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Avram CM, Brumbach BH, Hiller AL. A Report of Tamoxifen and Parkinson's Disease in a US Population and a Review of the Literature. Mov Disord 2021; 36:1238-1242. [PMID: 33449420 DOI: 10.1002/mds.28471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 11/08/2020] [Accepted: 12/09/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Tamoxifen, a selective estrogen receptor modulator, has been shown to variably affect Parkinson's disease (PD) risk. OBJECTIVE The aim of this study was to review epidemiological literature and evaluate the rate of PD in women with breast cancer with tamoxifen exposure in a US population. METHODS A literature search was conducted to identify relevant studies. We performed a retrospective cohort analysis using the Nurses' Health Study Version One to report descriptive statistics. RESULTS Most studies suggest there may be a time-dependent effect of tamoxifen on PD risk, with the risk increasing with time from exposure. However, rates of PD in persons exposed to tamoxifen overall appear to be low. In our cohort, PD was evident in 6.2 per 1,000 of those with tamoxifen use and 3.6 per 1,000 of those without tamoxifen use. Time from breast cancer to PD diagnosis was 9.7 years among women with tamoxifen exposure and 11.7 among women without. CONCLUSIONS Tamoxifen may be associated with an increased risk for PD. Further research is needed to elucidate the role of estrogen and selective estrogen antagonism in PD. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Carmen M Avram
- Duke University Medical Center, Durham, North Carolina, USA
| | | | - Amie L Hiller
- Oregon Health and Science University, Portland, Oregon, USA
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2
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Obata T. Glutaminergic tonic action potentiate MPP+-induced hydroxyl radical production in rat striatum. Neurosci Lett 2019; 705:51-53. [DOI: 10.1016/j.neulet.2019.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/03/2019] [Accepted: 02/09/2019] [Indexed: 11/15/2022]
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Kharrazian D, Herbert M, Vojdani A. The Associations between Immunological Reactivity to the Haptenation of Unconjugated Bisphenol A to Albumin and Protein Disulfide Isomerase with Alpha-Synuclein Antibodies. TOXICS 2019; 7:toxics7020026. [PMID: 31064082 PMCID: PMC6630361 DOI: 10.3390/toxics7020026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 02/07/2023]
Abstract
Patients with Parkinson’s disease (PD) have increased susceptibility to bisphenol A (BPA) exposure since they have an impaired biotransformation capacity to metabolize BPA. PD subjects have reduced levels of conjugated BPA compared to controls. Reduced ability to conjugate BPA provides increased opportunity for unconjugated BPA to bind to albumin in human serum and protein disulfide isomerase on neurons. Once unconjugated BPA binds to proteins, it changes the allosteric structure of the newly configured protein leading to protein misfolding and the ability of the newly configured protein to act as a neoantigen. Once this neoantigen is formed, the immune system produces antibodies against it. The goal of our research was to investigate associations between unconjugated BPA bound to human serum albumin (BPA–HSA) antibodies and alpha-synuclein antibodies and between Protein Disulfide Isomerase (PDI) antibodies and alpha-synuclein antibodies. Enzyme–linked immunosorbent assay was used to determine the occurrences of alpha-synuclein antibodies, antibodies to BPA–HSA adducts, and PDI antibodies in the sera of blood donors. Subjects that exhibited high levels of unconjugated BPA–HSA antibodies or PDI antibodies had correlations and substantial risk for also exhibiting high levels of alpha-synuclein antibodies (p < 0.0001). We conclude that there are significant associations and risks between antibodies to BPA–HSA adducts and PDI antibodies for developing alpha-synuclein antibodies.
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Affiliation(s)
- Datis Kharrazian
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.
- TRANSCEND Research Laboratory, Department of Neurology, Massachusetts General Hospital, 149 13th Street, Boston, MA 02129, USA.
- Department of Preventive Medicine, Loma Linda University School of Medicine, 24785 Stewart Street, Loma Linda, CA 92354, USA.
| | - Martha Herbert
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.
- TRANSCEND Research Laboratory, Department of Neurology, Massachusetts General Hospital, 149 13th Street, Boston, MA 02129, USA.
| | - Aristo Vojdani
- Department of Preventive Medicine, Loma Linda University School of Medicine, 24785 Stewart Street, Loma Linda, CA 92354, USA.
- Immunosciences Lab., Inc., 822 S. Robertson Boulevard, Suite 312, Los Angeles, CA 90035, USA.
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Extraction of water-soluble polysaccharide and the antioxidant activity from Semen cassiae. J Food Drug Anal 2014; 22:492-499. [PMID: 28911465 PMCID: PMC9354996 DOI: 10.1016/j.jfda.2014.01.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 01/15/2014] [Accepted: 01/18/2014] [Indexed: 11/29/2022] Open
Abstract
Water-soluble polysaccharide was isolated from Semen cassiae using water for extraction and ethanol for deposition. The optimized conditions for polysaccharide isolation by orthogonal experiments were a sample to liquid ratio of 1:30 at 80°C for 3.5 hours; the yield of polysaccharide from Semen cassiae under these conditions was 5.46%. Different polysaccharides (SCPW-1, SCPW-2, SCPW-3, SCPW-4, SCPW-5, SCPS-1, SCPS-2) were obtained from the extract (i.e., crude polysaccharide) by DEAE-cellulose column chromatography. The polysaccharides obtained showed different structures by Fourier transform infrared therein the five elected from the seven kinds separated. The antioxidant activities of the extract were evaluated. The scavenging rates of the present extract on hydroxyl and superoxide were 43.32% and 64.97%, respectively, at a concentration of polysaccharide of 94.03 μg/mL, which was better than vitamin C at the same concentration. The scavenging rate of the present extract on 1,1-diphenyl-2-picrylhydrazyl was 13.33% at a polysaccharide concentration of 94.03 μg/mL, which was less than vitamin C at the same concentration.
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Neurotoxic effects of nonylphenol: a review. Wien Klin Wochenschr 2013; 125:61-70. [DOI: 10.1007/s00508-012-0221-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 07/08/2012] [Indexed: 01/17/2023]
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Hormone replacement therapy and risk for neurodegenerative diseases. Int J Alzheimers Dis 2012; 2012:258454. [PMID: 22548198 PMCID: PMC3324889 DOI: 10.1155/2012/258454] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 01/17/2012] [Accepted: 01/18/2012] [Indexed: 02/02/2023] Open
Abstract
Over the past two decades, there has been a significant amount of research investigating the risks and benefits of hormone replacement therapy (HRT) with regards to neurodegenerative disease. Here, we review basic science studies, randomized clinical trials, and epidemiological studies, and discuss the putative neuroprotective effects of HRT in the context of Alzheimer's disease, Parkinson's disease, frontotemporal dementia, and HIV-associated neurocognitive disorder. Findings to date suggest a reduced risk of Alzheimer's disease and improved cognitive functioning of postmenopausal women who use 17β-estradiol. With regards to Parkinson's disease, there is consistent evidence from basic science studies for a neuroprotective effect of 17β-estradiol; however, results of clinical and epidemiological studies are inconclusive at this time, and there is a paucity of research examining the association between HRT and Parkinson's-related neurocognitive impairment. Even less understood are the effects of HRT on risk for frontotemporal dementia and HIV-associated neurocognitive disorder. Limits to the existing research are discussed, along with proposed future directions for the investigation of HRT and neurodegenerative diseases.
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Masuo Y, Ishido M. Neurotoxicity of endocrine disruptors: possible involvement in brain development and neurodegeneration. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2011; 14:346-369. [PMID: 21790316 DOI: 10.1080/10937404.2011.578557] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Environmental chemicals that act as endocrine disruptors do not appear to pose a risk to human reproduction; however, their effects on the central nervous systems are less well understood. Animal studies suggested that maternal exposure to endocrine-disrupting chemicals (EDC) produced changes in rearing behavior, locomotion, anxiety, and learning/memory in offspring, as well as neuronal abnormalities. Some investigations suggested that EDC exert effects on central monoaminergic neurons, especially dopaminergic neurons. Our data demonstrated that EDC attenuate the development of dopaminergic neurons, which might be involved in developmental disorders. Perinatal exposure to EDC might affect neuronal plasticity in the hippocampus, thereby potentially modulating neuronal development, leading to impaired cognitive and memory functions. Endocrine disruptors also attenuate gender differences in brain development. For example, the locus ceruleus is larger in female rats than in males, but treatments with bisphenol-A (BPA) enlarge this region in males. Some reports indicated that EDC induce hypothyroidism, which might be evidenced as abnormal brain development. Endocrine disruptors might also affect mature neurons, resulting in neurodegenerative disorders such as Parkinson's disease. The current review focused on alterations in the brain induced by EDC, specifically on the possible involvement of EDC in brain development and neurodegeneration.
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Affiliation(s)
- Yoshinori Masuo
- Laboratory of Neuroscience, Department of Biology, Faculty of Science, Toho University, Chiba, Japan.
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Fabrizio E, Vanacore N, Valente M, Rubino A, Meco G. High prevalence of extrapyramidal signs and symptoms in a group of Italian dental technicians. BMC Neurol 2007; 7:24. [PMID: 17686154 PMCID: PMC1988798 DOI: 10.1186/1471-2377-7-24] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2006] [Accepted: 08/08/2007] [Indexed: 11/22/2022] Open
Abstract
Background Occupational and chronic exposure to solvents and metals is considered a possible risk factor for Parkinson's disease and essential tremor. While manufacturing dental prostheses, dental technicians are exposed to numerous chemicals that contain toxins known to affect the central nervous system, such as solvents (which contain n-hexane in particular) and metals (which contain mercury, iron, chromium, cobalt and nickel). Methods We performed an epidemiological and clinical study on all 27 dental technicians working in a school for dental technicians. We asked all the technicians to fill in a self-administered questionnaire on extrapyramidal symptoms, and the General Health Questionnaire (GHQ), a self-administered screening instrument, to detect any psychiatric disorders. Moreover, we invited all 27 dental technicians to undergo a neurological examination and provide a detailed occupational history in our clinic. Results Of the 14 subjects who underwent the neurological examination, four had postural tremor and one had a diagnosis of Parkinson's disease. Conclusion We found a high prevalence of extrapyramidal signs and symptoms in this group of male dental technicians working in a state technical high school in Rome. We believe that this finding may be due to the presence of toxins in the dental technician's work.
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Affiliation(s)
- Edito Fabrizio
- Department of Neurological Sciences, "La Sapienza" University, Viale Università 3000185 Rome, Italy
| | - Nicola Vanacore
- National Centre of Epidemiology, National Institute of Health, Via Giano della Bella 34, 00161 Rome, Italy
| | - Marcella Valente
- Department of Neurological Sciences, "La Sapienza" University, Viale Università 3000185 Rome, Italy
| | - Alfonso Rubino
- Department of Neurological Sciences, "La Sapienza" University, Viale Università 3000185 Rome, Italy
| | - Giuseppe Meco
- Department of Neurological Sciences, "La Sapienza" University, Viale Università 3000185 Rome, Italy
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Radice S, Chiesara E, Frigerio S, Fumagalli R, Parolaro D, Rubino T, Marabini L. Estrogenic effect of procymidone through activation of MAPK in MCF-7 breast carcinoma cell line. Life Sci 2006; 78:2716-23. [PMID: 16310225 DOI: 10.1016/j.lfs.2005.10.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2005] [Accepted: 10/24/2005] [Indexed: 01/12/2023]
Abstract
Procymidone modifies sexual differentiation in vitro and induces estrogenic activity in primary cultured rainbow trout hepatocytes, as shown by an increase in the contents of vitellogenin and heat shock proteins. Since this dicarboximide fungicide is found in human tissues, it was considered of interest to investigate its ability to induce endocrine damage in the MCF-7 human cell line. The mechanism of this estrogenic action was also evaluated. Procymidone 100 microM stimulated cell growth from day 3 up to day 12 and raised the level of pS2 on day 3. Although procymidone does not bind the estrogen receptor (ER), the antiestrogen ICI 182780 inhibited its effect on cell growth and pS2 content, suggesting that the ER is involved indirectly in these effects. In exploring the mechanism of ER indirect activation we found that the antibody against c-Neu receptor (9G6) did not modify procymidone's effects on cell growth and pS2 expression. Thus, procymidone does not bind the c-Neu membrane receptor, excluding this indirect ER activation pathway. We also found that procymidone induced mitogen-activated protein kinase (MAPK) at 15 and 30 min, and that PD 98059, a MAPK (Erk1/2) inhibitor, prevented procymidone's effects on cell growth and pS2, indicating that MAPK activation is responsible for procymidone ER activation. The production of reactive oxygen species (ROS) with these times and elimination of the phenomenon by alpha-tocopherol (alpha-T), a ROS scavenger, is proof that oxygen free-radical production is at the basis of the MAPK activation by procymidone.
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Affiliation(s)
- Sonia Radice
- Department of Pharmacology, Chemotherapy and Medical Toxicology E. Trabucchi, University of Milan, Via Vanvitelli 32, 20129 Milan, Italy.
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Obata T. Imidaprilat suppresses nonylphenol and 1-methyl-4-phenylpyridinium ion (MPP+)-induced hydroxyl radical generation in rat striatum. Neurosci Res 2006; 54:192-6. [PMID: 16386813 DOI: 10.1016/j.neures.2005.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2005] [Revised: 11/18/2005] [Accepted: 11/24/2005] [Indexed: 11/21/2022]
Abstract
The present study examined the antioxidant effects of angiotensin-converting enzyme inhibitor (ACE), imidaprilat, on para-nonylphenol and 1-methyl-4-phenylpyridinium ion (MPP+)-induced hydroxyl radical (*OH) formation and dopamine (DA) efflux in extracellular fluid of rat striatum, using a microdialysis technique. para-Nonylphenol clearly enhanced *OH formation and DA efflux induced by MPP+. When imidaprilat was infused in para-nonylphenol and MPP+-treated rats, DA efflux and *OH formation significantly decreased, as compared with that in the para-nonylphenol and MPP+-treated control. Imidaprilat was able to scavenge *OH and DA efflux induced by para-nonylphenol and MPP+. When iron(II) was administered to para-nonylphenol-pretreated animals, iron(II) clearly produced a dose-dependent increase in the levels of 2,3-dihydroxybenzoic acid (2,3-DHBA), as compared with MPP+-only-treated rats. A positive linear correlation was observed between iron(II) and 2,3-DHBA (R2=0.985) in the dialysate. However, in the presence of imidaprilat, a small increase in the levels of 2,3-DHBA products was observed. The results suggest that imidaprilat may protect against para-nonylphenol and MPP+-induced *OH formation via suppressing DA efflux in the rat striatum.
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Affiliation(s)
- Toshio Obata
- Department of Analytical Chemistry, School of Pharmaceutical Sciences, Ohu University, Koriyama, Fukushima 963-8611, Japan.
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Obata T. Nitric oxide and MPP+-induced hydroxyl radical generation. J Neural Transm (Vienna) 2006; 113:1131-44. [PMID: 16463115 DOI: 10.1007/s00702-005-0415-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2005] [Accepted: 10/22/2005] [Indexed: 10/25/2022]
Abstract
Although neuroprotective effect of nitric oxide (NO) is discussed, NO has a role of pathogenesis of cellular injury. NO is synthesized from L-arginine by NO synthase (NOS). NO contributes to the extracellular potassium-ion concentration ([K(+)](o))-induced hydroxyl radical ((*)OH) generation. Cytotoxic free radicals such as peroxinitrite (ONOO(-)) and (*)OH may also be implicated in NO-mediated cell injury. NO activation was induced by K(+) depolarization. NO may react with superoxide anion (O(2) (-)) to form ONOO(-) and its decomposition generates (*)OH. 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) metabolite 1-methyl-4-phenylpyridinium ion (MPP(+)) involve toxicity induced by NO. Intraneuronal Ca(2+) triggered by MPP(+) may be detrimental to the functioning of dopaminergic nerve terminals in the striatum. Although the [K(+)](o)-induced depolarization enhances the formation of (*)OH product due to MPP(+), the (*)OH generation via NOS activation may be unrelated the dopamine (DA)-induced (*)OH generation. Depolarization enhances the MPP(+)-induced (*)OH formation via NOS activation. NOS inhibition is associated with a protective effect due to suppression of depolarization-induced (*)OH generation. ONOO(-) has been implicated as a causative factor under conditions in which DA neurons are damaged. These findings may be useful in elucidating the actual mechanism of free radical formation in the pathogenesis of neurodegenerative brain disorders, including Parkinson's disease and traumatic brain injuries.
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Affiliation(s)
- T Obata
- Department of Analytical Chemistry, Ohu University School of Pharmaceutical Sciences, Koriyama, Fukushima, Japan.
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Moreira PI, Custódio JB, Oliveira CR, Santos MS. Hydroxytamoxifen protects against oxidative stress in brain mitochondria. Biochem Pharmacol 2004; 68:195-204. [PMID: 15183131 DOI: 10.1016/j.bcp.2004.03.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2004] [Accepted: 03/19/2004] [Indexed: 11/18/2022]
Abstract
This study evaluated the effect of hydroxytamoxifen, the major active metabolite of tamoxifen (synthetic, nonsteroidal antiestrogen drug), on the function of brain mitochondria. We observed that only high concentrations of hydroxytamoxifen (60 nmol/mg protein) induced a significant decrease in RCR, while ADP/O ratio remained statistically unchanged. Similarly, only the highest concentration of hydroxytamoxifen (60 nmol/mg protein) affected the phosphorylative capacity of brain mitochondria, characterized by a decrease in the repolarization level and an increase in the repolarization lag phase. We observed that all the concentrations of hydroxytamoxifen tested (7.5, 15 and 30 nmol/mg protein) prevented lipid peroxidation induced by the oxidant pair ADP/Fe(2+). Furthermore, through the analyses of calcium fluxes and mitochondrial transmembrane potential parameters, we observed that hydroxytamoxifen (30 nmol/mg protein) exerted some protection against pore opening, although in a less extension than that promoted by cyclosporin A, the specific inhibitor of the mitochondrial permeability transition pore. However, in the presence of hydroxytamoxifen plus cyclosporin A, the protection observed was significantly higher when compared with that induced by both agents alone. These results support the idea that hydroxytamoxifen protects lipid peroxidation and inhibits the mitochondrial permeability transition pore in brain. Since numerous neurodegenerative diseases are intimately related with mitochondrial dysfunction resulting from lipid peroxidation and induction of mitochondrial permeability transition, among other factors, future therapeutical strategies could be designed taking in account this neuroprotective role of hydroxytamoxifen, which is pharmacologically much more potent and less toxic than its promoter tamoxifen.
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Affiliation(s)
- Paula I Moreira
- Centre for Neuroscience of Coimbra, University Coimbra, Coimbra, Portugal
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Radice S, Fumagalli R, Chiesara E, Ferraris M, Frigerio S, Marabini L. Estrogenic activity of procymidone in rainbow trout (Oncorhynchus mykiss) hepatocytes: a possible mechanism of action. Chem Biol Interact 2004; 147:185-93. [PMID: 15013820 DOI: 10.1016/j.cbi.2003.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2003] [Indexed: 11/21/2022]
Abstract
It is known that procymidone modifies sexual differentiation in vivo and in vitro, and that it induces vitellogenin (Vtg) synthesis in primary cultured rainbow trout hepatocytes. The aim of this study was to evaluate the mechanism underlying this latter in vitro estrogenic action. The cells were treated for 24 h with procymidone 150 microM (with 17beta-estradiol [E2] 20 microM as a positive control) combined with an estrogen receptor (ER) antagonist (tamoxifen 20 microM or ICI 182,780 1 microM) or, given the drug toxic action on the production of reactive oxygen species (ROS), a free radical scavenger (alpha-tocopherol 30 microM). The results from ELISA experiments provided evidence that procymidone Vtg-induction is inhibited by ER antagonists and by alpha-tocopherol suggesting that both ER and ROS are involved in this effect. The ROS detection revealed that the treatment with alpha-tocopherol and tamoxifen completely prevented ROS induction by procymidone, that was not inhibited by ICI 182,780. In exploring the mechanism mediating these events and its timing, we found that procymidone induced mitogen-activated protein kinase (MAPK) at 30 and 60 min, and that this effect was blocked by co-treatment with alpha-tocopherol. In summary, the results of the study clearly support the idea that the estrogenic activity of procymidone in primary cultured trout hepatocytes is mediated by ROS production, and that this activity is similar to that of the ligand-independent ER activation involving MAPK.
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Affiliation(s)
- Sonia Radice
- Department of Pharmacology, Chemotherapy and Medical Toxicology "E. Trabucchi", University of Milan, Via Vanvitelli 32, 20129 Milan, Italy.
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Murphy S, McCullough L, Littleton-Kearney M, Hurn P. Estrogen and selective estrogen receptor modulators: neuroprotection in the Women's Health Initiative era. Endocrine 2003; 21:17-26. [PMID: 12777699 DOI: 10.1385/endo:21:1:17] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2003] [Revised: 02/04/2003] [Accepted: 02/11/2003] [Indexed: 11/11/2022]
Abstract
Estrogen has been comprehensively studied as a neuroprotective agent in women, animals, and a variety of in vitro models of neural injury and degeneration. Most data suggest that estrogen can benefit the ischemic brain and reduce cell death. However, recent data from the Women's Health Initiative have raised concerns about the utility and safety of chronic estrogen use in women. While estrogen is a potent and reproducible neuroprotectant in animals and in vitro, its current administration in women has had unanticipated and paradoxical effects. Nonetheless, estrogen's diverse actions make it an ideal prototype for developing new neuroprotectants such as selective estrogen receptor modulators (SERMs). SERMs represent a class of drugs with mixed estrogen agonistic and antagonistic activity. Experimental and clinical data suggest a neuroprotective role for SERMs in normal and injured brain. The discrepancy among observational studies, preclinical data, and clinical trials emphasizes the need for further study of the mechanisms leading to the increased incidence of stroke observed in postmenopausal women. Research is still needed to optimize combined or estrogen alone hormone replacement therapy options as well as the prevention/management of cerebrovascular/ central nervous system disorders. This review critiques estrogen and SERMs' neuroprotective potential in experimental and clinical studies of stroke and cerebrovascular disease.
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Affiliation(s)
- Stephanie Murphy
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
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