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Growth regulation of estrogen receptor-negative breast cancer cells transfected with complementary DNAs for estrogen receptor.

BACKGROUND: The growth of estrogen receptor (ER)-positive breast cancer cells is hormonally regulated, but the majority of breast cancers are ER negative and unresponsive to hormonal therapy. PURPOSE AND METHODS: To test whether hormonal control over replication can be re-established in ER-negative cells, we transfected ER-negative MDA-MB-231 (clone 10A) cells with sense and antisense constitutive ER expression vectors containing the gene for either wild-type or mutant ER linked to the gene for neomycin resistance aminoglycoside phosphotransferase (neo). A Northern blot analysis was done on total RNA from eight of the 10 transfectant clones produced to detect messenger RNA coding for ER and neo, and a Western blot analysis was done on protein extracted from the cells of one mutant and two wild-type ER sense transfectant clones to determine the molecular weight of the ER in transfectants. Levels of ER in transfectants were measured both by enzyme immunoassay and by ligand-binding methods. To ascertain whether the ER in wild-type and mutant sense transfectants was functional, we tested the effects of 17 beta-estradiol (E2) and/or an antiestrogen, ICI 164,384, on 1) ER-activated gene regulation (by transient transfection of these cells a second time with a reporter plasmid containing an estrogen response element linked to the chloramphenicol acetyl transferase [CAT] gene), 2) induction of progesterone receptor, 3) DNA replication, and 4) cell cycle kinetics. RESULTS: Messenger RNA coding for ER and for neo was detectable in both sense and antisense transfectant clones. Sense transfectants (both mutant and wild-type) expressed ER protein with a molecular weight similar to that found in ER-positive control cells. By the ligand-binding method high levels of ER were detected in both wild-type and mutant transfectants, although by the enzyme immunoassay method lower levels were detected in mutant transfectants. ER from both wild-type and mutant sense transfectants appeared functional, since E2 stimulated the expression of reporter-linked CAT and of progesterone receptor in these transfectants. E2 inhibited DNA replication in wild-type sense transfectants at a concentration of 10(-10) M and mutant sense transfectants at a concentration of 10(-8) M, and ICI 164,384 blocked this effect. CONCLUSION: ER-negative breast cancer cells stably transfected with either a mutant or wild-type ER gene regain hormonal responsiveness; however, E2 inhibits rather than stimulates cell growth. IMPLICATION: Reactivation of quiescent ER may provide a novel therapeutic approach for controlling ER-negative breast cancers.

Base Sequence↗

Subdermal implants of different steroidal compounds for treatment of endocrinological disorders.

Various types of steroid-containing implants were used in the treatment of benign prostatic hypertrophy, congestive prostatitis, and hypogonadism. 2 Silastic capsules, each containing 22-23 mg of ethinyl estradiol, were inserted subcutaneously in 5 men with benign prostatic hypertrophy. A decline in testosterone levels to less than 1 ng/ml was attained within 6 months following insertion. 6-8 Silastic capsules containing 21-23 mg each of testosterone were implanted in 15 men: 2 castrates and 13 hypogonadals. Testosterone levels increased initially, reaching the highest level at 3 months. Thereafter, the testosterone concentrations declined but remained slightly above pretreatment levels at 9 months. In a group of 9 subjects, 7 men with hypogonadism and 2 women with hypernephroma were treated with 2 rods, each containing approximately 200 mg testosterone propionate. Testosterone concentrations showed initial rises but did not remain elevated. 12 male subjects, 6 with congestive prostatis and 6 with benign prostatic hypertrophy, were treated with a combination of 3 levonorgestrel rods and 3 estrone rods. Each rod contained 40 mg of steroid. This regimen had a therapeutic effect but was only partially successful in inhibiting spermatogenesis.

Adult↗

Small artery endothelial dysfunction in postmenopausal women: in vitro function, morphology, and modification by estrogen and selective estrogen receptor modulators.

OBJECTIVE: Our objective was to assess vascular endothelial function and morphology in resistance vasculature from healthy pre- and postmenopausal women in vitro and to determine potential mechanisms of vascular protection by estrogenic compounds. METHODS: Arteries (approximately 220 microm) were dissected from sc fat biopsies obtained from healthy premenopausal and postmenopausal women. Flow-mediated dilatation, agonist-induced endothelium-dependent and -independent relaxation, and myogenic responses to changes in intraluminal pressure were evaluated before and after incubation (3 h) with 17beta-estradiol, propyl pyrazole triol [a selective estrogen receptor-alpha (ERalpha) agonist], raloxifene (a second-generation selective ER modulator), and the phytoestrogen genistein, using pressure myography technique. In addition, endothelial morphology was assessed in arteries from pre- and postmenopausal women, and distribution of ERs within the artery wall from postmenopausal women was evaluated. RESULTS: Functional and morphological disturbances of endothelial function were observed in small arteries from postmenopausal women. Incubation with 17beta-estradiol improved postmenopausal resistance artery function, an effect mimicked by propyl pyrazole triol but not raloxifene or genistein. Immunohistochemical staining revealed similar expression of ERalpha and ERbeta in the smooth muscle of arteries from postmenopausal women; however, ERalpha was dominant in endothelium. CONCLUSIONS: The resistance arteries from postmenopausal women show functional and morphological abnormalities. ERalpha may contribute to vascular protection by estrogens in the peripheral resistance circulation in postmenopausal women. Selective ERalpha agonists warrant further investigation as therapeutic agents for prevention of cardiovascular disease in postmenopausal women.

Adult↗

New aspects in the development of cytotoxic-linked estrogens for the control of breast neoplasia.

The interest of cytotoxic-linked estrogens as therapeutical drugs for controlling the growth of breast cancers relies on their potential binding to estrogen receptors (ER) in these cancers. 14, 15-alpha and beta epoxide derivatives of estradiol-17 alpha and 17 beta were investigated for their ER binding affinity and their cytotoxic activities on the MCF-7 and Evsa-T cell lines. 14, 15 alpha and beta-epoxides of estradiol 17 alpha as well as the 14, 15 alpha epoxide of estradiol 17 beta bound to ER. No compound revealed any cytotoxicity on the cell lines. A 11 beta-aziridine derivative of estrone showed significant binding activity to ER. Concentrations of 10(-7) and 10(-8) M of this compound act stimulating on the growth of MCF-7 cell line. 10(-6) M is slightly inhibitory. There is no effect on Evsa-T cells. Binitrogen mustard derivatives of hexestrol and diethylstilbestrol displayed a very low binding activity whereas mononitrogen mustards of estrone showed a significant binding activity. At concentrations of 10(-6) M all mustard compounds inhibited the growth of MCF-7 cell line. The inhibitory influence of the mononitrogen mustards were higher than those of the binitrogen mustards. With regard to the Evsa-T cells only mononitrogen mustard displayed a growth inhibiting effect.

Breast Neoplasms↗

Bromocryptine-cyclofenil associated therapy: an effective and safe mode of treatment of female normoprolactinemic infertility.

In 51 infertile normoprolactinemic women, aged 19 to 44 years, with anovulatory menstrual cycles and with no endocrine disorders, who had never conceived after the currently employed drugs for female sterility (human chorionic gonadotropin, human menopausal gonadotropin, clomiphene, cyclofenil, bromocryptine itself) a new therapeutic approach was tried: cyclofenil and bromocryptine in association. Before the treatment, a standard luteinizing hormone (LH)-releasing hormone (LHRH) test (100 micrograms intravenously) was performed for each woman to evaluate serum gonadotropin and prolactin response; furthermore, the urinary estrogen excretion or the serum 17-beta-estradiol concentration had been evaluated in all women. The schedule of treatment was as follows: cyclofenil, 600 mg/day, from the 5th to the 12th day of the cycle and bromocryptine, 2.5 mg/day, from the 5th to the 26th day. This scheme was employed for three successive trials at the most. Forty pregnancies (80%) were achieved with the associated therapy, almost all (37) within the second treatment cycle. Thirty-one women delivered a vital baby, five are now pregnant, four aborted spontaneously. All seven women who had been unsuccessfully treated with bromocryptine alone, conceived after the associated regimen. In view of the excellent therapeutic results achieved in our hands, it is justified to consider our proposed scheme cyclofenil-bromocryptine an effective therapy for the management of infertile normo-prolactinemic women.

Adult↗

A potent specific pure antiestrogen with clinical potential.

Previous studies from this laboratory have described a series of 7 alpha-alkylamide analogues of estradiol with pure antiestrogenic activity, exemplified by ICI 164,384. A new compound, 7 alpha-[9-(4,4,5,5,5-pentafluoropentylsulfinyl)nonyl]estra-1,3,5(10 )- triene-3,17 beta-diol (ICI 182,780) has now been identified which has significantly increased antiestrogenic potency and retains pure estrogen antagonist activity. The antiuterotrophic potency of ICI 182,780 in the immature rat was more than 10-fold greater than that of ICI 164,384 (50% effective doses of 0.06 and 0.9 mg/kg, respectively). This order of magnitude increase of in vivo potency was also reflected, in part, by intrinsic activity at the estrogen receptor. The relative binding affinities of ICI 182,780 and ICI 164,384 were 0.89 and 0.19, respectively, compared with that of estradiol (1.0). Similarly, the in vitro growth-inhibitory potency of ICI 182,780 exceeded that of ICI 164,384 in MCF-7 human breast cancer cells, where 50% inhibitory concentrations of 0.29 and 1.3 nM, respectively, were recorded. ICI 182,780 was a more effective inhibitor of MCF-7 growth than 4'-hydroxytamoxifen, producing an 80% reduction of cell number under conditions where 4'-hydroxytamoxifen achieved a maximum of 50% inhibition. This increased efficacy was reflected by a greater reduction of the proportion of cells engaged in DNA synthesis in ICI 182,780-treated cell cultures compared with tamoxifen-treated cells. Sustained antiestrogenic effects, following a single parenteral dose of ICI 182,780 in oil suspension, were apparent in both rats and pigtail monkeys. In vivo, antitumor activity of ICI 182,780 was demonstrated with xenografts of MCF-7 and Br10 human breast cancers in nude mice. A single injection of ICI 182,780 provided antitumor efficacy equivalent to that of daily tamoxifen treatment for at least 4 weeks. The properties of ICI 182,780 identify this pure antiestrogen as a prime candidate with which to evaluate the potential therapeutic benefits of complete estrogen withdrawal in endocrine-responsive human breast cancer.

Animals↗

Cytostatic activity of an estradiol-linked nitrosourea in MXT mammary carcinoma and L 5222 leukemia.

Investigation of 1-(2-chloroethyl)-1-nitrosocarbamoyl-L-alanine-estradiol-17-ester (CNC-ala-17-E2) and of the unlinked single agents 1-(2-chloroethyl)-1-nitrosocarbamoyl-L-alanine (CNC-ala) and estradiol in the MXT mammary carcinoma in vivo uncovered a significant antitumor activity only for CNC-ala-17-E2 at a non-toxic dose level (growth inhibition greater than 70%). In vitro investigations using the clonogenic assay had a comparable result: Here, too, CNC-ala-17-E2 was superior to the unlinked single agents. No difference in therapeutic activity between CNC-ala-17-E2 and CNC-ala could be observed in a transplanted rat leukemia (L 5222).

Animals↗

Inhibition of p-450 aromatase prevents feminisation and induces protection during cysticercosis.

Cysticercotic male mice undergo an impressive feminisation process, characterised by 200 times increased serum 17beta-estradiol levels while testosterone and dihydrotestosterone are 90% reduced, which results in elevated parasite burden. Administration of Fadrozole (an aromatase inhibitor) in male and female mice suppressed the production of 17beta-estradiol, accompanied with a 70% reduction in parasite burden. This protective effect was associated in male mice with a recovery of the specific cellular immune response. Interleukin-6 (IL-6) serum levels, and its production by splenocytes, was augmented by 80%, together with a 10-fold increase in its expression in testes of infected male mice. Fadrozole treatment returned these levels to baseline values. Aromatase expression in the testes of infected male mice was not affected by Fadrozole. These results suggest that aromatase and IL-6 are key molecules in the production of the feminisation undergone by infected male mice and to Fadrozole treatment as a possible new therapeutic approach to cysticercosis.

Animals↗

Combined therapy with bromocriptine and clomiphene citrate for patients with normoprolactinemic amenorrhea.

The purpose of this study was to investigate the combined effect of bromocriptine (Brc) and clomiphene citrate (Cl) treatment on 40 patients with normoprolactinemic amenorrhea who failed to respond to Cl alone. The ovulation rate in this treatment was 57.3% (23/40) in the 40 cases, 55.6% (99/178) in 178 cycles; the pregnancy rate was 26.7%. This treatment was effective in 14 of 21 women with polycystic ovary-like syndrome (66.7%). Among those women who responded to treatment, prolactin (PRL) and LH levels were significantly decreased. Estradiol and progesterone levels were significantly increased in the patients who responded. Before treatment, the responsiveness of LH to LHRH among responders to Brc/Cl therapy was significantly higher than among the nonresponders. After treatment, the LH-releasing response following a conjugated estrogen injection in the patients who responded to the treatment was significantly greater than that in the patients who did not respond. The results suggest that the therapeutic effect of this treatment may be primarily due to the restoration and improvement of the impaired hypothalamo-pituitary axis.

Adolescent↗

Stimulation of fetal lung surfactant production by administration of 17beta-estradiol to the maternal rabbit.

We have investigated the effect of 17beta-estradiol on lung surfactant production in the fetal rabbit. Pregnant rabbits were administered intramuscularly 75microgram of 17beta-estradiol per day at 25 and 26 days' gestation. Control rabbits were similarly injected with the solvent only. At 27 days' gestation the fetuses were delivered by cesarean section and the lungs of the newborn rabbits were lavaged in situ with 0.9 per cent NaCl. Analysis of lung lavage and lavaged lung tissue phospholipids yielded the following results: (a) The 17beta-estradiol--treated group had three to four times more total phospholipid and phosphatidylcholine in the lung lavage than the control group. (b) The phosphatidylcholine/sphingomyelin ratio in the lung lavage was significantly higher in the treated than in the control group. (c) The lavaged lung tissue of the treated group had almost twice as much total phospholipid and phosphatidylcholine as the control group. These changes in lung phospholipid content and composition are in the direction of increased lung maturity and suggest that estrogen may have a role in fetal lung maturation and surfactant production.

Animals↗

Priming effects of novel nonsteroidal progesterone receptor modulators CP8816 and CP8863 on the development of adenomyosis in the mouse uterus.

The possibility of therapeutic application of novel nonsteroidal progesterone receptor modulators CP8816 and CP8863 for preventing the development of uterine adenomyosis was investigated in mice. First priming effects of CP8816 on 17beta-estradiol (E2)-induced cell division in uterine tissues were examined. As a result, pretreatment with CP8816 or progesterone significantly suppressed the elevation of the mitotic activity in the luminal epithelial cells of mice treated with E2 later. Priming with CP8816 had little effect on the stromal cells, but progesterone priming caused an increase of stromal mitotic activity in mice treated with E2 later. To evaluate the inhibitory effect of these compounds on the development of adenomyosis induced experimentally by pituitary grafting, 7-week-old female mice were isografted with a single anterior pituitary in the uterus and divided into four groups. Two groups of mice were given daily subcutaneous injections of 1 mg of CP8816 or the vehicle alone for 6 weeks from the day after the grafting. Remaining two groups of mice were given oral administration of 1 mg of CP8863 or the vehicle only for 5 weeks starting one week after the grafting. The incidence of adenomyosis was significantly lower in the groups of mice treated with CP8816 and CP8863 than in the respective control groups. The mechanism by which CP compounds inhibited the development of adenomyosis might be related to their priming effects, i.e., their inhibitory effect on epithelial cell division and lack of effect on stromal cell division after subsequent exposure to E2.

Animals↗

Endometrial carcinogenesis and its relation to oestrogens.

The epidemiological evidence suggesting an association between the administration of exogenous oestrogens and an increased risk of developing endometrial adenocarcinoma is critically reviewed and it is concluded that the case for oestrogens being a cause of endometrial cancer is proven. The benefits flowing from preventing postmenopausal osteoporosis by oestrogen replacement therapy are assessed and contrasted with the danger to life posed by endometrial adenocarcinoma: it is pointed out that the type of neoplasm developing in patients taking oestrogens is well differentiated, nonaggressive and easily cured, the survival rate being very high. The addition of progestational agents to the therapeutic regime may prevent the development of endometrial carcinoma but could introduce a risk of cardiovascular disease.

Adenocarcinoma↗

Levonorgestrel-releasing intrauterine system as an adjunct to estrogen for the treatment of menopausal symptoms--a review.

Exogenous estrogen is an effective means of prevention for postmenopausal symptoms. Estrogen treatment should be combined with progesterone in non-hysterectomized women to prevent estrogen-induced malignant transformation of the endometrium. Progesterone supplementation using continuous combined estrogen + progesterone treatment may result in an increased incidence of breast cancer and cardiovascular disease. In addition, progesterone supplementation with sequential estrogen + progesterone treatment may cause immediate adverse effects, such as irregular bleeding and spotting, breast congestion, fluid retention, abdominal distention, and a change in lipid profile. All these effects are related, at least in part, to the progesterone component of the therapy.To avoid these complications, researchers are seeking safer progestational components and different modes of administration. In this article we review the findings on the use of the novel levonorgestrel-releasing intrauterine system as a therapeutic tool for localized, rather than systemic, progesterone administration in postmenopausal women.

Estradiol↗

Inhibition of caffeine metabolism by estrogen replacement therapy in postmenopausal women.

This study was conducted to investigate the effect of therapeutic estrogen on cytochrome P450 1A2-mediated metabolism in postmenopausal women using caffeine as a model substrate. Twelve healthy postmenopausal women underwent estrogen replacement therapy in the form of estradiol (Estrace). Estradiol was initiated at a dose of 0.5 mg a day and titrated to achieve a steady-state plasma concentration of 50 to 150 pg/ml. Caffeine metabolic ratios (CMR; paraxanthine/caffeine) were assessed both before and after 8 weeks of estrogen replacement. For the 12 subjects, there was a mean reduction in CMR of -29.2 +/- 25.0 (p = 0.0019). Consistent with previous results found in younger women, these results indicate that exogenous estrogen in older women may inhibit CYP1A2-mediated caffeine metabolism.

Aged↗

Should supplemental estrogens be used as steroid-sparing agents in asthmatic women?

OBJECTIVE: To determine if supplemental estrogens should be used as steroid-sparing agents in asthmatic women. DESIGN: Case series. SETTING: Ambulatory care, community hospital. PATIENTS: Volunteer sample of three steroid-dependent asthmatic women. INTERVENTION: Addition of conjugated estrogens to existing asthma treatment. MAIN OUTCOME MEASURE: Ability to decrease oral steroid requirement. RESULTS: The mean age of the women was 55 +/- 11 years; two were former smokers (cases 1 and 2) and one was a nonsmoker (case 3). One women (case 3) was premenopausal and noted worsening of her asthma before and during menses. The other two women (cases 1 and 2) were postmenopausal. All three had been symptomatic from their asthma for 13.2 +/- 7.6 years. Each woman was being treated with maximal doses of inhaled albuterol, inhaled steroids, and therapeutic theophylline doses. Despite this aggressive management, all three women required daily supplemental steroids (mean dose, 26.7 +/- 11.5 mg of prednisone). Case 3 was started on a regimen of norethindrone/ethinyl estradiol 1/35, and cases 2 and 3 were begun on regimens of daily conjugated estrogen, 0.625 mg. Over the next 12 to 24 weeks, the conditions of all three women were symptomatically improved and their steroid therapy was discontinued. In addition, steroid-associated side effects of hypertension, weight gain, osteoporosis, and easy bruising lessened. CONCLUSION: Although this new observation of the steroid-sparing effect of estrogens remains preliminary, further study may help advance understanding of the mechanisms and treatment of asthma in women.

Administration, Oral↗

[Effect of estrogens on final body height in girls with a constitutionally tall stature--risk or benefit?].

OBJECTIVE: Investigation of the effect of a long-term oestrogen treatment on the growth and development of children, elaboration of a theoretical model for remaining growth of girls on a long-term oestrogen therapy predicting reduction of the final height in girls with constitutionally tall stature, analysis of early and late side-effects of therapy. TYPE OF STUDY: Open clinical study. NAME AND PLACE OF DEPARTMENT: Endocrine out-patient clinic of the Second Paediatric Department and gynaecological out-patient clinic for children and adolescents of the Gynaecological-Obstetric Department, Second Medical School--Charles University and University Hospital Prague--Motol. METHOD: Elaboration of theoretical model for remaining growth of girls on a long-term oestrogen therapy was based on an analysis of the remaining growth of upper and lower body segment of healthy Czech girls. RESULTS: The extent of assumed reduction of the final height in girls with constitutionally tall stature treated with oestrogen declines with advancing age at the onset of treatment. The optimal age for the onset of treatment is between 10 and 11 years. CONCLUSION: Treatment can be recommended only in girls with growth prediction above 185 cm and serious psychological difficulties resulting from excessive height, always after careful analysis of the biological development and growth prediction. In every case it is necessary to evaluate the possible benefit of treatment in relation to potential risks. The greatest problem is according to the authors late onset and overrating of the therapeutic possibilities.

Adolescent↗