2004] [Accepted: 02/18/2005] [Indexed: 11/23/2022]
Abstract
PURPOSE Estrogens are linked with depression due to their ability to alter the function of the serotonin neural systems. We hypothesize that postmenopausal women should have a higher degree of depressive symptoms than premenopausal women. Further, because estrogen levels in postmenopausal women positively correlate with body fat, we hypothesize that there is an inverse relationship between body fat and depressive symptoms among postmenopausal women. METHODS We enrolled 1156 Polish urban women aged 45 to 64 in a cross-sectional study. Depressive symptoms were assessed by the Center for Epidemiologic Studies-Depression Scale (CES-D) scale. Menopausal status and education level was assessed by a standardized questionnaire. MAIN FINDINGS Postmenopausal women had higher mean CES-D scores of depressive symptoms than premenopausal women (14.4 versus 13.2 respectively, p = .018). Both among pre- and postmenopausal women, those with higher education had lower scores of depressive symptoms. In addition, in postmenopausal women with lower education an inverse relationship was observed between body mass index (BMI) and depressive symptoms: a higher BMI was associated with a lower score of depressive symptoms (p = .009). Such a relationship was not present among premenopausal women or women who were postmenopausal but better educated. CONCLUSIONS This study indicates that menopausal status is related to differences in the degree of occurrence of depressive symptoms. Our results support the "Jolly Fat" hypothesis for postmenopausal women with lower education, namely, a higher BMI is associated with lower score of depressive symptoms.
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Affiliation(s)
- Grazyna Jasienska
- Department of Epidemiology and Population Studies, Jagiellonian University Collegium Medicum, Krakow, Poland.
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28
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Rücker B, Pochmann D, Fürstenau CR, Carneiro-Ramos MS, Battastini AMO, Barreto-Chaves MLM, Sarkis JJF. Effects of steroid hormones on synaptosomal ectonucleotidase activities from hippocampus and cortex of adult female rats. Gen Comp Endocrinol 2005; 140:94-100. [PMID: 15613271 DOI: 10.1016/j.ygcen.2004.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2004] [Revised: 10/01/2004] [Accepted: 10/12/2004] [Indexed: 11/24/2022]
Abstract
Over the last few years, the effects of steroid hormones on the brain have been intensively discussed. It has been demonstrated that ATP (acting as a neurotransmitter) is hydrolyzed to adenosine in the synaptic cleft by the conjugated action of ectonucleotidases, which include an enzyme of the E-NTPDase family (NTPDase3, apyrase, EC 3.6.1.5) and a 5'-nucleotidase (EC 3.1.3.5). The 5'-nucleotidase enzyme is able to hydrolyze AMP as well as other monophosphate nucleotides. The importance of this enzyme in the central nervous system is to participate in the adenosine formation, a nucleoside with neuroprotective properties and modulatory effects. However, several questions have been raised about the mechanisms of steroid hormones and the possible neuroprotective effects of estrogen. Thus, we examined the effects of gonadal steroid hormone deprivation, induced by ovary removal (OVX) and estradiol replacement therapy, on the ectonucleotidase activities in synaptosomes from hippocampus and cerebral cortex of adult rats. ATP and ADP hydrolysis in synaptosomes from cerebral cortex and hippocampus did not change as a function of OVX and results demonstrated an increase in AMP hydrolysis (82%) in the animals submitted to OVX in cerebral cortex, but not in hippocampus, when compared to control and sham-operated groups. Estradiol replacement therapy reversed this effect. RT-PCR analysis showed that the enhancement of enzyme activity in cerebral cortex could be explained by the higher expression of 5'-nucleotidase, following OVX. The hormones 17beta-estradiol (cyclodextrin-encapsulated 17beta-estradiol), DHEAS, and pregnenolone (1.0, 2.5, and 5.0 microM) did not alter the nucleotide hydrolysis, in vitro, in synaptosomes from cortex and hippocampus of female adult rats. Results presented, herein, should be considered relevant for hormone replacement therapy, since much controversy exists surrounding this area and the relationship between adenosine and sex steroids is still poorly understood.
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Affiliation(s)
- Bárbara Rücker
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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Malyala A, Pattee P, Nagalla SR, Kelly MJ, Rønnekleiv OK. Suppression subtractive hybridization and microarray identification of estrogen-regulated hypothalamic genes. Neurochem Res 2004; 29:1189-200. [PMID: 15176476 DOI: 10.1023/b:nere.0000023606.13670.1d] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The gonadal steroid estrogen is a pleiotropic hormone that has multiple effects on numerous cellular functions. One of estrogen's major targets is the brain, where the steroid not only affects growth, differentiation, and survival of neurons, but also regulates cell excitability. Because estrogen modulates multiple, overlapping signaling pathways, it has been difficult to scrutinize the transcriptional activity of the steroid. Therefore, we still lack a global picture of how different genes interact and are regulated by estrogen. Herein we report the use of suppression subtractive hybridization followed by custom microarray analysis of thousands of genes that are differentially expressed during the negative feedback phase of the female reproductive cycle. We have found a number of key transcripts that are regulated by estrogen and contribute to the alteration in synaptic transmission and hence excitability of hypothalamic neurons (e.g., GABA neurons). These include gec-1, GABA(B)R2, PI3 kinase subunit p55gamma, and a number of proteins containing pleckstrin homology domains that are critical for plasma membrane targeting. Studies are underway to refine our analysis to individual nuclei and individual cells. However, what has emerged from this highly sensitive microarray analysis is that estrogen affects neuronal plasticity in hypothalamic neurons not only by transcription of new membrane proteins (e.g., receptors and channels), but also by altering expression of downstream signaling molecules and proteins involved in neurosecretory pathways.
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Affiliation(s)
- Anna Malyala
- Department of Physiology and Pharmacology, Oregon Health and Science University, Portland, Oregon 97239, USA
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Jacobs PA, Hyland ME. An evaluation of the benefits of taking hormone replacement therapy with other prescription drugs. Maturitas 2003; 46:273-81. [PMID: 14625124 DOI: 10.1016/s0378-5122(03)00198-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Clinical trials of hormone replacement therapy (HRT) exclude women who have other health problems. The aim of our community survey was to investigate the impact of HRT on women with a variety of other health problems. METHOD Questionnaire sample of 935 women aged 45-58 years. The questionnaire assessed menopausal quality of life (QOL); self reported health status, prescription drug use and history of hormone supplement use. RESULTS Thirty five percent of the total sample had taken a variety of prescription drugs in the last 2 months. Prescription drug use was significantly higher in current and former users of HRT/ERT than in non-HRT/ERT users. Current and former HRT users who also took prescription drugs had a significantly lower mean length of HRT/ERT use when compared to women who took HRT/ERT with no prescription drugs. Peri and postmenopausal women currently taking HRT/ERT reported significantly higher MQOL than both former and non-HRT users, which suggest that the benefits of taking hormone supplements during the menopausal transition for some women. There was a significant interaction between hormone use, level of prescription drug use and QOL. Among women who have high levels of prescription drug use, those who take hormone supplements report significantly fewer deficits in QOL when compared to non or former users of HRT/ERT. Additionally, women taking selective serotonin re-uptake inhibitors (SSRI) plus HRT report significantly higher levels of QOL compared to women taking SSRI alone. CONCLUSIONS The advantages of taking HRT among who take prescription drugs could be attributed to the mood enhancing effects of estrogens. HRT should be considered for some peri and postmenopausal women who are taking SSRIs or who are taking at least three different types of prescription drugs.
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Affiliation(s)
- Pamela A Jacobs
- Department of Psychology, University of Plymouth, Drake Circus, Plymouth, Devon PL4 8AA, UK.
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