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Nishimura T, Takebe T. Synthetic human gonadal tissues for toxicology. Reprod Toxicol 2024; 126:108598. [PMID: 38657700 DOI: 10.1016/j.reprotox.2024.108598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 04/15/2024] [Accepted: 04/18/2024] [Indexed: 04/26/2024]
Abstract
The process of mammalian reproduction involves the development of fertile germ cells in the testis and ovary, supported by the surrounders. Fertilization leads to embryo development and ultimately the birth of offspring inheriting parental genome information. Any disruption in this process can result in disorders such as infertility and cancer. Chemical toxicity affecting the reproductive system and embryogenesis can impact birth rates, overall health, and fertility, highlighting the need for animal toxicity studies during drug development. However, the translation of animal data to human health remains challenging due to interspecies differences. In vitro culture systems offer a promising solution to bridge this gap, allowing the study of mammalian cells in an environment that mimics the physiology of the human body. Current advances on in vitro culture systems, such as organoids, enable the development of biomaterials that recapitulate the physiological state of reproductive organs. Application of these technologies to human gonadal cells would provide effective tools for drug screening and toxicity testing, and these models would be a powerful tool to study reproductive biology and pathology. This review focuses on the 2D/3D culture systems of human primary testicular and ovarian cells, highlighting the novel approaches for in vitro study of human reproductive toxicology, specifically in the context of testis and ovary.
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Affiliation(s)
- Toshiya Nishimura
- WPI Premium Research Institute for Human Metaverse Medicine (WPI-PRIMe), Osaka University, Osaka 565-0871, Japan.
| | - Takanori Takebe
- WPI Premium Research Institute for Human Metaverse Medicine (WPI-PRIMe), Osaka University, Osaka 565-0871, Japan; Division of Stem Cell and Organoid Medicine, Department of Genome Biology, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan; Division of Gastroenterology, Hepatology and Nutrition, Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA; Institute of Research, Tokyo Medical and Dental University (TMDU), Tokyo 113-8510, Japan; Center for Stem Cell and Organoid Medicine (CuSTOM), Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; Communication Design Center, Advanced Medical Research Center, Yokohama City University, Yokohama 236-0004, Japan.
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Liu M, Hummitzsch K, Bastian NA, Hartanti MD, Irving-Rodgers HF, Anderson RA, Rodgers RJ. Expression of PCOS candidate genes in bovine fetal and adult ovarian somatic cells. REPRODUCTION AND FERTILITY 2022; 3:RAF-22-0068. [PMID: 36346793 PMCID: PMC9782414 DOI: 10.1530/raf-22-0068] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 11/08/2022] [Indexed: 11/09/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine metabolic disorder that appears to have a genetic predisposition and a fetal origin. The fetal ovary has two major somatic cell types shown previously to be of different cellular origins, different morphologies and to differentially express 15 genes. We isolated the somatic gonadal ridge epithelial-like (GREL) cells (n = 7) and ovarian fetal fibroblasts (n = 6) by clonal expansion. Using qRT-PCR, we compared the gene expression levels of PCOS candidate genes with previous data on the expression levels in whole fetal ovaries across gestation. We also compared these levels with those in bovine adult ovarian cells including fibroblasts (n = 4), granulosa cells (n = 5) and surface epithelial cells (n = 5). Adult cell types exhibited clear differences in the expression of most genes. In fetal ovarian cells, DENND1A and ERBB3 had significantly higher expression in GREL cells. HMGA2 and TGFB1I1 tended to have higher expression in fetal fibroblasts than GREL cells. Another 19 genes did not exhibit differences between GREL cells and fetal fibroblasts and FBN3, FSHB, LHCGR, FSHR and ZBTB16 were very lowly expressed in GREL cells and fibroblasts. The culture of fetal fibroblasts in EGF-containing medium resulted in lower expression of NEIL2, but higher expression of MAPRE1 compared to culture in the absence of EGF. Thus, the two fetal ovarian somatic cell types mostly lacked differential expression of PCOS candidate genes.
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Affiliation(s)
- Menghe Liu
- School of Biomedicine, Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Katja Hummitzsch
- School of Biomedicine, Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Nicole A Bastian
- School of Biomedicine, Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Monica D Hartanti
- School of Biomedicine, Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Faculty of Medicine, Universitas Trisakti, Jakarta, Indonesia
- National Research and Innovation Agency, Jakarta, Indonesia
| | - Helen F Irving-Rodgers
- School of Biomedicine, Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- School of Medical Science, Griffith University, Gold Coast Campus, QLD, Australia
| | - Richard A Anderson
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Raymond J Rodgers
- School of Biomedicine, Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
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3
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ÜNAL MS, SEÇME M. Does the ovarian surface epithelium differentiate into primordial follicle and primary follicle precursor structures? CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1134852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Purpose: The aim of this study is to investigate the differentiation capacity of ovarian surface epithelial cells both in cell culture conditions and in ovarian tissue sections.
Materials and Methods: The ovaries of two prepubertal (4 weeks old) female rats were divided into small pieces and explant cell culture was created. Ovarian surface epithelium proliferating together with ovarian stromal cells in mixed cell culture was isolated and reproduced. In addition, ovarian surface epithelium was examined in histological sections of ovarian tissue and images were taken under the microscope.
Results: The morphological appearance of the ovarian surface epithelium was found to be cobblestone. In the count performed under phase contrast microscopy, it was observed that 2x106 and 3x106 cells were grown in the culture dishes, respectively. Primordial follicle-like structures were observed in some areas of the petri dishes. On the histological sections, primordial and primary follicle precursor structures were observed on the basement membrane.
Conclusion: Showing oocyte markers (Gdf-9, C-Mos, Zpc, Stella) and germ cell markers (Dazl, Vasa, Blimp1, Fragilis) both in cell cultures and in histological sections can give us valuable information in terms of monitoring the differentiation capacity of these cells.
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Perrone E, Tudisco R, Pafundi PC, Guido D, Ciucci A, Martinelli E, Zannoni GF, Piermattei A, Spadola S, Ferrante G, Marchetti C, Scambia G, Fagotti A, Gallo D. What’s beyond BRCA Mutational Status in High Grade Serous Ovarian Cancer? The Impact of Hormone Receptor Expression in a Large BRCA-Profiled Ovarian Cancer Patient Series: A Retrospective Cohort Study. Cancers (Basel) 2022; 14:cancers14194588. [PMID: 36230510 PMCID: PMC9559459 DOI: 10.3390/cancers14194588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 09/17/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Ovarian hormones are involved in ovarian cancer pathogenesis. However, few reports have investigated the hormone receptor pattern according to BRCA mutational status. The aim of this single-center, observational, retrospective study was to explore the relationship between hormone receptor status and BRCA1/2 mutation in a cohort of 207 high-grade serous ovarian carcinoma (HGSOC) patients. Interesting differences emerged between BRCA-mutated and BRCA wild-type women, in terms of pattern of receptor expression and its association to the outcome. On the whole, our findings, though needing further validation, extend our understanding of the complex interplay between BRCA1/2 protein and hormone signaling, suggesting new pathways to be exploited in order to develop future personalized therapy. Abstract Several studies have explored the prognostic role of hormone receptor status in high-grade serous ovarian cancer (HGSOC) patients. However, few reports have investigated their expression according to BRCA mutational status. The aim of this single-center, observational, retrospective study was to explore the hormone receptor pattern and its potential prognostic role in a cohort of 207 HGSOC women stratified for BRCA mutational status. To this end, ERα, ERβ1, ERβ2, ERβ5, PR, and AR expression were assessed by immunohistochemistry in 135 BRCA-wild type (BRCA-wt) and 72 BRCA1/2 mutation carriers (BRCA-mut). No significant difference emerged in hormone receptor expression between the two sub-samples, except for a significantly lower ERα expression observed in pre-menopausal BRCA1/2-mut as compared to BRCA-wt patients (p = 0.02). None of the examined hormone receptors has revealed a significant prognostic role in the whole sample, apart from the ratio ERα/ERβ5 nuclear, for which higher values disclosed a positive role on the outcome in BRCA-wt subgroup (HR 0.77; CI 0.61–0.96; p = 0.019). Conversely, it negatively affected overall survival in the presence of BRCA1/2-mut (HR 1.41; CI 1.06–1.87; p = 0.020). Finally, higher PR levels were associated with platinum sensitivity in the whole sample (p = 0.019). Our data, though needing further validation, suggest a potential role of oestrogen-mediated pathways in BRCA1/2-associated HGSOC tumorigenesis, thus revealing a possible therapeutic potential for targeting this interaction.
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Affiliation(s)
- Emanuele Perrone
- Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Riccardo Tudisco
- Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
- Universita’ Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Pia Clara Pafundi
- Epidemiology and Biostatistics Facility Core Research, Gemelli Science and Technology Park, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Davide Guido
- Bioinformatics Facility Core Research, Gemelli Science and Technology Park (GSTeP) Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Alessandra Ciucci
- Universita’ Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Unit of Translational Medicine for Woman and Child Health, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Enrica Martinelli
- Universita’ Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Unit of Translational Medicine for Woman and Child Health, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Gian Franco Zannoni
- Universita’ Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Gynecopathology and Breast Pathology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Alessia Piermattei
- Gynecopathology and Breast Pathology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Saveria Spadola
- Gynecopathology and Breast Pathology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Giulia Ferrante
- Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
- Universita’ Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Claudia Marchetti
- Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
- Universita’ Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Giovanni Scambia
- Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
- Universita’ Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Anna Fagotti
- Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
- Universita’ Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Daniela Gallo
- Universita’ Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Unit of Translational Medicine for Woman and Child Health, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
- Correspondence:
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Russ JE, Haywood ME, Lane SL, Schoolcraft WB, Katz-Jaffe MG. Spatially resolved transcriptomic profiling of ovarian aging in mice. iScience 2022; 25:104819. [PMID: 35996587 PMCID: PMC9391589 DOI: 10.1016/j.isci.2022.104819] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/25/2022] [Accepted: 07/19/2022] [Indexed: 11/24/2022] Open
Abstract
Ovarian aging precedes that of any other mammalian organ and is the primary cause of female age-related infertility. The biological mechanisms responsible for ovarian aging remain unclear. Previous studies have been limited by their use of bulk RNA-sequencing, which masks the dynamic and heterogeneous nature of the ovary. In this study, we spatially resolved the transcriptomic landscape of ovaries from young and aged outbred mice. In total, we defined eight main ovarian cell populations, all of which were characterized by significant transcriptomic changes between young and aged samples. Further sub-cluster analysis revealed separate transcriptomes for distinct granulosa cell populations found in young versus aged mice, in addition to an oocyte sub-cluster population completely absent from aged mouse ovaries. This study provides a new perspective on mammalian ovarian aging using spatial transcriptomics to achieve deeper understanding of the localization and cell-population-specific mechanisms underlying age-related fertility decline. Spatial transcriptomic analysis of murine ovarian aging characterizes cell populations Distinct granulosa cell populations exist in aged mice compared to young These are associated with the disruption of inhibins, activins, and gap junction activity Oocyte transcriptomes captured in vivo and within follicles of varying maturity
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Affiliation(s)
- Jennifer E. Russ
- Colorado Center for Reproductive Medicine, Lone Tree, CO 80124, USA
| | - Mary E. Haywood
- Colorado Center for Reproductive Medicine, Lone Tree, CO 80124, USA
| | - Sydney L. Lane
- Colorado Center for Reproductive Medicine, Lone Tree, CO 80124, USA
| | | | - Mandy G. Katz-Jaffe
- Colorado Center for Reproductive Medicine, Lone Tree, CO 80124, USA
- Corresponding author
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6
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Ellwanger B, Schüler‐Toprak S, Jochem C, Leitzmann MF, Baurecht H. Anthropometric factors and the risk of ovarian cancer: A systematic review and meta-analysis. Cancer Rep (Hoboken) 2022; 5:e1618. [PMID: 35384414 PMCID: PMC9675384 DOI: 10.1002/cnr2.1618] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 03/17/2022] [Accepted: 03/27/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Excess weight is convincingly associated with several cancers, but the association with ovarian cancer is insufficiently clarified, in particular regarding subgroups defined by menopausal status and ovarian cancer histologic type. AIMS We carried out a comprehensive systematic review and meta-analysis of overweight and obesity in relation to ovarian cancer with focus on different subgroups. METHODS AND RESULTS We searched PubMed and Web of Science for relevant cohort and case-control studies published from inception to June 2021 in English language and using a clear definition of overweight and obesity. We combined maximally adjusted risk estimates using a random effects model. We analyzed data from 15 cohort and 26 case-control studies, including 28 471 ovarian cancer cases. The relative risk of ovarian cancer for overweight and obesity was 1.06 (95% confidence interval [CI] = 1.00-1.12) and 1.19 (95% CI = 1.11-1.28), respectively. Among premenopausal women, increased ovarian cancer risk was noted for overweight (RR 1.34; 95% CI = 1.03-1.75) and obesity (RR 1.51; 95% CI = 1.21-1.88). By comparison, among postmenopausal women no statistically significant association was found for overweight (RR 1.00; 95% CI 0.87-1.14) and obesity (RR1.03; 95% CI = 0.82-1.31). Increased risk was found for mucinous (RR 1.44; 95% CI = 1.03-2.01) and clear cell (RR 1.82; 95% CI = 1.11-2.99) ovarian cancer subtypes, but not for serous (RR1.12; 95% CI = 0.84-1.50;) and endometroid subtypes (RR1.24; 95% CI =0.96-1.60). CONCLUSIONS Obesity is associated with increased ovarian cancer risk. That relation is largely due to a positive association between adiposity and ovarian cancer among premenopausal but not postmenopausal women and among cases with mucinous and clear cell but not serous or endometrioid histology.
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Affiliation(s)
- Bernadette Ellwanger
- Department of Epidemiology and Preventive MedicineUniversity of RegensburgRegensburgGermany
| | - Susanne Schüler‐Toprak
- Department of Obstetrics and GynecologyUniversity Medical Center RegensburgRegensburgGermany
| | - Carmen Jochem
- Department of Epidemiology and Preventive MedicineUniversity of RegensburgRegensburgGermany
| | - Michael F. Leitzmann
- Department of Epidemiology and Preventive MedicineUniversity of RegensburgRegensburgGermany
| | - Hansjörg Baurecht
- Department of Epidemiology and Preventive MedicineUniversity of RegensburgRegensburgGermany
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7
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Manning-Geist BL, Gordhandas SB, Giri DD, Iasonos A, Zhou Q, Girshman J, O'Cearbhaill RE, Zamarin D, Lichtman SM, Sabbatini PJ, Tew WP, Li K, McDonnell AS, Aviki EM, Chi DS, Aghajanian CA, Grisham RN. Phase II study of enzalutamide in androgen receptor positive, recurrent, high- and low-grade serous ovarian cancer. Gynecol Oncol 2022; 164:12-17. [PMID: 34763937 PMCID: PMC9449573 DOI: 10.1016/j.ygyno.2021.10.087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES We sought to determine the safety and efficacy of the oral androgen receptor antagonist enzalutamide in patients with previously treated, recurrent, AR-positive (AR+) ovarian cancer. METHODS This was a single-institution phase II study of patients with AR+ ovarian cancer with measurable disease with 1-3 prior lines of chemotherapy; patients were screened for enrollment from 11/2013-7/2018. Following consent, archival tissue was evaluated for AR+. Enrolled patients received daily enzalutamide 160 mg until progression of disease or treatment discontinuation. Adverse events were graded by CTCAE v4.0. Co-primary endpoints were 6-month progression-free survival (PFS6) and overall response rate (ORR) by RECIST 1.1 criteria. RESULTS During the study period, 160 patients were screened and 59 (45 high-grade serous [HGS] and 14 low-grade serous [LGS]) consented to treatment on study. There was 1 confirmed and 1 unconfirmed partial response. The ORR was 1.7% (90% CI: 0.2-100%). The overall PFS6 rate (as binary) was 22% (90% CI: 15.1-100%). The 6-month PFS rate (as time to event) was 19.8% for HGS patients (90% CI: 12.7-100%) and 38.5% (90% CI: 21.7%-100%) for LGS patients. Grade 3 toxicities occurred in 6 patients (one toxicity (Grade 3 rash) was considered a dose-limiting toxicity). One patient died of cardiac arrest after 42 days on treatment of a cardiac arrest not attributed to study drug. CONCLUSIONS The study met its primary endpoint, with a PFS6 rate of 22% (n = 13); however, the overall response rate was low. Enzalutamide was well tolerated and may be a potential treatment option in select patients.
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Affiliation(s)
| | | | - Dilip D Giri
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alexia Iasonos
- Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Joan & Sanford I. Weill Medical College of Cornell University, New York, NY, USA
| | - Qin Zhou
- Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jeffrey Girshman
- Joan & Sanford I. Weill Medical College of Cornell University, New York, NY, USA; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Roisin E O'Cearbhaill
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Joan & Sanford I. Weill Medical College of Cornell University, New York, NY, USA
| | - Dmitriy Zamarin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Joan & Sanford I. Weill Medical College of Cornell University, New York, NY, USA
| | - Stuart M Lichtman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Joan & Sanford I. Weill Medical College of Cornell University, New York, NY, USA
| | - Paul J Sabbatini
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Joan & Sanford I. Weill Medical College of Cornell University, New York, NY, USA
| | - William P Tew
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Joan & Sanford I. Weill Medical College of Cornell University, New York, NY, USA
| | - Karen Li
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Autumn S McDonnell
- Research and Technology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Emeline M Aviki
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Joan & Sanford I. Weill Medical College of Cornell University, New York, NY, USA
| | - Dennis S Chi
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Joan & Sanford I. Weill Medical College of Cornell University, New York, NY, USA
| | - Carol A Aghajanian
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Joan & Sanford I. Weill Medical College of Cornell University, New York, NY, USA
| | - Rachel N Grisham
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Joan & Sanford I. Weill Medical College of Cornell University, New York, NY, USA.
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8
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Oh H, Saquib N, Ochs-Balcom HM, Pfeiffer RM, Richey PA, Shadyab AH, Wild RA, Underland L, Anderson GL, Xu X, Trabert B. Recreational Physical Activity, Sitting, and Androgen Metabolism among Postmenopausal Women in the Women's Health Initiative Observational Study. Cancer Epidemiol Biomarkers Prev 2021; 31:97-107. [PMID: 34663616 DOI: 10.1158/1055-9965.epi-21-0809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/17/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Prolonged sitting and physical inactivity are associated with higher circulating levels of estrogens. It is unknown whether these risk factors are associated with circulating androgens/androgen metabolites, another set of hormones implicated in the etiology of cancers in postmenopausal women. METHODS We conducted a cross-sectional analysis of 1,782 postmenopausal women in the Women's Health Initiative Observational Study. Serum concentrations of 12 androgens/androgen metabolites were quantified using liquid chromatography-tandem mass spectrometry. Physical activity and sitting time were self-reported at baseline. We performed linear regression to estimate geometric means (GM) of androgen/androgen metabolite concentrations (pmol/L) according to physical activity and sitting time, adjusting for potential confounders and stratified by menopausal hormone therapy (MHT) use. RESULTS Physical activity (≥15 vs. 0 MET-h/wk) was inversely associated with estrogen-to-androgen ratios among never/former MHT users (adj-GM = 37.5 vs. 49.6 unconjugated estrone:androstenedione; 20.2 vs. 30.3 unconjugated estradiol:testosterone; all P trend ≤ 0.03) but was not associated among current MHT users. Prolonged sitting (≥10 vs. ≤5 h/d) was positively associated with these ratios among both never/former (adj-GM = 44.2 vs. 38.3, P trend = 0.10; adj-GM = 23.4 vs. 20.2, P trend = 0.17; respectively) and current MHT users (adj-GM = 197 vs. 147; 105 vs. 75.5; respectively; all P trend ≤0.02), but the associations were statistically significant among current MHT users only. The associations persisted after adjustment for BMI. After adjustment for adrenal androgens, physical activity and sitting were not associated with androgen metabolites. CONCLUSIONS Physical activity and sitting were associated with serum estrogen-to-androgen ratios but not androgen metabolites. IMPACT This study contributes to our understanding of the link between physical activity, sitting, and cancer risk in postmenopausal women.
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Affiliation(s)
- Hannah Oh
- Interdisciplinary Program in Precision Public Health, Graduate School of Korea University, Seoul, Republic of Korea. .,Division of Health Policy and Management, College of Health Sciences, Korea University, Seoul, Republic of Korea
| | - Nazmus Saquib
- College of Medicine, Sulaiman AlRajhi University, Al Bukairiyah, Saudi Arabia
| | - Heather M Ochs-Balcom
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, New York
| | - Ruth M Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Phyllis A Richey
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California
| | - Robert A Wild
- Department of Obstetrics and Gynecology, Biostatistics and Epidemiology, Hudson College of Public Health, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma
| | - Lisa Underland
- Department of Pediatric Endocrinology and Diabetes, Children's Hospital at Montefiore, Bronx, New York
| | - Garnet L Anderson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Xia Xu
- Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
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9
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Li H, Liu Y, Wang Y, Zhao X, Qi X. Hormone therapy for ovarian cancer: Emphasis on mechanisms and applications (Review). Oncol Rep 2021; 46:223. [PMID: 34435651 PMCID: PMC8424487 DOI: 10.3892/or.2021.8174] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/04/2021] [Indexed: 02/05/2023] Open
Abstract
Ovarian cancer (OC) remains the leading cause of mortality due to gynecological malignancies. Epidemiological studies have demonstrated that steroid hormones released from the hypothalamic-pituitary-ovarian axis can play a role in stimulating or inhibiting OC progression, with gonadotropins, estrogens and androgens promoting OC progression, while gonadotropin-releasing hormone (GnRH) and progesterone may be protective factors in OC. Experimental studies have indicated that hormone receptors are expressed in OC cells and mediate the growth stimulatory or growth inhibitory effects of hormones on these cells. Hormone therapy agents have been evaluated in a number of clinical trials. The majority of these trials were conducted in patients with relapsed or refractory OC with average efficacy and limited side-effects. A better understanding of the mechanisms through which hormones affect cell growth may improve the efficacy of hormone therapy. In the present review article, the role of hormones (GnRH, gonadotropins, androgens, estrogens and progestins) and their receptors in OC tumorigenesis, and hormonal therapy in OC treatment is discussed and summarized.
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Affiliation(s)
- Hongyi Li
- Department of Gynecology and Obstetrics, Development and Related Diseases of Women and Children and Key Laboratory of Sichuan Province, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Yu Liu
- Department of Gynecology and Obstetrics, Development and Related Diseases of Women and Children and Key Laboratory of Sichuan Province, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Yang Wang
- Laboratory of Aging Research and Cancer Drug Target, State Key Laboratory of Biotherapy, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xia Zhao
- Department of Gynecology and Obstetrics, Development and Related Diseases of Women and Children and Key Laboratory of Sichuan Province, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xiaorong Qi
- Department of Gynecology and Obstetrics, Development and Related Diseases of Women and Children and Key Laboratory of Sichuan Province, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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10
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Androgen/Androgen Receptor Signaling in Ovarian Cancer: Molecular Regulation and Therapeutic Potentials. Int J Mol Sci 2021; 22:ijms22147748. [PMID: 34299364 PMCID: PMC8304547 DOI: 10.3390/ijms22147748] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/15/2021] [Accepted: 07/15/2021] [Indexed: 12/18/2022] Open
Abstract
Ovarian cancer (OVCA) arises from three cellular origins, namely surface epithelial cells, germ cells, and stromal cells. More than 85% of OVCAs are EOCs (epithelial ovarian carcinomas), which are the most lethal gynecological malignancies. Cancer stem/progenitor cells (CSPCs) are considered to be cancer promoters due to their capacity for unlimited self-renewal and drug resistance. Androgen receptor (AR) belongs to the nuclear receptor superfamily and can be activated through binding to its ligand androgens. Studies have reported an association between AR expression and EOC carcinogenesis, and AR is suggested to be involved in proliferation, migration/invasion, and stemness. In addition, alternative AR activating signals, including both ligand-dependent and ligand-independent, are involved in OVCA progression. Although some clinical trials have previously been conducted to evaluate the effects of anti-androgens in EOC, no significant results have been reported. In contrast, experimental studies evaluating the effects of anti-androgen or anti-AR reagents in AR-expressing EOC models have demonstrated positive results for suppressing disease progression. Since AR is involved in complex signaling pathways and may be expressed at various levels in OVCA, the aim of this article was to provide an overview of current studies and perspectives regarding the relevance of androgen/AR roles in OVCA.
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11
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Fallopian Tube-Derived Tumor Cells Induce Testosterone Secretion from the Ovary, Increasing Epithelial Proliferation and Invasion. Cancers (Basel) 2021; 13:cancers13081925. [PMID: 33923536 PMCID: PMC8073317 DOI: 10.3390/cancers13081925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/06/2021] [Accepted: 04/11/2021] [Indexed: 12/11/2022] Open
Abstract
The fallopian tube epithelium is the site of origin for a majority of high grade serous ovarian carcinomas (HGSOC). The chemical communication between the fallopian tube and the ovary in the development of HGSOC from the fallopian tube is of interest since the fimbriated ends in proximity of the ovary harbor serous tubal intraepithelial carcinoma (STICs). Epidemiological data indicates that androgens play a role in ovarian carcinogenesis; however, the oncogenic impact of androgen exposure on the fallopian tube, or tubal neoplastic precursor lesions, has yet to be explored. In this report, imaging mass spectrometry identified that testosterone is produced by the ovary when exposed to tumorigenic fallopian tube derived PTEN deficient cells. Androgen exposure increased cellular viability, proliferation, and invasion of murine cell models of healthy fallopian tube epithelium and PAX2 deficient models of the preneoplastic secretory cell outgrowths (SCOUTs). Proliferation and invasion induced by androgen was reversed by co-treatment with androgen receptor (AR) antagonist, bicalutamide. Furthermore, ablation of phosphorylated ERK reversed proliferation, but not invasion. Investigation of two hyperandrogenic rodent models of polycystic ovarian syndrome revealed that peripheral administration of androgens does not induce fallopian proliferation in vivo. These data suggest that tumorigenic lesions in the fallopian tube may induce an androgenic microenvironment proximal to the ovary, which may in turn promote proliferation of the fallopian tube epithelium and preneoplastic lesions.
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12
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Limaye S, Kumar P, Pragya R, Sambath J, Patil D, Srinivasan A, Apurva S, Srivastava N, Patil S, Patil R, Datta V, Akolkar D, Datar R. A case report of androgen receptor inhibitor therapy in recurrent high-grade serous ovarian cancer. Oncotarget 2020; 11:4358-4363. [PMID: 33245722 PMCID: PMC7679039 DOI: 10.18632/oncotarget.27809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/27/2020] [Indexed: 11/25/2022] Open
Abstract
Ovarian cancer is common gynaecological malignancy and a leading cause of death among women. Despite the advances in treatment strategies, majority of patients present with recurrence after first- or second-line treatment. Targeted therapy that has proven to be effective in other advanced or metastatic solid tumors have also demonstrated its efficacy in ovarian cancer. Recent studies have shown that the androgen receptor (AR) signalling is involved in pathogenicity and progression of cancer. Current observations suggest AR could be a potential target in managing the disease. In this case report we present a patient with high grade serous ovarian cancer (HGSOC) with multiple relapses with excellent disease control on AR inhibition with bicalutamide.
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Affiliation(s)
- Sewanti Limaye
- Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, India
| | - Prashant Kumar
- Datar Cancer Genetics Limited, Nasik, Maharashtra, India.,Institute of Bioinformatics, International Technology Park, Bangalore, Karnataka, India.,Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ramya Pragya
- Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, India
| | - Janani Sambath
- Institute of Bioinformatics, International Technology Park, Bangalore, Karnataka, India.,Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Darshana Patil
- Datar Cancer Genetics Limited, Nasik, Maharashtra, India
| | | | - Sachin Apurva
- Datar Cancer Genetics Limited, Nasik, Maharashtra, India
| | | | - Sanket Patil
- Datar Cancer Genetics Limited, Nasik, Maharashtra, India
| | - Revati Patil
- Datar Cancer Genetics Limited, Nasik, Maharashtra, India
| | - Vineet Datta
- Datar Cancer Genetics Limited, Nasik, Maharashtra, India
| | | | - Rajan Datar
- Datar Cancer Genetics Limited, Nasik, Maharashtra, India
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13
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Alzamil L, Nikolakopoulou K, Turco MY. Organoid systems to study the human female reproductive tract and pregnancy. Cell Death Differ 2020; 28:35-51. [PMID: 32494027 PMCID: PMC7852529 DOI: 10.1038/s41418-020-0565-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/24/2020] [Accepted: 05/15/2020] [Indexed: 12/21/2022] Open
Abstract
Both the proper functioning of the female reproductive tract (FRT) and normal placental development are essential for women’s health, wellbeing, and pregnancy outcome. The study of the FRT in humans has been challenging due to limitations in the in vitro and in vivo tools available. Recent developments in 3D organoid technology that model the different regions of the FRT include organoids of the ovaries, fallopian tubes, endometrium and cervix, as well as placental trophoblast. These models are opening up new avenues to investigate the normal biology and pathology of the FRT. In this review, we discuss the advances, potential, and limitations of organoid cultures of the human FRT. ■. ![]()
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Affiliation(s)
- Lama Alzamil
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QP, UK
| | | | - Margherita Y Turco
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QP, UK. .,Centre for Trophoblast Research, Downing Street, Cambridge, CB2 3EG, UK.
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14
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Soave I, Occhiali T, Assorgi C, Marci R, Caserta D. Environmental toxin exposure in polycystic ovary syndrome women and possible ovarian neoplastic repercussion. Curr Med Res Opin 2020; 36:693-703. [PMID: 32046531 DOI: 10.1080/03007995.2020.1729108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Purpose: Over the last two decades, increasing attention has been paid to environmental toxins and their effects on the female reproductive system. Endocrine disrupting chemicals (EDCs) are exogenous substances or mixtures that can mimic the action of steroid hormones and interfere with their metabolism. Advanced glycation end products (AGEs) are proinflammatory molecules that can interact with cell surface receptors and mediate the triggering of proinflammatory pathways and oxidative stress. The purpose of this review is to explore the effects of environmental toxin exposure in the pathogenesis of both polycystic ovary syndrome (PCOS) and OC (ovarian cancer), considered separately, and also to evaluate possible neoplastic ovarian repercussion after exposure in patients diagnosed with PCOS.Materials and methods: We searched PubMed for articles published in the English language with the use of the following MeSH search terms: "polycystic ovary syndrome" and "ovarian cancer" combined with "endocrine disruptors". Titles and abstracts were examined and full articles that met the selection criteria were retrieved. A manual search of review articles and cross-references completed the search.Results: Extensive data from different studies collected in recent years concerning the effects of EDC/AGE exposure have confirmed their role in the pathophysiology of both PCOS and OC. They favor PCOS/OC development through different mechanisms that finally lead to hormonal and metabolic disruption and epigenetic modifications.Conclusions: Environmental toxin exposure in PCOS women could favor neoplastic transformation by exacerbating and potentiating some PCOS features. Further research, although difficult, is needed in order to prevent further diffusion of these substances in the environment, or at least to provide adequate information to the population considered at risk.
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Affiliation(s)
- Ilaria Soave
- Department of Surgical and Clinical Sciences and Translational Medicine, S. Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - Tommaso Occhiali
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Italy
| | - Chiara Assorgi
- Department of Surgical and Clinical Sciences and Translational Medicine, S. Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - Roberto Marci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Italy
| | - Donatella Caserta
- Department of Surgical and Clinical Sciences and Translational Medicine, S. Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
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15
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De Roo C, Tilleman K, Vercruysse C, Declercq H, T'Sjoen G, Weyers S, De Sutter P. Texture profile analysis reveals a stiffer ovarian cortex after testosterone therapy: a pilot study. J Assist Reprod Genet 2019; 36:1837-1843. [PMID: 31327130 PMCID: PMC6730976 DOI: 10.1007/s10815-019-01513-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 06/19/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose The importance of the surrounding ovarian stromal cells and extracellular matrix in the development and maturation of follicles has recently gained attention. An aberrant extracellular matrix has been described in ovaries of patients with polycystic ovary syndrome where a more rigid structural environment, possibly induced by endogenous testosterone, impairs normal folliculogenesis. In this context, we describe the textural parameters of the ovarian cortex of transgender men after prolonged testosterone administration compared to the textural parameters of the non-exposed ovarian cortex originating from female oncological patients. Methods Texture profile analysis (TPA) was performed on ovarian cortex (5 × 5 mm) of oncological and transgender patients in order to measure stiffness, hardness, cohesiveness, and springiness of the ovarian cortex (LRXplus universal testing system). Statistical analysis was performed using repeated measurements mixed models and the Spearman rank order correlation test (IBM SPSS Statistics 23). Results A total of 36 frozen-thawed cortical strips (5 × 5 mm) were subjected to TPA. The superficial part of cortex fragments originating from transgender persons (fragments < 1.4 mm; N = 10) appeared to be significantly stiffer compared to cortex derived from oncology patients (fragments < 1.4 mm; N = 7) (6.78 ± 1.38 N/mm versus 5.41 ± 0.9 N/mm respectively, p = 0.036). Conclusions This is the first application of TPA in ovarian cortex to study the physical properties. Comparing the physical properties, we objectively describe an increased cortical stiffness in the most outer part of the ovarian cortex following prolonged testosterone administration in transgender men compared to the ovarian cortex of oncological patients. This preliminary and novel approach could be the start of future research to understand the physical properties of ovarian tissue. Electronic supplementary material The online version of this article (10.1007/s10815-019-01513-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- C De Roo
- Department of Reproductive Medicine, Ghent-Fertility and Stem Cell Team (G-FaST), Ghent University Hospital, 9000, Ghent, Belgium.
| | - K Tilleman
- Department of Reproductive Medicine, Ghent-Fertility and Stem Cell Team (G-FaST), Ghent University Hospital, 9000, Ghent, Belgium
| | - C Vercruysse
- Bio print Core Facility, Tissue Engineering and Biomaterials, Department of Basic Medical Science, Faculty of Medicine and Health Science, Ghent University, 9000, Ghent, Belgium
| | - H Declercq
- Bio print Core Facility, Tissue Engineering and Biomaterials, Department of Basic Medical Science, Faculty of Medicine and Health Science, Ghent University, 9000, Ghent, Belgium
| | - G T'Sjoen
- Department of Endocrinology and Center for Sexology and Gender, Ghent University Hospital, 9000, Ghent, Belgium
| | - S Weyers
- Department of Reproductive Medicine, Ghent-Fertility and Stem Cell Team (G-FaST), Ghent University Hospital, 9000, Ghent, Belgium
| | - P De Sutter
- Department of Reproductive Medicine, Ghent-Fertility and Stem Cell Team (G-FaST), Ghent University Hospital, 9000, Ghent, Belgium
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16
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The Role of Androgen Receptor Signaling in Ovarian Cancer. Cells 2019; 8:cells8020176. [PMID: 30791431 PMCID: PMC6406955 DOI: 10.3390/cells8020176] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/14/2019] [Accepted: 02/16/2019] [Indexed: 12/13/2022] Open
Abstract
Emerging evidence has suggested that androgen receptor signaling plays an important role in ovarian cancer outgrowth. Specifically, androgen receptor activation appears to be associated with increased risks of developing ovarian cancer and inducing tumor progression. However, conflicting findings have also been reported. This review summarizes and discusses the available data indicating the involvement of androgens as well as androgen receptor and related signals in ovarian carcinogenesis and cancer growth. Although the underlying molecular mechanisms for androgen receptor functions in ovarian cancer remain far from being fully understood, current observations may offer effective chemopreventive and therapeutic approaches, via modulation of androgen receptor activity, against ovarian cancer. Indeed, several clinical trials have been conducted to determine the efficacy of androgen deprivation therapy in patients with ovarian cancer.
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17
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Trabert B, Michels KA, Anderson GL, Brinton LA, Falk RT, Geczik AM, Harris HR, Pan K, Pfeiffer RM, Qi L, Rohan T, Wentzensen N, Xu X. Circulating androgens and postmenopausal ovarian cancer risk in the Women's Health Initiative Observational Study. Int J Cancer 2019; 145:2051-2060. [PMID: 30684389 DOI: 10.1002/ijc.32157] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/07/2018] [Accepted: 01/10/2019] [Indexed: 11/11/2022]
Abstract
Our knowledge of epidemiologic risk factors for ovarian cancer supports a role for androgens in the pathogenesis of this disease; however, few studies have examined associations between circulating androgens and ovarian cancer risk. Using highly sensitive LC-MS/MS assays, we evaluated associations between pre-diagnostic serum levels of 12 androgens, including novel androgen metabolites that reflect androgen activity in tissues, and ovarian cancer risk among postmenopausal women in a nested case-control study in the Women's Health Initiative (WHI) Observational Study (OS). We frequency-matched 169 ovarian cancer cases to 410 controls from women enrolled in WHI-OS who were not using menopausal hormones at enrollment/blood draw. We estimated associations overall and by subtype (n = 102 serous/67 non-serous) using multivariable adjusted logistic regression. Androgen/androgen metabolite levels were not associated with overall ovarian cancer risk. In analyses by subtype, women with increased levels of androsterone-glucuronide (ADT-G) and total 5-α reduced glucuronide metabolites (markers of tissue-level androgenic activity) were at increased risk of developing non-serous ovarian cancer: ADT-G tertile (T)3 versus T1 odds ratio [OR] (95% confidence interval [CI]) 4.36 (1.68-11.32), p-heterogeneity 0.002; total glucuronide metabolites 3.63 (1.47-8.95), 0.002. Risk of developing serous tumors was unrelated to these markers. ADT-G and total glucuronide metabolites, better markers of tissue-level androgenic activity in women than testosterone, were associated with an increased risk of developing non-serous ovarian cancer. Our work demonstrates that sex steroid metabolism is important in the etiology of non-serous ovarian cancers and supports a heterogeneous hormonal etiology across histologic subtypes of ovarian cancer.
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Affiliation(s)
- Britton Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Kara A Michels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Garnet L Anderson
- Division of Public Health Sciences, Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Roni T Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Ashley M Geczik
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Holly R Harris
- Division of Public Health Sciences, Epidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Kathy Pan
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Ruth M Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Lihong Qi
- Public Health Sciences, School of Medicine, UC Davis, Sacramento, CA
| | - Thomas Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.,Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Xia Xu
- Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD
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18
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The role of the androgen receptor in ovarian cancer carcinogenesis and its clinical implications. Oncotarget 2018; 8:29395-29405. [PMID: 27741511 PMCID: PMC5438739 DOI: 10.18632/oncotarget.12561] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 09/25/2016] [Indexed: 12/22/2022] Open
Abstract
Ovarian cancer is the major cause of death in women with gynecologic malignancies. There is emerging evidence that Androgen/androgen receptor (AR) signaling plays a critical role in the etiology and progression of this disease. Androgen receptor is frequently expressed in various subtypes of ovarian cancers and androgen/AR signaling has been shown to promote proliferation, migration, and invasion of ovarian cancer cells. Furthermore, shorter AR CAG repeats length and increased AR activity are associated with increased ovarian cancer risk and may be a useful prognosticator under certain circumstances. Here, we summarize current findings regarding the role of the AR in ovarian cancer and discuss agents that target this pathway as potential therapeutics for ovarian cancer.
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19
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Ose J, Poole EM, Schock H, Lehtinen M, Arslan AA, Zeleniuch-Jacquotte A, Visvanathan K, Helzlsouer K, Buring JE, Lee IM, Tjønneland A, Dossus L, Trichopoulou A, Masala G, Onland-Moret NC, Weiderpass E, Duell EJ, Idahl A, Travis RC, Rinaldi S, Merritt MA, Trabert B, Wentzensen N, Tworoger SS, Kaaks R, Fortner RT. Androgens Are Differentially Associated with Ovarian Cancer Subtypes in the Ovarian Cancer Cohort Consortium. Cancer Res 2017; 77:3951-3960. [PMID: 28381542 PMCID: PMC5512110 DOI: 10.1158/0008-5472.can-16-3322] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 02/15/2017] [Accepted: 03/31/2017] [Indexed: 12/22/2022]
Abstract
Invasive epithelial ovarian cancer (EOC) is the most lethal gynecologic malignancy. The etiology of EOC remains elusive; however, experimental and epidemiologic data suggest a role for hormone-related exposures in ovarian carcinogenesis and risk factor differences by histologic phenotypes and developmental pathways. Research on prediagnosis androgen concentrations and EOC risk has yielded inconclusive results, and analyses incorporating EOC subtypes are sparse. We conducted a pooled analysis of 7 nested case-control studies in the Ovarian Cancer Cohort Consortium to investigate the association between pre-diagnosis circulating androgens [testosterone, free testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEAS)], sex hormone binding globulin (SHBG), and EOC risk by tumor characteristics (i.e., histology, grade, and stage). The final study population included 1,331 EOC cases and 3,017 matched controls. Multivariable conditional logistic regression was used to assess risk associations in pooled individual data. Testosterone was positively associated with EOC risk (all subtypes combined, ORlog2 = 1.12; 95% confidence interval 1.02-1.24); other endogenous androgens and SHBG were not associated with overall risk. Higher concentrations of testosterone and androstenedione associated with an increased risk in endometrioid and mucinous tumors [e.g., testosterone, endometrioid tumors, ORlog2 = 1.40 (1.03-1.91)], but not serous or clear cell. An inverse association was observed between androstenedione and high grade serous tumors [ORlog2 = 0.76 (0.60-0.96)]. Our analyses provide further evidence for a role of hormone-related pathways in EOC risk, with differences in associations between androgens and histologic subtypes of EOC. Cancer Res; 77(14); 3951-60. ©2017 AACR.
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Affiliation(s)
- Jennifer Ose
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Baden-Württemberg, Germany
- Department of Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Elizabeth M Poole
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Helena Schock
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Baden-Württemberg, Germany
| | - Matti Lehtinen
- Karolinska Institutet, Department of Laboratory Medicine, Huddinge, Sweden
| | - Alan A Arslan
- Department of Obstetrics and Gynecology, New York University School of Medicine; Perlmutter Cancer Center, New York University, New York, New York
- Department of Population Health and Environmental Medicine, New York University School of Medicine; Perlmutter Cancer Center, New York University, New York, New York
| | - Anne Zeleniuch-Jacquotte
- Department of Population Health and Environmental Medicine, New York University School of Medicine; Perlmutter Cancer Center, New York University, New York, New York
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kathy Helzlsouer
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - I-Min Lee
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Anne Tjønneland
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Laure Dossus
- INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, Villejuif, France
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Giovanna Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - N Charlotte Onland-Moret
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Eric J Duell
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Annika Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umea University, Umea, Sweden
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Sabina Rinaldi
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France
| | - Melissa A Merritt
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Shelley S Tworoger
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Baden-Württemberg, Germany
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Baden-Württemberg, Germany.
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20
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Siddiqui M, Ahmad MS, Wahab AT, Yousuf S, Fatima N, Naveed Shaikh N, Rahman AU, Choudhary MI. Biotransformation of a potent anabolic steroid, mibolerone, with Cunninghamella blakesleeana, C. echinulata, and Macrophomina phaseolina, and biological activity evaluation of its metabolites. PLoS One 2017; 12:e0171476. [PMID: 28234904 PMCID: PMC5325191 DOI: 10.1371/journal.pone.0171476] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/20/2017] [Indexed: 01/31/2023] Open
Abstract
Seven metabolites were obtained from the microbial transformation of anabolic-androgenic steroid mibolerone (1) with Cunninghamella blakesleeana, C. echinulata, and Macrophomina phaseolina. Their structures were determined as 10β,17β-dihydroxy-7α,17α-dimethylestr-4-en-3-one (2), 6β,17β-dihydroxy-7α,17α-dimethylestr-4-en-3-one (3), 6β,10β,17β-trihydroxy-7α,17α-dimethylestr-4-en-3-one (4), 11β,17β-dihydroxy-(20-hydroxymethyl)-7α,17α-dimethylestr-4-en-3-one (5), 1α,17β-dihydroxy-7α,17α-dimethylestr-4-en-3-one (6), 1α,11β,17β-trihydroxy-7α,17α-dimethylestr-4-en-3-one (7), and 11β,17β-dihydroxy-7α,17α-dimethylestr-4-en-3-one (8), on the basis of spectroscopic studies. All metabolites, except 8, were identified as new compounds. This study indicates that C. blakesleeana, and C. echinulata are able to catalyze hydroxylation at allylic positions, while M. phaseolina can catalyze hydroxylation of CH2 and CH3 groups of substrate 1. Mibolerone (1) was found to be a moderate inhibitor of β-glucuronidase enzyme (IC50 = 42.98 ± 1.24 μM) during random biological screening, while its metabolites 2–4, and 8 were found to be inactive. Mibolerone (1) was also found to be significantly active against Leishmania major promastigotes (IC50 = 29.64 ± 0.88 μM). Its transformed products 3 (IC50 = 79.09 ± 0.06 μM), and 8 (IC50 = 70.09 ± 0.05 μM) showed a weak leishmanicidal activity, while 2 and 4 were found to be inactive. In addition, substrate 1 (IC50 = 35.7 ± 4.46 μM), and its metabolite 8 (IC50 = 34.16 ± 5.3 μM) exhibited potent cytotoxicity against HeLa cancer cell line (human cervical carcinoma). Metabolite 2 (IC50 = 46.5 ± 5.4 μM) also showed a significant cytotoxicity, while 3 (IC50 = 107.8 ± 4.0 μM) and 4 (IC50 = 152.5 ± 2.15 μM) showed weak cytotoxicity against HeLa cancer cell line. Compound 1 (IC50 = 46.3 ± 11.7 μM), and its transformed products 2 (IC50 = 43.3 ± 7.7 μM), 3 (IC50 = 65.6 ± 2.5 μM), and 4 (IC50 = 89.4 ± 2.7 μM) were also found to be moderately toxic to 3T3 cell line (mouse fibroblast). Interestingly, metabolite 8 showed no cytotoxicity against 3T3 cell line. Compounds 1–4, and 8 were also evaluated for inhibition of tyrosinase, carbonic anhydrase, and α-glucosidase enzymes, and all were found to be inactive.
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Affiliation(s)
- Mahwish Siddiqui
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Malik Shoaib Ahmad
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Atia-tul- Wahab
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Sammer Yousuf
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Narjis Fatima
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Nimra Naveed Shaikh
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Atta-ur- Rahman
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - M. Iqbal Choudhary
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
- * E-mail:
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AR-Signaling in Human Malignancies: Prostate Cancer and Beyond. Cancers (Basel) 2017; 9:cancers9010007. [PMID: 28085048 PMCID: PMC5295778 DOI: 10.3390/cancers9010007] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/04/2017] [Accepted: 01/05/2017] [Indexed: 12/11/2022] Open
Abstract
In the 1940s Charles Huggins reported remarkable palliative benefits following surgical castration in men with advanced prostate cancer, and since then the androgen receptor (AR) has remained the main therapeutic target in this disease. Over the past couple of decades, our understanding of AR-signaling biology has dramatically improved, and it has become apparent that the AR can modulate a number of other well-described oncogenic signaling pathways. Not surprisingly, mounting preclinical and epidemiologic data now supports a role for AR-signaling in promoting the growth and progression of several cancers other than prostate, and early phase clinical trials have documented preliminary signs of efficacy when AR-signaling inhibitors are used in several of these malignancies. In this article, we provide an overview of the evidence supporting the use of AR-directed therapies in prostate as well as other cancers, with an emphasis on the rationale for targeting AR-signaling across tumor types.
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22
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Thomsen LH, Schnack TH, Buchardi K, Hummelshoj L, Missmer SA, Forman A, Blaakaer J. Risk factors of epithelial ovarian carcinomas among women with endometriosis: a systematic review. Acta Obstet Gynecol Scand 2016; 96:761-778. [DOI: 10.1111/aogs.13010] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 08/23/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Line H. Thomsen
- Department of Gynecology and Obstetrics; Aarhus University Hospital; Aarhus Denmark
| | - Tine H. Schnack
- Gynecologic and Obstetric Department; Rigshospitalet University Hospital of Copenhagen; Copenhagen Denmark
| | | | | | - Stacey A. Missmer
- Department of Obstetrics; Gynecology and Reproductive Biology College of Human Medicine; Michigan State University; Boston MA USA
- Department of Epidemiology; Harvard T.H. Chan School of Public Health; Boston MA USA
| | - Axel Forman
- Department of Gynecology and Obstetrics; Aarhus University Hospital; Aarhus Denmark
| | - Jan Blaakaer
- Department of Gynecology and Obstetrics; Aarhus University Hospital; Aarhus Denmark
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Wu X, Zhan Y, Li X, Wei J, Santiago L, Daniels G, Deng F, Zhong X, Chiriboga L, Basch R, Xiong S, Dong Y, Zhang X, Lee P. Nuclear TBLR1 as an ER corepressor promotes cell proliferation, migration and invasion in breast and ovarian cancer. Am J Cancer Res 2016; 6:2351-2360. [PMID: 27822424 PMCID: PMC5088298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/06/2016] [Indexed: 06/06/2023] Open
Abstract
Estrogen receptors (ER) play important roles in the development and progression of breast and ovarian cancers. ERs mediate transcriptional regulation through interaction with cofactors and binding to response elements within the regulatory elements of target genes. Here, we examined the expression and function of TBLR1/TBL1XR1, a core component of NCoR (nuclear receptor corepressor) and SMRT (silencing mediator of retinoic acid and thyroid receptor) corepressor complexes, in breast and ovarian cancers. We found that although TBLR1 is present in both the nucleus and cytoplasm of normal and neoplastic breast and ovarian cells, it is expressed at significantly higher levels in the nucleus of malignant breast and ovarian cells compared to benign cells. TBLR1 functions as an ER corepressor to inhibit ER-mediated transcriptional activation in both breast and ovarian cell lines, but it has no effect on androgen receptor (AR) mediated transcriptional activation in these cells. Furthermore, ectopic expression of nuclear TBLR1 in breast and ovarian cancer cells stimulates cell proliferation. The increased cell proliferation by nuclear TBLR1 is through both ER-independent and ER-dependent mechanisms as evidenced by increased growth in hormone-free medium and estrogen medium, as well as reduced growth with ER knockdown by siRNA. Nuclear TBLR1 overexpression also increased migration and invasion in both breast and ovarian cancer cells. Determining the functional relationship between TBLR1 and ER may provide insights to develop novel treatment strategies and improve response to hormonal therapy in breast and ovarian cancers.
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Affiliation(s)
- Xinyu Wu
- Department of Pathology, New York University School of MedicineNew York, NY
| | - Yang Zhan
- Structural & Cellular Biology, Tulane University School of MedicineNew Orleans, LA
| | - Xin Li
- Basic Science and Craniofacial Biology, New York University College of DentistryNew York, NY
- Department of Urology, New York University School of MedicineNew York, NY
- Department of NYU Cancer Institute, New York University School of MedicineNew York, NY
| | - Jianjun Wei
- Department of Pathology, Northwestern School of MedicineChicago, IL
| | - Larion Santiago
- Department of Pathology, New York University School of MedicineNew York, NY
| | - Garrett Daniels
- Department of Pathology, New York University School of MedicineNew York, NY
| | - Fangming Deng
- Department of Pathology, New York University School of MedicineNew York, NY
| | - Xuelin Zhong
- Department of Pathology, New York University School of MedicineNew York, NY
| | - Luis Chiriboga
- Department of Pathology, New York University School of MedicineNew York, NY
| | - Ross Basch
- Department of Pathology, New York University School of MedicineNew York, NY
| | - Sheng Xiong
- Department of Pathology, New York University School of MedicineNew York, NY
| | - Yan Dong
- Structural & Cellular Biology, Tulane University School of MedicineNew Orleans, LA
| | - Xinmin Zhang
- Department of Pathology, Hofstra North Shore-LIJ School of MedicineHempstead, New York, NY
| | - Peng Lee
- Department of Pathology, New York University School of MedicineNew York, NY
- Department of Urology, New York University School of MedicineNew York, NY
- Department of NYU Cancer Institute, New York University School of MedicineNew York, NY
- Department of New York Harbor Healthcare System, New York University School of MedicineNew York, NY
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24
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Gharwan H, Bunch KP, Annunziata CM. The role of reproductive hormones in epithelial ovarian carcinogenesis. Endocr Relat Cancer 2015; 22:R339-63. [PMID: 26373571 DOI: 10.1530/erc-14-0550] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/15/2015] [Indexed: 12/12/2022]
Abstract
Epithelial ovarian cancer comprises ∼85% of all ovarian cancer cases. Despite acceptance regarding the influence of reproductive hormones on ovarian cancer risk and considerable advances in the understanding of epithelial ovarian carcinogenesis on a molecular level, complete understanding of the biologic processes underlying malignant transformation of ovarian surface epithelium is lacking. Various hypotheses have been proposed over the past several decades to explain the etiology of the disease. The role of reproductive hormones in epithelial ovarian carcinogenesis remains a key topic of research. Primary questions in the field of ovarian cancer biology center on its developmental cell of origin, the positive and negative effects of each class of hormones on ovarian cancer initiation and progression, and the role of the immune system in the ovarian cancer microenvironment. The development of the female reproductive tract is dictated by the hormonal milieu during embryogenesis. Intensive research efforts have revealed that ovarian cancer is a heterogenous disease that may develop from multiple extra-ovarian tissues, including both Müllerian (fallopian tubes, endometrium) and non-Müllerian structures (gastrointestinal tissue), contributing to its heterogeneity and distinct histologic subtypes. The mechanism underlying ovarian localization, however, remains unclear. Here, we discuss the role of reproductive hormones in influencing the immune system and tipping the balance against or in favor of developing ovarian cancer. We comment on animal models that are critical for experimentally validating existing hypotheses in key areas of endocrine research and useful for preclinical drug development. Finally, we address emerging therapeutic trends directed against ovarian cancer.
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Affiliation(s)
- Helen Gharwan
- National Cancer InstituteNational Institutes of Health, 10 Center Drive, Building 10, 12N226, Bethesda, Maryland 20892-1906, USAWomen's Malignancies BranchNational Cancer Institute, National Institutes of Health, Center for Cancer Research, Bethesda, Maryland, USADepartment of Gynecologic OncologyWalter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Kristen P Bunch
- National Cancer InstituteNational Institutes of Health, 10 Center Drive, Building 10, 12N226, Bethesda, Maryland 20892-1906, USAWomen's Malignancies BranchNational Cancer Institute, National Institutes of Health, Center for Cancer Research, Bethesda, Maryland, USADepartment of Gynecologic OncologyWalter Reed National Military Medical Center, Bethesda, Maryland, USA National Cancer InstituteNational Institutes of Health, 10 Center Drive, Building 10, 12N226, Bethesda, Maryland 20892-1906, USAWomen's Malignancies BranchNational Cancer Institute, National Institutes of Health, Center for Cancer Research, Bethesda, Maryland, USADepartment of Gynecologic OncologyWalter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Christina M Annunziata
- National Cancer InstituteNational Institutes of Health, 10 Center Drive, Building 10, 12N226, Bethesda, Maryland 20892-1906, USAWomen's Malignancies BranchNational Cancer Institute, National Institutes of Health, Center for Cancer Research, Bethesda, Maryland, USADepartment of Gynecologic OncologyWalter Reed National Military Medical Center, Bethesda, Maryland, USA
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25
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Sun T, Plutynski A, Ward S, Rubin JB. An integrative view on sex differences in brain tumors. Cell Mol Life Sci 2015; 72:3323-42. [PMID: 25985759 PMCID: PMC4531141 DOI: 10.1007/s00018-015-1930-2] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 04/27/2015] [Accepted: 05/11/2015] [Indexed: 02/07/2023]
Abstract
Sex differences in human health and disease can range from undetectable to profound. Differences in brain tumor rates and outcome are evident in males and females throughout the world and regardless of age. These observations indicate that fundamental aspects of sex determination can impact the biology of brain tumors. It is likely that optimal personalized approaches to the treatment of male and female brain tumor patients will require recognizing and understanding the ways in which the biology of their tumors can differ. It is our view that sex-specific approaches to brain tumor screening and care will be enhanced by rigorously documenting differences in brain tumor rates and outcomes in males and females, and understanding the developmental and evolutionary origins of sex differences. Here we offer such an integrative perspective on brain tumors. It is our intent to encourage the consideration of sex differences in clinical and basic scientific investigations.
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Affiliation(s)
- Tao Sun
- />Department of Pediatrics, Washington University School of Medicine, St Louis, USA
| | - Anya Plutynski
- />Department of Philosophy, Washington University in St Louis, St Louis, USA
| | - Stacey Ward
- />Department of Pediatrics, Washington University School of Medicine, St Louis, USA
| | - Joshua B. Rubin
- />Department of Pediatrics, Washington University School of Medicine, St Louis, USA
- />Department of Anatomy and Neurobiology, Washington University School of Medicine, 660 South Euclid Ave, St Louis, MO 63110 USA
- />Campus Box 8208, 660 South Euclid Ave, St Louis, MO 63110 USA
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26
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Cho D, Park H, Park SH, Kim K, Chung M, Moon W, Kang M, Jang K. The expression of DBC1/CCAR2 is associated with poor prognosis of ovarian carcinoma. J Ovarian Res 2015; 8:2. [PMID: 25823848 PMCID: PMC4335761 DOI: 10.1186/s13048-015-0129-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 01/31/2015] [Indexed: 01/05/2023] Open
Abstract
Background Recent reports have shown that deleted in breast cancer 1 (DBC1/CCAR2) is an indicator of poor prognosis of various human cancers. However, its expression in ovarian carcinoma has not been reported. Methods We investigated the immunohistochemical expression of DBC1 and BRCA1 and their prognostic significance in 104 ovarian carcinomas. Survival analyses were performed according to the Kaplan-Meier method, as well as univariate and multivariate Cox proportional hazard regression analysis. Results Positive expression of DBC1 and BRCA1 were seen in 63% (66/104) and 44% (46/104) of overall ovarian carcinomas, respectively. DBC1 expression was significantly associated with advanced clinicopathological factors such as high tumor stage, latent distant metastasis, platinum-resistance, elevated serum levels of CA125, high histologic grade, and BRCA1 expression. In the histological subtypes of ovarian carcinomas, DBC1 expression was more common in serous carcinoma (72%, 54/75) than mucinous carcinoma (15%, 3/20). BRCA1 expression was significantly associated with latent distant metastasis, platinum-resistance, and higher histologic grade. In addition, DBC1 expression was significantly associated with shorter overall survival (OS) and relapse-free survival (RFS) in 104 ovarian carcinomas (OS; P < 0.001, RFS; P < 0.001) and 63 high-grade serous carcinomas (OS; P = 0.008, RFS; P = 0.023) by univariate analysis. BRCA1 expression was significantly associated with OS and RFS in 104 ovarian carcinomas (OS; P = 0.005, RFS; P = 0.002) and 75 serous carcinomas (OS; P = 0.047, RFS; P = 0.038) by univariate analysis. Moreover, DBC1 expression was an independent prognostic indicator for OS in both 104 ovarian carcinomas (P = 0.021) and 63 high-grade serous carcinomas (P = 0.011) by multivariate analysis. Conclusions These results indicate that the expression of DBC1 and BRCA1 are closely related with in the progression of ovarian carcinomas and may have clinical utility in the prediction of prognosis of ovarian carcinomas. Especially, DBC1 expression could be employed as a significant prognostic indicator for ovarian carcinomas especially in high-grade serous carcinomas.
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27
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Gruessner C, Gruessner A, Glaser K, AbuShahin N, Zhou Y, Laughren C, Wright H, Pinkerton S, Yi X, Stoffer J, Azodi M, Zheng W, Chambers SK. Flutamide and biomarkers in women at high risk for ovarian cancer: preclinical and clinical evidence. Cancer Prev Res (Phila) 2014; 7:896-905. [PMID: 24950779 PMCID: PMC4154987 DOI: 10.1158/1940-6207.capr-13-0408] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We hypothesized that (i) preclinical biologic evidence exists for the role of androgens in ovarian cancer development and (ii) flutamide treatment of women at high risk for ovarian cancer may identify meaningful tissue biomarkers of androgen action and of ovarian cancer initiation. We showed that androgen ablation of male mice led to a 24-fold decrease in tumor burden from serous ovarian cells. In a phase II study, we studied the effect of preoperative flutamide treatment (125 mg/day × 6 weeks) in 12 women versus 47 controls, 47% with BRCA mutation. We analyzed immunohistochemical scores of candidate proteins CSF-1, CSF-1R, and ErbB4 in the epithelium and stroma of fallopian tube, ovary, and ovarian endosalpingiosis. Flutamide decreased the levels, notably, of CSF-1 and ErbB4 in ovarian stroma (P ≤ 0.0006) and ovarian endosalpingiosis (P ≤ 0.01), ErbB4 in ovarian epithelium (P = 0.006), and CSF-1R in ovarian endosalpingiosis (P = 0.009). Our logistic regression model clearly distinguished the flutamide patients from controls (P ≤ 0.0001). Our analysis of the precision of this model of CSF-1 and ErbB4 expression in ovarian stroma achieved 100% sensitivity and 97% specificity (AUC = 0.99). Thus, our data suggest that a short 6-week exposure of flutamide reversed elevated levels of CSF-1 and ErbB4 (both of which we had previously found correlated with high risk status). CSF-1 and ErbB4 in ovarian stroma led to a model with high predictive value for flutamide sensitivity. The effect of flutamide on marker expression in ovarian endosalpingiosis, previously associated with BRCA carrier status, suggests that ovarian endosalpingiosis may be a latent precursor to pelvic serous cancers.
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Affiliation(s)
- Christine Gruessner
- College of Medicine, University of Arizona, Tucson, Arizona. Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Angelika Gruessner
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Katherine Glaser
- College of Medicine, University of Arizona, Tucson, Arizona. Department of Obstetrics and Gynecology, University of Arizona, Tucson, Arizona
| | | | - Yi Zhou
- University of Arizona Cancer Center, Tucson, Arizona
| | | | | | | | - Xiaofang Yi
- University of Arizona Cancer Center, Tucson, Arizona
| | | | - Masoud Azodi
- Department of Obstetrics and Gynecology, Yale University, New Haven, Connecticut
| | - Wenxin Zheng
- College of Medicine, University of Arizona, Tucson, Arizona. University of Arizona Cancer Center, Tucson, Arizona. Department of Pathology, University of Arizona, Tucson, Arizona
| | - Setsuko K Chambers
- College of Medicine, University of Arizona, Tucson, Arizona. Department of Obstetrics and Gynecology, University of Arizona, Tucson, Arizona. University of Arizona Cancer Center, Tucson, Arizona.
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28
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Gibson DA, Simitsidellis I, Collins F, Saunders PTK. Evidence of androgen action in endometrial and ovarian cancers. Endocr Relat Cancer 2014; 21:T203-18. [PMID: 24623742 DOI: 10.1530/erc-13-0551] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Endometrial cancer (EC) and ovarian cancer are common gynaecological malignancies. The impact of androgen action in these cancers is poorly understood; however, there is emerging evidence to suggest that targeting androgen signalling may be of therapeutic benefit. Epidemiological evidence suggests that there is an increased risk of EC associated with exposure to elevated levels of androgens, and genetic variants in genes related to both androgen biosynthesis and action are associated with an increased risk of both EC and ovarian cancer. Androgen receptors (ARs) may be a potential therapeutic target in EC due to reported anti-proliferative activities of androgens. By contrast, androgens may promote growth of some ovarian cancers and anti-androgen therapy has been proposed. Introduction of new therapies targeting ARs expressed in EC or ovarian cancer will require a much greater understanding of the impacts of cell context-specific AR-dependent signalling and how ARs can crosstalk with other steroid receptors during progression of disease. This review considers the evidence that androgens may be important in the aetiology of EC and ovarian cancer with discussion of evidence for androgen action in normal and malignant endometrial and ovarian tissue.
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Affiliation(s)
- Douglas A Gibson
- MRC Centre for Reproductive HealthThe University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Ioannis Simitsidellis
- MRC Centre for Reproductive HealthThe University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Frances Collins
- MRC Centre for Reproductive HealthThe University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Philippa T K Saunders
- MRC Centre for Reproductive HealthThe University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
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29
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Schock H, Surcel HM, Zeleniuch-Jacquotte A, Grankvist K, Lakso HÅ, Fortner RT, Kaaks R, Pukkala E, Lehtinen M, Toniolo P, Lundin E. Early pregnancy sex steroids and maternal risk of epithelial ovarian cancer. Endocr Relat Cancer 2014; 21:831-44. [PMID: 25270324 PMCID: PMC4282682 DOI: 10.1530/erc-14-0282] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Well-established associations between reproductive characteristics and epithelial ovarian cancer (EOC) support an involvement of sex steroid hormones in the etiology of EOC. Limited previous studies have evaluated circulating androgens and the risk of EOC, and estrogens and progesterone have been investigated in only one of the previous studies. Furthermore, there is little data on potential heterogeneity in the association between circulating hormones and EOC by histological subgroup. Therefore, we conducted a nested case-control study within the Finnish Maternity Cohort and the Northern Sweden Maternity Cohort to investigate the associations between circulating pre-diagnostic sex steroid concentrations and the histological subtypes of EOC. We identified 1052 EOC cases among cohort members diagnosed after recruitment (1975-2008) and before March 2011. Up to three controls were individually matched to each case (n=2694). Testosterone, androstenedione, 17-hydroxyprogesterone (17-OHP), progesterone, estradiol (E2), and sex hormone-binding globulin levels were measured in serum samples collected during the last pregnancy before EOC diagnosis. We used conditional logistic regression to estimate odds ratios (ORs) and 95% CIs. Associations between hormones and EOC differed with respect to tumor histology and invasiveness. Sex steroid concentrations were not associated with invasive serous tumors; however, doubling of testosterone and 17-OHP concentration was associated with approximately 40% increased risk of borderline serous tumors. A doubling of androgen concentrations was associated with a 50% increased risk of mucinous tumors. The risk of endometrioid tumors increased with higher E2 concentrations (OR: 1.89 (1.20-2.98)). This large prospective study in pregnant women supports a role of sex steroid hormones in the etiology of EOC arising in the ovaries.
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MESH Headings
- Adenocarcinoma, Clear Cell/blood
- Adenocarcinoma, Clear Cell/diagnosis
- Adenocarcinoma, Clear Cell/etiology
- Adenocarcinoma, Mucinous/blood
- Adenocarcinoma, Mucinous/diagnosis
- Adenocarcinoma, Mucinous/etiology
- Adolescent
- Adult
- Biomarkers, Tumor/blood
- Case-Control Studies
- Cystadenocarcinoma, Serous/blood
- Cystadenocarcinoma, Serous/diagnosis
- Cystadenocarcinoma, Serous/etiology
- Endometrial Neoplasms/blood
- Endometrial Neoplasms/diagnosis
- Endometrial Neoplasms/etiology
- Female
- Follow-Up Studies
- Gonadal Steroid Hormones/adverse effects
- Gonadal Steroid Hormones/blood
- Humans
- Middle Aged
- Neoplasm Invasiveness
- Neoplasm Staging
- Ovarian Neoplasms/blood
- Ovarian Neoplasms/diagnosis
- Ovarian Neoplasms/etiology
- Pregnancy
- Prognosis
- Prospective Studies
- Young Adult
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Affiliation(s)
- Helena Schock
- Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden
| | - Heljä-Marja Surcel
- Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden
| | - Anne Zeleniuch-Jacquotte
- Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden
| | - Kjell Grankvist
- Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden
| | - Hans-Åke Lakso
- Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden
| | - Renée Turzanski Fortner
- Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden
| | - Rudolf Kaaks
- Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden
| | - Eero Pukkala
- Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden
| | - Matti Lehtinen
- Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden
| | - Paolo Toniolo
- Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer
| | - Eva Lundin
- Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden Division of Cancer EpidemiologyGerman Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg 69120, GermanyDepartment of Medical BiosciencesUmeå University, Umeå, SwedenUnit of Sexual and Reproductive HealthNational Institute for Health and Welfare, Oulu, FinlandDepartments of Population Health and Environmental MedicineNew York University School of Medicine, New York, New York, USANew York University Cancer InstituteNew York University School of Medicine, New York, New York, USAFinnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer Research, Helsinki, FinlandSchool of Health SciencesUniversity of Tampere, Tampere, FinlandDepartment of Obstetrics and GynecologyNew York University School of Medicine, New York, New York, USAInstitute of Social and Preventive MedicineCentre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPublic Health and Clinical Medicine: Nutritional ResearchUmeå University, Umeå, Sweden
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Mendez C, Morales-Vasquez F, Perez-Montiel D, Gomora MJ, Espinola-Zetina C, Hernandez-Martinez A, Lopez-Basave H, Pedernera E. Estrogen and androgen receptor expression in surface epithelium and inclusion cyst in the ovary of premenopausal and postmenopausal women. J Ovarian Res 2013; 6:85. [PMID: 24279585 PMCID: PMC4176294 DOI: 10.1186/1757-2215-6-85] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 11/23/2013] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The importance of surface epithelium and epithelial inclusion cysts in the ovary arises from studies demonstrating that these structures are susceptible to epithelial ovarian cancer development. The expression of estrogen receptor alpha (ER alpha), androgen receptor (AR), in epithelial cells of the ovary from premenopausal and postmenopausal women is interesting because sexual steroid hormones are involved in cell growth and differentiation. METHODS The presence of ER alpha, AR, and the orphan G protein-coupled receptor 30 (GPR30) was demonstrated by immunofluorescence in ovaries obtained from 79 pre and postmenopausal patients, undergoing histero-salpingo-oophorectomy for proliferative gynecological diseases. The proportion of patients that displayed positive reaction for estrogen and androgen receptors in epithelial cells of the ovary was evaluated according to menopausal status and associated pathology. RESULTS The proportion of patients that displayed a positive receptor expression in the epithelial cells of the ovarian surface and cortical inclusion cysts shows that ER alpha is present in 20 of 79 patients (0.25), AR in 33 of 79 (0.42) and GPR30 in 38 of 55 (0.69). There are no differences in ER alpha, AR, and GPR30 expression between pre and postmenopausal patients and considering the associated pathology, proportions for ER alpha and GPR30 are similar. The patients with cervical cancer show a higher proportion of AR expression in epithelial cells of the ovary, which is statistically significant (P < 0.01) compared with patients with other proliferative diseases. CONCLUSIONS The presence of ER alpha, AR, and GPR30 in the surface epithelial ovarian cells and its derivatives are observed with a proportion that is specific for each receptor. The proportion of expression for these receptors in the epithelial cells of the ovary does not change after menopause. The proportion of ovaries with AR positive epithelial cells in patients with cervical squamous carcinoma is higher compared with other gynecological pathologies.
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Affiliation(s)
- Carmen Mendez
- Departamento de Embriologia, Facultad de Medicina, Universidad Nacional Autonoma de Mexico, Ciudad Universitaria, 04510, Mexico, DF, Mexico
| | - Flavia Morales-Vasquez
- FMV Departamento de Oncologia Medica, Instituto Nacional de Cancerologia, DPM Departamento de Anatomia Patologica, HLB Departamento de Cirugia Oncologica, Mexico, DF, Mexico
| | - Delia Perez-Montiel
- FMV Departamento de Oncologia Medica, Instituto Nacional de Cancerologia, DPM Departamento de Anatomia Patologica, HLB Departamento de Cirugia Oncologica, Mexico, DF, Mexico
| | - Maria J Gomora
- Departamento de Embriologia, Facultad de Medicina, Universidad Nacional Autonoma de Mexico, Ciudad Universitaria, 04510, Mexico, DF, Mexico
| | - Clementina Espinola-Zetina
- Hospital Militar de Especialidades de la Mujer y Neonatologia. Secretaria de la Defensa Nacional, Mexico, DF, Mexico
| | - Azucena Hernandez-Martinez
- Hospital Militar de Especialidades de la Mujer y Neonatologia. Secretaria de la Defensa Nacional, Mexico, DF, Mexico
| | - Horacio Lopez-Basave
- FMV Departamento de Oncologia Medica, Instituto Nacional de Cancerologia, DPM Departamento de Anatomia Patologica, HLB Departamento de Cirugia Oncologica, Mexico, DF, Mexico
| | - Enrique Pedernera
- Departamento de Embriologia, Facultad de Medicina, Universidad Nacional Autonoma de Mexico, Ciudad Universitaria, 04510, Mexico, DF, Mexico
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Wieciech I, Durlej-Grzesiak M, Słomczyńska M. Influence of the antiandrogen flutamide on the androgen receptor gene expression in the placenta and umbilical cord during pregnancy in the pig. Acta Histochem 2013; 115:290-5. [PMID: 22951468 DOI: 10.1016/j.acthis.2012.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 08/06/2012] [Accepted: 08/07/2012] [Indexed: 10/27/2022]
Abstract
The aim of this study was to determine the immunolocalization and expression of the androgen receptor (AR) in the pig placenta and umbilical cord during pregnancy following exposure to flutamide, a non-steroidal antiandrogen, at its various stages. Pregnant pigs were injected with flutamide at a daily dose of 50mg/kg body weight at different stages of pregnancy: from day 83-89 (n=2); from day 101-107 (n=2). They were sacrificed and tissues collected one day after the last injection. Control animals, two for each experimental point, were injected only with the vehicle (corn oil). Collected tissue samples were fixed for immunohistochemistry or frozen for protein isolation. AR protein was detected in the nucleus of trophoblast cells forming the structure of ridges and in maternal endothelial cells, which are involved in the placental barrier formation. It was also localized in the nuclei of cells forming umbilical cord components: allantoic duct epithelium, amniotic epithelium, Wharton's jelly and the muscular layer of the umbilical cord vein and arteries. Relative optical density analysis showed increased expression in the material derived from animals treated with flutamide. The presence of AR in the placental barrier and in the umbilical cord components suggests a role of androgen in those temporary organs. Flutamide could impact on the levels of the AR protein in the reproductive tracts during pregnancy in sows.
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Schüler S, Ponnath M, Engel J, Ortmann O. Ovarian epithelial tumors and reproductive factors: a systematic review. Arch Gynecol Obstet 2013; 287:1187-204. [PMID: 23503972 DOI: 10.1007/s00404-013-2784-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 02/28/2013] [Indexed: 12/11/2022]
Abstract
PURPOSE The aim of this systematic review is to summarize the current knowledge about the etiology and pathogenesis of borderline tumors ovarian cancer with special emphasis on the role of endocrine treatments and reproductive factors to establish a foundation for future studies. METHODS We performed a systematic review on the relation between ovarian epithelial tumors (OET) and reproductive factors using the keywords: ovarian cancer, ovarian tumor, ovarian borderline tumor, age at menarche, age at menopause, parity, infertility, PCO syndrome, oral contraception, menopausal hormone therapy, fertility treatment. Totally, 3,290 abstracts were scanned for their relevance in this publication and 127 were finally included. RESULTS The incidence of ovarian epithelial cancer and ovarian borderline tumors is influenced by certain reproductive factors. The strongest protective effects are conferred by parity and use of oral contraceptive pills. Recent molecular biologic and histopathologic studies prove that OET represent a diverse group of tumors, each histologic type with a different genetic background. This is at least partly reflected in epidemiologic and clinical studies showing different risk modulating effects of reproductive factors and endocrine therapies on OET. CONCLUSIONS The etiology and pathogenesis of ovarian cancer are still not fully understood. None of the so far proposed hypothesis on the development of OET can fully account for the epidemiologic and clinical findings in the context of reproductive factors and OET development. Further research approaches are warranted and need to put more weight on the clinical and genetical diversity of OET to yield a more detailed insight into their pathogenesis.
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Affiliation(s)
- Susanne Schüler
- Department of Obstetrics and Gynecology, University of Regensburg, Caritas-Hospital St. Josef, Landshuter Straße 65, 93053 Regensburg, Germany.
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Gong TT, Wu QJ, Vogtmann E, Lin B, Wang YL. Age at menarche and risk of ovarian cancer: a meta-analysis of epidemiological studies. Int J Cancer 2012; 132:2894-900. [PMID: 23175139 DOI: 10.1002/ijc.27952] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 11/08/2012] [Indexed: 01/22/2023]
Abstract
Epidemiological studies have reported inconsistent associations between menarcheal age and ovarian cancer risk. To our knowledge, a meta-analysis for the association between menarcheal age and ovarian cancer has not been reported. Relevant published studies of menarcheal age and ovarian cancer were identified using MEDLINE, EMBASE and Web of Science through the end of April 2012. Two authors (T-T.G. and Q-J.W.) independently assessed eligibility and extracted data. We pooled the relative risks (RRs) from individual studies using a random-effects model and performed heterogeneity and publication bias analyses. A total of 27 observational studies consisting of 22 case-control and five cohort studies were included in our analysis. In a pooled analysis of all studies, a statistically significant inverse association was observed between menarcheal age (for the oldest compared to the youngest category) and ovarian cancer risk (RR = 0.85; 95% confidence interval [CI] = 0.75-0.97). The pooled RRs of ovarian cancer for the oldest versus the youngest categories of menarcheal age in prospective and case-control studies were 0.89 (95% CI = 0.76-1.03) and 0.84 (95% CI = 0.70-0.99), respectively. Inverse associations between menarcheal age and ovarian cancer risk were observed in most subgroups; however, the significant association was restricted to invasive and borderline serous ovarian cancer. In conclusion, findings from this meta-analysis support that menarcheal age was inversely associated with the risk of ovarian cancer. More large studies are warranted to stratify these results by different cancer grading and histotype of ovarian cancer.
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Affiliation(s)
- Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, People's Republic of China
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Modugno F, Laskey R, Smith AL, Andersen CL, Haluska P, Oesterreich S. Hormone response in ovarian cancer: time to reconsider as a clinical target? Endocr Relat Cancer 2012; 19:R255-79. [PMID: 23045324 PMCID: PMC3696394 DOI: 10.1530/erc-12-0175] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Ovarian cancer is the sixth most common cancer worldwide among women in developed countries and the most lethal of all gynecologic malignancies. There is a critical need for the introduction of targeted therapies to improve outcome. Epidemiological evidence suggests a critical role for steroid hormones in ovarian tumorigenesis. There is also increasing evidence from in vitro studies that estrogen, progestin, and androgen regulate proliferation and invasion of epithelial ovarian cancer cells. Limited clinical trials have shown modest response rates; however, they have consistently identified a small subset of patients that respond very well to endocrine therapy with few side effects. We propose that it is timely to perform additional well-designed trials that should include biomarkers of response.
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Affiliation(s)
- Francesmary Modugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pennsylvania, USA
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Abstract
Ovarian cancer is the sixth most common cancer worldwide among women in developed countries and the most lethal of all gynecologic malignancies. There is a critical need for the introduction of targeted therapies to improve outcome. Epidemiological evidence suggests a critical role for steroid hormones in ovarian tumorigenesis. There is also increasing evidence from in vitro studies that estrogen, progestin, and androgen regulate proliferation and invasion of epithelial ovarian cancer cells. Limited clinical trials have shown modest response rates; however, they have consistently identified a small subset of patients that respond very well to endocrine therapy with few side effects. We propose that it is timely to perform additional well-designed trials that should include biomarkers of response.
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Mohler ML, Coss CC, Duke CB, Patil SA, Miller DD, Dalton JT. Androgen receptor antagonists: a patent review (2008-2011). Expert Opin Ther Pat 2012; 22:541-65. [PMID: 22583332 DOI: 10.1517/13543776.2012.682571] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Androgen receptor (AR) antagonists are predominantly used as chemical castration to treat prostate cancer (i.e., in conjunction with androgen deprivation therapy (ADT)). Unfortunately, castration-resistant prostate cancer (CRPC) typically develops that is refractory to targeted therapy. Insights into CRPC biology have led to the emergence of a promising clinical candidate MDV3100 (1) and a resurgence in this field. A pipeline of preclinical competitive (C-terminally directed) antagonists was discovered using a variety of innovative screening paradigms. Some inhibit nuclear translocation, selectively downregulate or degrade AR (SARD), antagonize wild-type and escape mutant AR (pan-antagonists) and/or antagonize AR target organs in vivo. Separately, the N-terminal domain has emerged as a promising novel target for noncompetitive antagonists. AREAS COVERED AR antagonists whose patents published between 2008 and 2011 are reviewed. Antagonists are organized based on the screening paradigm reported as discussed above. EXPERT OPINION Novel mechanisms provide a more informed basis for selecting a competitive antagonist; however, high potency and favorable in vivo properties remain paramount. Noncompetitive antagonists have theoretical advantages suggestive of improved clinical efficacy, but no clinical proof of concept as of yet.
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Affiliation(s)
- Michael L Mohler
- Preclinical Research and Development, GTx, Inc., 3 North Dunlap Street, Memphis, TN 38163, USA
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Elattar A, Warburton KG, Mukhopadhyay A, Freer RM, Shaheen F, Cross P, Plummer ER, Robson CN, Edmondson RJ. Androgen receptor expression is a biological marker for androgen sensitivity in high grade serous epithelial ovarian cancer. Gynecol Oncol 2012; 124:142-7. [DOI: 10.1016/j.ygyno.2011.09.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 09/01/2011] [Accepted: 09/03/2011] [Indexed: 01/12/2023]
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Nourbakhsh M, Golestani A, Zahrai M, Modarressi MH, Malekpour Z, Karami-Tehrani F. Androgens stimulate telomerase expression, activity and phosphorylation in ovarian adenocarcinoma cells. Mol Cell Endocrinol 2010; 330:10-6. [PMID: 20673788 DOI: 10.1016/j.mce.2010.07.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Revised: 07/17/2010] [Accepted: 07/22/2010] [Indexed: 10/19/2022]
Abstract
Androgens have been implicated in increasing ovarian cancer risk. Most ovarian cancer cells have high telomerase activity which is effective in inducing ovarian carcinogenesis. The purpose of this study was to investigate the effects of testosterone and androstenedione on the viability of an ovarian adenocarcinoma cell line, the activity and expression of telomerase, and the phosphorylation status of its catalytic subunit in these cells. Results showed that androgens significantly increased the viability of ovarian cancer cells and that these hormones induced the expression, activity and phosphorylation of telomerase. This upregulation was blocked by phosphatidylinositol 3-kinase pathway inhibitors. These findings might have implications for understanding the role of androgens in ovarian carcinogenesis.
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Affiliation(s)
- Mitra Nourbakhsh
- Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, 1417613151 Tehran, Iran
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Saad AF, Hu W, Sood AK. Microenvironment and pathogenesis of epithelial ovarian cancer. HORMONES & CANCER 2010; 1:277-90. [PMID: 21761359 PMCID: PMC3199131 DOI: 10.1007/s12672-010-0054-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Multiple genetic alterations play a role in the pathogenesis of ovarian cancer. Although many key proteins and pathways involved in ovarian carcinogenesis and metastasis have been discovered, knowledge of the early steps leading to malignancy remains poorly understood. This poor understanding stems from lack of data from early-stage cancers and absence of a well-established premalignant state universal to all ovarian cancer subtypes. Existing evidence suggests that ovarian cancers develop either through a stepwise mutation process (low-grade pathway), through genetic instability resulting in hastened metastasis (high-grade pathway), or more recently through what has been described as the "'fimbrial-ovarian' serous neoplasia theory." In this latter model, ovarian serous cancers evolve from premalignant lesions in the distal fallopian tube called tubal intraepithelial carcinoma. In this manuscript, we review key genetic and molecular changes that occur in cancer cell progression and suggest a model of ovarian cancer pathogenesis involving both tumor cell mutations and microenvironmental factors.
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Affiliation(s)
- Antonio F. Saad
- Department of Obstetrics and Gynecology, U.T.M.B. Galveston Branch, 301 University Blvd, Galveston, TX 77555, USA
| | - Wei Hu
- Department of Gynecologic Oncology, U.T.M.D. Anderson Cancer Center, 1155 Herman Pressler, Unit 1362, Houston, TX 77030, USA
| | - Anil K. Sood
- Department of Gynecologic Oncology, U.T.M.D. Anderson Cancer Center, 1155 Herman Pressler, Unit 1362, Houston, TX 77030, USA. Department of Cancer Biology, U.T.M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 173, Houston, TX 77030, USA. Center for RNA Interference and Non-Coding RNA, 1515 Holcombe Boulevard, Houston, TX 77030, USA. Departments of Gynecologic Oncology and Cancer Biology, The University of Texas M.D. Anderson Cancer Center, 1155 Herman Pressler, Unit 1362, Houston, TX 77030, USA
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Nodin B, Zendehrokh N, Brändstedt J, Nilsson E, Manjer J, Brennan DJ, Jirström K. Increased androgen receptor expression in serous carcinoma of the ovary is associated with an improved survival. J Ovarian Res 2010; 3:14. [PMID: 20565760 PMCID: PMC2902477 DOI: 10.1186/1757-2215-3-14] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Accepted: 06/17/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Altered androgen hormone homeostasis and androgen receptor (AR) activity have been implicated in ovarian carcinogenesis but the relationship between AR expression in ovarian cancer and clinical outcome remains unclear. METHODS In this study, the prognostic impact of AR expression was investigated using immunohistochemistry in tissue microarrays from 154 incident cases of epithelial ovarian cancer (EOC) in the prospective, population-based cohorts Malmö Diet and Cancer Study and Malmö Preventive Project. A subset of corresponding fallopian tubes (n = 36) with no histopathological evidence of disease was also analysed. RESULTS While abundantly expressed in the majority of fallopian tubes with more than 75% positive nuclei in 16/36 (44%) cases, AR was absent in 108/154 (70%) of EOC cases. AR expression was not related to prognosis in the entire cohort, but in the serous subtype (n = 90), AR positivity (> 10% positive nuclei) was associated with a prolonged disease specific survival in univariate (HR= 0.49; 95% CI 0.25-0.96; p= 0.038) and multivariate (HR= 0.46; 95% CI 0.22-0.97; p= 0.042) analysis, adjusted for age, grade and clinical stage. CONCLUSIONS AR expression is considerably reduced in EOC as compared to fallopian tubes, and in EOC of the serous subtype, high AR expression is a favourable prognostic factor. These results indicate that assessment of AR expression might be of value for treatment stratification of EOC patients with serous ovarian carcinoma.
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Affiliation(s)
- Björn Nodin
- Center for Molecular Pathology, Department of Laboratory Medicine, Lund University, and Skåne Regional Laboratories, Malmö, Sweden.
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McEwan IJ, McGuinness D, Hay CW, Millar RP, Saunders PTK, Fraser HM. Identification of androgen receptor phosphorylation in the primate ovary in vivo. Reproduction 2010; 140:93-104. [PMID: 20406952 PMCID: PMC2892820 DOI: 10.1530/rep-10-0140] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The androgen receptor (AR) is a member of the nuclear receptor superfamily, and is important for both male and female reproductive health. The receptor is a target for a number of post-translational modifications including phosphorylation, which has been intensively studied in vitro. However, little is known about the phosphorylation status of the receptor in target tissues in vivo. The common marmoset is a useful model for studying human reproductive functions, and comparison of the AR primary sequence from this primate shows high conservation of serines known to be phosphorylated in the human receptor and corresponding flanking amino acids. We have used a panel of phosphospecific antibodies to study AR phosphorylation in the marmoset ovary throughout the follicular phase and after treatment with GNRH antagonist or testosterone propionate. In normal follicular phase ovaries, total AR (both phosphorylated and non-phosphorylated forms) immunopositive staining was observed in several cell types including granulosa cells of developing follicles, theca cells and endothelial cells lining blood vessels. Receptor phosphorylation at serines 81, 308, and 650 was detected primarily in the granulosa cells of developing follicles, surface epithelium, and vessel endothelial cells. Testosterone treatment lead to a modest increase in AR staining in all stages of follicle studied, while GNRH antagonist had no effect. Neither treatment significantly altered the pattern of phosphorylation compared to the control group. These results demonstrate that phosphorylation of the AR occurs, at a subset of serine residues, in a reproductive target tissue in vivo, which appears refractory to hormonal manipulations.
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Affiliation(s)
- Iain J McEwan
- MRC Human Reproductive Sciences Unit, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, Scotland, UK.
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Distribution of androgen and progesterone receptors in the spiny mouse (Acomys cahirinus) ovary during postnatal life. Reprod Biol 2010; 10:37-51. [DOI: 10.1016/s1642-431x(12)60036-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Sheach LA, Adeney EM, Kucukmetin A, Wilkinson SJ, Fisher AD, Elattar A, Robson CN, Edmondson RJ. Androgen-related expression of G-proteins in ovarian cancer. Br J Cancer 2009; 101:498-503. [PMID: 19623182 PMCID: PMC2720237 DOI: 10.1038/sj.bjc.6605153] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Epidemiological and in vitro data implicate androgens in the aetiology of ovarian cancer, but the mechanisms by which this is mediated are unclear. In this study, we wished to examine the effects of androgens on gene expression in ovarian cancer. METHODS The expression of androgen receptor (AR) in OVCAR3 and OSEC2 cells was confirmed using immunoblotting and response to androgens was measured using flow cytometric assessment of S-phase fraction. The differential gene expression between androgen stimulated and unstimulated OVCAR3 ovarian cancer cells was examined with a cDNA microarray. The upregulation of a subset of these genes was then confirmed with reverse transcriptase PCR in both OVCAR3 and OSEC2, an ovarian epithelial cell line. Finally, the clinical significance of this upregulation was investigated by examining the expression of Rab25 and Rab35, two G-protein-related molecules in an ovarian cancer tissue microarray (TMA). RESULTS OVCAR3 and OSEC2 cells were shown to express the AR and showed an increase in S-phase fraction in response to androgen treatment. Treatment of OVCAR3 cells with androgen resulted in a significant upregulation of 121 genes. These findings were confirmed for a subset of seven monomeric G-protein-related genes in both OVCAR3 and OSEC2 cells. After staining for Rab25 and Rab35, the majority of TMA sections examined showed expression for Rab25 (92%) and Rab35 (95%). The expression of Rab25 correlated with histological grade, and expression was higher in endometrioid (median histoscore 10.5) than serous (7.5) or mucinous (5.3) tumours. The expression of Rab25 correlated positively with AR expression supporting its role as an androgen responsive gene in ovarian cancer. CONCLUSIONS These results suggest that androgens can effect expression of the oncogenic GTPases in ovarian cancer. We propose that the androgen responsive Rab35 may have clinical importance as a biomarker of AR function.
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Affiliation(s)
- L A Sheach
- Northern Institute for Cancer Research, Newcastle University, Newcastle, UK
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Galgano MT, Conaway M, Spencer AM, Paschal BM, Frierson HF. PRK1 distribution in normal tissues and carcinomas: overexpression and activation in ovarian serous carcinoma. Hum Pathol 2009; 40:1434-40. [PMID: 19427017 DOI: 10.1016/j.humpath.2009.02.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Revised: 02/16/2009] [Accepted: 02/19/2009] [Indexed: 01/05/2023]
Abstract
Protein kinase C-related kinases are regulated by phosphatidylinositol-3-kinase and Rho family GTPases. The isoform PRK1 has been characterized in detail in prostate cancer, but not in other carcinomas. We analyzed our prior microarray data for PRK1 gene expression in 175 carcinomas and evaluated tissue microarrays for protein expression in 251 carcinomas and a comprehensive group of normal tissues. We also used immunoblotting to determine the levels and phosphoactivation status of PRK1, PRK2, and PDK1 in 12 ovarian serous carcinomas, SKOV3 cells, and 3 samples of normal ovarian surface epithelium (OSE). The highest average level of PRK1 messenger RNA was observed in ovarian serous carcinomas compared with all other carcinomas, including those of the prostate, bladder/ureter, breast, colon, stomach/esophagus, kidney, liver, pancreas, and lung (P = .05). By immunohistochemistry, PRK1 was observed in selected normal cells, including epithelium from the gynecologic tract and hematolymphoid elements. All serous ovarian and endometrial endometrioid adenocarcinomas and mesotheliomas were immunoreactive for PRK1. The findings in nonserous ovarian and most carcinomas from the prostate, breast, and pancreas were also positive but less consistently so. In comparison with OSE, the serous carcinomas typically had greater pPRK1/total PRK1 (P = .02) as well as greater pPDK/total PDK (P = .01). The relative phosphorylation status of these 2 kinases correlated within each sample. In summary, PRK1 is present in various malignancies, but especially in serous carcinomas, where the increased activation status of PRK1 and its upstream regulator, PDK, as compared with normal OSE suggests a role in ovarian cancer development or progression.
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Affiliation(s)
- Mary T Galgano
- Robert E. Fechner Laboratory of Surgical Pathology, Department of Pathology, University of Virginia Health System, Charlottesville, VA 22908, USA.
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Papacleovoulou G, Hogg K, Fegan KS, Critchley HO, Hillier SG, Mason JI. Regulation of 3 -hydroxysteroid dehydrogenase type 1 and type 2 gene expression and function in the human ovarian surface epithelium by cytokines. Mol Hum Reprod 2009; 15:379-92. [DOI: 10.1093/molehr/gap022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Gogoi R, Kudla M, Gil O, Fishman D. The activity of medroxyprogesterone acetate, an androgenic ligand, in ovarian cancer cell invasion. Reprod Sci 2009; 15:846-52. [PMID: 19017820 DOI: 10.1177/1933719108323446] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES An epithelial ovarian cancer cell line constitutively expressing the androgen receptor was created to evaluate the mechanism and effects of androgen receptor activation on epithelial ovarian cancer cell invasion. METHODS Immunocytochemistry and Western blot analyses confirmed androgen receptor expression. Boyden chamber invasion assays were performed using cells treated with the androgen receptor ligands medroxyprogesterone acetate or dihydrotestosterone. The matrix metalloproteinases associated with invasion were investigated using zymographic assays. RESULTS Androgen receptor-mediated invasion is ligand dependent. While both medroxyprogesterone acetate and dihydrotestosterone signal through androgen receptor, medroxyprogesterone acetate is more effective at stimulating invasion of epithelial ovarian cancer cells. Unlike the wild-type epithelial ovarian cancer cells, this increase in invasion in androgen receptor + epithelial ovarian cancer cells does not seem to be dependent on matrix metalloproteinase 2 or 9 activation. CONCLUSION Although classified as a progestin, medroxyprogesterone acetate has significant androgenic activity unique from the pure androgen dihydrotestosterone. Our studies suggest that pharmacologic doses of medroxyprogesterone acetate may actually increase the invasive potential of epithelial ovarian cancer cells.
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Affiliation(s)
- Radhika Gogoi
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, New York University, New York, NY, USA
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Wilkinson SJ, Kucukmetin A, Cross P, Darby S, Gnanapragasam VJ, Calvert AH, Robson CN, Edmondson RJ. Expression of gonadotrophin releasing hormone receptor I is a favorable prognostic factor in epithelial ovarian cancer. Hum Pathol 2008; 39:1197-204. [PMID: 18495208 DOI: 10.1016/j.humpath.2007.12.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2007] [Revised: 12/10/2007] [Accepted: 12/20/2007] [Indexed: 10/22/2022]
Abstract
The majority of epithelial ovarian cancers originate in the ovarian surface epithelium. The ovarian surface epithelium is a hormonally responsive tissue, and hormones are thought to play a key role in the development of this type of cancer. Gonadotrophin releasing hormone II is one of 2 isoforms which are thought to act through gonadotrophin releasing hormone receptor I, and gonadotrophin releasing hormone II has been shown to cause growth inhibition of cultured ovarian surface epithelium. The aim of this study was to investigate the expression levels and prognostic significance of gonadotrophin releasing hormone II and the gonadotrophin releasing hormone receptor I in epithelial ovarian cancer. Gonadotrophin releasing hormone II and gonadotrophin releasing hormone receptor I messenger RNA expression was examined in 23 cancers and 7 normal ovarian surface epithelium samples by quantitative real time polymerase chain reaction. An ovarian cancer tissue microarray containing 139 cases was constructed and immunohistochemical analysis of gonadotrophin releasing hormone II and gonadotrophin releasing hormone receptor I protein expression was performed and correlated with clinical outcome data. Gonadotrophin releasing hormone II messenger RNA expression was lower in cancer samples compared to normal ovarian surface epithelium samples (P < .05). Gonadotrophin releasing hormone II protein expression correlated with histologic subtype (25% serous versus 45% nonserous, P < .05) but not with overall survival. Gonadotrophin releasing hormone receptor I messenger RNA expression was highest in serous tumors when compared to non serous (P < .05) and normal tissue (P < .001). Expression of the gonadotrophin releasing hormone receptor I protein was also found to correlate with patient survival (P < .05). We have demonstrated gonadotrophin releasing hormone II and its receptor, gonadotrophin releasing hormone receptor I, are present in clinical ovarian samples, and that gonadotrophin releasing hormone receptor I protein expression is a favorable prognostic factor, suggesting these proteins play an important role in the development of epithelial ovarian cancer.
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Affiliation(s)
- S J Wilkinson
- Northern Institute for Cancer Research, Newcastle University, NE2 4HH Newcastle, UK.
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Landen CN, Birrer MJ, Sood AK. Early Events in the Pathogenesis of Epithelial Ovarian Cancer. J Clin Oncol 2008; 26:995-1005. [DOI: 10.1200/jco.2006.07.9970] [Citation(s) in RCA: 319] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Ovarian carcinogenesis, as in most cancers, involves multiple genetic alterations. A great deal has been learned about proteins and pathways important in the early stages of malignant transformation and metastasis, as derived from studies of individual tumors, microarray data, animal models, and inherited disorders that confer susceptibility. However, a full understanding of the earliest recognizable events in epithelial ovarian carcinogenesis is limited by the lack of a well-defined premalignant state common to all ovarian subtypes and by the paucity of data from early-stage cancers. Evidence suggests that ovarian cancers can progress both through a stepwise mutation process (low-grade pathway) and through greater genetic instability that leads to rapid metastasis without an identifiable precursor lesion (high-grade pathway). In this review, we discuss many of the genetic and molecular disorders in each key process that is altered in cancer cells, and we present a model of ovarian pathogenesis that incorporates the role of tumor cell mutations and factors in the host microenvironment important to tumor initiation and progression.
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Affiliation(s)
- Charles N. Landen
- From the Department of Gynecologic Oncology and the Department of Cancer Biology, University of Texas M.D. Anderson Cancer Center, Houston, TX; and the Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Michael J. Birrer
- From the Department of Gynecologic Oncology and the Department of Cancer Biology, University of Texas M.D. Anderson Cancer Center, Houston, TX; and the Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Anil K. Sood
- From the Department of Gynecologic Oncology and the Department of Cancer Biology, University of Texas M.D. Anderson Cancer Center, Houston, TX; and the Center for Cancer Research, National Cancer Institute, Bethesda, MD
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The androgen receptor and prostate cancer: A role for sexual selection and sexual conflict? Med Hypotheses 2008; 70:435-43. [DOI: 10.1016/j.mehy.2007.04.044] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2007] [Accepted: 04/16/2007] [Indexed: 11/20/2022]
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Abstract
Ovarian carcinoma continues to be the leading cause of death due to gynecological malignancy. Epidemiologic studies indicate that steroid hormones play roles in ovarian carcinogenesis. Gonadotropins, estrogen, and androgen may be causative factors, while gonadotropin-releasing hormone and progesterone may be protective factors in ovarian cancer pathogenesis. Experimental studies have shown that hormonal receptors are expressed in ovarian cancer cells and mediate the growth-stimulatory or growth-inhibitory effects of the hormones on these cells. Hormonal therapeutic agents have been evaluated in several clinical trials. Most of these trials were conducted in patients with recurrent or refractory ovarian cancer, with modest efficacy and few side effects. Better understanding of the mechanisms through which hormones affect cell growth may improve the efficacy of hormonal therapy. Molecular markers that can reliably predict major clinical outcomes should be investigated further in well-designed trials.
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Affiliation(s)
- H Zheng
- Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77230-1439, USA
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