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Pang H, Chen S, Klyne DM, Harrich D, Ding W, Yang S, Han FY. Low back pain and osteoarthritis pain: a perspective of estrogen. Bone Res 2023; 11:42. [PMID: 37542028 PMCID: PMC10403578 DOI: 10.1038/s41413-023-00280-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 06/28/2023] [Accepted: 07/10/2023] [Indexed: 08/06/2023] Open
Abstract
Low back pain (LBP) is the world's leading cause of disability and is increasing in prevalence more rapidly than any other pain condition. Intervertebral disc (IVD) degeneration and facet joint osteoarthritis (FJOA) are two common causes of LBP, and both occur more frequently in elderly women than in other populations. Moreover, osteoarthritis (OA) and OA pain, regardless of the joint, are experienced by up to twice as many women as men, and this difference is amplified during menopause. Changes in estrogen may be an important contributor to these pain states. Receptors for estrogen have been found within IVD tissue and nearby joints, highlighting the potential roles of estrogen within and surrounding the IVDs and joints. In addition, estrogen supplementation has been shown to be effective at ameliorating IVD degeneration and OA progression, indicating its potential use as a therapeutic agent for people with LBP and OA pain. This review comprehensively examines the relationship between estrogen and these pain conditions by summarizing recent preclinical and clinical findings. The potential molecular mechanisms by which estrogen may relieve LBP associated with IVD degeneration and FJOA and OA pain are discussed.
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Affiliation(s)
- Huiwen Pang
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia
| | - Shihui Chen
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia
| | - David M Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia
| | - David Harrich
- Department of Cell and Molecular Biology, QIMR Berghofer Medical Research Institute, Herston, QLD, 4006, Australia
| | - Wenyuan Ding
- Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, China
- Hebei Joint International Research Center for Spinal Diseases, 139 Ziqiang Road, Shijiazhuang, 050051, China
| | - Sidong Yang
- Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, China.
- Hebei Joint International Research Center for Spinal Diseases, 139 Ziqiang Road, Shijiazhuang, 050051, China.
| | - Felicity Y Han
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia.
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Luo X, Liu W, Zhao M, Wang J, Gao X, Feng F. The evaluation of sea cucumber ( Acaudina leucoprocta) peptide on sex hormone regulation in normal and premature ovarian failure female mice. Food Funct 2023; 14:1430-1445. [PMID: 36645395 DOI: 10.1039/d2fo01707e] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Sea cucumber peptides (SCPs) have various functional activities. However, studies to evaluate the efficacy and safety of SCPs from the perspective of sex hormones are still lacking. In this study, normal and premature ovarian failure (POF) female mice were used to assess the effect of SCPs on the sex hormones. The ovarian and uterine indices were not influenced by SCP both in normal and POF mice. In normal mice, SCP showed no significant impact on the estrous cycle, ovarian, uterine morphology, sex hormone levels, and sex hormone synthesis-related genes of the ovary. However, 0.6 mg per g bw dosage of SCP (SCPH) statistically increased mapk1 expression on normal mice hypothalamus. In POF mice, SCPH played a more positive role than a low dosage of SCP (0.2 mg per g bw). SCP ameliorated POF-induced estrous cycle disturbances and significantly increased serum estradiol, testosterone, and AMH levels. Moreover, SCP increased the synthesis of the sex hormone by upregulating the expression of StAR, Fshr, and Cyp19a1 in the ovary, which might be due to the activation of the cAMP-related signaling pathways. The upregulation of mapk1, Esr1, and Gnrh was also observed in the hypothalamus. Together, SCP is safe for normal female mice and seems to have positive effects on POF mice from sex hormone regulation. However, the risk of excessive supplementation of sex hormones induced by the SCP intake in POF mice needs to be further explored.
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Affiliation(s)
- Xianliang Luo
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China.
| | - Wangxin Liu
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China.
| | - Minjie Zhao
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China.
| | - Jing Wang
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China.
| | - Xinchang Gao
- Department of Chemistry, Tsinghua University, Beijing 100084, China
| | - Fengqin Feng
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China.
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Douglass A, Dattilo M, Feola AJ. Evidence for Menopause as a Sex-Specific Risk Factor for Glaucoma. Cell Mol Neurobiol 2023; 43:79-97. [PMID: 34981287 PMCID: PMC9250947 DOI: 10.1007/s10571-021-01179-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/03/2021] [Indexed: 01/07/2023]
Abstract
Glaucoma is a leading cause of irreversible blindness worldwide and is characterized by progressive loss of visual function and retinal ganglion cells (RGC). Current epidemiological, clinical, and basic science evidence suggest that estrogen plays a role in the aging of the optic nerve. Menopause, a major biological life event affecting all women, coincides with a decrease in circulating sex hormones, such as estrogen. While 59% of the glaucomatous population are females, sex is not considered a risk factor for developing glaucoma. In this review, we explore whether menopause is a sex-specific risk factor for glaucoma. First, we investigate how menopause is defined as a sex-specific risk factor for other pathologies, including cardiovascular disease, osteoarthritis, and bone health. Next, we discuss clinical evidence that highlights the potential role of menopause in glaucoma. We also highlight preclinical studies that demonstrate larger vision and RGC loss following surgical menopause and how estrogen is protective in models of RGC injury. Lastly, we explore how surgical menopause and estrogen signaling are related to risk factors associated with developing glaucoma (e.g., intraocular pressure, aqueous outflow resistance, and ocular biomechanics). We hypothesize that menopause potentially sets the stage to develop glaucoma and therefore is a sex-specific risk factor for this disease.
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Affiliation(s)
- Amber Douglass
- grid.484294.7Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA USA
| | - Michael Dattilo
- grid.189967.80000 0001 0941 6502Department of Ophthalmology, Emory Eye Center, Emory University School of Medicine, B2503, Clinic B Building, 1365B Clifton Road NE, Atlanta, GA 30322 USA ,grid.414026.50000 0004 0419 4084Department of Ophthalmology, Atlanta Veterans Affairs Medical Center, Atlanta, GA USA ,grid.213917.f0000 0001 2097 4943Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA USA
| | - Andrew J. Feola
- grid.484294.7Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA USA ,grid.189967.80000 0001 0941 6502Department of Ophthalmology, Emory Eye Center, Emory University School of Medicine, B2503, Clinic B Building, 1365B Clifton Road NE, Atlanta, GA 30322 USA ,grid.213917.f0000 0001 2097 4943Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA USA
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Zhao Y, Wang H, Li Z, Wang Z, Huo Y, Yang S, Ding W. Lumbar Disk Degeneration in Female Patients with and without Ovariectomy: A Case-Control Study. World Neurosurg 2021; 156:68-75. [PMID: 34571241 DOI: 10.1016/j.wneu.2021.09.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We sought to provide clinical evidence of the potential influence of ovariectomy (OVX) on intervertebral disk degeneration. METHODS We retrospectively reviewed patients with a history of OVX who visited our hospital for lower back pain. In addition, 60 age-matched patients without OVX were randomly selected as control subjects. Next, the following demographic data were recorded and compared among groups: age, body mass index, duration of OVX, history of smoking, alcohol use, hypertension, diabetes, cardiocerebrovascular disease, hyperlipemia, osteoporosis, and degenerative spondylolisthesis. Next, the severity of lumbar disk degeneration, evaluated by the modified Pfirrmann grading system, was compared between groups. Data analyses were performed with SPSS 20.0. software. RESULTS A total of 15 OVX (unilateral, n = 10; bilateral, n = 5) patients were included with a mean age of 62.40 ± 10.64. The average durations of OVX were 21.33 ± 9.24 years. There existed no remarkable intergroup differences in the demographic data (P > 0.05). Overall, the average Pfirrmann grading scores from L1/2 to L5/S1 presented as L1/2 < L2/3 < L3/4 ≤ L5/S1 ≤ L4/5, with no marked differences between groups (P > 0.05). Nevertheless, OVX groups displayed a relatively higher score at each level than non-OVX group. Moreover, the scores from L3/4 to L5/S1 were higher in the bilateral OVX group relative to the unilateral OVX group while they were equal at L1/2 and L2/3. CONCLUSIONS Our findings demonstrated that OVX contributed to the progression of lumbar disk degeneration to some extent, but it appeared to be a long-term event.
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Affiliation(s)
- Yachao Zhao
- Department of Spine Surgery, The Third Hospital of Hebei Medical University, Hebei Province, P. R. China
| | - Haidong Wang
- Department of Spine Surgery, The Third Hospital of Hebei Medical University, Hebei Province, P. R. China
| | - Zhaohui Li
- Department of Spine Surgery, The Third Hospital of Hebei Medical University, Hebei Province, P. R. China
| | - Zhiwei Wang
- Department of Spine Surgery, The Third Hospital of Hebei Medical University, Hebei Province, P. R. China
| | - Yachong Huo
- Department of Spine Surgery, The Third Hospital of Hebei Medical University, Hebei Province, P. R. China
| | - Sidong Yang
- Department of Spine Surgery, The Third Hospital of Hebei Medical University, Hebei Province, P. R. China
| | - Wenyuan Ding
- Department of Spine Surgery, The Third Hospital of Hebei Medical University, Hebei Province, P. R. China.
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Hughbanks ML, Rodriguez-Fontan F, Kleck CJ, Burger-Van der Walt E. Estrogen receptor Alpha in human knee articular cartilage of healthy and osteoarthritic females. J Orthop 2021; 27:1-8. [PMID: 34413582 DOI: 10.1016/j.jor.2021.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/08/2021] [Indexed: 12/14/2022] Open
Abstract
Objective Estrogen and osteoarthritis association has previously been proposed. This study evaluates the presence of estrogen receptors (ER)-α in articular cartilage, and its association. Methods A prospective cohort study of women undergoing anterior cruciate ligament reconstruction (controls) or total knee arthroplasty (cases) was performed. Cartilage samples were processed and ER-α expression was quantified. Results Twenty patients were included: 12 cases and 8 controls. ER-α expression was higher in the case subjects. Conclusion Increased ER-α expression is associated with age, and degeneration. This suggests estrogen deficiency is a risk for osteoarthritis and is inversely related to proliferative looking chondrocytes.
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Affiliation(s)
- Marissa L Hughbanks
- School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.,Department of Orthopedics, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | | | - Christopher J Kleck
- Department of Orthopedics, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.,The Spine Center at University of Colorado Hospital, Aurora, CO, USA
| | - Evalina Burger-Van der Walt
- Department of Orthopedics, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.,The Spine Center at University of Colorado Hospital, Aurora, CO, USA
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Langer RD. The role of medications in successful aging. Climacteric 2021; 24:505-512. [PMID: 33977831 DOI: 10.1080/13697137.2021.1911991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Successful aging includes good health and low levels of disability. To that end, primary prevention is far better than managing subsequent organ damage. When medication is needed to prevent or manage disease, the preferred choice should be associated with the greatest benefits and fewest adverse effects. Cardiovascular diseases are the leading cause of morbidity and mortality in postmenopausal women worldwide. Considering disease-adjusted life years, other leading causes are chronic obstructive pulmonary disease, diabetes mellitus, dementias, hearing loss, cancers of the breast, lung and bowel, osteoporosis, fractures and falls, depression, osteoarthritis, refractive errors of the eye and non-diabetic chronic kidney disease. This review explores the global prevalence of these diseases in women aged 50 years and older, and medications commonly used for them, and contrasts the effects of menopausal hormone therapy (MHT) with others. When initiated early, there is good evidence for MHT benefit in all-cause mortality and primary prevention of cardiovascular disease, diabetes and osteoporosis; fair evidence for benefit in dementias, depression and osteoarthritis; limited evidence for benefit in chronic obstructive pulmonary disease, hearing loss, non-diabetic chronic kidney disease and colorectal cancer; null effects on lung cancer and refractive errors; and varied effects on breast cancer and stroke. Relative benefits and adverse effects of other medications warrant consideration.
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Affiliation(s)
- R D Langer
- Jackson Hole Center for Preventive Medicine, Jackson, WY, USA.,Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
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Vacca V, Marinelli S, De Angelis F, Angelini DF, Piras E, Battistini L, Pavone F, Coccurello R. Sexually Dimorphic Immune and Neuroimmune Changes Following Peripheral Nerve Injury in Mice: Novel Insights for Gender Medicine. Int J Mol Sci 2021; 22:ijms22094397. [PMID: 33922372 PMCID: PMC8122838 DOI: 10.3390/ijms22094397] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/07/2021] [Accepted: 04/16/2021] [Indexed: 01/14/2023] Open
Abstract
Neuropathic pain (NeP) in humans is often a life-long condition with no effective therapy available. The higher incidence of female gender in NeP onset is worldwide reported, and although the cause is generally attributed to sex hormones, the actual mechanisms and the players involved are still unclear. Glial and immune cells take part in NeP development, and orchestrate the neuroimmune and inflammatory response, releasing pro-inflammatory factors with chemoattractant properties that activate resident immune cells and recruit immune cells from circulation. The neuro-immune crosstalk is a key contributor to pain hypersensitivity following peripheral nervous system injury. Our previous works showed that in spite of the fact that female mice had an earlier analgesic response than males following nerve lesion, the recovery from NeP was never complete, suggesting that this difference could occur in the very early stages after injury. To further investigate gender differences in immune and neuroimmune responses to NeP, we studied the main immune cells and mediators elicited both in plasma and sciatic nerves by peripheral nerve lesion. After injury, we found a different pattern of distribution of immune cell populations showing either a higher infiltration of T cells in nerves from females or a higher infiltration of macrophages in nerves from males. Moreover, in comparison to male mice, the levels of cytokines and chemokines were differently up- and down-regulated in blood and nerve lysates from female mice. Our study provides some novel insights for the understanding of gender-associated differences in the generation and perseveration of NeP as well as for the isolation of specific neurodegenerative mechanisms underlying NeP. The identification of gender-associated inflammatory profiles in neuropathy is of key importance for the development of differential biomarkers and gender-specific personalized medicine.
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Affiliation(s)
- Valentina Vacca
- CNR-National Research Council, CNR, Institute of Biochemistry and Cell Biology, Monterotondo Scalo, 00015 Rome, Italy; (V.V.); (S.M.); (F.D.A.)
- IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (D.F.A.); (E.P.); (L.B.)
| | - Sara Marinelli
- CNR-National Research Council, CNR, Institute of Biochemistry and Cell Biology, Monterotondo Scalo, 00015 Rome, Italy; (V.V.); (S.M.); (F.D.A.)
- IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (D.F.A.); (E.P.); (L.B.)
| | - Federica De Angelis
- CNR-National Research Council, CNR, Institute of Biochemistry and Cell Biology, Monterotondo Scalo, 00015 Rome, Italy; (V.V.); (S.M.); (F.D.A.)
- IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (D.F.A.); (E.P.); (L.B.)
| | | | - Eleonora Piras
- IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (D.F.A.); (E.P.); (L.B.)
| | - Luca Battistini
- IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (D.F.A.); (E.P.); (L.B.)
| | - Flaminia Pavone
- CNR-National Research Council, CNR, Institute of Biochemistry and Cell Biology, Monterotondo Scalo, 00015 Rome, Italy; (V.V.); (S.M.); (F.D.A.)
- IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (D.F.A.); (E.P.); (L.B.)
- Correspondence: (F.P.); (R.C.)
| | - Roberto Coccurello
- IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (D.F.A.); (E.P.); (L.B.)
- CNR-National Research Council, CNR, Institute for Complex System (ISC), via dei Taurini 19, 00185 Rome, Italy
- Correspondence: (F.P.); (R.C.)
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Jin LY, Song XX, Li XF. The role of estrogen in intervertebral disc degeneration. Steroids 2020; 154:108549. [PMID: 31812622 DOI: 10.1016/j.steroids.2019.108549] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/22/2019] [Accepted: 11/27/2019] [Indexed: 02/08/2023]
Abstract
Intervertebral disc degeneration (IVDD) is a main contributor to low back and radicular pain, which imposes heavy economic burdens on society. However, the etiology and mechanism of IVDD are complex and still not completely clear. In particular, the role of estrogen in IVDD has not received much attention in recent research, although estrogen plays a crucial role in the metabolic dysfunction of others musculoskeletal structures, such as bone, muscle, and tendon. In this review, we attempt to describe the role of estrogen in IVDD and to summarize the proposed mechanisms in vivo and in vitro, as well as, to outline several interesting questions in this field.
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Affiliation(s)
- Lin-Yu Jin
- Department of Orthopaedic Surgery, Baoshan Branch of Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1058, Huan Zheng Bei Rd, Shanghai 200444, China; Department of Spinal Surgery, Peking University People's Hospital, Peking University, Beijing 100044, China
| | - Xiao-Xing Song
- Department of Anesthesiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Er Lu, Shanghai 200025, China.
| | - Xin-Feng Li
- Department of Orthopaedic Surgery, Baoshan Branch of Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1058, Huan Zheng Bei Rd, Shanghai 200444, China.
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Knee osteoarthritis and menopausal hormone therapy in postmenopausal women: a nationwide cross-sectional study. Menopause 2019; 26:598-602. [PMID: 30586007 DOI: 10.1097/gme.0000000000001280] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The incidence of osteoarthritis (OA) increases after menopause, and may be related to hormonal changes in women. Estrogen deficiency is known to affect the development of OA, and menopausal hormone therapy (MHT) is suggested to be related to the development of OA. However, the relationship between knee OA and MHT remains controversial. The association between knee OA prevalence and MHT was investigated using large-scale national data. METHODS Data were collected from 4,766 postmenopausal women from the Korea National Health and Nutrition Examination Survey (2009-2012). MHT was defined as regular hormone medication for ≥1 year, and demographic and lifestyle variables were compared between the MHT and non-MHT groups. Knee OA was defined according to symptoms and radiographic findings. RESULTS In the multiple logistic regression models, the OA odds ratio was 0.70 for the MHT group (95% confidence interval 0.50-0.99), compared with the non-MHT group. CONCLUSIONS The prevalence of knee OA was lower in participants with MHT than in those without MHT.
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