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Abstract
The association between obstructed müllerian duct anomalies and endometriosis has been well established and the pathogenesis is attributed to the theory of retrograde menstruation. However, this relationship with endometriosis is less clear in women with unobstructed müllerian duct anomalies and in those with rudimentary uterine structures that lack functioning endometrial tissue. This article reviews the embryology, genetics, pathophysiology, and American Society for Reproductive Medicine (ASRM) classification for müllerian duct anomalies together with the genetics and pathophysiology of endometriosis to provide a framework for understanding the complex relationship between these two entities. Available published data examining the coexistence of endometriosis in relationship to müllerian duct anomalies, including studies that stratify this relationship according to specific classes of anomalies, are reviewed and organized. Awareness of the increased prevalence of endometriosis among patients with uterine anomalies, particularly those with outflow obstruction, may facilitate early diagnosis of endometriosis and subsequent intervention, with the potential to reverse disease symptoms and arrest disease progression.
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2
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Sood A, Akhtar M. T-shaped Uterus in the 21 st Century (Post DES era) - We Need to Know More! J Hum Reprod Sci 2019; 12:283-286. [PMID: 32038076 PMCID: PMC6937769 DOI: 10.4103/jhrs.jhrs_101_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/24/2019] [Accepted: 11/01/2019] [Indexed: 11/05/2022] Open
Abstract
T-Shaped uterus is a rare uterine malformation, and has classically been associated with "in-utero" exposure of DES (diethylstilbestrol). Surprisingly, the prevalence of T shaped uterus is significant even today. Hysteroscopic metroplasty is a simple procedure which can potentially improve outcomes in sub-fertile women, but the data is not robust. There is a need for centralised database for registration of women with T shaped uterine anomalies, which will help in defining clear diagnostic criteria, surgical indication & technique, and follow up of reproductive outcomes after the procedure.
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Affiliation(s)
- Akanksha Sood
- Department of Reproductive Medicine, St. Mary's Hospital, Manchester, UK
| | - Muhammad Akhtar
- Department of Reproductive Medicine, St. Mary's Hospital, Manchester, UK
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3
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Abstract
Diethylstilbestrol (DES) is a synthetic estrogen given to pregnant women to prevent miscarriages and preterm labor; the drug was used between 1941 and 1971 in the United States and into the 1980s in other countries. DES exposure is associated with significant long-term health effects, including increased risk for breast cancer, cervical and vaginal clear cell adenocarcinoma, reproductive tract abnormalities, infertility, poor pregnancy outcomes, and early menopause. This article reviews the potential health risks associated with DES exposure, how to assess which patients are at risk, and management recommendations for patients exposed to DES.
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4
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Chambers KC. Conditioned taste aversions. World J Otorhinolaryngol Head Neck Surg 2018; 4:92-100. [PMID: 30035267 PMCID: PMC6051479 DOI: 10.1016/j.wjorl.2018.02.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 02/26/2018] [Indexed: 11/21/2022] Open
Abstract
When one becomes ill after consuming a meal, there is a propensity to target a particular taste as the cause of the illness. The qualities of the taste most likely targeted include more novel, less preferred, and higher protein content. This association between a particular taste and illness is a form of learning that is termed conditioned taste aversion (CTA). A consequence of the learned association is that the taste will become aversive. When experiencing the taste again, individuals will show aversive reactions such as expressions of loathing, will experience mimicked illness sensations such as nausea, and subsequently, will avoid further exposure to the taste. The ability to acquire CTA occurs across species and across ages within a species. In the rat animal model, however, age differences exist in the capability of acquiring CTAs when increasingly longer intervals are imposed between consumption of a novel sweet solution and onset of illness. Pups have a decreased ability compared to young adults while aged rats have an increased ability. Evidence suggests that the failure of pups to acquire CTA at longer intervals is due to an immature retrieval mechanism and the facilitated ability of aged rats is due to a compromised clock mechanism that tracks the passage of time. Learned taste-illness association serves the critical function of informing individuals of the toxic nature of certain foods, thus preventing further illness and potentially death. Additionally, it contributes to the hypophagia observed during cancer chemotherapy and may contribute to the hypophagia found while suffering from bacterial infection, chronic medical conditions such as cancer, and restrictive food intake disorders such as anorexia nervosa.
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Abafe OA, Gatyeni PM, Chokwe T. Development and validation of a confirmatory method for the determination of stilbene estrogens in ostrich serum. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2017; 35:458-466. [PMID: 29210606 DOI: 10.1080/19440049.2017.1411617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A simple and accurate ultra-high-performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) method was developed and validated for the first time as a confirmatory method for the simultaneous determination of stilbenes - hexestrol and diethylstibestrol in serum. Extraction was based on a simple acid denaturation of protein followed by liquid-liquid extraction using methyl tert butyl ether. Extracts were directly injected into the UHPLC-MS/MS without further purification. Excellent recoveries in the range 82-99% and 91-128% were obtained for hexestrol and diethylstibestrol, respectively. Both within-day repeatability and between-day reproducibility were generally satisfactory with RSD <20%. The linearity of the internal standard based matrix-matched calibration curve measured as the coefficient of regression (r2) was generally >0.99 for both hexestrol and diethylstibestrol. Both matrix effect and uncertainties associated with sample preparation and instrumental analysis were significantly reduced with the use of a deuterated compound (hexestrol-d4) as internal standard. The LOD and LOQ were 0.09 and 0.08 ng/ml, and 0.28 and 0.25 ng/ml, respectively, for hexestrol and diethylstibestrol. The method was found to be suitable for the simultaneous determination of hexestrol and diethylstibestrol in serum.
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Affiliation(s)
| | - Pumza M Gatyeni
- a Department of Residue Analysis , Agricultural Research Council-OVR , Pretoria , South Africa
| | - Tlou Chokwe
- b Department of Analytical Services , Rand Water Scientific Services , Vereeniging , South Africa
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Al Jishi T, Sergi C. Current perspective of diethylstilbestrol (DES) exposure in mothers and offspring. Reprod Toxicol 2017; 71:71-77. [DOI: 10.1016/j.reprotox.2017.04.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 04/15/2017] [Accepted: 04/27/2017] [Indexed: 02/08/2023]
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7
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Alves MG, Oliveira PF. Effects of non-steroidal estrogen diethylstilbestrol on pH and ion transport in the mantle epithelium of a bivalve Anodonta cygnea. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2013; 97:230-235. [PMID: 23953926 DOI: 10.1016/j.ecoenv.2013.07.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 07/20/2013] [Accepted: 07/25/2013] [Indexed: 06/02/2023]
Abstract
Freshwater bivalves are used as sentinel organisms to detect pollutants effects in the aquatic environment due to their sedentary nature, filter-feeding behaviour. We aimed to determine the in vivo, ex vivo and in vitro influence of Diethylstilbestrol (DES), a widely used synthetic non-steroidal estrogen and endocrine disruptor, in Anodonta cygnea shell growth mechanisms. For that, in vivo exposure to DES (0.75μM) during 15 days, in vitro and ex vivo exposure of outer mantle epithelium (OME) cells to DES (0.75μM), were performed followed by study of short-circuit current (Isc), transepithelial potential (Vt) and transepithelial conductance (Gt) as well as identification of membrane transport systems and intracellular pH (pHi). Our results show that in vivo exposure to DES decreases in 30% the OME Isc and ex vivo addition of DES to the basolateral side of OME also induced Isc decrease. Several membrane transporters such as V-type ATPases, Na(+)/H(+) exchangers, Na(+)-K(+) pump, Na(+)-driven and Na(+)-independent HCO3(-)/Cl(-) transporters and Na(+)/HCO3(-) co-transporter were identified as responsible for pHi maintenance in OME and noteworthy, DES caused a pHi decrease in OME cells similar to the effect observed when OME cells were exposed to 4,4'-diisothiocyanostilbene disulfonic acid (DIDS), an inhibitor of several bicarbonate membrane transporters. The addition of DIDS after OME cells exposure to DES did not cause any alteration. We concluded that DES is able to modulate membrane ion transport and pHi in the OME of A. cygnea and that this effect seems to be due to inhibition of HCO3(-)/Cl(-) co-transporters present on the basolateral membrane.
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Affiliation(s)
- Marco G Alves
- CICS-UBI-Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal
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Bosquiazzo VL, Vigezzi L, Muñoz-de-Toro M, Luque EH. Perinatal exposure to diethylstilbestrol alters the functional differentiation of the adult rat uterus. J Steroid Biochem Mol Biol 2013; 138:1-9. [PMID: 23454116 DOI: 10.1016/j.jsbmb.2013.02.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 02/15/2013] [Accepted: 02/18/2013] [Indexed: 10/27/2022]
Abstract
The exposure to endocrine disrupters and female reproductive tract disorders has not been totally clarified. The present study assessed the long-term effect of perinatal (gestation+lactation) exposure to diethylstilbestrol (DES) on the rat uterus and the effect of estrogen replacement therapy. DES (5μg/kg bw/day) was administered in the drinking water from gestational day 9 until weaning and we studied the uterus of young adult (PND90) and adult (PND360) females. To investigate whether perinatal exposure to DES modified the uterine response to a long-lasting estrogen treatment, 12-month-old rats exposed to DES were ovariectomized and treated with 17β-estradiol for 3 months (PND460). In young adult rats (PND90), the DES treatment decreased both the proliferation of glandular epithelial cells and the percentage of glandular perimeter occupied by α-smooth muscle actin-positive cells. The other tissue compartments remained unchanged. Cell apoptosis was not altered in DES-exposed females. In control adult rats (PND360), there were some morphologically abnormal uterine glands. In adult rats exposed to DES, the incidence of glands with cellular anomalies increased. In response to estrogens (PND460), the incidence of cystic glands increased in the DES group. We observed glands with daughter glands and conglomerates of glands only on PND460 and in response to estrogen replacement therapy, independently of DES exposure. The p63 isoforms were expressed without changes on PND460. Estrogen receptors α and β showed no changes, while the progesterone receptor decreased in the subepithelial stroma of DES-exposed animals with estrogen treatment. The long-lasting effects of perinatal exposure to DES included the induction of abnormalities in uterine tissues of aged female rats and an altered response of the adult uterus to estradiol.
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Affiliation(s)
- Verónica L Bosquiazzo
- Laboratorio de Endocrinología y Tumores Hormonodependientes, School of Biochemistry and Biological Sciences, Universidad Nacional del Litoral, Santa Fe, Argentina
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Sun H, Wu Y, Xia X, Liu X, Shi Z. Interaction between diethylstilbestrol and bovine serum albumin. MONATSHEFTE FUR CHEMIE 2012. [DOI: 10.1007/s00706-012-0852-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Kass L, Altamirano GA, Bosquiazzo VL, Luque EH, Muñoz-de-Toro M. Perinatal exposure to xenoestrogens impairs mammary gland differentiation and modifies milk composition in Wistar rats. Reprod Toxicol 2012; 33:390-400. [DOI: 10.1016/j.reprotox.2012.02.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 01/19/2012] [Accepted: 02/02/2012] [Indexed: 12/11/2022]
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Song MC, Park J, Kim TJ. Diethylstilbestrol induces arrest of rat vascular smooth muscle cell cycle progression through downregulation of cyclin D1 and cyclin E. Mol Cell Biochem 2011; 360:103-9. [PMID: 21909809 DOI: 10.1007/s11010-011-1048-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 08/27/2011] [Indexed: 12/30/2022]
Abstract
Cardiovascular disease is associated with a multitude of pathophysiologic conditions, including vascular smooth muscle cell (VSMC) proliferation in response to vessel injury. Diethylstilbestrol (DES) was previously prescribed for at-risk pregnancies to prevent abortion, miscarriage, and premature labor. Our aim in this study was to elucidate the effects and molecular mechanism of DES on proliferation and cell cycle progression of platelet-derived growth factor (PDGF)-BB-stimulated rat aortic VSMCs. Treating the cells with DES (1-7 μM) dramatically inhibited cell proliferation in a dose-dependent manner without any cytotoxic effects. In addition, DES blocked cell cycle progression from PDGF-BB-stimulated cells, which we found was related to down-regulation of the cell cycle regulatory factors, cyclin D1, and cyclin E. Our data demonstrate that DES inhibits rat aortic VSMC proliferation and cell cycle progression through regulation of cell cycle-related proteins. Therefore, our observations may explain, in part, the mechanistic basis underlying the therapeutic effects of DES in cardiovascular disease.
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Affiliation(s)
- Min-Cheol Song
- Division of Biological Science and Technology, College of Science and Technology, Yonsei University, Wonju, Korea
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Tang WY, Newbold R, Mardilovich K, Jefferson W, Cheng RYS, Medvedovic M, Ho SM. Persistent hypomethylation in the promoter of nucleosomal binding protein 1 (Nsbp1) correlates with overexpression of Nsbp1 in mouse uteri neonatally exposed to diethylstilbestrol or genistein. Endocrinology 2008; 149:5922-31. [PMID: 18669593 PMCID: PMC2613067 DOI: 10.1210/en.2008-0682] [Citation(s) in RCA: 136] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Neonatal exposure of CD-1 mice to diethylstilbestrol (DES) or genistein (GEN) induces uterine adenocarcinoma in aging animals. Uterine carcinogenesis in this model is ovarian dependent because its evolution is blocked by prepubertal ovariectomy. This study seeks to discover novel uterine genes whose expression is altered by such early endocrine disruption via an epigenetic mechanism. Neonatal mice were treated with 1 or 1000 microg/kg DES, 50 mg/kg GEN, or oil (control) on d 1-5. One group of treated mice was killed before puberty on d 19. Others were ovariectomized or left intact, and killed at 6 and 18 months of age. Methylation-sensitive restriction fingerprinting was performed to identify differentially methylated sequences associated with neonatal exposure to DES/GEN. Among 14 candidates, nucleosomal binding protein 1 (Nsbp1), the gene for a nucleosome-core-particle binding protein, was selected for further study because of its central role in chromatin remodeling. In uteri of immature control mice, Nsbp1 promoter CpG island (CGI) was minimally methylated. Once control mice reached puberty, the Nsbp1 CGI became hypermethylated, and gene expression declined further. In contrast, in neonatal DES/GEN-treated mice, the Nsbp1 CGI stayed anomalously hypomethylated, and the gene exhibited persistent overexpression throughout life. However, if neonatal DES/GEN-treated mice were ovariectomized before puberty, the CGI remained minimally to moderately methylated, and gene expression was subdued except in the group treated with 1000 microg/kg DES. Thus, the life reprogramming of uterine Nsbp1 expression by neonatal DES/GEN exposure appears to be mediated by an epigenetic mechanism that interacts with ovarian hormones in adulthood.
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Affiliation(s)
- Wan-Yee Tang
- Department of Environmental Health, Kettering Complex, Room 128, 3223 Eden Avenue, University of Cincinnati Medical Center, P.O. Box 670056, Cincinnati, Ohio 45267-0056, USA
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Fenaux JB, Gogal RM, Lindsay D, Hardy C, Ward DL, Saunders G, Ahmed SA. Altered Splenocyte Function in Aged C57BL/6 Mice Prenatally Exposed to Diethylstilbestrol. J Immunotoxicol 2008; 2:221-9. [DOI: 10.1080/15476910500362952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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14
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Maranghi F, Tassinari R, Moracci G, Macrì C, Mantovani A. Effects of a low oral dose of diethylstilbestrol (DES) on reproductive tract development in F1 female CD-1 mice. Reprod Toxicol 2008; 26:146-50. [PMID: 18692564 DOI: 10.1016/j.reprotox.2008.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2008] [Revised: 06/27/2008] [Accepted: 07/08/2008] [Indexed: 01/20/2023]
Abstract
The synthetic estrogen diethylstilbestrol (DES) is a model to study the effects on female reproductive tract of endocrine disrupting chemicals interacting with estrogen receptors. Pregnant CD-1 mice were given daily by gavage 10microg/kg bw of DES (the lower range of therapeutic exposure) during gestational days 9-16, critical period for reproductive tract development. Parameters of sexual development were recorded after weaning and at sexual maturation. No signs of general toxicity were observed in dams. In DES-treated group, reduced litter weight during lactation and earlier vaginal patency was observed. Uterus weight was increased in F1 treated females at weaning. Histological analysis showed reduced endometrium thickness and increased polyovular follicles, irregular and oocytes with condensed chromatin in the ovary at sexual maturity. Prenatal DES oral administration induces subtle but significant effects on puberty onset, uterine and ovary morphology.
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Affiliation(s)
- Francesca Maranghi
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy.
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Newbold RR, Jefferson WN, Grissom SF, Padilla-Banks E, Snyder RJ, Lobenhofer EK. Developmental exposure to diethylstilbestrol alters uterine gene expression that may be associated with uterine neoplasia later in life. Mol Carcinog 2007; 46:783-96. [PMID: 17394237 PMCID: PMC2254327 DOI: 10.1002/mc.20308] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Previously, we described a mouse model where the well-known reproductive carcinogen with estrogenic activity, diethylstilbestrol (DES), caused uterine adenocarcinoma following neonatal treatment. Tumor incidence was dose-dependent reaching >90% by 18 mo following neonatal treatment with 1000 microg/kg/d of DES. These tumors followed the initiation/promotion model of hormonal carcinogenesis with developmental exposure as initiator, and exposure to ovarian hormones at puberty as the promoter. To identify molecular pathways involved in DES-initiation events, uterine gene expression profiles were examined in prepubertal mice exposed to DES (1, 10, or 1000 microg/kg/d) on days 1-5 and compared to controls. Of more than 20 000 transcripts, approximately 3% were differentially expressed in at least one DES treatment group compared to controls; some transcripts demonstrated dose-responsiveness. Assessment of gene ontology annotation revealed alterations in genes associated with cell growth, differentiation, and adhesion. When expression profiles were compared to published studies of uteri from 5-d-old DES-treated mice, or adult mice treated with 17beta estradiol, similarities were seen suggesting persistent differential expression of estrogen responsive genes following developmental DES exposure. Moreover, several altered genes were identified in human uterine adenocarcinomas. Four altered genes [lactotransferrin (Ltf), transforming growth factor beta inducible (Tgfb1), cyclin D1 (Ccnd1), and secreted frizzled-related protein 4 (Sfrp4)], selected for real-time RT-PCR analysis, correlated well with the directionality of the microarray data. These data suggested altered gene expression profiles observed 2 wk after treatment ceased, were established at the time of developmental exposure and maybe related to the initiation events resulting in carcinogenesis.
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Affiliation(s)
- Retha R Newbold
- Developmental Endocrinology and Endocrine Disruptor Section, Laboratory of Molecular Toxicology, NIEHS, Research Triangle Park, North Carolina 27709, USA
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Silbergeld EK, Patrick TE. Environmental exposures, toxicologic mechanisms, and adverse pregnancy outcomes. Am J Obstet Gynecol 2005; 192:S11-21. [PMID: 15891707 DOI: 10.1016/j.ajog.2004.06.117] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Environmental risk factors (defined as those agents and stresses that are generally the responsibility of environmental agencies) are often tangible indicators of economic and social disparity in the United States. Many site-specific analyses have reported that communities of color and poverty are exposed more often and more intensively to such environmental hazards as lead, air pollution, agrochemicals, incinerator emissions, and releases from hazardous waste sites. Thus, exposures to these toxicants may explain part of the socioeconomic disparity that is observed in terms of risks of adverse pregnancy outcomes. The purpose of this study was to describe the associations between certain environmental exposures and reproductive outcomes through a discussion of both epidemiologic and animal model studies. In addition, we list potential sources of exposure data and describe physiologic changes in pregnancy that may increase the likelihood of both external exposures and increased internal dose. Several models for further study of environmental risk factors are suggested to increase our understanding of gene-environment interactions toward the goal of indentifying preventable risk factors to improve reproductive outcomes of particular concern to disadvantaged populations.
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Affiliation(s)
- Ellen K Silbergeld
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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Schulmeister L. Diethylstilbestrol exposure: how well informed are you about this health risk? Clin J Oncol Nurs 2003; 7:373-4. [PMID: 12929266 DOI: 10.1188/03.cjon.373-374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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