Functional roles of female sex hormones and their nuclear receptors in cervical cancer

Long-term 4-nonylphenol exposure drives cervical cell malignancy through MAPK-mediated ferroptosis inhibition

4-NP (4-nonylphenol), a prevalent environmental endocrine disruptor with estrogenic properties, is commonly detected in drinking water and food sources. It poses a significant risk of endocrine disruption, thereby influencing the onset and progression of diverse diseases, including tumorigenesis. However, its specific impact on cervical cancer remains to be fully elucidated. Our study focused on the biological effects of sustained exposure to low-dose 4-NP on human normal cervical epithelial cells (HcerEpic). After a continuous 30-week exposure to 4-NP, the treated cells exhibited a significant malignant transformation, whereas the solvent control group showed limited malignant phenotypes. Subsequent analyses of the metabolomic profiles of the transformed cells unveiled marked irregularities in glutathione metabolism and unsaturated fatty acid metabolism. Analyses of transcriptomic profiles revealed significant activation of the MAPK signaling pathway and suppression of ferroptosis processes in these cells. Furthermore, the expression of MT2A was significantly upregulated following 4-NP exposure. Knockdown of MT2A restored the aberrant activation of the MAPK signaling pathway, elevated antioxidant capacity, ferroptosis inhibition, and ultimately the development of malignant phenotypes that induced by 4-NP in the transformed cells. Mechanistically, MT2A increased cellular antioxidant capabilities and facilitated the removal of toxic iron ions by enhancing the phosphorylation of ERK1/2 and JNK MAPK pathways. The administration of activators and inhibitors of the MAPK pathway confirmed that the MAPK pathway mediated the 4-NP-induced suppression of ferroptosis and, ultimately, the malignant transformation of cervical epithelial cells. Overall, our findings elucidated a dynamic molecular transformation induced by prolonged exposure to 4-NP, and delineated comprehensive biological perspectives underlying 4-NP-induced cervical carcinogenesis. This offers novel theoretical underpinnings for the assessment of the carcinogenic risks associated with 4-NP.

A nitrogen-doped hollow carbon nanospheres-based aptasensor for non-invasive salivary detection of progesterone

Developing an easy-to-use and non-invasive sensor for monitoring progesterone (P4) as a multi-functional hormone is highly demanded for point-of-care testing. In this study, an ultrasensitive electrochemical aptasensor is fabricated for monitoring P4 in human biofluids. The sensing interface was designed based on the porous nitrogen-doped hollow carbon spheres (N-HCSs). The N-HCSs covalently immobilized high-dense aptamer (Apt) sequences as the bioreceptor of P4. The electron transfer of the redox probe was hindered by incubating P4 on the aptasensor surface and forming the P4-Apt complexes. Meanwhile, the signaling was decreased under two wide linear dynamic ranges (LDRs) from 10 fM to 5.6 μM with a limit of detection (LOD) value of 3.33 fM. The aptasensor presented satisfactory selectivity in the presence of different off-target species with successful feasibility for P4 detection in some human urine and saliva samples. The aptasensor with high sensitivity, as an advantage for on-site and sensitive measurement of P4, can be considered a non-invasive tool for routine analysis of real-world clinical samples method.

Effects of neoadjuvant chemotherapy combined with radical laparoscopic surgery with quality nursing care on clinical efficacy and sex hormones in patients with cervical cancer

OBJECTIVE

To observe the effects of neoadjuvant chemotherapy combined with radical laparoscopic surgery with quality nursing care on the clinical efficacy and sex hormones of cervical cancer patients.

METHODS

The clinical data of 107 patients with cervical cancer admitted to Yanan University Affiliated Hospital between January 2017 and January 2020 were retrospectively analyzed in this study. Among them, 50 patients received only laparoscopic radical surgery (surgical group), and the other 57 received neoadjuvant chemotherapy combined with laparoscopic radical surgery (Joint group); patients in both groups received quality nursing care. The baseline and surgical data of the two groups were compared, and the changes in tumor markers and sex hormones before and after treatment were analyzed. Cox regression was used to analyze the independent prognostic factors affecting patients' 2-year survival.

RESULTS

The patients in the two groups did not show statistical differences in baseline and surgical data (all P > 0.05). After treatment, the levels of squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA), and serum glycan antigen 125 (CA125) were significantly reduced in both groups. However, the reduction was more pronounced in the joint group than that in the surgical group (P < 0.0001). Meanwhile, estrogen (E2) levels decreased more significantly in the Joint group, while follicle-stimulating hormone (FSH) and luteinizing hormone (LH) increased more significantly (all P < 0.0001). Multifactorial Cox regression analysis revealed that E2, LH and SCC-Ag were independent prognostic factors affecting 2-year survival (all P < 0.05).

CONCLUSION

Neoadjuvant chemotherapy combined with laparoscopic radical surgery is more effective in reducing the levels of tumor markers and significantly affects the levels of sex hormones. E2, LH, and SCC-Ag are the independent prognostic factors for 2-year survival in patients with cervical cancer. This study provides evidence to support the comprehensive treatment of cervical cancer.

Safety of assisted reproductive techniques in gynecological cancer patients

PURPOSE OF REVIEW

Gynecological cancer is a very important cause of comorbidity and mortality in women. The current delay in motherhood is increasing the incidence of women under 40 years of age that have not yet achieved their maternity goals when they are diagnosed and standard treatment negatively impacts the reproductive potential of cancer survivors. In this review, we update the information available about the safety of fertility-sparing treatments in young gynecological cancer patients, as well as the safety and efficacy of assisted reproductive techniques (ART) in such group. We also evaluate the long-term gynecological cancer risk in women requiring ART.

RECENT FINDINGS

Although eligibility criteria continue to be very strict, there are more and more reports of fertility-sparing approaches outside of what traditionally has been considered safe. Molecular assessment is starting to be used in the selection of appropriate candidates. Data increasingly shows the long term safety and the efficacy of ART and pregnancy in these patients.

SUMMARY

Appropriate selection is key to safely preconize fertility-sparing alternatives. Because subfertility may be a result of these procedures, ART could be indicated in this setting. Neither ART nor pregnancy appear to increase recurrences or affect survival rates.

Coicis Semen for the treatment of malignant tumors of the female reproductive system: A review of traditional Chinese medicinal uses, phytochemistry, pharmacokinetics, and pharmacodynamics

Coicis Semen is an important food product and traditional Chinese medicine (TCM) derived from the dried and mature seeds of Coix lacryma-jobi L.var.ma-yuen (Roman.) Stapf. An increasing number of studies have investigated its use, either alone or in combination with other botanical drugs, to treat female reproductive system malignancies, and its pharmacological effects have been confirmed clinically. This review aims to provide an overview of Coicis Semen's historical role in treating female reproductive system malignancies based on TCM theory, to summarize clinical trials results, and to analyze information pertaining to the main phytochemical components, pharmacokinetics, related anti-cancer pharmacological effects, and toxicology of Coicis Semen. Information on Coicis Semen was collected from internationally accepted scientific databases. Seventy-four clinical trials were identified that used Coicis Semen in combination with other Chinese medicine to treat female reproductive system malignancies, most of which demonstrated good anti-tumor efficacy and few adverse reactions. To date, more than 80 individual compounds have been isolated from this botanical drug. In terms of anti-tumor effects, Coix seed oil has been studied the most. Pharmacokinetic data suggest that the active ingredients in Coicis Semen are widely distributed after administration, and Coicis Semen and its active compounds play a beneficial role in treating female reproductive system malignancies. Mechanistically, the anti-cancer effects may be related to inhibition of tumor cell proliferation and promotion of apoptosis, inhibition of tumor angiogenesis, suppression of the chronic inflammatory microenvironment of tumors, modulation of immune function, and regulation of the female reproductive system. Most acute toxicity and genotoxicity studies have shown that Coicis Semen is non-toxic. However, the existing studies have many limitations, and the future research direction should emphasize 1) the relationship between drug concentration and pharmacological action as well as toxicity; 2) the structural modification or the synthesis of analogues led by the active ingredients of Coicis Semen to enhance pharmacological activities and bioavailability; 3) accurately revealing the anti-cancer pharmacological effects of Coicis Semen and its compounds through multi-omics technology. We hope that this review can determine future directions and inform novel drug development for treating female reproductive malignancies.

Circ_0007534 as new emerging target in cancer: Biological functions and molecular interactions

Circular RNA (circRNAs), an important member of the non-coding RNA (ncRNA) family, are widely expressed in a variety of biological cells. Owing to their stable structures, sequence conservations, and cell- or tissue-specific expressions, these RNA have become a popular subject of scientific research. With the development of sequencing methods, it has been revealed that circRNAs exert their biological function by sponging microRNAs (miRNAs), regulating transcription, or binding to proteins. Humans have historically been significantly impacted by various types of cancer. Studies have shown that circRNAs are abnormally expressed in various cancers and are involved in the occurrence and development of malignant tumors, such as tumor cell proliferation, migration, and invasion. As one of its star molecules, circ_0007534 is upregulated in colorectal, cervical, and pancreatic cancers; is closely related to the occurrence, development, and prognosis of tumors; and is expected to become a novel tumor marker and therapeutic target. This article briefly reviews the expression and mechanism of circ_0007534 in malignant tumors based on the domestic and foreign literature.

Ambient air emissions of endocrine-disrupting metals and the incidence of hormone receptor- and HER2-dependent female breast cancer in USA

Limited evidence exists on the relationship between exposure to endocrine-disrupting metals in ambient air and hormone receptor- and HER2-dependent breast cancer. This study investigates the association between ambient air emissions of endocrine-disrupting metals and the incidence of female breast cancer of different receptor status. County-level data from the US national datasets were analyzed for the association between emissions of various metals including arsenic, cadmium, chromium VI, lead, and mercury, and the annual age-adjusted incidence of hormone receptor-dependent breast cancer for 1990-2016 and HER2-dependent breast cancer for 2010-2016 using adjusted linear regression models. Lead emissions showed the strongest association among the metals examined with the incidence of different receptor status breast cancers, including ER-positive, ER-negative, PR-negative, HER2-negative, and Triple-negative breast cancers, with the adjusted β ranging from 917.26 for ER-negative to 3182.37 for HER2-negative breast cancer. Arsenic and mercury showed significant associations with the incidence of ER-positive, ER-negative, PR-positive, and PR-negative breast cancers. However, cadmium emissions were only significantly associated with ER-negative breast cancer. Moreover, chromium was not associated with any subtypes of breast cancer. Among all of the metals, only lead and mercury emissions showed significant associations with HER2-negative and Triple-negative breast cancer incidence. The results from this study suggest that increased exposure to endocrine-disrupting metals, especially lead, in ambient air could be associated with an increased incidence of female breast cancers with various receptor status in the US. Prospective studies are warranted to further explore this relationship.

Estrogen Inhibits Epithelial Progesterone Receptor-Dependent Progestin Therapy Efficacy in a Mouse Model of Cervical Cancer

Although the uterine cervix responds to the female sex hormone change, the role of progesterone in cervical cancer is poorly understood. It has been shown that medroxyprogesterone acetate (MPA) regresses cervical cancer in the transgenic mouse model expressing human papillomavirus type 16 E6 and E7 oncogenes. As MPA interacts most strongly with progesterone receptor (PR), we reasoned that PR would contribute to MPA-induced regression of cervical cancer. We also hypothesized that estrogen influences the therapeutic activity of MPA because it promotes cervical cancer growth in the same mouse model. The present study showed that the deletion of Pgr in the cervical cancer cells ablated the MPA's therapeutic effect in the human papillomavirus transgenic mouse model. Additionally, estrogen attenuated cancer regression by MPA in the same model system. These observations indicate that MPA can effectively regress cervical cancer only when cancer cells express PR and estrogen levels are low. These results suggest that, if translatable, MPA should be administered when estrogen levels are low in patients with PR-positive cervical cancer.

Nuclear receptors: from molecular mechanisms to therapeutics

Nuclear receptors are classically defined as ligand-activated transcription factors that regulate key functions in reproduction, development, and physiology. Humans have 48 nuclear receptors, which when dysregulated are often linked to diseases. Because most nuclear receptors can be selectively activated or inactivated by small molecules, they are prominent therapeutic targets. The basic understanding of this family of transcription factors was accelerated in the 1980s upon the cloning of the first hormone receptors. During the next 20 years, a deep understanding of hormone signaling was achieved that has translated to numerous clinical applications, such as the development of standard-of-care endocrine therapies for hormonally driven breast and prostate cancers. A 2004 issue of this journal reviewed progress on elucidating the structures of nuclear receptors and their mechanisms of action. In the current issue, we focus on the broad application of new knowledge in this field for therapy across diverse disease states including cancer, cardiovascular disease, various inflammatory diseases, the aging brain, and COVID-19.