Influence of prenatal exposure to cimetidine and alcohol on selected morphological parameters of sexual differentiation: a preliminary report

Prenatal ethanol exposure and changes in fetal neuroendocrine metabolic programming

Prenatal ethanol exposure (PEE) (mainly through maternal alcohol consumption) has become widespread. However, studies suggest that it can cause intrauterine growth retardation (IUGR) and multi-organ developmental toxicity in offspring, and susceptibility to various chronic diseases (such as neuropsychiatric diseases, metabolic syndrome, and related diseases) in adults. Through ethanol's direct effects and its indirect effects mediated by maternal-derived glucocorticoids, PEE alters epigenetic modifications and organ developmental programming during fetal development, which damages the offspring health and increases susceptibility to various chronic diseases after birth. Ethanol directly leads to the developmental toxicity of multiple tissues and organs in many ways. Regarding maternal-derived glucocorticoid-mediated IUGR, developmental programming, and susceptibility to multiple conditions after birth, ethanol induces programmed changes in the neuroendocrine axes of offspring, such as the hypothalamus-pituitary-adrenal (HPA) and glucocorticoid-insulin-like growth factor 1 (GC-IGF1) axes. In addition, the differences in ethanol metabolic enzymes, placental glucocorticoid barrier function, and the sensitivity to glucocorticoids in various tissues and organs mediate the severity and sex differences in the developmental toxicity of ethanol exposure during pregnancy. Offspring exposed to ethanol during pregnancy have a "thrifty phenotype" in the fetal period, and show "catch-up growth" in the case of abundant nutrition after birth; when encountering adverse environments, these offspring are more likely to develop diseases. Here, we review the developmental toxicity, functional alterations in multiple organs, and neuroendocrine metabolic programming mechanisms induced by PEE based on our research and that of other investigators. This should provide new perspectives for the effective prevention and treatment of ethanol developmental toxicity and the early prevention of related fetal-originated diseases.

Adverse reproductive outcomes associated with fetal alcohol exposure: a systematic review

Fetal alcohol exposure results in well-characterised neurobehavioural deficits in offspring, which form the basis for diagnosing fetal alcohol spectrum disorder. However, there is increasing interest in the full range of health complications that can arise in children and adults with this disorder. We used a systematic review approach to locate all clinical and preclinical studies across a broad range of health outcomes in offspring exposed to prenatal alcohol. Our search encompassed four databases (PubMed, CINAHL, EMBASE and Web of Science) and titles/abstracts from retrieved studies were screened against strict inclusion/exclusion criteria. This review specifically evaluated studies reporting on reproductive outcomes in both males and females. A total of 23 studies were included, 5 clinical and 18 preclinical. Although there was a wide range in the quality of reporting across both clinical and preclinical studies, and variable results, trends emerged amongst the reproductive measures that were investigated. In females, most studies focussed on age at first menarche/puberty onset, with evidence for a significant delay in alcohol-exposed offspring. In males, offspring exposed to prenatal alcohol had altered testosterone levels, reduced testes and accessory gland weights and reduced sperm concentration and semen volume. However, further studies are required due to the paucity of clinical studies, the narrow scope of female reproductive outcomes examined and inconsistencies in outcomes across preclinical studies. We recommend that adolescents and individuals of reproductive age diagnosed with f-etal alcohol spectrum disorder be assessed for reproductive dysfunction to allow appropriate management of their reproductive health and fertility.

Neuronal basis of reproductive dysfunctions associated with diet and alcohol: From the womb to adulthood

The theory that individuals are born as tabula rasa and that their knowledge comes from experience and perception is no longer true. Studies suggest that experience is gained as early as in the mother's womb. Moreover, environmental stressors like alcohol or inadequate diet can affect physiological systems such as the hypothalmic-pituitary-gonadal (HPG) axis. The effects of these stressors can manifest as alterations in sexual development and adult reproductive functions. In this review, we consider and compare evidence from animal models and human studies demonstrating the role of environmental stressors (alcohol and under- or overnutrition) on the HPG axis. We review the role of alcohol and inadequate diet in prenatal reproductive system programming and consider specific candidate neurons in the adult hypothalamus through which reproductive function is being regulated. Finally, we review evidence from animal studies on the role that alcohol and diet play in fertility and reproductive disorders. We conclude that in order to better understand reproductive failure in animals and humans we need to consider in utero development and pay more attention to early life experience when searching for the origins of reproductive diseases.

Prenatal alcohol exposure: foetal programming, the hypothalamic-pituitary-adrenal axis and sex differences in outcome

Prenatal exposure to alcohol has adverse effects on offspring neuroendocrine and behavioural functions. Alcohol readily crosses the placenta, thus directly affecting developing foetal endocrine organs. In addition, alcohol-induced changes in maternal endocrine function can disrupt the normal hormonal interactions between the pregnant female and foetal systems, altering the normal hormone balance and, indirectly, affecting the development of foetal metabolic, physiological and endocrine functions. The present review focuses on the adverse effects of prenatal alcohol exposure on offspring neuroendocrine function, with particular emphasis on the hypothalamic-pituitary-adrenal (HPA) axis, a key player in the stress response. The HPA axis is highly susceptible to programming during foetal and neonatal development. Here, we review data demonstrating that alcohol exposure in utero programmes the foetal HPA axis such that HPA tone is increased throughout life. Importantly, we show that, although alterations in HPA responsiveness and regulation are robust phenomena, occurring in both male and female offspring, sexually dimorphic effects of alcohol are frequently observed. We present updated findings on possible mechanisms underlying differential effects of alcohol on male and female offspring, with special emphasis on effects at different levels of the HPA axis, and on modulatory influences of the hypothalamic-pituitary-gonadal hormones and serotonin. Finally, possible mechanisms underlying foetal programming of the HPA axis, and the long-term implications of increased exposure to endogenous glucocorticoids for offspring vulnerability to illnesses or disorders later in life are discussed.

Cimetidine (Tagamet) is a reproductive toxicant in male rats affecting peritubular cells

Cimetidine (Tagamet) is a potent histaminic H2-receptor antagonist, extensively prescribed for ulcers and now available without prescription. Cimetidine is a known testicular toxicant, but its mechanism of action remains uncertain. Rats were treated i.p. with cimetidine either at 50 mg/kg or 250 mg/kg body weight for 59 days. Accessory sex organ weights, but not testis weight, were significantly reduced in the high dose treated groups. FSH levels were significantly elevated in both treated groups, but testosterone levels were unchanged. A high degree of variability characterized testis histology, with most tubules appearing normal and some tubules (15-17%) partially lacking or devoid of germ cells. Morphometry showed that although seminiferous tubule volume was not significantly changed, the volume of peritubular tissue was reduced in the high dose group. There was extensive duplication of the basal lamina, lamina densa in both apparently normal spermatogenic tubules and severely damaged tubules. Apoptotic peritubular myoid cells were also found. TUNEL labeling confirmed extensive apoptotic cell death in peritubular cells, but revealed apoptosis of vascular smooth muscle. Given that 1) peritubular myoid cell apoptosis occurs in apparently normal tubules, that 2) basal lamina disorders are found, and that 3) peritubular cells are lost from the testis, it is suggested that the primary event in cimetidine-related damage is targeted to testicular smooth muscle cells. This is the first in vivo-administered toxicant to be described that targets myoid cells, resulting in abnormal spermatogenesis.

Pre- and postnatal oral toxicity of vinclozolin in Wistar and Long-Evans rats

Vinclozolin administered to pregnant Wistar and Long-Evans rats from day 14 postcoitum to day 3 postpartum at 200 mg/kg body wt/day was maternally toxic (reduced food consumption and body weight gain) and increased perinatal mortality; major adverse effects on sex-specific organs in male offspring were seen (reduced anogenital distance and index; persistence of nipples/areolas into adulthood; hypospadic penis; penile hypoplasia or development of a vaginal pouch; transient paraphimosis; hypoplasia and chronic inflammation of epididymides, prostate, seminal vesicles, and coagulating glands; and also testicular tubular atrophy and chronic inflammation of the urinary bladder in some Long-Evans) with isolated inflammation-related deaths due to pyelonephritis. At 12 mg/kg, prevalence of female areola/nipple anlagen in immature (preweaning) male offspring was increased in both strains; these persisted to adulthood in a few treated Long-Evans but not Wistar offspring. Adult Long-Evans but not Wistar at this dose also had hypoplasia of prostate, seminal vesicles, and coagulating glands, and a minority had testicular tubular atrophy. The no-observed-adverse-effect levels (NOAEL) were 12 and 6 mg/kg body wt in Wistar and Long-Evans rats, respectively, in these studies. The data suggest that both the Long-Evans and the Wistar rats are comparably sensitive to the antiandrogenic effects of vinclozolin. At dose levels below the NOAEL (1 and 3 mg/kg, respectively), there were no indications of any test-substance-related effects.

Androstenedione synergizes with stress or prenatal drug exposure to retard fetal growth: role of IGF

Pregnant Sprague-Dawley dams were implanted with a Silastic capsule (3 or 10 mm) containing androstenedione (AN) or cholesterol prior to being administered one of several treatments that create an endocrine profile of stress: maternal exposure to alcohol, pair feeding (PF), cocaine (COC), or restraint stress (RS). Controls (chow fed, CF) were left undisturbed during pregnancy. Treatments were administered from day 14 to day 22 of gestation. Fetuses were delivered by cesarean section on day 22. Results revealed that administration of AN to pregnant dams at a dose that does not influence fetal growth by itself can retard fetal growth in the presence of alcohol, PF, COC or RS. Data indicate that these effects are not directly attributable to changes in adrenocorticotropin (ACTH) or corticosterone levels. Preliminary results suggest a role for insulinlike growth factor (IGF) binding proteins (IGFBPs). Overall, these data demonstrate that AN can synergize with drugs and/or stress to enhance intrauterine growth retardation (IUGR). One underlying cause of this synergism between stress-related environmental events and androgenic actions on fetal growth may be increased expression of IGFBPs, which can sequester IGFs, thereby inhibiting their trophic actions on fetal and/or placental tissue.

Development of secondary sex characteristics in male rats after fetal and perinatal cimetidine exposure

Cimetidine has been reported to cause antiandrogenic effects in male pups of female rats receiving cimetidine during gestation. Because of conflicting reports of cimetidine causing permanent antiandrogenic effects in male rats, we studied the sexual development of male rats born to females receiving cimetidine. Water or water and cimetidine (194 mg/kg of body weight per day) were administered to pregnant rats from day 12 of gestation through weaning. A total of 130 male pups were studied. Testicular prostate gland/seminal vesicle weights, anogenital distance, serum testosterone and dihydrotestosterone levels, and seminiferous tubule areas were compared between the two groups. Transfer of cimetidine across the placenta and though breast milk was confirmed by HPLC analysis of serum from female littermates at 0, 10, and 20 days of age. With the exception of a smaller anogenital distance (p < 0.03) and a lower anogenital index (p < 0.05) in the cimetidine-exposed newborn rats, no statistically significant differences were observed in the measured parameters between the cimetidine-exposed and control groups. Cimetidine exposure during the fetal and perinatal periods did not alter the development of secondary sex characteristics in male rat pups.

Comparison of two weeks versus one week of prenatal ethanol exposure in the rat on gonadal organ weights, sperm count, and onset of puberty

Sprague-Dawley dams from Harlan Ind. (Indianapolis, IN) were administered a fortified ethanol liquid diet containing 35% ethanol derived calories for two weeks (E-2) beginning on day 7 or one week (E-1) beginning on day 13 of gestation and continuing through parturition. Control dams were pair-fed an isocaloric liquid diet containing no ethanol during these periods or remained on lab chow and water. E-2 dams consumed an average of 13.52 g ethanol/kg bwt during the first week of exposure (days 8-14) and 12.50 g ethanol/kg bwt the second week (days 14-20). E-1 dams consumed significantly less than E-2 dams during the second week (9.75 g/kg; p < 0.0001). Although the lower consumption in E-1 dams led to a significant decrease in maternal weight gained during the few days of pregnancy compared to E-2 dams, birthweights of E-1 offspring were significantly heavier than those of E-2 offspring (p < 0.05). No effect of ethanol was detected on anogenital distance at birth in either sex. Puberty was delayed in female offspring of both E-1 and E-2 dams (p < 0.01) as measured by age of vaginal opening. These data suggest that the primary teratogenic actions of ethanol in the rat on fetal growth, as well as delayed puberty in females, occur in the last week of gestation. In adult E-2 males, testis weight was significantly heavier than all other groups when indexed to body weight. No effect of prenatal ethanol exposure was observed on the indexed weights of prostate, epididymis, or seminal vesicles.(ABSTRACT TRUNCATED AT 250 WORDS)

Lack of prenatal testosterone surge in fetal rats exposed to alcohol: alterations in testicular morphology and physiology

Pregnant Sprague-Dawley rats were administered a liquid alcohol diet (35% ethanol-derived calories), a pair-fed isocaloric diet, or dry food pellets beginning on Day 14 of gestation and continuing until parturition. Testosterone levels in male fetuses were measured on Days 17 through 20 of gestation. The normal surge of testosterone on Days 18 and 19 was present in controls, but notably absent in male fetuses exposed to alcohol. Light microscopic examination of the testes at birth revealed a reduction in the number of leydig cells in the alcohol exposed group and the presence of a large number of vacuoles in the seminiferous tubules. In vitro studies of fetal testes at 18 and 22 days of gestation revealed that this in utero alcohol exposure regimen produced a marked insensitivity to rat LH (10 ng/ml) stimulation of testosterone secretion compared to controls. The response to ethanol (160 mg/dl) in alcohol exposed testes was characterized by a long-lasting suppression of testosterone compared to a large increase observed in control testes. No differences in anogenital distance were observed among the groups. Together, these data may explain some of the long-term feminizing and demasculinizing effects on reproductive and nonreproductive sexually dimorphic behaviors observed in adult males prenatally exposed to alcohol.