Effect of estrogen (17 beta-estradiol) on the susceptibility of mice to disseminated gonococcal infection

Hormonal steroids induce multidrug resistance and stress response genes in Neisseria gonorrhoeae by binding to MtrR

Transcriptional regulator MtrR inhibits the expression of the multidrug efflux pump operon mtrCDE in the pathogenic bacterium Neisseria gonorrhoeae. Here, we show that MtrR binds the hormonal steroids progesterone, β-estradiol, and testosterone, which are present at urogenital infection sites, as well as ethinyl estrogen, a component of some hormonal contraceptives. Steroid binding leads to the decreased affinity of MtrR for cognate DNA, increased mtrCDE expression, and enhanced antimicrobial resistance. Furthermore, we solve crystal structures of MtrR bound to each steroid, thus revealing their binding mechanisms and the conformational changes that induce MtrR.

Cyclic processes in the uterine tubes, endometrium, myometrium, and cervix: pathways and perturbations

This review leads the 2023 Call for Papers in MHR: 'Cyclical function of the female reproductive tract' and will outline the complex and fascinating changes that take place in the reproductive tract during the menstrual cycle. We will also explore associated reproductive tract abnormalities that impact or are impacted by the menstrual cycle. Between menarche and menopause, women and people who menstruate living in high-income countries can expect to experience ∼450 menstrual cycles. The primary function of the menstrual cycle is to prepare the reproductive system for pregnancy in the event of fertilization. In the absence of pregnancy, ovarian hormone levels fall, triggering the end of the menstrual cycle and onset of menstruation. We have chosen to exclude the ovaries and focus on the other structures that make up the reproductive tract: uterine tubes, endometrium, myometrium, and cervix, which also functionally change in response to fluctuations in ovarian hormone production across the menstrual cycle. This inaugural paper for the 2023 MHR special collection will discuss our current understanding of the normal physiological processes involved in uterine cyclicity (limited specifically to the uterine tubes, endometrium, myometrium, and cervix) in humans, and other mammals where relevant. We will emphasize where knowledge gaps exist and highlight the impact that reproductive tract and uterine cycle perturbations have on health and fertility.

Sex and Gender Differences in Bacterial Infections

There is a growing awareness of the importance of sex and gender in medicine and research. Women typically have stronger immune responses to self and foreign antigens than men, resulting in sex-based differences in autoimmunity and infectious diseases. In both animals and humans, males are generally more susceptible than females to bacterial infections. At the same time, gender differences in health-seeking behavior, quality of health care, and adherence to treatment recommendations have been reported. This review explores our current understanding of differences between males and females in bacterial diseases. We describe how genetic, immunological, hormonal, and anatomical factors interact to influence sex-based differences in pathophysiology, epidemiology, clinical presentation, disease severity, and prognosis, and how gender roles affect the behavior of patients and providers in the health care system.

Estrogen Action in the Epithelial Cells of the Mouse Vagina Regulates Neutrophil Infiltration and Vaginal Tissue Integrity

In the female reproductive tract, the innate immune system is modulated by two sex steroid hormones, estrogen and progesterone. A cyclical wave of neutrophils in the vaginal lumen is triggered by chemokines and correlates with circulating estrogen levels. Classical estrogen signaling in the female reproductive tract is activated through estrogen receptor α (encoded by the Esr1 gene). To study the role of estrogen action in the vagina, we used a mouse model in which Esr1 was conditionally ablated from the epithelial cells (Wnt7a^cre/+; Esr1^f/f). Histological evidence showed that in response to a physical stress, the lack of ESR1 caused the vaginal epithelium to deteriorate due to the absence of a protective cornified layer and a reduction in keratin production. In the absence of ESR1 in the vaginal epithelial tissue, we also observed an excess of neutrophil infiltration, regardless of the estrous cycle stage. The histological presence of neutrophils was found to correlate with persistent enzymatic activity in the cervical-vaginal fluid. Together, these findings suggest that ESR1 activity in the vaginal epithelial cells is required to maintain proper structural integrity of the vagina and immune response, both of which are necessary for protecting the vagina against physical damage and resetting the vaginal environment.

Sexual dimorphism in bacterial infections

Background

Sex differences are important epidemiological factors that impact in the frequency and severity of infectious diseases. A clear sexual dimorphism in bacterial infections has been reported in both humans and animal models. Nevertheless, the molecular mechanisms involved in this gender bias are just starting to be elucidated. In the present article, we aim to review the available data in the literature that report bacterial infections presenting a clear sexual dimorphism, without considering behavioral and social factors.

Main body

The sexual dimorphism in bacterial infections has been mainly attributed to the differential levels of sex hormones between males and females, as well as to genetic factors. In general, males are more susceptible to gastrointestinal and respiratory bacterial diseases and sepsis, while females are more susceptible to genitourinary tract bacterial infections. However, these incidences depend on the population evaluated, animal model and the bacterial species. Female protection against bacterial infections and the associated complications is assumed to be due to the pro-inflammatory effect of estradiol, while male susceptibility to those infections is associated with the testosterone-mediated immune suppression, probably via their specific receptors. Recent studies indicate that the protective effect of estradiol depends on the estrogen receptor subtype and the specific tissue compartment involved in the bacterial insult, suggesting that tissue-specific expression of particular sex steroid receptors contributes to the susceptibility to bacterial infections. Furthermore, this gender bias also depends on the effects of sex hormones on specific bacterial species. Finally, since a large number of genes related to immune functions are located on the X chromosome, X-linked mosaicism confers a highly polymorphic gene expression program that allows women to respond with a more expanded immune repertoire as compared with men.

Conclusion

Notwithstanding there is increasing evidence that confirms the sexual dimorphism in certain bacterial infections and the molecular mechanisms associated, further studies are required to clarify conflicting data and to determine the role of specific hormone receptors involved in the gender bias of bacterial infections, as well as their potential as therapeutic targets.

Intermittent nasal carriage with Staphylococcus aureus within a menstrual cycle: Results from a prospective cohort of healthy carriers

Female sex hormones have been related to nasal Staphylococcus aureus carriage in healthy individuals; however, whether nasal staphylococcal carriage varies by menstrual cycle phase remains unknown.We sampled anterior nares of female healthcare workers twice per week for 6 consecutive menstrual cycles. We used mixed-effects Poisson regression models to determine whether intermittent carriage was associated with cycle phases in a given individual. We also performed recurrent event survival analysis to identify host factors linked to incident carriage status.Overall, we collected 754 nasal swabs over 89 consecutive person-cycles from 14 intermittent carriers. In 84 ovulation-defined menstrual cycles (715 swabs), the period prevalence of staphylococcal carriage was 58.7%, 63.1%, and 64.9% in the follicular, periovulatory, and luteal phases, respectively; these differences were not statistically significant after multivariable adjustment and correction for within-person correlation (adjusted relative risk [RR]-periovulatory 0.92, P: 0.30; luteal 1.00, P: 0.98).Using survival analysis, we identified several host factors that were associated with incident loss, gain of colonization, or both. For example, as compared to women aged 20 to 30 years, those aged 30 to 40 years were less likely to losing carriage (hazard ratio [HR]: 0.26, 95% confidence interval [CI]: 0.09, 0.80) but were as likely to regaining carriage (HR: 0.53, 95% CI: 0.21, 1.34). In comparison, being underweight (body mass index [BMI] <18.5) was significantly associated with a higher risk for regaining (HR: 1.95, 95% CI: 1.34, 1.51) and losing (HR: 1.57, 95% CI: 1.16, 2.12) colonization, indicating the alternating tendency for status changes. Personal hygiene behaviors, such as nostril cleansing habit and methods, differentially affected carriers' risk for losing or regaining staphylococcal colonization.Using an intensive sampling scheme, we found that nasal staphylococcal carriage could vary substantially over time in healthy carriers. Yet, such dynamic intraperson changes in carriage status did not depend on menstrual cycle phases but were associated with host age, BMI, and personal hygiene behavior.

The role of sex hormones in immune protection of the female reproductive tract

Within the human female reproductive tract (FRT), the challenge of protection against sexually transmitted infections (STIs) is coupled with the need to enable successful reproduction. Oestradiol and progesterone, which are secreted during the menstrual cycle, affect epithelial cells, fibroblasts and immune cells in the FRT to modify their functions and hence the individual's susceptibility to STIs in ways that are unique to specific sites in the FRT. The innate and adaptive immune systems are under hormonal control, and immune protection in the FRT varies with the phase of the menstrual cycle. Immune protection is dampened during the secretory phase of the cycle to optimize conditions for fertilization and pregnancy, which creates a 'window of vulnerability' during which potential pathogens can enter and infect the FRT.

The effect of indomethacin, myeloperoxidase, and certain steroid hormones on bactericidal activity: an ex vivo and in vivo experimental study

BACKGROUND

The role of myeloperoxidase (MPO) is essential in the killing of phagocytosed bacteria. Certain steroid hormones increase MPO plasma concentration. Our aim was to test the effect of MPO, its inhibitor indomethacin, and certain steroid hormones on bactericidal activity.

METHODS

Human polymorphonuclear leukocytes (PMN) were incubated with opsonised Escherichia coli and either MPO, indomethacin, estradiol, or hydrocortisone. Intracellular killing capacity was evaluated with UV microscopy after treatment with fluorescent dye. Next, an in vivo experiment was performed with nine groups of rats: in the first phase of the study indomethacin treatment and Pasteurella multocida infection (Ii), indomethacin treatment without infection (I0), untreated control with infection (Mi) and untreated control without infection (M0); in the second phase of the study rats with infection and testosterone treatment (NT), castration, infection and testosterone treatment (CT), castration, infection and estradiol treatment (CE), non-castrated infected control (N0), and castrated infected control (C0). After treatment bacteria were reisolated from the liver and heart blood on agar plates, and laboratory parameters were analyzed. For the comparison of laboratory results ANOVA or Kruskal-Wallis test and LSD post hoc test was used.

RESULTS

Indomethacin did not have a remarkable effect on the bacterial killing of PMNs, while the other compounds increased bacterial killing to various degrees. In the animal model indomethacin and infection caused a poor clinical state, a great number of reisolated bacteria, elevated white blood cell (WBC) count, decreased C-reactive protein (CRP) and serum albumin levels. Testosterone treatment resulted in less bacterial colony numbers in group NT, but not in group CT compared to respective controls (N0, C0). Estradiol treatment (CE) decreased colony numbers compared to control (C0). Hormone administration resulted in lower WBC counts, and in group CE, a decreased CRP.

CONCLUSIONS

MPO, estradiol, and hydrocortisone improve bacterial killing activity of PMNs. Indomethacin treatment and castration weaken immune responses and clinical state of infected rats, while testosterone and estradiol have a beneficial effect.

Candida albicans escapes from mouse neutrophils

Candida albicans, the most commonly isolated human fungal pathogen, is able to grow as budding yeasts or filamentous forms, such as hyphae. The ability to switch morphology has been attributed a crucial role for the pathogenesis of C. albicans. To mimic disseminated candidiasis in humans, the mouse is the most widely used model organism. Neutrophils are essential immune cells to prevent opportunistic mycoses. To explore potential differences between the rodent infection model and the human host, we compared the interactions of C. albicans with neutrophil granulocytes from mice and humans. We revealed that murine neutrophils exhibited a significantly lower ability to kill C. albicans than their human counterparts. Strikingly, C. albicans yeast cells formed germ tubes upon internalization by murine neutrophils, eventually rupturing the neutrophil membrane and thereby, killing the phagocyte. On the contrary, growth and subsequent escape of C. albicans are blocked inside human neutrophils. According to our findings, this blockage in human neutrophils might be a result of higher levels of MPO activity and the presence of α-defensins. We therefore outline differences in antifungal immune defense between humans and mouse strains, which facilitates a more accurate interpretation of in vivo results.

Increased total scavenger capacity in rats fed corticosterone and cortisol on lipid-rich diet

BACKGROUND

In our earlier studies both corticosterone and cortisol had antioxidant effect in vitro.

OBJECTIVES

Our aim was to clarify whether corticosterone and cortisol oral administration results in beneficial antioxidant changes in Sprague-Dawley adult male rats in vivo.

METHODS

Experimental animals were fed a lipid rich diet and treated with corticosterone or cortisol in the drinking fluid. Control group was fed only lipid rich diet with untreated drinking water. The untreated group was feda normal diet with untreated water. Total scavenger capacity (TSC) was measured before and after 4 weeks of treatment in blood samples using a chemiluminometric assay.

RESULTS

Both corticosterone and cortisol treatment caused increased TSC. The control group and the untreated group showed no significant changes in TSC.

CONCLUSION

Our results support the hypothesis that corticosterone and cortisol administration can improve the antioxidant status not only in vitro but also in vivo.

Combined hormonal contraception may be protective against Neisseria gonorrhoeae infection

BACKGROUND

The role of hormonal contraception on acquisition of gonorrhea has not been well-characterized, as the transmission dynamics of Neisseria gonorrhoeae are poorly understood. The purpose of this study is to determine the influence of hormonal contraception on gonococcal infection in women exposed to males with gonococcal urethritis.

METHODS

Females aged 15 to 35 years reporting sexual contact to a male partner diagnosed with N. gonorrhoeae were enrolled. Demographic and sexual histories, physical findings, and laboratory tests were collected. Women testing positive and negative for cervical N. gonorrhoeae were compared using chi and Fisher exact tests, with multivariable logistic regression performed on those factors independently associated with gonococcal infection on univariate analysis.

RESULTS

N. gonorrhoeae infection occurred in 68 of 107 (64%) women. Women using combined hormonal contraception were significantly less likely than nonusers to test positive for N. gonorrhoeae (32% vs. 76%; prevalence ratio: 0.42; 95% confidence interval: 0.22, 0.78; P = 0.006). Gonorrhea was also less common in depomedroxyprogesterone acetate users. A new sexual partner was also associated with testing positive for gonorrhea (35% vs. 13%; prevalence ratio: 1.47; 95% confidence interval: 1.13, 1.90; P = 0.004).

CONCLUSIONS

Women using combined hormonal contraceptives or depomedroxyprogesterone acetate were less likely to test positive for N. gonorrhoeae after sexual exposure compared with nonusers. Our data suggest that, in addition to contraceptive benefits, modern hormonal contraception may have a protective effect on the acquisition of N. gonorrhoeae.

Estrogens augment cell surface TLR4 expression on murine macrophages and regulate sepsis susceptibility in vivo

Gender-based differences exist in infectious disease susceptibility. In general, females generate more robust and potentially protective humoral and cell-mediated immune responses after antigenic challenge than their male counterparts. Furthermore, evidence is accumulating that sex may also influence the early perception of microbial challenges and the generation of inflammatory immune responses such as sepsis. These differences have previously been attributed to the actions of reproductive hormones. Whereas androgens have been shown to suppress acute host immune responses to bacterial endotoxin challenge, estrogens have been found to promote increased resistance to bacterial infections. However, the mechanisms by which estrogens exert immunoprotective effects have not been established. In this study, we investigated the in vivo effects of 17beta-estradiol on endotoxin susceptibility in mice. Importantly, we have examined the actions of this female reproductive hormone on the expression of pattern recognition receptors that recognize bacterial endotoxin by key innate immune sentinel cells. We show that removal of endogenous estrogens decreases both pro- and antiinflammatory cytokine production, with a concomitant reduction in circulating levels of lipopolysaccharide-binding protein and cell surface expression of Toll-like receptor 4 on murine macrophages. Exogenous in vivo replacement of 17beta-estradiol, but not progesterone, significantly elevates sera lipopolysaccharide-binding protein levels and cell surface expression of Toll-like receptor 4 and CD14 on macrophages. Furthermore, this effect corresponds with significantly higher inflammatory cytokine levels after in vivo lipopolysaccharide challenge and a marked increase in endotoxin-associated morbidity. Taken together, these data provide a potential mechanism underlying the immunoenhancing effects of estrogens.

The evaluation of the immunomodulating properties of ERA-63 a pharmaceutical with estrogenic activity

This paper describes studies performed with ERA-63 a low molecular weight pharmaceutical with intended immunomodulatory effects. Since this compound was also known to have estrogenic activity a non-conventional approach was taken in order to differentiate between estrogenic and non-estrogenic-induced immunomodulatory effects. EE was included not only for qualitative comparison (hazard identification) between immunomodulatory effects but also, in case of similar effects, to facilitate the extrapolation of the findings in the rat to anticipated effects in humans. After 28 days of treatment with dosages ranging from pharmacological up to clearly toxic levels for both compounds the immunotoxic potential was assessed by performing a T cell-dependent antibody response and a host resistance assay in rats. Selected ERA-63 dose levels (0.167-0.2, 1.67-2 and 16.7-20mg/kg) were expected to have comparable estrogenic activity to respective EE dose levels (0.05, 0.5 and 5mg/kg). General toxicity parameters reflecting estrogenic activity (i.e. decreased body- and organ weights of thymus and testis, and increased bilirubin and GGT levels) confirmed the comparable estrogenic activity for both compounds at the dose levels tested. Together with the comparable estrogen-related immune suppression (i.e. decreases in specific antibody responses and an increased susceptibility for Listeria monocytogenes infects) for both compounds, this indicates that available clinical data for EE facilitates the human risk assessment of ERA-63.

Neisseria gonorrhoeae catalase is not required for experimental genital tract infection despite the induction of a localized neutrophil response

Neisseria gonorrhoeae produces several antioxidant defenses, including high levels of catalase, which may facilitate the persistence during an inflammatory response via neutralization of H2O2 produced by phagocytes. In vivo testing of the role of catalase in gonococcal survival is critical since several physiological factors impact interactions between N. gonorrhoeae and polymorphonuclear leukocytes (PMNs). Here we assessed the importance of gonococcal catalase in a surrogate model of female genital tract infection. Female BALB/c mice were treated with 17-beta estradiol to promote susceptibility to N. gonorrhoeae and inoculated intravaginally with wild-type gonococci or a catalase (kat) deletion mutant. A localized PMN influx occurred in an average of 43 and 81% of mice infected with wild-type or kat mutant gonococci, respectively, and PMNs associated with numerous wild-type or catalase-deficient bacteria were observed in vaginal smears. The combined results of six experiments showed a significant difference in the number of days wild-type bacteria were recovered compared to the catalase-deficient gonococci. However, there was much variability between experiments, and we found no correlation between PMN influx, colonization load, and clearance of wild-type or kat mutant bacteria. Estradiol treatment did not impair bacterial uptake, the luminol-dependent chemiluminescence response, or the killing capacity of isolated murine PMNs against N. gonorrhoeae or Staphylococcus aureus. Our data suggest N. gonorrhoeae is not significantly challenged by H2O2 produced by PMNs in the murine lower genital tract; alternatively, redundant defense mechanisms may protect the gonococcus from reactive oxygen species during infection.

Escherichia coli derived factors modulate human granulosa cell steroidogenesis

AIM

In order to identify bacterial compounds which directly affect granulosa cell steroidogenesis, the effect of culture-supernatants and extracts from Escherichia coli were tested in an in vitro granulosa cell culture model.

METHODS

Samples were drawn from the culture-supernatant of E. coli ATCC25922 cultured in Luria-broth medium. Bacterial extract was prepared by incubation of freshly harvested bacteria in buffer. The bacterial culture-supernatants and extracts were added to human granulosa cells in culture. The granulosa cells collected from the follicular aspirates from women undergoing in-vitro fertilization were cultured for 17-53 h and progesterone or oestradiol was assayed in the spent culture medium.

RESULTS

The E. coli culture-supernatant stimulated the basal granulosa cell progesterone production demonstrating its maximum activity reached after 200-240 min of bacterial growth. The heat denaturated bacterial extract as well as its low-molecular-weight fraction (<10 kDa) stimulated both the basal and the hCG-stimulated progesterone production; the oestradiol production was slightly inhibited. Stimulation of progesterone production was time dependent increasing from 125 +/- 18% of control within the first 3 h to 205 +/- 35% within 17-53 h. The high-molecular-weight fraction (>30 kDa) of the bacterial extract inhibited progesterone production. The inhibitory activity was significantly diminished by heat denaturation.

CONCLUSIONS

The present study demonstrates the existence of various compounds which are secreted by E. coli and could also be extracted out of E. coli bacteria. These bacterial compounds modulate ovarian steroidogenesis. Further studies are needed to clarify how far these compounds contribute to menstrual disturbance observed in chronic pelvic inflammation.

Influence of gender and age on course of infection and cytokine responses in mice with disseminated Cryptococcus neoformans infection

OBJECTIVE

To study the influence of gender and age on the course of infection and the cytokine response in a murine model of disseminated cryptococcosis.

METHODS

The course of the infection (survival and fungal load in blood and tissues) as well as pro-inflammatory and anti-inflammatory cytokine responses in plasma and organs were compared according to gender and age in outbred mice previously infected with Cryptococcus neoformans NIH52D.

RESULTS

Although survival and fungal load were similar in male and female mice, the expression of all cytokines in plasma and of tumour necrosis factor-alpha and interferon-gamma in spleen was significantly increased in female mice compared to male mice in two independent experiments. Young male mice had a significantly shortened survival, were significantly more infected and had predominant tumour necrosis factor-alpha and interferon-gamma responses in comparison with older male mice.

CONCLUSION

Host factors should be taken into account when studying the immune response to experimental C. neoformans infection. Our data support epidemiological and clinical data showing differences in susceptibility to cryptococcosis according to gender and age.

Induced myeloperoxidase activity and related superoxide inhibition during hormone replacement therapy

OBJECTIVE

To test whether the menopause entails any changes in the myeloperoxidase activity of neutrophil granulocytes. The effects of hormone replacement therapy on myeloperoxidase activity and related changes in free radical production were also investigated.

DESIGN

Laboratory investigation of the effect of oestrogen on intracellular myeloperoxidase activity and release from human neutrophil granulocytes. Analysis of related changes in superoxide anion generation.

SETTING

2nd Department of Medicine and 1st Department of Obstetrics and Gynaecology, Semmelweis University, Budapest.

SAMPLES

Intracellular myeloperoxidase activity (mean peroxidase index) was measured automatically in blood samples obtained for general laboratory work-up from 135 randomly selected patients in our department. Blood samples from 11 postmenopausal women were analysed before and during hormone replacement therapy. Blood samples from 20 healthy volunteers were obtained and neutrophil granulocytes separated for in vitro measurement of superoxide anion production after adding myeloperoxidase to the incubation media.

METHODS

The mean peroxidase index was measured using a Technicon H-3 instrument. myeloperoxidase release from neutrophils was quantified by ELISA technique. Superoxide production of isolated neutrophil granulocytes was measured by photometry.

MAIN OUTCOME MEASURES

Intracellular activity of myeloperoxidase, concentration of myeloperoxidase-protein in supernatant of neutrophils, release of superoxide anion from neutrophil granulocytes.

RESULTS

1. Intracellular myeloperoxidase activity in neutrophils was lower in postmenopausal women, than in females with regular cycles (-1.84 +/- 3.06 versus 1.59 +/- 3.55, P < 0,001). 2. In postmenopausal women intracellular myeloperoxidase activity and myeloperoxidase release increased during hormone replacement therapy (-5.54 +/- 6.63 versus -0.2 +/- 6.05; P < 0.001 and 52.74 mU/ml +/- 25.73 versus 251.4 +/-234.1 mU/ml; P < 0.05). 3. Adding myeloperoxidase to neutrophil granulocyte suspensions, the production of superoxide anion fell (e.g. adding 280 ng/ml myeloperoxidase: 77.9 +/- 14.04 % of control production, P < 0.001).

CONCLUSION

Hormone replacement restores the reduced myeloperoxidase activity in menopausal women. Adding myeloperoxidase to neutrophil granulocytes, the production of free radicals decreases.

Effect of oestrogen on Mycobacterium avium complex pulmonary infection in mice

The purpose of the present study was to elucidate the role of oestrogen in the pathogenesis of Mycobacterium avium complex (MAC) pulmonary disease, which occurs most frequently in postmenopausal women. The study was carried out in a murine infectious model using ovariectomized DBA/2 female mice. Infection with MAC was established by intratracheal administration of bacilli. In some experiments, ovariectomized mice were treated with exogenous 17 beta-estradiol (E2). The number of bacilli in the lungs of infected mice which received ovariectomy was significantly larger than that in the lungs of sham-operated control mice, and treatment of ovariectomized mice with exogenous E2 restored the burden of bacilli to the same level as that in the sham-operated control mice. We next examined the effect of E2 in vitro using bone marrow-derived macrophages obtained from DBA/2 female mice. The macrophages showed bacteriostatic activity against MAC after treatment with interferon-gamma (IFN-gamma) and this activity was further enhanced by the exogenous addition of E2 to the culture medium. In parallel with these findings, E2 augmented the production of reactive nitrogen intermediates (RNI) by macrophages pretreated with IFN-gamma and stimulated with MAC, as shown by evaluating nitrite production and inducible nitric oxide synthase mRNA expression. These findings taken together suggest that absence of endogenous oestrogen appears to be responsible for the development of MAC pulmonary disease in this mouse model and that the enhancement by E2 of anti-MAC activity of murine macrophages induced through increased RNI production may play some role in resistance to MAC infection.

In vitro effects of different steroid hormones on superoxide anion production of human neutrophil granulocytes

Neutrophil granulocytes play an important role in atherogenesis also through their free radical generation. According to recent studies, a point of action by which estrogens can provide protection against atherosclerosis is their inhibiting effect on superoxide anion production. The aim of our study was to test whether this means a common effect of steroids on superoxide production, or whether various steroid hormones have different action on superoxide generation of human granulocytes. Neutrophils were separated from the blood samples of twelve healthy volunteers. Isolated cells were incubated with different concentrations (10(-9), 10(-8), 10(-7) M) of hydrocortisone, aldosterone, cortexolone, 17-beta-estradiol, progesterone, and testosterone. Superoxide anion production was determined by photometry using the reduction of ferricytochrome-C. Compared to that of control cells neutrophils incubated with 17-beta-estradiol, progesterone, testosterone and hydrocortisone showed significantly reduced superoxide production. No significant alteration of superoxide anion production was found after the incubation of cells with aldosterone and cortexolone. It is concluded that similarly to estradiol other sex steroids and cortisol can inhibit the free radical production of human granulocytes, but mineralocorticoid aldosterone and Reichstein's substance S do not show such activity. Our results provide new evidence supporting the theory that certain types of steroid hormones have antioxidant capacity. This may give further reasons for investigating the molecular background of the existence or absence of this property and thus might lead to the development of new free radical scavengers.

The effects of hormones on sex differences in infection: from genes to behavior

Males of many species are more susceptible than females to infections caused by parasites, fungi, bacteria, and viruses. One proximate cause of sex differences in infection is differences in endocrine-immune interactions. Specifically, males may be more susceptible to infection than females because sex steroids, specifically androgens in males and estrogens in females, modulate several aspects of host immunity. It is, however, becoming increasingly more apparent that in addition to affecting host immunity, sex steroid hormones alter genes and behaviors that influence susceptibility and resistance to infection. Thus, males may be more susceptible to infection than females not only because androgens reduce immunocompetence, but because sex steroid hormones affect disease resistance genes and behaviors that make males more susceptible to infection. Consideration of the cumulative effects of sex steroid hormones on susceptibility to infection may serve to clarify current discrepancies in the literature and offer alternative hypotheses to the view that sex steroid hormones only alter susceptibility to infection via changes in host immune function.

Experimental gonococcal genital tract infection and opacity protein expression in estradiol-treated mice

The development of effective prophylactic agents against gonorrhea and the study of adaptation by Neisseria gonorrhoeae to the urogenital mucosa are hindered by the lack of a well-established animal model of gonococcal genital tract infection. Here, a murine model of long-term gonococcal genital tract infection is described. Female BALB/c mice were treated with 17-beta-estradiol and inoculated intravaginally with wild-type gonococcal strain FA1090 or MS11. N. gonorrhoeae was recovered from vaginal swabs for an average of 12 to 13 days following inoculation with 10(6) CFU of either strain. Inflammation occurred in over 80% of infected mice, and diplococci were associated with epithelial cells and neutrophils in stained vaginal smears. Ascended infection occurred in 17 to 20% of mice inoculated with strain FA1090. An outbred mouse strain (SLC:ddY) previously reported to be naturally susceptible to N. gonorrhoeae was also tested; however, as with BALB/c mice, estradiol was required for prolonged infection. Although piliation was not maintained during experimental murine infection, 46 to 100% of vaginal isolates from four of eight BALB/c mice and three of four SLC:ddY mice expressed one or more opacity (Opa) proteins within 4 days after inoculation with an Opa-negative variant of strain FA1090. The observed selection for and/or induction of gonococcal Opa protein expression during murine infection appears to parallel events that occur during experimental urethritis in volunteers.

Beta-estradiol-induced decrease in IL-12 and TNF-alpha expression suppresses macrophage functions in the course of Listeria monocytogenes infection in mice

Mice treated with a contraceptive dose of beta-estradiol (E2) demonstrated changes in their macrophage (Mphi) number and functions. While E2 increased and decreased the Mphi number in PBMC and PEC respectively, it enhanced the in vitro phagocytosis of FITC-labeled beads by both cells. E2 treatment also enhanced the phagocytic function of Mphi as assessed by the in vivo carbon clearance assay. In contrast, the in vitro intracellular killing function of adherent cells in peritoneal exudate cells (PEC) against Listeria monocytogenes decreased after E2 treatment. In line with the decrease in the intracellular killing function, the E2-treated mice showed an impaired protection against L. monocytogenes infection. To clarify the mechanism of the E2-mediated suppression of the protective response against L. monocytogenes infection, we next analyzed the cytokine expression by PEC in E2-treated L. monocytogenes-infected mice. On day 5 of the infection, the expression of IL-12, TNF-alpha and IL-10 by adherent PEC from the E2-treated mice was lower than that from the control-infected mice. The decrease in the cytokine expression by adherent PEC of E2-treated mice coincided with the decrease of IFN-gamma expression, and the increase in the IL-4, IL-10 and TGF-beta expressions by non-adherent PEC. These results revealed two aspects of the effects of E2 on Mphi. Even though E2 was found to enhance Mphi phagocytosis, the anti-bacterial function was suppressed. This suppression may be mediated by the inhibition of both IL-12 and TNF-alpha which play important roles in the protective response against intracellular bacteria.

Morphological transition of Paracoccidioides brasiliensis conidia to yeast cells: in vivo inhibition in females

Clinical paracoccidioidomycosis is 13 times more common in men than in women. Estrogen inhibits the transition of mycelia or conidia (the saprophytic form of Paracoccidioides brasiliensis) to yeasts (the parasitic form) in vitro. Here, we show that, in male mice that were infected intranasally (mimicking natural infection) the transition of conidia in bronchoalveolar lavage fluids to intermediate forms and yeasts occurred over 24 to 96 h; CFU and yeasts (shown by histopathology) increased subsequently. In females, transition did not occur and infection cleared. These events in vivo are consistent with epidemiological and in vitro observations, suggesting that female hormones block transition and are responsible for resistance.

Influence of ovarian hormones on urogenital infection

Numerous studies have examined the influence of hormones on infectious diseases and there is now a wealth of data relating to the more specific effect of the sex hormones, oestrogen and progesterone, on urogenital infections. The interaction between these hormones and the immune system is complex and the variation of hormonal effect between species further complicates the true picture as related to humans. Although it is difficult therefore to draw general conclusions regarding predominant effects of specific hormones, there is the suggestion that oestrogen enhances the pathogenicity of many urogenital micro-organisms. Our understanding of the influential role played by sex hormones in disease pathogenesis is at an early stage and illustrates well the importance of drawing together and interpreting as a whole both epidemiological and molecular studies.

The in vitro effects of estradiol and cortisol on the function of a long-term goldfish macrophage cell line

We examined the in vitro effects of estradiol and cortisol on the inflammatory function of a macrophage cell line. A dose-dependent inhibition of chemotaxis (0.5 and 0.1 microM, for estradiol and cortisol, respectively) and phagocytosis (1.0 microM for both steroids) were observed after treatment. Estradiol did not affect the nitric oxide production by the macrophage cell line, while cortisol strongly inhibited in vitro nitric oxide production. The steroids did not affect the ability of the macrophages to mount a respiratory burst response as measured by the NBT reduction assay.

Periodontal status of women taking postmenopausal estrogen supplementation

The association between supplementary estrogen intake and periodontal and gingival status in a total of 228 women 50 to 64 years of age was examined. Clinical parameters including visible supragingival plaque, subgingival calculus, probing pocket depth, clinical attachment level, alveolar bone height measurements, and number of remaining teeth were measured. Gingival status was recorded as gingival bleeding after gentle manipulation. Selected periopathogens, socio-economic, demographic, smoking habits, and health care variables were assessed. Gingival bleeding was significantly lower in the estrogen supplement group (n = 57) compared to the control group (n = 171) (P = 0.009); the estrogen group also exhibited significantly lower visible plaque levels (P = 0.030) and fewer Capnocytophaga-ssp. (P = 0.032). Dental care was more frequent (P < 0.001), and education levels were higher (P = 0.022) in the estrogen group. To investigate whether differences among the above parameters contributed to the difference in gingival bleeding, an age-adjusted analysis of covariance (ANCOVA) was used. The final ANCOVA indicated non-significant relationships for all parameters examined except estrogen intake (P = 0.044). Women taking estrogen exhibited lower gingival bleeding than the control group after correcting for these factors. The results indicate that estrogen supplementation is associated with less gingival bleeding in women aged 50 to 64, as compared to an age-matched control group.

Sex differences in host resistance to Mycobacterium marinum infection in mice

Sex differences were observed in host resistance to Mycobacterium marinum infection in mice. Males were found to be more susceptible than females in terms of mortality, incidence of gross skin lesions, and bacterial load in the lungs and spleen. The degree of sex differences varied from strain to strain of test mice, in the order C3H/He, A/J, and BALB/c greater than DBA/2, B10.A, and C57BL/6, on the basis of survival time and multiplication of organisms in the visceral organs. Although this ordering corresponded to the susceptibilities of both male and female mice to the organisms, much greater strain dependency was seen in males than in females. Castration caused an increase in the host resistance of males, but this effect was substantially reversed by continuous testosterone treatment. Testosterone also increased the susceptibility of female mice to this infection. These findings imply that the male sex hormone is involved in the lowered anti-M. marinum resistance of males. Although athymic mice were more susceptible than euthymic mice, a substantial degree of sex difference was also observed in the T-cell-depleted animals, indicating that natural host resistance to this infection is sex dependent. Indeed, more efficient macrophage mobilization at the site of infection was seen in females than in males. Although female T-cell transplantation improved the lowered resistance of athymic mice, there was a sex difference in bacterial growth in the lungs. This implies that sex hormones affect T-cell functions.

Glucocorticoids suppress and oestrogens enhance the lipopolysaccharide-induced increase in putrescine and N1-acetylspermidine in mouse liver

Previously we reported that administration of lipopolysaccharide (LPS) to mice increased the hepatic levels of putrescine (PUT) and N1-acetylspermidine (N1-acetyl-SPD). In the current study, we examined the in vivo effects of some steroid hormones on the LPS-induced increase in PUT and N1-acetyl-SPD. Corticosterone, hydrocortisone and dexamethasone suppressed the LPS-induced increase in PUT and N1-acetyl-SPD in mouse liver in a dose-dependent manner, dexamethasone being the most effective among them. On the other hand, oestrone and oestradiol-17 beta enhanced the LPS-induced increase in PUT and N1-acetyl-SPD in a dose-dependent manner. Oestradiol-17 alpha and 16 beta-ethyl-oestradiol, as an inactive oestradiol isomer and an antioestrogen, respectively, likewise enhanced the increase in PUT and N1-acetyl-SPD concentrations induced by LPS. 16 alpha-hydroxy-oestradiol (oestriol), 16 alpha-hydroxyestrone, 2-hydroxyoestradiol, 2-hydroxyoesterone, progesterone, testosterone, diethylstilboestrol and nonsteroidal antioestrogens such as tamoxifen and nafoxidine had no effect on the increase. Oestradiol-17 beta enhanced and corticosterone had little effect on the carbon tetrachloride-induced increase in PUT and N1-acetyl-SPD. These results suggest that glucocorticoids suppress the increase by preventing the immunological injury by Kupffer cells on hepatocytes and that the stimulatory effect of oestrogens may not be associated with their oestrogenic activities mediated by the oestrogen receptor system.

Sex differences in the susceptibility of mice to infection induced by Mycobacterium intracellulare

Sex differences in the susceptibility of Balb-c mice to Mycobacterium intracellulare infection were studied. When mice were given M. intracellulare intravenously, macroscopic lesions were considerably more extensive in the lungs, liver, and kidneys of male mice than in female mice. A significantly more marked growth of organisms occurred in these visceral organs of the male mice during the course of infection for as long as 16 wk after the challenge. This difference can be partly explained by the finding that the antimicrobial activity of host peritoneal macrophages is more potent in the female mice.

The relation between serum sex steroid levels and plasma cell infiltrates in endometritis

We measured serum levels of progesterone and estradiol among 35 patients with endometritis confirmed by endometrial biopsy. The onset of symptoms took place predominantly in the proliferative phase of the cycle. A negative correlation was found between the serum progesterone levels and the histopathologic severity of plasma cell endometritis. Our results suggest that the hormonal status contributes to the immune response and susceptibility to endometrial infection.

The concentration of salivary steroid hormones and the prevalence of gingivitis at puberty

Gingival conditions of 1323 junior high schoolchildren aged 12-15 were examined, and 132 children who had either healthy gingivae or severe gingivitis were called to the clinic. More precise examination of gingivitis was performed by assessment of Jackson's gingivitis index (G.I.), probing depth (P.D.), and bleeding on probing. Whole saliva was collected, and the salivary concentrations of estradiol, progesterone, and testosterone were determined by radioimmunoassay. Subgingival bacterial plaque was sampled from 36 children, and total bacterial counts and morphological differentiation were performed under a phase-contrast microscope. For statistical analysis, both males and females were divided into two groups according to the concentration of each sex hormone and subgrouped by the results of clinical examinations. Chi-square analysis using 2-by-2 tables was performed to determine the relation between salivary steroid hormone levels and gingival inflammation.

The results suggest that unbalanced secretion of certain hormones might be one of the factors promoting gingivitis at puberty.