Determination of urinary androgens in women with polycystic ovary syndrome using LC-QqQ/MS and the application of thin film solid-phase microextraction (TF-SPME)

Hyperandrogenism is one of the most pronounced symptoms of Polycystic Ovary Syndrome (PCOS) and seems to play a key role in the pathogenesis of this complex disorder. Nevertheless, there is still a lack of consistent results regarding common steroid predictors of PCOS. Therefore, a liquid chromatography tandem mass spectrometry (HPLC-QqQ/MS) method was developed and validated to determine the concentrations of four classic androgens: androstenedione (An-dione), testosterone (T), 5α-dihydrotestosterone (DHT) and androsterone (An) in urine samples obtained from women with PCOS and healthy controls. The limits of detection were between 0.04 and 0.09 ng/mL, while the limits of quantification ranged from 0.1 to 0.3 ng/mL respectively. As a pre-treatment procedure prior to analysis, hydrolysis using β-glucuronidase and thin film solid-phase microextraction (TF-SPME) was applied. The methodology was employed to perform targeted metabolomics of urinary steroids in women with PCOS and healthy controls. All measured androgens: An-dione (p < 0.0001), T (p = 0.0001), DHT (p < 0.0001) and An (p = 0.0002) showed significantly higher concentrations in the urine of women with PCOS. The largest difference in the mean concentration was found for DHT, which was 2.8 times higher in the PCOS group (13.9 ± 14.1 ng/mg creatinine) in comparison to healthy controls (4.9 ± 3.4 ng/mg creatinine). The results of receiver operating characteristic curve indicated that determination of the panel of three urinary androgens: T+DHT+An-dione with, under the study assumptions, was the best predictor of PCOS diagnosis (AUC of ROC curve = 0.91 (95 % CI: 0.8212-0.9905). The application of an LC-MS/MS-based analysis, together with highly sensitive extraction techniques like TF-SPME, is a suitable approach to perform fast assays and obtain reliable results - crucial in the search for valuable and significant steroids predictors of PCOS.

Assessment of baby disposable diapers application for urine collection and determination of phthalate metabolites

The baby disposable diapers were investigated as a sampling material for urine collection and validated for the evaluation of the exposure of children to xenobiotics. Phthalate metabolites detected in urine samples were chosen as proof-of-concept analytes. For the determination of phthalate metabolites in children's urine samples, high performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS) was used. Two sampling approaches were compared, namely sterile containers and baby disposable diapers. Thirty urine samples from infants and toddlers were analyzed by both methods in parallel and the results were compared. It was found that for diaper sampling, lower concentrations of the metabolites were observed, however, the general distribution for particular metabolites remains the same for both methods. For most of the metabolites high determination coefficients were obtained, namely 0.9929 for MEHHP, 0.9836 for MMP, 0.9796 for MECPP, and 0.9784 for 2-cx-MMHP. For MEOHP the determination correlation coefficient was 0.9154, while for MBP was - 0.7771 and MEHP was - 0.5228. In general, for diaper sampling an underestimation for 2-cx-MMHP and MEOHP was observed, while for MMP diaper-based approach provides overestimation. However, the proposed procedure confirms the possibility of using baby disposable diapers as a material for the collection of urine samples for biomonitoring purposes and fast screening of phthalates exposure.

Bisphenol A analogues and metabolic syndrome in women with polycystic ovary syndrome

Bisphenols (BPs) have become a chemical group of special interest due to their ability to interfere with the endocrine system and their ubiquitous presence in the environment. As some of them possess mild estrogenic and anti-androgenic effects, they might be associated with the diagnosis of polycystic ovary syndrome (PCOS). Acting on multiple tissues, BPs exposure may lead to metabolic derangements characteristic for metabolic syndrome (MetS). Therefore, the aim of this study was to determine the potential relationship between exposure to some BPA analogues and features of the MetS in women with PCOS. Serum BPE, BPC, BPG, BPM, BPP, BPZ, BPFL, and BPBP concentrations did not differ significantly between the PCOS (n = 135) and the control subjects (n = 104). However, women whose serum BPM and BPP concentrations were in the highest tertile were more likely to be diagnosed with PCOS (adjusted OR; [95%CI] 0.43; [0.20; 0.89], P < 0.001 and 0.56; [0.27; 0.96], P = 0.049, consequently). Serum concentrations of BPs were not associated with the MetS diagnosis in the PCOS group. There was a negative correlation between the concentrations of serum BPBP and total serum cholesterol (r = - 0.153; P = 0.019), BPE and serum testosterone (r = - 0.160; P = 0.014) as well as BPC and HDL-cholesterol (r = - 0.138; P = 0.036). There was a positive correlation between the concentrations of BPP and serum triglycerides (r = 0.138; P = 0.036). Our results point to the potential association between exposure to BPM, BPP, and the diagnosis of PCOS, along with the impact of BPBP, BPE, BPC, and BPP on the metabolic features of the MetS.

Searching for the primary metabolic alterations of polycystic ovary syndrome by application of the untargeted metabolomics approach

Despite a large number of studies, the pathogenesis of polycystic ovary syndrome (PCOS) still remains unexplained. In light of ambiguous observations reported in metabolomics, there is a need to carry out studies focusing on confirming the discriminating power of the proposed metabolomics biomarkers. Our research aimed to perform a validation study of metabolites detected in our previous study from serum samples, on the new set of samples obtained from PCOS women and healthy controls to confirm previously selected compounds. Additionally, the second biological matrix - urine - was used to get a more comprehensive insight into metabolic alterations. We applied two analytical techniques - gas chromatography and liquid chromatography coupled with mass spectrometry to analyze both serum and urine samples obtained from 35 PCOS patients and 35 healthy women. Thank to our approach, we identified and described a comprehensive set of metabolites altered in PCOS patients. Results of our study indicate increased steroid hormone synthesis, alteration in sphingo- and phospholipids metabolism, and disturbed fatty acids metabolism. Moreover, the citric acid cycle, γ-glutamyl cycle, vitamin B metabolism, and a few primary amino acids like tryptophan, phenylalanine, histidine, and alanine are altered.

Alteration of Branched-Chain and Aromatic Amino Acid Profile as a Novel Approach in Studying Polycystic Ovary Syndrome Pathogenesis

Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects reproductive-age women and predisposes them to the development of metabolic disturbances. Recent research has shown that several metabolic factors may play a role in PCOS pathogenesis, and it has been suggested that an alteration in the amino acid profile might be a predictive sign of metabolic disorders. Metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) are concepts that have attracted scientific attention; however, a universal definition has not been established yet for these terms. Already existing definitions of MHO involve the coexistence of obesity with the absence or minimal presence of other metabolic syndrome parameters. A group of 326 women, 209 diagnosed with PCOS and 117 healthy individuals, participated in this study. Multiple parameters were assessed, including anthropometrical, biochemical, and hormonal ones, and gas-liquid chromatography, combined with tandem mass spectrometry, was used to investigate the amino acid profile. Statistical analysis revealed noticeably higher levels of all aromatic amino acids in PCOS women compared to the control group: phenylalanine 47.37 ± 7.0 vs. 45.4 ± 6.09 nmol/mL (p = 0.01), tyrosine 61.69 ± 9.56 vs. 58.08 ± 8.89 nmol/mL (p < 0.01), and tryptophan 53.66 ± 11.42 vs. 49.81 ± 11.18 nmol/mL (p < 0.01); however, there was no significant difference in the "tryptophan ratio" between the PCOS and control group (p = 0.88). A comparison of MHO and MUO PCOS women revealed that LAP, leucine, and isoleucine concentrations were significantly higher among the MUO subgroup: respectively, 101.98 ± 34.74 vs. 55.80 ± 24.33 (p < 0.001); 153.26 ± 22.26 vs. 137.25 ± 25.76 nmol/mL (p = 0.04); and 92.92 ± 16.09 vs. 82.60 ± 18.70 nmol/mL (p = 0.02). No significant differences in BMI, fasting glucose, and HOMA-IR between MHO and MUO were found: respectively, 35.0 ± 4.8 vs. 36.1 ± 4.6 kg/m2 (p = 0.59); 88.0 ± 6.0 vs. 87.73 ± 6.28 mg/dL (p = 0.67); and 3.36 ± 1.70 vs. 4.17 ± 1.77 (p = 0.1). The identification of altered amino acid profiles in PCOS holds potential clinical implications. Amino acids may serve as biomarkers for diagnosing and monitoring the metabolic status of individuals with PCOS. The alteration of BCAAs and AAAs may be involved in PCOS pathogenesis, but the underlying mechanism should be further investigated.

Weight gain in menopause: systematic review of adverse events in women treated with black cohosh

Weight gain is a frequent problem in perimenopausal and postmenopausal women. Cimicifuga racemosa (CR) is a popular treatment option for menopausal symptoms. The aim of this review was to investigate whether there is scientific evidence that CR causes weight gain. We searched our database for medically confirmed, spontaneous adverse events regarding weight gain, literature for case reports and randomized controlled trials. Thirty cases in total were spontaneously reported in 15 years. The causality was not considered certain/likely in any of the cases. A nurse (consumer) assessed the causality as possible. Only one case was published in the literature. However, no change in body fat composition was reported, and the causality seems unlikely. Of the 31 identified studies, 17 were double-blind placebo-controlled, five were double-blind reference-controlled and nine were open reference-controlled. In total, 1839 women were treated with CR for up to 12 months. Two studies reported weight gain as an adverse event; however, no significant differences in weight changes were observed between the groups. One case of weight gain (about 2 kg) was reported, but the authors did not specify in which treatment group. In conclusion, this study provides no scientific evidence that the use of Cimicifuga racemosa causes weight gain in menopausal women.

Recommendations of the Polish Sexological Society on medical care in transgender adults - position statement of the expert panel

Attempts at unifying the diagnostic and therapeutic procedures for transgender individuals experiencing gender dysphoria were first undertaken in Poland in the 1980s. Since then, there has been a change in the perception of transgenderism, almost paradigmatic, expressed in subsequent editions of the diagnostic systems (DSM, ICD), which is also associated with the fundamental changes in the principles of conducting trans-specific healthcare. This triggered the need to formulate recommendations for specialists practicing in Poland, which would at least partly reflect the evolution of views and guidelines on clinical care in transgender adults seeking help due to gender dysphoria.

Serum bisphenol A analogues in women diagnosed with the polycystic ovary syndrome - is there an association?

Due to the endocrine disrupting effects of bisphenol A (BPA) several governmental authorities have banned its use and the manufacturers had to find alternative substances with similar chemical properties. This led to the increase in the use of so-called BPA analogues, which however also turn out to possess mild estrogenic and ani-androgenic properties and thus, may cause fertility problems and sex-hormone dependent endocrinopathies. The aim of this study was to evaluate the potential association between the exposure to BPA and its two analogues: BPS and BPF, with the diagnosis of the polycystic ovary syndrome (PCOS), which remains the most common female endocrinopathy. Serum concentrations of BPA, BPS and BPF were measured using high performance liquid chromatography method with tandem mass spectrometry (HPLC-MS/MS) among 199 women with PCOS and 158 control subjects. In women with PCOS serum BPS concentrations were significantly higher compared to the control subjects (geometric mean [95% CI]: 0.14 ng/mL [0.10; 1.17] vs. 0.08 ng/mL [0.06; 0.09], P = 0.023). Serum BPA and BPF concentrations did not differ between the studied groups. There was however a negative correlation between serum BPA and HOMA-IR (r = - 0.233, P = 0.001) and TST (r = - 0.203, P = 0.006) in women with PCOS. No correlations were found between the serum BPs and other metabolic parameters such as serum lipids, insulin, DHEA-S, androstenedione and FAI. When studying the association between serum BPA analogues and PCOS it turned out that women whose serum BPS concentrations were in the first tertile were more likely to be diagnosed with this endocrinopathy (OR [95% CI]: 1.21 [1.04; 3.46], P = 0.017). This association was also statistically significant when adjusted for age, education, BMI, smoking, income, and alcohol consumption (adjusted OR [95% CI]: 1.12 [1.03; 3.71], P = 0.029). These results point to the potential association between the exposure to BPS and the diagnosis of PCOS. The role of BPA is not clear and warrants further studies.

Metabolomic Insight into Polycystic Ovary Syndrome-An Overview

Searching for the mechanisms of the polycystic ovary syndrome (PCOS) pathophysiology has become a crucial aspect of research performed in the last decades. However, the pathogenesis of this complex and heterogeneous endocrinopathy remains unknown. Thus, there is a need to investigate the metabolic pathways, which could be involved in the pathophysiology of PCOS and to find the metabolic markers of this disorder. The application of metabolomics gives a promising insight into the research on PCOS. It is a valuable and rapidly expanding tool, enabling the discovery of novel metabolites, which may be the potential biomarkers of several metabolic and endocrine disorders. The utilization of this approach could also improve the process of diagnosis and therefore, make treatment more effective. This review article aims to summarize actual and meaningful metabolomic studies in PCOS and point to the potential biomarkers detected in serum, urine, and follicular fluid of the affected women.

Environmental exposure to nonylphenol and cancer progression Risk-A systematic review

Environmental exposure to nonylphenol (NP) can adversely affect human and wildlife health. A systematic review was conducted to evaluate the relationship between environmental NP exposure and cancer progression risk. Literature surveys were conducted within several international databases using appropriate keywords. A comprehensive search yielded 58 eligible studies involving a wide range of adverse effects, exposure assessment methods, study designs, and experimental models. Most studies reported that NP strongly induced breast cancer progression in intended experiments. Positive associations between NP exposure and ovarian, uterine, pituitary, and testicular cancers were also reported. Although some studies reported no relation between environmental NP exposure and tumour and/or cancer progression, NP (a known endocrine disrupting chemical) induced action mechanisms in multiple experimental models and may interfere with/hyper-activate oestrogen signalling. Secretion of oestrogen and development of reproductive tissues like breasts, uteruses, and ovaries showed strong associations with possible neoplasia (i.e., uncontrolled development of tumours and/or malignant cancers). Findings of this study are important for informing policymakers to pass legislation limiting the use of environmental contaminants such as NP before all adverse effects of exposure have been determined.

Exposure to Bisphenol A Analogs and the Thyroid Function and Volume in Women of Reproductive Age-Cross-Sectional Study

Bisphenols (BPs) are commonly known plastifiers that are widely used in industry. The knowledge about the impact of BPs on thyroid function is scarce. Proper thyroid functioning is especially important for women of reproductive age, as hypothyroidism affects fertility, pregnancy outcomes and the offspring. There are no studies analyzing the influence of BPs on thyroid function and volume in non-pregnant young women. The aim of this cross-sectional study was to evaluate the relationship between bisphenol A and its 10 analogs (BPS, BPC, BPE, BPF, BPG, BPM, BPP, BPZ, BPFL, and BPBP) on thyroid function and volume in women of reproductive age. Inclusion criteria were: female sex, age 18-40 years. Exclusion criteria were history of any thyroid disease, pharmacotherapy influencing thyroid function, pregnancy or puerperium, and diagnosis of autoimmune thyroid disease during this study. Venous blood was drawn for measurement of thyrotropin (TSH), free thyroxine, thyroid peroxidase antibodies, thyroglobulin antibodies, BPs. Urine samples were analyzed for: ioduria and BPs. Ultrasound examination of thyroid gland was performed. One hundred eighty participants were included into the study. A negative correlation was found between urine BPC and the thyroid volume (R = -0.258; p = 0.0005). Patients with detected urine BPC presented smaller thyroid glands than those with not-detected urine BPC (p = 0.0008). A positive correlation was found between TSH and urine BPC (R = 0.228; p = 0.002). Patients with detected urine BPC presented higher concentrations of TSH versus those with not-detected urine BPC (p = 0.003). There were no relationships between any of serum BPs as well as the other urine BPs and thyroid function and its volume. The only BP that demonstrated the relationship between thyroid function and its volume was BPC, probably because of its chemical structure that most resembles thyroxine. Exposure to this BP may result in the development of hypothyroidism that could have a negative impact on pregnancy and the offspring.

[Recomendations on non-pharmacological interventions in women with PCOS to reduce body weight and improve metabolic disorders [Zalecenia dotyczące postępowania niefarmakologicznego u kobiet z PCOS celem zmniejszenia masy ciała i poprawy zaburzeń metabolicznych]]

Women with PCOS are characterised by ovarian hyperandrogenism, which, apart from fertility problems, hirsutism, acne, and androgenic alopecia, also leads to the development of central (android) obesity and its adverse metabolic consequences. Additionally, women with PCOS have intrinsic insulin resistance (IR) with its consequent hyperinsulinaemia, which leads to the development of atherosclerosis, arterial hypertension, and type 2 diabetes mellitus (T2DM), which give rise to cardiovascular disease (CVD), being the main cause of death among women. Although there are several publications on the topic of life-style changes in women with PCOS to normalise body weight and thus to reduce the adverse metabolic consequences of obesity, such as T2DM and CVD, the number of randomised studies that would enable the formation of strong recommendations is very limited. Nevertheless, taking into consideration the pathophysiology, any intervention implementing healthy dietary habits leading to the reduction of body weigh should be the core of non-pharmacological treatment in women with PCOS. The aim of the given recommendations herein is to point out and systemise the interventions on lifestyle change in women with PCOS as well as to form a practical guideline for the health care specialists, dieticians, and mental-therapists (psychologist) who take care of women with this syndrome.

DIAGNOSIS OF ENDOCRINE DISEASE: Drug-induced endocrinopathies and diabetes: a combo-endocrinology overview

In the currently overwhelming era of polypharmacy, the balance of the dynamic and delicate endocrine system can easily be disturbed by interfering pharmaceutical agents like medications. Drugs can cause endocrine abnormalities via different mechanisms, including direct alteration of hormone production, changes in the regulation of the feedback axis, on hormonal transport, binding and signaling, as well as similar changes to counter-regulatory hormone systems. Furthermore, drugs can interfere with the hormonal assays, leading to erroneous laboratory results that disorientate clinicians from the right diagnosis. The purpose of this review is to cover a contemporary topic, the drug-induced endocrinopathies, which was presented in the monothematic annual Combo Endo Course 2018. This challenging part of endocrinology is constantly expanding particularly during the last decade, with the new oncological therapeutic agents, targeting novel molecular pathways in the process of malignancies. In this new context of drug-induced endocrine disease, clinicians should be aware that drugs can cause endocrine abnormalities via different mechanisms and mimic a variety of clinical scenarios. Therefore, it is extremely important for clinicians not only to promptly recognize drug-induced hormonal and metabolic abnormalities, but also to address the therapeutic issues for timely intervention.

Genes involved in hormone metabolism and cellular response in human ovarian granulosa cells

Endocrinal interactions are one of the most crucial regulatory mechanisms that maintain the state of homeostasis in humans. Processes such as oogenesis, folliculogenesis, menstruation and pregnancy remain under hormonal control. A key role in folliculogenesis is played by granulosa cells. Moreover, granulosa cells take part in corpus luteum formation after ovulation. Because of that, it is important to understand the ways in which the granulosa cells, associated with those processes, respond to hormonal stimulus. In the present study, a transcriptomic analysis of human granulosa cells (GCs) was carried out with the use of expression microarrays. The results were validated by RT-qPCR. The total RNA was isolated after 1st, 7th, 15th and 30th days of long-term primary cultures. The main focus of this work was placed on the genes belonging to "Response to estradiol", "Response to follicle-stimulating-hormone", "Cellular response to hormone stimulus", "Cellular hormone metabolic process" and "Hormone biosynthetic process" gene ontology groups. These groups of genes have been associated with GC hormone metabolism and cellular response to hormones. Eighty genes belonging to these groups were identified. Those that were members of more than one of the analyzed gene ontology groups, or exhibited unique expression patterns, were selected for further analysis. All of the selected genes were described, with their expression patterns detailed. In this manuscript, two gene expression patterns have been described. The first one showed large downregulation of genes in the later stages of culture, with the second one presenting upregulation of expression after day 1 of IVC. The present research was focused on six genes found to be the most important for steroidogenesis: STAR, POR, CYP11A1, ADM, GCLC, IL1B, as well as three genes of higher expression at the later stages of long-term in vitro culture: NR2F2, BMP4, COL1A1. The main goal of the presented study was to select genes involved in response to hormonal stimulus and hormone metabolism in GC long-term in vitro culture.

Identification of the metabolic fingerprints in women with polycystic ovary syndrome using the multiplatform metabolomics technique

In addition to chronic anovulation and clinical signs of hyperandrogenism women with polycystic ovary syndrome (PCOS) are insulin resistant and therefore, develop central obesity with its long term consequences such as dyslipidaemia, hypertension, atherosclerosis and type 2 diabetes mellitus (T2DM), which all lead to the development of cardiovascular disease (CVD). Due to the polysymptomatic nature of this syndrome and lack of consensus on its diagnostic criteria there is a strong need of finding a reliable biochemical or molecular marker, which would facilitate making the accurate diagnosis of PCOS. Therefore, the aim of our study was to perform a metabolomics analysis with the use of two complementary techniques: gas chromatography and liquid chromatography coupled with mass spectrometry, of the serum samples from women with PCOS (n = 30) and to compare them with healthy age and BMI matched controls (n = 30). Obtained results were subjected to one-dimensional statistical analysis (student's t-test or its non-parametric equivalent U Mann-Whitney test) and multivariate statistical analysis (the principal component analysis [PCA], variable importance into projection [VIP] and selectivity ratio [SR]). The results of our study showed that women with PCOS are characterised by metabolic disorders of the amino acids, carbohydrates, steroid hormones, lipids and purines. Compared to control subjects, women with PCOS had increased serum levels of phospholipids, aromatic amino acids, organic acids, hormones and sphinganine and decreased total cholesterol. Among the identified compounds, total cholesterol, phenylalanine and dehydroepiandrosterone sulfate, uric and lactic acid were the compounds with the strongest discriminating power.

'Heart development and morphogenesis' is a novel pathway for human ovarian granulosa cell differentiation during long‑term in vitro cultivation‑a microarray approach

Granulosa cells (GCs) have many functions in the endocrine system. Most notably, they produce progesterone following ovulation. However, it has recently been proven that GCs can change their properties when subjected to long-term culture. In the present study, GCs were collected from hyper-stimulated ovarian follicles during in vitro fertilization procedures. They were grown in vitro, in a long-term manner. RNA was collected following 1, 7, 15 and 30 days of culture. Expression microarrays were used for analysis, which allowed to identify groups of genes characteristic for particular cellular processes. In addition, reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was performed to validate the obtained results. Two ontological groups characteristic for processes associated with the development and morphogenesis of the heart were identified during the analyses: ‘Heart development’ and ‘heart morphogenesis’. The results of the microarrays revealed that the highest change in expression was demonstrated by the lysyl Oxidase, oxytocin receptor, nexilin F-actin binding protein, and cysteine-rich protein 3 genes. The lowest change was exhibited by odd-skipped related transcription factor 1, plakophilin 2, transcription growth factor-β receptor 1, and kinesin family member 3A. The direction of changes was confirmed by RT-qPCR results. In the present study, it was suggested that GCs may have the potential to differentiate towards other cell types under long-term in vitro culture conditions. Thus, genes belonging to the presented ontological groups can be considered as novel markers of proliferation and differentiation of GCs towards the heart muscle cells.

Transcriptomic profile of cell cycle progression genes in human ovarian granulosa cells

The ovarian granulosa cells (GCs) that form the structure of follicle undergo substantial modification during the various stages of human folliculogenesis. These modifications include morphological changes, accompanied by differential expression of genes, encoding proteins which are mainly involved in cell growth, proliferation and differentiation. Recent data bring a new insight into the aspects of GCs' stem-like specificity and plasticity, enabling their prolonged proliferation and differentiation into other cell types. This manuscript focuses attention on emerging alterations during GC cell cycle - a series of biochemical and biophysical changes within the cell. Human GCs were collected from follicles of women set to undergo intracytoplasmic sperm injection procedure, as a part of remnant follicular fluid. The cells were primarily cultured for 30 days. Throughout this time, we observed the prominent change in cell morphology from epithelial-like to fibroblast-like, suggesting differentiation to other cell types. Additionally, at days 1, 7, 15 and 30, the RNA was isolated for molecular assays. Using Affymetrix® Human Genome U219 Array, we found 2579 human transcripts that were differentially expressed in GCs. From these genes, we extracted 582 Gene Ontology Biological Process (GO BP) Terms and 45 KEGG pathways, among which we investigated transcripts belonging to four GO BPs associated with cell proliferation: "cell cycle phase transition", "G1/S phase transition", G2/M phase transition" and "cell cycle checkpoint". Microarray results were validated by RT-qPCR. Increased expression of all the genes studied indicated that increase in GC proliferation during long-term in vitro culture is orchestrated by the up-regulation of genes related to cell cycle control. Furthermore, observed changes in cell morphology may be regulated by a presented set of genes, leading to the induction of pathways specific for stemness plasticity and transdifferentiation in vitro.

Determination of trace levels of eleven bisphenol A analogues in human blood serum by high performance liquid chromatography-tandem mass spectrometry

Chemicals showing structural or functional similarity to bisphenol A (BPA), commonly called BPA analogues, have recently drawn scientific attention due to their common industrial and commercial application as a substitute for BPA. In the European Union, the use of BPA has been severely restricted by law due to its endocrine disrupting properties. Unfortunately, it seems that all BPA analogues show comparable biological activity, including hormonal disruption, toxicity and genotoxicity. Until now, the knowledge about human exposure to BPA analogues is scarce, mainly due to the lack of the data concerning their occurrence in human derived biological samples. This study presents the development of an analytical method for determination of trace levels of eleven BPA analogues in human blood serum samples. The method involves fast and simple liquid-liquid extraction, using low sample and solvent volumes. Chromatographic separation of analytes was optimized using one-factor-at-a-time approach (mobile phase composition, gradient shape, chromatographic column selection, separation temperature, etc.). The method allows for effective separation of the analytes, even in the case of configurational isomers (bisphenol M and bisphenol P). The calibration curves for all analytes were linear in the range tested. The limits of detection and quantitation were in the range of 0.0079÷0.039ng/mL and 0.024÷0.12ng/mL respectively. Compound-dependent recovery values were in the rage of 88÷138%. Matrix effects were mitigated with the help of matrix-matched calibration curves prepared for every batch of samples. Results obtained after the analysis of 245 real human blood serum samples indicate that human beings are exposed to different BPA analogues, that are present in the environment and in common, daily use products.

Polish Society of Endocrinology Position statement on endocrine disrupting chemicals (EDCs)

With the reference to the position statements of the Endocrine Society, the Paediatric Endocrine Society, and the European Society of Paediatric Endocrinology, the Polish Society of Endocrinology points out the adverse health effects caused by endocrine disrupting chemicals (EDCs) commonly used in daily life as components of plastics, food containers, pharmaceuticals, and cosmetics. The statement is based on the alarming data about the increase of the prevalence of many endocrine disorders such as: cryptorchidism, precocious puberty in girls and boys, and hormone-dependent cancers (endometrium, breast, prostate). In our opinion, it is of human benefit to conduct epidemiological studies that will enable the estimation of the risk factors of exposure to EDCs and the probability of endocrine disorders. Increasing consumerism and the industrial boom has led to severe pollution of the environment with a corresponding negative impact on human health; thus, there is great necessity for the biomonitoring of EDCs in Poland.

Endocrine disrupting chemicals as potential risk factor for estrogen-dependent cancers

Civilization, industrialization, and urbanization create an environment where humans are continuously exposed to endocrine disrupting chemicals (EDCs). Some of breast cancers and endometrial cancer, which are the most common female malignant neoplasms, are estrogen-dependent tumors. Prolonged exposure to estrogens or substances with estrogenic properties may be a risk factor for their development. This paper aimed to discuss the potential adverse effect of EDCs on human health, including the role of EDCs in hormone-dependent carcinogenesis. A review of literature regarding the sources of environmental exposure to EDCs and molecular mechanisms of their action was performed. We analyzed the possible mechanisms of how these substances alter the function of the endocrine system, resulting in adverse health effects. Hundreds of substances with endocrine disrupting potential have been identified in our environment. There is accumulating evidence linking exposure to EDCs with the development of mammary and endometrial cancer. By interacting with steroid receptors, EDCs can impact the cellular processes potentially leading to carcinogenesis. There are also data showing the effect of EDCs on immune dysfunction. During lifespan, people are usually exposed to a mixture of various EDCs, which complicates the assessment of individual substances or compounds implicated in cancer development. As the prevalence of hormone-dependent tumors among women continues to increase, their successful prevention is of human benefit. Institutions representing medicine, science, industry, and governments should develop joint strategies to decrease exposure to EDC, and thus to reduce the risk of hormonedependent tumors in women.

Endocrine disrupting chemicals (EDCs) and female cancer: Informing the patients

Breast and uterine cancer are the most frequent female gender related neoplasms whose growth is mostly estrogen dependent. Therefore, any EDC exhibiting estrogenic effects may increase the risk of these two malignancies. This review focuses on the potential role of EDCs with estrogenic potential on the risk of breast and uterine neoplasms but also points to the possible role of the exposure to EDCs in the pathogenesis of ovarian and cervical cancer. It also underlines the necessity of informing the public about the presence of EDCs in common consumer products, their detrimental health effects and methods of reducing the exposure risk.

Health risk of exposure to Bisphenol A (BPA)

Bisphenol A (BPA) belongs to chemicals that are produced in large quantities worldwide. It is commonly used as monomer in polycarbonate synthesis, plasticizer in the production of epoxy resins, as well as an additive for the elimination of surfeit of hydrochloric acid during the polyvinyl chloride (PVC) production. BPA is not only used in the production of plastics intended to a direct contact with food, including plastic packaging and kitchenware, but also in inner coatings of cans and jar caps. There are various routes of human exposure to this substance such as oral, by inhalation and transdermal. The main sources of exposure to BPA include food packaging and dust, dental materials, healthcare equipment, thermal paper, toys and articles for children and infants. BPA is metabolized in the liver to form bisphenol A glucuronide and mostly in this form is excreted with urine. Due to its phenolic structure BPA has been shown to interact with estrogen receptors and to act as agonist or antagonist via estrogen receptor (ER) dependent signalling pathways. Therefore, BPA has been shown to play a role in the pathogenesis of several endocrine disorders including female and male infertility, precocious puberty, hormone dependent tumours such as breast and prostate cancer and several metabolic disorders including polycystic ovary syndrome (PCOS). Because of the constant, daily exposure and its tendency to bio-accumulation, BPA seems to require special attention such as biomonitoring. This observation should include clinical tests of BPA concentration in the urine, which is not only one of the best methods of evaluation of the exposure to this compound, but also the dependence of the daily intake of BPA and the risk of some endocrine disorders.

Bisphenol A (BPA) and its potential role in the pathogenesis of the polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is the most common and the most heterogeneous endocrine disorder in premenopausal women. Apart from signs of hyperandrogenism such as acne, hirsutism and hair loss, women with PCOS usually present with menstrual irregularities and fertility problems.Additionally, they are often characterized by impaired glucose tolerance, which usually leads to the development of type 2 diabetes mellitus (T2DM). This review article describes current and novel approach to the pathomechanisms of PCOS and the potential role of an endocrine disrupting chemical ("endocrine disruptor" - ED) - bisphenol A (BPA), which is commonly used as a plasticizer and due to its molecular structure can interact with estrogen receptors (ERs). Recent observations point to the higher levels of BPA in biological fluids of women with PCOS and its role in the pathogenesis of hyperandrogenism and hyperinsulinemia. It seems that mother's exposure to BPA during pregnancy may also lead to the development of PCOS in the female offspring.

Bad eating habits as the main cause of obesity among children

Obesity is undoubtedly one of the biggest medical problems of the 21st century. Regrettably, the problem affects more and more children and adolescents. 10% of world's school-aged children have an excess body weight and a quarter of these children are obese. In Europe every fifth school-aged child suffers from an excess body weight. The prevalence of overweight and obesity among Polish adolescents is about 14%. An excess body weight can be the consequence of genetic factors, endocrine disorders or certain drugs. However, "simple obesity" is the most common, consequence of providing too much energy from food products in comparison to energy expenditure (caloric excess). Today's lifestyle promotes the development of obesity. The lack of physical activity, sedentary lifestyle and energy-rich diet are the main causes of an excess body fat accumulation. Because of improper eating behaviours children consume an excess amount of energy; and their diet is deficient in elements necessary for proper development. The examples of such bad eating habits are: snacking highly processed and calorie-rich foods between meals eating in front of the TV screen, skipping breakfasts, drinking sugar-sweetened beverages, "eating out" frequently and "emotional eating". Bad eating behaviours are crucial factors for the development of obesity. Eating habits are usually formed in early childhood and parents play a very important role in their development.

Effect of exercise training on insulin sensitivity, mitochondria and computed tomography muscle attenuation in overweight women with and without polycystic ovary syndrome

AIMS/HYPOTHESIS

Polycystic ovary syndrome (PCOS) is an insulin resistant (IR) state. Increased skeletal muscle lipid content and impaired mitochondrial biogenesis have been implicated in the pathogenesis of IR. We investigated whether differences in these variables explain the IR of women affected by PCOS and whether improvements in IR with exercise are reflected by changes in these variables.

METHODS

Sixteen PCOS and 13 non-PCOS overweight women were assessed, and eight PCOS and seven non-PCOS women were reassessed after 12 weeks of moderate and vigorous exercise training. Outcomes included insulin sensitivity (glucose infusion rate [GIR]), skeletal muscle gene expression and protein abundance, enzyme activity of selected mitochondrial components, and computed tomography (CT) attenuation-estimated muscle lipid.

RESULTS

GIR was lower in women with PCOS versus those without (p = 0.01) and increased with exercise in both groups. Baseline CT muscle attenuation suggested a trend to less muscle lipid in PCOS, which increased with exercise training, with a difference in the change in muscle lipid (p = 0.01, age-corrected), compared with non-PCOS women. GIR correlated with PGC1A gene expression across the whole group; skeletal muscle expression of mitochondrial biogenesis markers was not different between groups at baseline, or after training. Neither lipid changes nor mitochondrial changes correlated with changes in GIR.

CONCLUSIONS/INTERPRETATION

Differences in IR in women with and without PCOS were not explained by differences in skeletal muscle lipid or mitochondrial parameters. Improvements in IR with exercise were dissociated from mitochondrial parameters. CT muscle attenuation suggested a differential capacity of PCOS muscle to store lipid compared with non-PCOS.

TRIAL REGISTRATION

Clinicaltrials.gov ISRCTN84763265.

FUNDING

National Health & Medical Research Council (Grant number 606553), Monash University and The Jean Hailes Foundation.

Differential Diagnosis of Hyperandrogenism in Women with Polycystic Ovary Syndrome

According to the Androgen Excess and Polycystic Ovary Syndrome Society (AE&PCOS), the main feature of PCOS is clinical hyperandrogenism or laboratory hyperandrogenaemia. Therefore, in diagnosing PCOS one must always exclude other causes of androgen excess. In a woman with hyperandrogenism, the diagnosis of PCOS can usually be made according to the patient’s history and careful clinical examination. Signs of mild hyperandrogenaemia usually start after the menarche and cycles continue to be anovulatory in adult life. Non-classical congenital adrenal hyperplasia (NCCAH) can be another cause of hyperandrogenism with oligomenorrhea. This can be diagnosed in a patient with elevated basal or ACTH stimulated serum 17OH-progesterone (17-OHP) levels or in a case of a significant decrease in serum testosterone (TST) and dehydroepiandrosterone sulphate (DHEA-S) in a two day dexamethasone suppression test. Cushing’s disease (ACTH producing pituitary adenoma) is a rare cause of hyperandrogenaemia in women with recent onset of hyperandrogenism. However, it must always be taken into the consideration in a patient with accompanying signs of hypercortisolism. It can usually be excluded by performing an overnight dexamethasone suppression test or the measurement of 24 h urinary free cortisol levels. Severe signs of hyperandrogenism which lead to virilization should always lead to the exclusion of androgen secreting tumors of ovarian or adrenal origin. These are very rare but should be always taken into the account in a patient with recent onset of severe signs of androgen excess and very high serum androgen levels. Mild signs of hyperandrogenaemia in a woman with recent oligomenorrhea should always lead to the exclusion of hyperprolactinaemia.

Ovarian function and obesity--interrelationship, impact on women's reproductive lifespan and treatment options

Insulin resistance (IR) is a consequence of obesity, and in women it is often inextricably linked with ovarian function leading to clinical reproductive manifestations such as early menarche onset, subfertility and polycystic ovary syndrome (PCOS). Likewise, the dramatic fall in oestrogen production after menopause may contribute to weight gain and changes in adipose tissue distribution. Overall, women who are obese, especially those with reproductive complications including PCOS, have been identified as specific high risk subgroups for further progression through to prediabetes, type 2 diabetes mellitus (T2DM) and potentially cardiovascular disease (CVD). This review focuses on the interrelationship between the ovarian function and obesity as well as its treatment strategies.

Effects of dietary equol administration on the mammary gland in ovariectomized Sprague-Dawley rats

OBJECTIVE

To evaluate the effects of dietary equol, a metabolite of soy-derived daidzein or formononetin present in red clover, on the mammary gland of ovariectomized Sprague-Dawley rats.

DESIGN

Sixty ovariectomized rats were divided into five groups (n = 12) and fed soy-free chow with the addition of equol (50 mg/kg chow and 400 mg/kg chow) or estradiol-3 benzoate (E2B) (4.3 mg/kg chow and 17.3 mg/kg chow). The control group received soy-free chow only. After 3 months animals were killed, blood was collected, and the mammary glands were removed for histological and immunohistochemical evaluation.

RESULTS

Equol and E2B treatment significantly increased serum equol and 17beta-estradiol concentrations, respectively. Serum prolactin in animals treated with high-dose equol was also significantly higher than in the controls. Animals treated with high-dose equol had a significantly higher number of terminal ducts and type II lobules compared with controls. This was also apparent in animals treated with low- and high-dose E2B, but a higher number of type I lobules also was seen. Compared with controls, animals treated with high-dose equol had a significantly higher percentage of proliferating cell nuclear antigen-positive cells in terminal ducts and type II lobules. The percentage of progesterone receptor-positive cells in animals treated with high-dose equol was significantly higher only in type II lobules. In animals treated with low- and high-dose E2B, the percentage of proliferating cell nuclear antigen- and progesterone receptor-positive cells was significantly higher in all the mammary structures. Low-dose equol did not have any effects on the parameters listed above.

CONCLUSIONS

High-dose dietary equol administration to ovariectomized rats exerts clear mammotropic effects.

Dietary quercetin does not affect pituitary lutenizing hormone (LH) expression and has no uterotropic effects in ovariectomized Sprague–Dawley rats

INTRODUCTION

The aim of this study was to investigate the potency of LH suppression and the uterotrophic effects of quercetin, a flavonoid widely present in our diet which in vitro has been shown to posses estrogenic properties.

METHODS

Fifty-nine female Sprague-Dawley (SD) rats were ovariectomized (ovx) and fed with soy-free rodent chow with the addition of quercetin or estradiol-3 benzoate (E2B). Quercetin was added to the rodent chow at the dose of 200mg/kg (n=12) and 1000 mg/kg (n=11) which on average corresponded to 3.55 mg and 18.42 mg per animal per day, respectively, and E2B at the dose of 4.3mg/kg (n=12) or 17.3mg/kg (n=12) which corresponded to 0.07 mg and 0.20 mg per animal per day, respectively. The control group (n=12) received soy-free chow only. After three months of treatment, animals were sacrificed and using real time RT-PCR, pituitary LHbeta and uterine insulin like growth factor (IGF)-1, progesterone receptor (PR) and complement 3 protein (C3) mRNA levels were measured. Additionally, the in vitro binding capacity of quercetin with a porcine cytosolic ER preparation was evaluated.

RESULTS

In contrast to E2B, dietary quercetin did not decrease pituitary LH expression, had no effects on uterine weight and uterine expression of estrogen regulated genes. The binding capacity of quercetin with the ERs was also 35000-fold lower compared with 17beta-estradiol (E2).

CONCLUSION

Our study shows that quercetin does not show any estrogenic effects in the pituitary and the uterus of the ovx SD rats.

Uterotropic effects of dietary equol administration in ovariectomized Sprague-Dawley rats

AIM

The aim of the present study was to evaluate the uterotropic effects of the administration of dietary equol, a metabolite of soy-derived daidzein or formononetin present in red clover, in an ovariectomized rat model of menopause.

METHOD

Two doses of racemic equol were used (50 mg/kg of chow and 400 mg/kg of chow) and the results were compared with two doses of estradiol-3 benzoate (E2B) (4.3 mg/kg of chow and 17.3 mg/kg of chow). After 3 months, animals were sacrificed and the uteri were removed, weighed and paraffin-embedded for morphometrical and immunohistochemical evaluation. The expression of selected uterine estrogen-responsive genes was also measured using real-time reverse transcription-polymerase chain reaction.

RESULTS

Compared to controls, uterine weights in animals treated with high-dose equol were significantly higher, presented histologic features of mild estrogenic stimulation and had greater epithelial height and thickness of the uterine stroma and myometrium. Staining for the presence of the proliferating cell nuclear antigen (PCNA) also showed a greater prevalence of the PCNA-positive cells in the uterine stroma in animals treated with high-dose equol. Conversely, the percentage of PCNA-positive cells in the uterine epithelium was lower compared to the controls. Dietary high-dose equol treatment also increased significantly levels of uterine insulin-like growth factor 1, progesterone receptor and complement protein 3 mRNA. Although statistically significant, all these effects were, however, lower in magnitude compared to the effects of low- and high-dose E2B treatment. Low-dose equol did not have any effects on the above-studied parameters.

CONCLUSION

Long-term high-dose dietary equol administration to ovariectomized rats exerts uterotropic effects at the cellular and molecular level which question the safety of uncontrolled and unlimited consumption of soy or red clover supplements by postmenopausal women with intact uteri.

Effects of dietary equol administration on ovariectomy induced bone loss in Sprague-Dawley rats

Oestrogen deficiency leads to a considerable bone loss, thus, osteopenia and osteoporosis are serious complications after menopause.

OBJECTIVES

To evaluate the effects of a daidzein metabolite equol on bone mass density (BMD) and markers of bone remodelling in an ovariectomized (ovx) rat model of postmenopausal bone loss and compare them with the effects of 17beta-estradiol.

METHODS

Twenty-eight female Sprague-Dawley rats were ovx and fed soy-free chow only (control group, n = 8), or with the addition of oestradiol-3 benzoate (E2B) (10mg/kg, n = 10) or equol (400 mg/kg, n = 10). At baseline and after 6-week treatment period, proximal tibia and lumbar spine BMD were measured using computer tomography. Animals were then sacrificed, blood was collected and uteri were removed.

RESULTS

Similarly to E2B, dietary equol decreased weight gain and showed mild uterotropic activity. E2B attenuated ovx induced BMD loss at proximal tibia whereas equol had no effect. At lumbar spine, however, equol not only attenuated trabecular bone loss but also increased its density. This effect was also apparent in animals treated with E2B. Cortical BMD at proximal tibia and lumbar spine were not very much influenced by ovx and treatment with E2B or equol did not induce significant changes at these sites. Plasma osteocalcin and type I collagen fragments (cross-laps) in equol treated animals did not differ from the controls whereas in E2B treated animals they were both significantly decreased.

CONCLUSIONS

In spite of its mild uterotropic potential, dietary equol shows limited bone sparing effects in ovx rats.

Prevalence and risk factors of anabolic-androgenic steroids (AAS) abuse among adolescents and young adults in Poland

OBJECTIVE

To estimate the prevalence of anabolic-androgenic steroids (AAS) abuse among adolescent and young adults in Poland.

METHOD

3,687 men (48.2%) and women (51.8%), median age 23 (interquartile range 19-30 years) participated in a survey via a "pop-up window" which appeared on two popular Polish internet portals during one month. Questions concerning their body image, exercise behaviour, education level and use of anabolic-androgenic steroids were asked.

RESULTS

The prevalence of anabolic-androgenic steroids use was 6.2% among males and 2.9% among females. Male AAS users, compared to non-users, were more often concerned about their physical appearance, were less educated and often engaged in some sport activity. Among female AAS users, no significant differences concerning self-body image satisfaction or participation in sports were found. However, compared to non-users, female AAS users were less educated.

CONCLUSION

The abuse of AAS is a reality in Poland and may become a serious health concern among adolescents and young adults.

Effects of dietary equol on body weight gain, intra-abdominal fat accumulation, plasma lipids, and glucose tolerance in ovariectomized Sprague-Dawley rats

OBJECTIVE

To evaluate the effects of dietary equol, a metabolite of the phytoestrogen daidzein, on body weight gain, intra-abdominal fat accumulation, plasma leptin, lipids, and glucose tolerance in ovariectomized rats and to compare them to the effects of 17beta-estradiol.

DESIGN

Twenty-eight female Sprague-Dawley rats were ovariectomized and fed soy-free chow with the addition of estradiol-3 benzoate (E2B) (10 mg/kg, n=10) or equol (400 mg/kg, n=10). The control group (n=8) received soy-free chow only. Weight and food intake were recorded once weekly. After 6 weeks, intra-abdominal fat was measured using computed tomography, and the intraperitoneal glucose tolerance test was performed. In the seventh week, the animals were killed, blood was collected for plasma, and uteri were removed.

RESULTS

Dietary equol significantly increased uterine mass. This effect was, however, 3.5 times lower in magnitude compared to E2B. Similar to E2B, dietary equol decreased weight gain, intra-abdominal fat accumulation, and plasma leptin levels. Equol-treated animals had also lower plasma total cholesterol and triglyceride levels compared to controls. E2B treatment also decreased plasma total cholesterol as well as high-density lipoprotein and low-density lipoprotein cholesterol. In the glucose tolerance test, the area under the curve was significantly smaller in the E2B- and equol-treated animals compared to controls. Also, E2B-treated animals had lower fasting plasma insulin levels.

CONCLUSIONS

In ovariectomized rats, dietary equol administration attenuates weight gain and shows favorable metabolic effects. However, because of its mild uterotrophic activity, its use in the prevention of postmenopausal weight gain and related metabolic disorders in women with an intact uterus is questionable in terms of safety and warrants further studies.

Dietary daidzein and puerarin do not affect pituitary LH expression but exert uterotropic effects in ovariectomized rats

OBJECTIVE

To investigate the potency of LH suppression, as an indirect measure of alleviation of postmenopausal vasomotor symptoms, as well as the uterotropic effects of two isoflavones: daidzein and puerarin in an ovariectomized (ovx) rat model and compare them with the effects of 17beta-estradiol benzoate (E2B).

DESIGN

Eighty female Sprague-Dawley rats were ovx and divided into six different treatment groups and one control group (11-12 animals per group). Daidzein, puerarin and E2B were added to the soy free rodent chow in low and high doses (250 mg and 1000 mg per kg, 600 mg and 3000 mg per kg and 4.3 mg and 17.3 mg per kg, respectively). After 3 months of treatment, animals were sacrificed and using real time RT-PCR, pituitary LHbeta and uterine IGF-1, PR and C3 mRNA levels were measured. Additionally serum LH levels were measured in a radioimmunoassay.

RESULTS

Both of our tested isoflavones at low and high doses had no effect on the expression of the pituitary LH at the mRNA and protein level. Only E2B at both doses significantly decreased pituitary LHbeta gene expression and serum LH levels. Daidzein and puerarin at high dose increased significantly uterine weights. Uterine IGF-1 gene expression was only upregulated in puerarin high group. Uterine PR mRNA levels were higher in animals fed with low dose daidzein and high dose puerarin. Uterine C3 gene expression was upregulated in animals fed with daidzein and puerarin at high doses. Although statistically significant, all these effects were however very discrete compared to those of E2B at low and high doses.

CONCLUSION

We speculate that due to the lack of LH suppressing effects in our model, it is very unlikely for daidzein and puerarin to alleviate vasomotor symptoms in postmenopausal women. In contrast, due to their uterotropic effects, high dose consumption of commercially available preparations containing daidzein or puerarin may expose women with an intact uterus to the risk of endometrial hyperplasia.

Effects of dietary equol on the pituitary of the ovariectomized rats

The aim of our study was to evaluate the effects of dietary equol, metabolite of a phytoestrogen daidzein, on the secretion of prolactin (PRL) and lutenizing hormone (LH), as well as the expression of estrogen receptors (ERalpha, ERbeta and truncated estrogen receptor-1 (TERP-1) in the pituitary gland of ovariectomized (ovx) female Sprague-Dawley rats. Two doses of equol (50 mg/kg of chow and 400 mg/kg of chow) were used and the results were compared with the effects of estradiol 3-benzoate (E2B), also given at two doses (4.3 mg/kg of chow and 17.3 mg/kg of chow). Treatment period was 3 months. Dietary equol administration at the high dose increased significantly serum PRL levels. This effect was also observed in the E2B group but this difference did not reach statistical significance. Surprisingly, high dose dietary equol treatment also significantly increased serum LH levels, which was in contrast to E2B treatment where serum LH levels were significantly decreased at both doses. Serum LH levels in the equol low group were unaffected. Equol treatment had no effects on pituitary ERalpha or ERbeta gene expression. In contrast, high dose E2B treatment increased significantly pituitary ERalpha mRNA levels but decreased those of ERbeta. Both doses of E2B also increased significantly pituitary TERP-1 mRNA levels. This effect was also observed in the equol high group but at a much smaller magnitude. In conclusion, high dose dietary equol administration to ovx rats exerts estrogenic like effects on the lactotropes and anti-estrogenic on the gonadotropes.

In vitro effects of benzophenone-2 and octyl-methoxycinnamate on the production of interferon-gamma and interleukin-10 by murine splenocytes

Chemical ultraviolet light absorbers (UV-filters) are nowadays widely used in cosmetic and plastic industry. Recent in vitro and in vivo studies have reported that certain chemical UV-filters possess estrogenic activity raising the question of whether these compounds are safe to human health. Work on estrogenic effects of these compounds, however, has focused mostly on reproductive organs, and as the presence of estrogen receptors has been identified in several cells of the immune system, UV screens also may have a great impact on immunity. Thus, we have studied the in vitro effects of two widely used UV-filters--benzophenone-2 (BP-2) and octyl-methoxycinnamate (OMC)--on the production of interferon (IFN)-gamma and interleukin (IL)-10, two cytokines representing Th1- and Th2-type response, respectively, by activated murine splenocytes. Cells were cultured on 48-well plastic plates and stimulated with 12-miristate 13-acetate (PMA) (5 ng/ml) and ionomycin (50 ng/ml) in the presence of different concentrations (10-5-10-8M) of the studied substances or 17beta-estradiol (E2). After 48 hr incubation the supernatants were collected and the levels of IFN-gamma and IL-10 were measured using immunoenzymatic assay. Our results show that BP-2 and OMC at high concentrations (10-5M) shifted the Th1/Th2 balance toward a Th2 response (lower IFN-gamma production and higher IL-10). These effects were comparable to those of E2. Our results clearly show that UV-screens at high doses also may possess immunomodulatory effects some of which resemble those of E2.

Effects of intranasal 17β-estradiol administration on serum bioactive interleukin-6 and C-reactive protein levels in healthy postmenopausal women

OBJECTIVE

Oral estrogen increases the levels of C-reactive protein (CRP), which is an independent risk factor for coronary heart disease in healthy individuals. The aim of our study was to investigate the effects of intranasal 17beta-estradiol (E2) on serum CRP and its most potent stimulant, interleukin-6 in healthy postmenopausal women.

DESIGN

Thirty-six healthy postmenopausal women (45-54 y) were enrolled. According to their individual preferences, they were assigned to intranasal (n = 10), transdermal (n = 14), or oral (n = 12) continuous E2 treatment with a sequential progestin (10-14 d in a 28-d cycle). Blood samples were drawn at baseline and after 3, 6, and 12 months during the estrogen-only phase to adjust for the progestin effect.

RESULTS

In women taking intranasal or transdermal E2, there were no significant changes in median serum CRP levels during the 12-month treatment period. In women taking oral E2 preparations, serum median CRP levels were significantly higher compared to baseline after 6 and 12 months of the therapy (P < 0.05). Conversely, serum median bioactive interleukin-6 levels were significantly lower after 6 and 12 months in women taking E2 intranasally or orally and after 12 months in women taking E2 transdermally (P < 0.05).

CONCLUSIONS

The results of our study show that intranasal, similarly to transdermal, E2 administration does not increase serum CRP levels in postmenopausal women. They also support the hypothesis that CRP increase during oral estrogen treatment is not mediated by the enhancement of interleukin-6 production by the immune cells but is rather caused by the hepatic first-pass metabolism effect.

In vitro effects of genistein and resveratrol on the production of interferon-gamma (IFNgamma) and interleukin-10 (IL-10) by stimulated murine splenocytes

Phytoestrogens are a group of plant-derived biologically active substances with a chemical structure that resembles that of 17beta-estradiol (E2). As the presence of estrogen receptors (ER) has been identified in several immune cells, phytoestrogens may also have a great impact on the immune system. The aim of our study was to determine the in vitro effects of genistein and resveratrol on the production of interferon-gamma (IFNgamma) and interleukin-10 (IL-10) by stimulated murine splenocytes and compare them with the effects of natural E2. Phorbol 12-miristate 13-acetate (PMA) together with ionomycin was used to stimulate the cells. E2 and genistein did not show any significant effects on the stimulated production of IFNgamma. Resveratrol had a mild inhibitory effect on IFNgamma production at the concentration of 10(-7)M; however, this difference did not reach statistical significance (p>0.05). IL-10 levels in the splenocytes culture supernatants were found to be increased in the presence of E2, genistein and resveratrol; however, these effects were also not statistically significant. To determine whether the exposure to our studied phytoestrogens induced a shift in the T-helper 1/T-helper 2 (Th1/Th2) balance, we calculated the ratio between the production of IFNgamma, the prototypic Th1 cytokine, and the production of IL-10, the prototypic Th2 cytokine, at different concentrations of our tested substances. Genistein at the concentrations of 10(-6) and 10(-7)M and resveratrol at the concentrations of 10(-6)M decreased significantly the IFNgamma/IL-10 ratio. This decrease was comparable to that of E2 at the concentrations of 10(-7)M. From our in vitro experiments we conclude that genistein and resveratrol, similarly to E2, by decreasing the IFNgamma/IL10 ratio may shift the Th1/Th2 balance towards the Th2 response.

[Role of tumor necrosis factor (TNF) and interleukin-6 (IL-6) in the pathogenesis of late complications of menopause. Effects of hormone replacement therapy on TNF and IL-6 expression]

Tumor necrosis factor (TNF) and interleukin-6 (IL-6) are pleiotropic cytokines produced by immune and nonimmune cells. Inappropriate expression and production of TNF and IL-6 is thought to be involved in the pathogenesis of numerous diseases, including atherosclerosis which leads to coronary heart disease, osteoporosis and Alzheimer's disease. Conversely, these disorders belong to the late complications of menopause and hormone replacement therapy (HRT) may successfully improve them. Several studies have shown that postmenopausal women show an enhanced expression of TNF and IL-6. On contrary, the use of hormone replacement therapy by postmenopausal women has been shown to down regulate this overexpression. Therefore, the mechanisms underlying the protective effects of HRT can also be attributed to its immunomodulating properties which seem to restore cytokine homeostasis in postmenopausal women.

High levels of circulating interleukin-10 in diabetic nephropathy patients

AIMS

The aim of our study was to analyse the level of circulating interleukin-10 (IL-10) and relate it to the grade of albuminuria in patients with diabetic nephropathy (DN) due to type 1 diabetes mellitus (DM). Since IL-10 has met the criteria for an anti-inflammatory and an immunosuppressive cytokine, its activity may be important for clinical outcome of DN.

METHODS

The IL-10 level was measured by ELISA in serum samples from thirty patients with DN due to type 1 DM, and compared with thirty patients with type 1 DM without DN and a control group of thirty, healthy, age- and sex-matched people.

RESULTS

We observed a greatly elevated concentration of circulating IL-10 in 30/30 DM patients with DN (mean 140 pg/mL +/- 102), compared to DM patients without DN in whom IL-10 was detectable in only 11/30 patients (0.79 pg/mL +/- 1.24), and the group of healthy people in whom IL-10 was detectable in only 3/30 donors (0.92 pg/mL +/- 0.17). IL-10 appeared to be the strongest independent predictor of albuminuria, followed by HbA1c, diastolic blood pressure and DN duration. There was a positive correlation between the values of IL-10 and albuminuria in DM patients with DN. The patients in the fourth quartile of albuminuria had a distinctly higher concentration of IL-10 than those in the lower quartiles.

CONCLUSIONS

The increased concentration of IL-10 in the serum samples from DM patients with DN seems to depend on the severity of the nephropathy. The excessive IL-10 production may indirectly contribute towards DN progression. On the other hand, it may explain the relatively long course of diabetic nephropathy.

The second to fourth digit ratio in elite and non-elite female athletes

Contests in the animal world to determine social status almost exclusively involve males, which points out that androgens may be indispensable in the development of competitive instincts. In animal studies, it has been shown that prenatal exposure to androgens may produce permanent changes toward more aggressive behavior in adulthood. Thus, there is a strong suspicion that women involved in competitive activities, such as sports, may have been exposed to high androgen levels in utero. There is strong evidence that the ratio between the second to fourth digits ratio (2D:4D ratio) correlates negatively with intrauterine androgen concentrations and could potentially be used as a marker for prenatal androgen exposure. Therefore, the purpose of our study was to test the hypothesis that women engaged in sports have lower 2D:4D ratio-a marker of high prenatal androgen exposure. We measured the 2D:4D ratios in elite and non-elite female athletes and compared them with female individuals not engaged in any sport activities. Our results showed that elite female athletes have significantly lower left hand 2D:4D ratios compared to the control group (P < 0.05). Therefore, we can speculate that low 2D:4D ratio may be a positive correlate of sports potential in females.

Knowledge and use of hormone replacement therapy among Polish women: estimates from a nationally representative study—HORTPOL 2002

OBJECTIVES

To evaluate the knowledge about hormone replacement therapy (HRT) and the prevalence of its current use in Polish female population.

METHODS

Cross-sectional survey on a representative sample of 1544 women between 18 and 87 years of age.

RESULTS

Almost half of the Polish women have heard of HRT. Depending on the education level, 26-38% of women knew that HRT alleviates the physical and psychological symptoms of menopause and 18-32% knew that HRT reduces the risk of developing osteoporosis. Forty-three percent of all the women with a higher level of education were aware that HRT increases the risk of breast and uterine cancer. The prevalence of current HRT use among women aged 45-64 was 12%. Women who had only basic education were less likely to use HRT than those with a medium and higher education level. Lack of information about HRT was the main cause of not using it. Forty-four percent of the perimenopausal women (age range 45-54 years) have never heard of HRT and 36% were never told by their healthcare providers that they could use it. Nineteen percent of perimenopausal women were not using HRT because they were afraid of the HRT related risks. Sixty-four percent of women who were using HRT were prescribed oral HRT preparations.

CONCLUSIONS

A fairly small proportion of Polish women currently uses HRT, largely because most remain poorly informed about the therapy.

[Influence of erythropoietin on immunological system of patients with chronic renal failure]

Recombinant human erythropoietin (epoetin) administration is a well established therapy of anaemia in maintenance hemodialysis (HD) patients. During the treatment, along with an increase in haemoglobin (Hb) level also an improvement of physical and sexual activity and cognitive functions was observed. Moreover, recent studies have shown an impact of epoetin on lipid-carbohydrate and protein metabolism, endocrinological functions and immune system [1-7]. It is still unclear whether all these changes are caused by direct epoetin activity or they are associated with the correction of anaemia and better oxygen supply and therefore an improvement of the conditions required for many metabolic function. The goal of the first study performed in our centre was to estimate the influence of epoetin alpha (Eprex) administered in the doses not affecting erythropoiesis (7-10 IU/kg/three times a week for 12 weeks) on serum levels of interleukin (IL) 2, 6 and tumor necrosis factor TNF-alpha [8, 9]. 10 HD patients (3 F, 7 M) aged from 33 to 62 years participated in that study. The level of IL-2, IL-6 and TNF-alpha was measured by means of bioassay using a highly sensitive cell line respectively CTLL, B9 and fibrosarcoma--WEHI 164 (clone 13). Cells viability was tested by colorimetric MTT assay. During the first period of observation stable Hb concentration and unchanged although significantly higher than in healthy people levels of TNF-alpha and IL-6 were noticed. Serum level of IL-2 increased significantly and in the 10 week it reached the values observed in healthy humans although after that period of time it dropped to the initial values. The aim of the following study was to estimate the influence of epoetin on IL-2, IL-10 and TNF-alpha production by whole blood cell culture [1, 2]. 10 HD patients (2 F, 8 M) aged from 35 to 53 years receiving standard doses of epoetin alpha (Eprex) for six months (in vivo experiments) and another 10 HD patients (3 F, 7 M) aged from 40 to 60 years not receiving epoetin participated in the study (in vitro experiments--cell culture were stimulated with different doses of (epoetin alpha--Eprex and epoetin beta--Recormon): 0.05; 0.1; 0.5; 1.0 IU/ml). IL 2 and TNF-alpha were measured using the bioassay mentioned above, IL 10 by ELISA immunoassay. The levels of IL10 increased in all epoetin treated patients and it was accompanied by transitory decrease of TNF-alpha. The levels of IL-2 increased in 7/10 patients under the study. Addition of epoetin in vitro to the whole blood culture of HD patients before implementation of epoetin confirmed that it is able to directly stimulate IL-2 production. The highest levels of stimulation of IL-2 secretion were observed for the physiological doses of epoetin (0.05 IU/ml). The aim of the more recent study was to examine changes in CD4+ and CD8+ T-cell subpopulations, the expression of the inhibitory molecule, CD152+ on T lymphocytes and the levels of IL-2, IL-6, IL-10, IL-12 and TNF-alpha in HD patients [10]. Additionally serum levels of C reactive protein (CRP), C3, C4 components of complement and immunoglobulin IgG, IgM and IgA were measured. 14 patients (8 F, 6 M) aged from 31 to 64 years receiving standard doses of epoetin alpha (Eprex) for twelve months (in vivo experiments) and another 4 HD patients (2 F, 2 M) aged from 43 to 57 years not receiving epoetin participated in the study (in vitro experiments--cell culture were stimulated with epoetin as in previous study).

METHODS

IL-2, IL-6, and TNF-alpha were measured using bioassays described above, IL-12 and IL-10 by ELISA immunoassay. Expression of T-cell surface molecules was measured both in vivo by flow cytometry of lymphocytes sampled from peripheral blood and in vitro using whole blood cell culture stimulated with physiological as well as non-physiological doses of epoetin. The levels of C3, C4, IgG, IgM and IgA were estimated using nephelometric method. Compared with the findings before the start of epoetin therapy the CD4+/CD8+ ratio increased after 1 year of follow-up, whereas the percentage of CD152+ peripheral blood lymphocytes decreased. The increase of the CD4+/CD8+ ratio was dependent on a decrease of the percentage of CD8+ cells. The decrease of CD152+ population affected mainly CD8+152+ T cells. All these effects became apparent after 6 months of epoetin treatment. In vitro stimulation of whole blood cultures revealed that the addition of physiological concentration of epoetin decreased the percentage of CD8+152+ T cells. The pattern of the cytokines shifted towards Th1 phenotype (increase of IL-2 and IL-12) with a decreased level of proinflammatory cytokines (decrease of IL-6 and TNF-alpha). Treatment with epoetin did not alter plasma CRP, C3, C4 components of complement, immunoglobulin, as well as total count of lymphocytes. Summing up, administration of epoetin to maintenance HD patients not only treats the anaemia but also results in favourable changes in immune system. Epoetin is probably not only hemopoietic factor but also an immunomodulatory cytokine.

Serum interleukin-6 levels and bone mineral density at the femoral neck in post-menopausal women with Type 1 diabetes

BACKGROUND

Although osteopenia is often reported in Type 1 diabetes mellitus, the pathogenic mechanisms are not fully understood. Oestrogen deficiency also leads to decreased bone mineral density (BMD). Enhanced interleukin-6 (IL-6) production among Type 1 diabetic patients could be involved in the pathogenesis of diabetic bone loss since it is a potent bone resorbing cytokine.

AIMS

To evaluate the relationship between serum bioactive IL-6 levels and BMD at the femoral neck of post-menopausal women with Type 1 diabetes.

METHODS

We studied BMD, urine excretion of deoxypirydynoline crosslinks, serum bioactive IL-6 and soluble IL-6 receptor (sIL-6R) levels in 20 post-menopausal women with Type 1 diabetes mellitus, and compared these results with 20 matched healthy post-menopausal controls.

RESULTS

Post-menopausal women with Type 1 diabetes had significantly lower BMD at the femoral neck and increased serum bioactive IL-6 levels compared with the control group, but no relationship was observed between these variables in a multiple regression analysis. Using BMD at the femoral neck of diabetic women as the dependent variable in the multiple step regression analysis model, we found that independent variables that were strongly associated with bone mass at the femoral neck in this group were: time since menopause and duration of diabetes.

CONCLUSIONS

Although our study had a small sample size, we found that post-menopausal women with Type 1 diabetes mellitus present lower bone mass and higher serum bioactive IL-6 levels than matched healthy controls, but we were unable to find a correlation between these two parameters.