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Synergism of diethylstilbestrol and radiation in mammary carcinogenesis in female F344 rats.

One compressed 20-mg pellet containing cholesterol only or cholesterol mixed with 0.98, 1.6, 2.6, or 3.9 mg of diethylstilbestrol (DES) was implanted into each of 203 female F344 rats. Two days later, half the animals in each group were exposed to 150 R of X-rays, and the other half were sham irradiated. The rats were maintained until 350 days post implantation. Mortality increased with the higher doses of DES, with or without X-rays. DES at all dose levels, with or without X-rays, produced pituitary tumors and pyometritis. Only rats that received both DES and X-rays had mammary adenocarcinomas (AC). A synergistic AC response was found in the group that received 2.6 mg DES plus X-rays. Synergism was defined as a significantly greater incidence of rats with mammary neoplasia resulting from DES plus X-ray treatment when compared to the summed incidence from comparable individual treatments. For all other groups of rats that received both treatments, synergism was detected only when their data were combined. Synergism was not detected among rats that had fibroadenomas (FA). Both types of neoplasms were independent phenomena because no significant relationship was found between the incidences of FA and AC.

Adenocarcinoma↗

Induction of urogenital neoplasia and abnormalities from prenatal exposure to diethylstilbestrol.

The occurrence of vaginal clear cell adenocarcinoma in young women following exposure in utero to diethylstilbestrol (DES) is now well documented. In addition to this carcinogenic potential. DES has been shown to be teratogenic. In females, the DES-related malformations include vaginal adenosis, transverse ridges of the vagina or cervix and uterine abnormalities. Although no neoplasms have been observed in DES-exposed males, malformations of the epididymis, testes and phallus are relatively common and may result in infertility. The carcinogenic mechanism of DES may be either a direct induction of malignant potential in vaginal cells or a teratogenic effect causing ectopic Müllerian epithelium which could be exposed later to mutagenic agents in the vagina. The absence of malignancy in DES-exposed males may favor the latter hypothesis since male Müllerian remnants are internal structures and thus would not be exposed to surface carcinogens.

Adenocarcinoma↗

[Comparative evaluation of chemical methods for determining diethylstilbestrol in tissues of animal origin].

Three chemical methods for determination diethylstilbestrol (DES) in biological material (Jons and Deferage, 1953; Ponder, 1966; Official Method of Pharmacopoeia, USA, 1965) were compared. The most adequate method for determination of DES in animal tissue is the Official method of Pharmacopoeia based on a specific reaction. The method yields reproducible results. Average recovery of pure DES added to biological material was 78%. The method by Jons and Deferage though providing recovery of 86% of the added DES is based on nonspecific reaction with SbCl5, which resulted in too high results. Method of Pharmacopoeia (USA) was used to determine residual amounts of DES in tissues of a rabbit, implanted with 0.1 mg DES per 1 kg weight. One month after implantation, trace amounts of DES were detected only in muscle tissues. Two and three months after implantation, the residual amounts of DES in the rabbit tissues were not detected.

Animals↗

Angiosarcoma of the liver associated with diethylstilbestrol.

Angiosarcoma of the liver occurred in a 76-year-old man who had been treated for a well-differentiated adenocarcinoma of the liver with diethylstilbestrol for 13 years. Angiosarcoma was also present within pulmonary and renal arteries. The possibility that the intraarterial lesions might represent independent primary tumors is considered.

Adenocarcinoma↗

Effect of diethylstilbestrol on skin sterols of the male rat.

Diethylstilbestrol (DES) was injected in doses ranging from 600 micro g to 0.4 micrograms/kg body weight into mature male rats over a 3 wk period. Profound effects on skin morphology and on sterol content of skin were noted. The sebaceous glands atrophied and the epidermis lost granularity. The concentrations of all skin sterols, with the exception of cholesterol, were reduced. At a dose level of DES of 4 micrograms/kg there was still a perceptible reduction in the concentration of Delta(7)-cholestenol. Incubation of skin fragments with acetate-2-(14)C for 2 hr demonstrated a reduced uptake of (14)C into the nonsaponifiable fraction of skin lipids at all dose levels studied. Preliminary thin-layer chromatography of the nonsaponifiable fraction revealed that the uptake of (14)C into cholesterol was only slightly decreased; uptake into cholesterol precursors was decreased somewhat more. The epidermis and dermis were separated by incubation of skin with elastase and hyaluronidase. The epidermis contained at least three times as much sterol per mg dry weight as did the dermis. Unesterified cholesterol was the major sterol present in both layers; the other sterols were present mainly as esters. DES injection resulted in no change in the free sterol content but markedly reduced the ester content of the epidermis and dermis.

Acetates↗

Psychological effects of diethylstilbestrol exposure.

The psychological response of daughters and their mothers to discovery of in utero diethylstilbestrol (DES) exposure was studied. At the DES Colposcopy Clinic, 41 daughters and 20 mothers were extensively interviewed. Twelve patients with abnormal cytology tests were controls. Initial anxiety was usually followed by acceptance of the condition after examination and counseling. Patients responded best when informed of their problem by their mothers and when the relationship between mother and daughter was good. The majority of patients found colposcopy to be unpleasant; they tended to be disturbed in proportion to the degree of being upset about DES exposure. The most common problem among mothers was guilt. A questionnaire survey of physicians showed that they had less concern for psychological problems than patients or mothers did. Sensitivity and good communication on the part of medical personnel are recommended.

Adenocarcinoma↗

Intrauterine diethylstilbestrol exposure and its consequences: pathologic characteristics of vaginal adenosis, clear cell adenocarcinoma, and related lesions.

In 1971, the development of clear cell adenocarcinoma of the vagina in young females was first linked to a history of intrauterine exposure to diethylstilbestrol (DES). This communication reviews data on cases accessioned in the Registry of Clear Cell Adenocarcinoma of the Genital Tract in Young Females, findings in exposed female and male subjects without cancer, and discusses current concepts of the pathogenesis of the DES-related anomalies of the lower genital tract.

Adenocarcinoma↗

Synergism of diethylstilbestrol and other carcinogens in concurrent development of hepatic, mammary, and pituitary tumors in castrated male rats.

Castrated male WF rats, given implants of pellets containing 5.0 mg diethylstilbestrol (DES), were given N-butyl-N-nitrosourea (NBU) in small amounts, which alone produced no mammary tumors in intact female rats. Treatment resulted in the high yield of hepatic tumors (HT), mammary tumors (MT), and pituitary tumors (PT) concurrently in each rat. If animals were further treated with prolactin, the development of HT and MT was accelerated, whereas that of PT was suppressed. None of the intact or castrated rats receiving NBU and/or prolactin developed tumors in any tissues if DES treatment was omitted. Exposure of male rats, preconditioned similarly to NBU treatment, to 200 rads of 14.1-MeV fast-neutron radiation also elicited HT, MT, and PT with an efficiency comparable to that of NBU-treated rats. These findings indicate that DES played an essential role in the whole carcinogenic process in each tissue and that castrated male rats, if conditioned properly with estrogens, are useful for the study of the carcinogenesis mechanism in these tissues.

Animals↗

Suppression of cell-mediated immunocompetence after subchronic exposure to diethylstilbestrol in female B6C3F1 mice.

The effect of the nonsteroidal estrogenic compound, diethylstilbestrol (DES) on cell-mediated immunocompetence in the mouse has been assessed. Adult female B6C3F1 mice were injected (s.c.) with 0.2, 1.0 and 4.0 mg/kg of DES daily for 14 days. All immunological tests and toxicological parameters were determined at least 24 hr after the last exposure. Thymic involution and hepatomegaly were noted at the lowest dose of DES. The most sensitive indicator of immunosuppression by DES was the delayed hypersensitivity response (DHR) to keyhole limpet hemocyanin in mice sensitized without adjuvant. The lowest dose of DES produced a 93% decrease, compared with a 39% decrease for the same DHR model in mice sensitized to keyhole limpet hemocyanin plus adjuvant and a 63% decrease for the DHR to sheep erythrocytes. A 35% decrease of the acute inflammatory response to carrageenin was produced by the lowest dose of DES. Day 2 proliferative responses to both concanavalin A and phytohemagglutinin (T-cell mitogens) were depressed by the lowest dose of DES, whereas significant suppression of the response to lipopolysaccharide (B-cell mitogen) was only noted at the highest dose of DES. The effects of DES on Day 3 proliferative responses were less dramatic. The mixed lymphocyte response was significantly suppressed by 1.0 and 4.0 mg/kg of DES on all days in culture. The reversibility of the DES effects was studied by resting the mice for 30 days between exposure and measuring a given parameter. All effects on organ weights and the depression of both the sheep erythrocytes DHR and the carrageenin inflammatory response were reversed.

Animals↗

Morphologic and neoplastic transformation of Syrian hamster embryo fibroblasts by diethylstilbestrol and its analogs.

A mammalian cell culture system using normal, diploid Syrian hamster embryo fibroblasts was used as a model to study the ability of diethylstilbestrol (DES) and related compounds to induce neoplastic transformation. Like benzo(a)pyrene, a known chemical carcinogen, DES (0.01 to 10 micrograms/ml) induces morphological transformation of Syrian hamster embryo fibroblasts in vitro; the transformed colonies were indistinguishable from colonies of benzo(a)pyrene-transformed cells. The morphologically transformed colonies derived from either benzo(a)pyrene- or DES-treated cells were tumorigenic when injected into newborn hamsters. At doses of 0.01 to 1 microgram/ml for 48 hr, DES did not inhibit or stimulate cell proliferation. Structural analogs of DES were also tested in the Syrian hamster embryo transformation system. Like DES, tetrafluorodiethylstilbestrol, dimethylstilbestrol, and cis,cis-dienestrol morphologically transformed Syrian hamster embryo cells. The transformation frequency of dimethylstilbestrol was much less than that of DES, tetrafluorodiethylstilbestrol, or cis,cis-dienestrol. Hexestrol, dimethoxydiethylstilbestrol, and trans,trans-dienestrol did not transform these cells. No correlation could be demonstrated between reported estrogenic potency of the compounds and their cell-transforming capacity. Structure-activity relationships developed for these chemicals suggest that metabolism via specific pathways plays a role in DES-induced cell transformation.

Animals↗

Cervical papillomavirus infection in diethylstilbestrol-exposed progeny.

Histologic sections from cervical and vaginal biopsies showing dysplasia in 37 women exposed to diethylstilbestrol (DES) in utero were stained for human papillomavirus structural antigens using an immunoperoxidase technique. Forty-three percent of the lesions had detectable papillomavirus antigens. These findings indicate that a significant proportion of cervical dysplasia observed in DES-exposed progeny is associated with papillomavirus infection.

Animals↗

Dependence on exogenous metabolic activation for induction of unscheduled DNA synthesis in Syrian hamster embryo cells by diethylstilbestrol and related compounds.

Diethylstilbestrol (DES) induces morphological and neoplastic transformation of Syrian hamster embryo cells in vitro in the absence of any measurable induction of gene mutations, which is consistent with the lack of genotoxicity of DES in a number of other assays. However, a few reports of a genotoxic activity of DES in certain systems have been published. In order to understand these differences, we have investigated whether DES induces unscheduled DNA synthesis (UDS) in Syrian hamster embryo cells under the conditions which result in cell transformation and have examined the role of an exogenous metabolic activation system on DES-induced UDS. DES, over a concentration range of 1 to 10 micrograms/ml, failed to induce any detectable UDS in the cells, while other known transforming agents, including UV irradiation (6 to 24 J/sq m), benzo(a)pyrene (0.1 to 1.0 micrograms/ml), and aflatoxin B1 (10 to 100 micrograms/ml), induced significant levels of UDS. In contrast, UDS was induced in a dose-dependent manner by DES (1 to 10 micrograms/ml) after addition of an Aroclor-induced rat liver postmitochondrial supernatant fraction and other cofactors for exogenous metabolic activation. In order to probe the basis for this alteration in UDS induction, the ability of structural analogues and metabolites of DES to induce UDS was examined. In the absence of exogenous activation, the only oxidative metabolite of DES detected in the presence of the cells was cis,cis-dienestrol, which did not induce UDS by itself. In the presence of exogenous activation, cis,cis-dienestrol and its trans,trans-isomer induced UDS but not to a greater extent than DES. With the addition of the exogenous metabolizing system, increased metabolism of DES to cis,cis-dienestrol and additional polar derivatives of DES or dienestrol, possibly hydroxylated derivatives, were observed. With exogenous metabolic activation, tetrafluoro-DES and hexestrol, which differ in their ability to be peroxidatively metabolized to quinone and phenoxyradical intermediates, both induced UDS, although tetrafluorodiethylstilbestrol at 10 micrograms/ml stimulated a higher level of UDS. None of the DES-related compounds examined was active in the UDS assay without exogenous metabolic activation, but all of the compounds can potentially form phenoxyradical intermediates by a peroxidase-mediated reaction. The compounds which can be further oxidized to a quinone were most active in inducing UDS. These results are consistent with the hypothesis that this peroxidase-mediated pathway is important in the induction of UDS, although secondary metabolites may also be involved.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

A histological study of the promotive effect of diethylstilbestrol on diethylnitrosamine initiated carcinogenesis of liver in rat.

A single dose (80 mg/kg) of diethylnitrosamine (DEN) was given orally to castrated female Wistar rats. One week after that one half of the animals were treated with diethylstilbestrol (DES) 3 mg/kg/once a week subcutaneously. The other half of the animals received no any hormone or hormone derivatives. The change of the liver cells in animals treated with DEN alone failed to progress beyond the stage of hepatocellular alterations in foci or neoplastic nodules within 8 months, while most of those animals which received DES treatment after DEN initiation developed hepatocellular carcinomas after 6 months. This result denotes that the DES exerts a definite promotive effect on DEN initiated liver cell carcinogenesis.

Animals↗

[Diethylstilbestrol in urine of slaughtered cattle].

The results of an investigation during 1981-1984 for the presence of diethylstilbestrol (DES) in 12576 samples of bovine urine in the Netherlands are presented. The screening was performed by radioimmunochemical detection after chromatographic purification on celite. Subsequent final confirmation was performed by combined high pressure liquid chromatography-gas chromatography mass spectrometry. On the average in 1.7% of the 12576 samples the presence of stilbenes , primarily DES, was proven. Probably due to the reintroduction of the meat inspection act regarding the control for DES, a substantial decrease to 0.2% (4 samples) was observed in the first three months of 1984. In these 4 samples out of 2333 samples the presence of dienestrol (DE) was confirmed. No DES or hexestrol (HEX) could be detected.

Animals↗

Induction of sister chromatid exchange by diethylstilbestrol in metabolically competent hepatoma cell lines but not in fibroblasts.

The effect of diethylstilbestrol (DES) on sister chromatid exchange (SCE) induction was measured in four cell lines to determine whether metabolic activation of DES is a factor in its genotoxic potential. Two of these, cell lines derived from a human hepatoblastoma (HepG2-GW) and a rat hepatoma (H4-AG), have been shown previously in our laboratory to be capable of metabolizing several procarcinogens to their active forms. DES, in a dose range of 1 X 10(-8) M to 1 X 10(-5) M, increased SCE frequencies by 50 to 60% in both the rat and human hepatoma lines but had no effect on SCE induction in Chinese hamster lung fibroblasts (V79-GW) or human diploid skin fibroblasts (MGH 2C-GW), both of which are nonmetabolizing cell lines. Furthermore, pretreatment of the responsive cell lines (H4-AG and HepG2-GW) with indomethacin, an inhibitor of prostaglandin synthetase-mediated metabolism of DES, effectively prevented the induction of SCE by DES. DES failed to increase the frequency of hypoxanthine-guanine phosphoribosyltransferase locus mutants in H4-AG cells, over a dose range which induced SCE. These observations suggest that DES induces SCE but does not induce gene mutation. These data strongly support growing evidence that metabolic activation of DES may be an important factor in its genotoxic and carcinogenic mechanisms.

Animals↗

[Administration of diethylstilbestrol during pregnancy, a public health problem].

The analysis of the health risks associated with the administration of diethylstilbestrol (DES) during pregnancy (for the prevention or treatment of threatened abortions) has been largely published. Concerning mothers, a relationship between DES exposure during pregnancy and risk of cancer is unproved. However, existing studies are sufficient cause for serious concern over drug's carcinogenic potential, and further follow-up studies are required. Concerning daughters, a clear association between in utero exposure to DES and clear cell adenocarcinoma of the vagina or cervix is established (incidence between 0.14 and 1.4 per 1000 through age 24). The risk for squamous cell cancer of the vagina and cervix does not seem to be increased. Cervico-vaginal adenosis is frequent (20% to 60% of exposed subjects). This is not a pre-cancerous lesion, its spontaneous evolution is towards regression. No treatment is prescribed. Morphological changes of the genital tract have been described, their consequences on fertility and pregnancy are not clear. Concerning sons, an excess of genital abnormalities (especially of the epididymis and undescended testis) has been reported, but information on the fertility implications of these findings is not available. There is no evidence of an increased risk of testicular cancer. The analysis of all these informations should allow to bring up a policy to take into account these risks in the population.

Adult↗

Involvement of prostaglandin synthetase in the peroxidative metabolism of diethylstilbestrol in Syrian hamster embryo fibroblast cell cultures.

The mechanism for induction of tumors by estrogens is still unresolved. Neoplastic transformation of Syrian hamster embryo fibroblasts by diethylstilbestrol (DES) suggests that established principles of chemical carcinogenesis may be involved. The Syrian hamster embryo fibroblast cells provide a system in which now the question can be asked whether the metabolic activation of DES is a prerequisite for its biological activity in this system. In this study, Syrian hamster embryo fibroblast cell cultures were shown to oxidatively metabolize DES to cis,cisdienestrol (Z,Z-DIES) which is a DES metabolite commonly found in vivo. The only other metabolic conversion of DES detectable in these cell cultures was the formation of the glucuronides of DES and Z,Z-DIES. Z,Z-DIES is formed more efficiently in incubations with rapidly growing cells than in cultures approaching confluence. When arachidonic acid was added to the medium, Z,Z-DIES formation was enhanced, whereas indomethacin added to the cell cultures inhibited the formation of this metabolite. These data suggest the involvement of prostaglandin synthetase in the oxidative metabolism of DES by Syrian hamster embryo fibroblast cells in culture and suggest that cooxidation may play a role for its biotransformation in whole cells. Moreover, since many competing metabolic pathways are available to DES in vivo, this present study adds important additional support to the hypothesis that metabolism of DES via a peroxidative route plays a role in its carcinogenicity.

Animals↗

Transplacental action of diethylstilbestrol on mammary carcinogenesis in female rats given one or two doses of 7,12-dimethylbenz(a)anthracene.

Aspects of the development, morphology, and estrogen binding capacity of mammary tumors in rats exposed prenatally to the synthetic estrogen, diethylstilbestrol (DES), and treated postnatally with 7,12-dimethylbenz(a)anthracene (DMBA) were analyzed as part of a project aimed at understanding the effects of transplacental exposure to DES on estrogen-sensitive tissues. Pregnant Sprague-Dawley rats were given injections of DES (total dose, 1.2 micrograms) or vehicle alone on Days 15 and 18 of gestation. All female offspring were given gastric intubations of DMBA, either a single 10-mg dose on Day 50 or two doses (10 mg each) on Days 50 and 57. Among rats treated postnatally with 10 mg of DMBA, the DES-exposed group had a significantly greater incidence of palpable mammary tumors than did the vehicle-exposed controls. In addition, there was an earlier time of appearance of palpable tumors in the DES-exposed group. When the data from rats treated postnatally with two 10-mg doses of DMBA were analyzed, there were no significant differences in palpable mammary tumor incidence or tumor latency between the DES-exposed and vehicle-exposed groups. When the pathology of the mammary tumors produced in rats treated with 10 mg of DMBA was analyzed, the DES-exposed group had a significantly higher proportion of benign tumors (fibroadenoma, adenoma, lobular hyperplasia) than adenocarcinomata compared to vehicle-exposed controls. Both exposure groups had similar numbers of nonpalpable mammary lesions discovered at necropsy. Estrogen binding capacities of representative adenocarcinomata did not differ significantly between the two prenatal exposure groups treated postnatally with 10 mg of DMBA. These results demonstrate the importance of the dose of the challenge carcinogen in revealing the effects of transplacental drug exposure and may have special significance for women who were exposed to DES in utero.

9,10-Dimethyl-1,2-benzanthracene↗