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Wasnik VB, Acharya N, Mohammad S. Genitourinary Syndrome of Menopause: A Narrative Review Focusing on Its Effects on the Sexual Health and Quality of Life of Women. Cureus 2023; 15:e48143. [PMID: 38046779 PMCID: PMC10692865 DOI: 10.7759/cureus.48143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/02/2023] [Indexed: 12/05/2023] Open
Abstract
Genitourinary syndrome of menopause (GSM) is a progressive condition due to a hypoestrogenic state affecting perimenopausal and menopausal women. GSM was previously known as urogenital syndrome, vulvovaginal atrophy, or atrophic vaginitis. The term vulvovaginal atrophy did not encompass the symptoms of the urinary tract like incontinence, urgency, and discomfort, or allude that it is due to a hypoestrogenic state. Although a significant segment of the population is affected by GSM, it is very sparsely studied, detected, and treated. GSM affects the quality of life and sexual health of most menopausal women suffering from it. Only a few healthcare providers ask about the symptoms of GSM and a tiny percentage of women seek consultation for it. This may be because they are either embarrassed or believe it to be a part of the natural process of aging. As the life expectancy of women has increased in general, the prevalence of GSM has also risen, while it still remains underdiagnosed and untreated. Properly educating women so that they can seek consultation regarding symptoms of GSM, and training healthcare professionals about communicating with the patient, as well as correctly identifying, diagnosing, and managing the patient are all important to overcome this communication barrier. Once we cross the barrier of diagnosing patients with GSM, we still have to manage the patients with tailor-made prescriptions according to the severity of the symptoms and their preferences. While there are various treatment options, the most effective one is low-dose topical estrogen therapy. In this review, we intend to explore the existing knowledge about GSM and its effect on the quality of life and sexual health of women along with the treatment options for managing and reversing the effects of GSM.
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Affiliation(s)
- Vaibhavi B Wasnik
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Neema Acharya
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Shazia Mohammad
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
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Estrugo CP, Rodríguez MT, de Guevara NML, Gómez JG, Ridocci F, Moro-Martín MT, Guinot M, Saz-Leal P, Nieto Magro C. Combination of Soy Isoflavones, 8-Prenylnaringenin and Melatonin Improves Hot Flashes and Health-Related Quality of Life Outcomes in Postmenopausal Women: Flavie Study. J Menopausal Med 2023; 29:73-83. [PMID: 37691315 PMCID: PMC10505517 DOI: 10.6118/jmm.22034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 05/26/2023] [Accepted: 08/11/2023] [Indexed: 09/12/2023] Open
Abstract
OBJECTIVES This study aims to investigate the effects of a combination of soy isoflavones, 8-prenylnaringenin (8-PN), and melatonin in postmenopausal women suffering from moderate-to-severe hot flashes (HFs). METHODS A multicenter, prospective, open-label study enrolled 44 postmenopausal women suffering from moderate-to-severe HFs (≥ 5 daily or ≥ 35 weekly) to receive 54.4 mg standardized soy isoflavones (including 24.5 mg genistein and 16.3 mg daidzein), 100 µg 8-PN, and 1 mg melatonin once daily for 12 weeks. The primary clinical outcomes included changes in health-related quality of life (HRQoL) scores (Menopause-Specific QoL questionnaire [MENQoL] and Cervantes Scale) and HFs following 4 and 12 weeks of treatment. Other analyses included treatment adherence, acceptability, tolerability, and safety. RESULTS All of the four domains of MENQoL questionnaire significantly improved at 4 weeks (P < 0.05) and 12 weeks (P < 0.001), affecting significantly the vasomotor, psychosocial, and physical spheres (41.2%, 26.3%, and 25.0%; 12 weeks improvements, respectively). Similarly, in the menopause (39.3%) and psychic (51.7%) domains (both P < 0.05 at 12 weeks), the global score of the Cervantes Scale significantly increased at 4 weeks (18.6%) and 12 weeks (35.4%). Accordingly, moderate-to-severe HFs significantly decreased at 4 weeks compared to baseline (41.7% reduction) and further reduced at 12 weeks (76.5%), including the total number of episodes. CONCLUSIONS Food supplements containing soy isoflavones, 8-PN, and melatonin showed an early and progressive benefit for reducing clinically significant HFs and for improving HRQoL across all domains, favorably affecting postmenopausal women's overall well-being.
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Affiliation(s)
| | | | | | | | | | | | - Misericordia Guinot
- Department of Obstetrics and Gynecology, Dra. Guinot's Surgery, Barcelona, Spain
| | - Paula Saz-Leal
- Medical Affairs, Italfarmaco (ITF) Research Pharma Sociedad de Responsabilidad Limitada Unipersonal (SLU), Madrid, Spain.
| | - Concepción Nieto Magro
- Medical Affairs, Italfarmaco (ITF) Research Pharma Sociedad de Responsabilidad Limitada Unipersonal (SLU), Madrid, Spain
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Women's knowledge and awareness on menopause symptoms and its treatment options remains inadequate: a report from the United Arab Emirates. ACTA ACUST UNITED AC 2021; 28:918-927. [PMID: 33973540 DOI: 10.1097/gme.0000000000001783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We aimed to evaluate the awareness, knowledge, and perception of middle-aged women regarding menopause and hormone therapy (HT). METHODS This observational study was conducted on pre-, peri-, post-, and surgically menopausal women (n = 591) from January 2020 until June 2020 in Dubai. A structured questionnaire was developed based on previous literature to assess participants' knowledge and awareness of menopause and HT. The questionnaire was implemented by face-to-face interview. Factors associated with the degree of menopausal knowledge were identified. RESULTS Majority (498, 82%) of participant women had fair to poor overall knowledge on menopause, did not know whom HT is used for (404, 48%), and for whom it is contradicted (455, 77%). Knowledge on menopause and HT was highly associated with better attitudes (P < 0.001 and P < 0.001, respectively).Furthermore, the greater the knowledge on menopause, the better the knowledge of HT (P < 0.001). Education was the primary factor that played a significant role in having better knowledge or attitudes. Nationality showed an association with better attitudes on menopause, with non-Arabs having better attitudes than Arabs and UAE nationals. CONCLUSIONS Community medicine educators and primary healthcare providers need to prepare tailored premenopausal and postmenopausal educational interventional programs for further educating women and preparing them for this phase of their lives.
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Sugiura K, Kobayashi T, Ojima T. National survey of confirmed thromboembolism related to female hormones in Japan. J Obstet Gynaecol Res 2020; 46:1173-1182. [DOI: 10.1111/jog.14303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 04/25/2020] [Accepted: 04/30/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Kazuko Sugiura
- Department of Reproductive Health Nursing/Midwifery Nagoya City University Graduate School of Nursing Nagoya Japan
| | - Takao Kobayashi
- Department of Obstetrics and Gynecology Hamamatsu Medical Center Hamamatsu Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine Hamamatsu University School of Medicine Hamamatsu Japan
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Dotlic J, Nicevic S, Kurtagic I, Radovanovic S, Rancic B, Markovic N, Milosevic B, Gazibara T. Hormonal therapy in menopausal transition: implications for improvement of health-related quality of life. Gynecol Endocrinol 2020; 36:327-332. [PMID: 31603006 DOI: 10.1080/09513590.2019.1676409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The study aim was to assess scores of the Menopause Rating Scale (MRS) among women who use and desire to use hormonal therapy (HT), as well as to evaluate factors contributing to HT use and desire to use HT among women in menopausal transition. A total of 513 mid-aged women participated in the study. Data were collected using socio-demographic questionnaire, MRS and Beck Depression Inventory. The prevalence of current HT use was 9.7%, while 4.5% of women who did not use HT expressed a desire to start using HT. The MRS cutoff score for HT use was 10.5 and 11.5 among those who desire to use HT. Living in the central city districts, having lower body mass index, younger age at menopause, more gynecological illnesses, and worse MRS were associated with HT use. Living in the central city districts, having fewer births, more gynecological and chronic illnesses and having more depressive symptoms were associated with the desire to use HT. Mid-aged women who perceive their quality of life as poor due to climacteric symptoms should be advised to consider HT to improve their health status and everyday functioning.
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Affiliation(s)
- Jelena Dotlic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Selmina Nicevic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
| | - Ilma Kurtagic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
| | - Sanja Radovanovic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
| | - Biljana Rancic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
| | - Nikolina Markovic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
| | - Branislav Milosevic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
| | - Tatjana Gazibara
- Institute for Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Kagan R, Kellogg-Spadt S, Parish SJ. Practical Treatment Considerations in the Management of Genitourinary Syndrome of Menopause. Drugs Aging 2020; 36:897-908. [PMID: 31452067 PMCID: PMC6764929 DOI: 10.1007/s40266-019-00700-w] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Genitourinary syndrome of menopause is a condition comprising the atrophic symptoms and signs women may experience in the vulvovaginal and bladder-urethral areas as a result of the loss of sex steroids that occurs with menopause. It is a progressive condition that does not resolve without treatment and can adversely affect a woman’s quality of life. For a variety of reasons, many symptomatic women do not seek treatment and, of those who do, many are unhappy with their options. Additionally, many healthcare providers do not actively screen their menopausal patients for the symptoms of genitourinary syndrome of menopause. In this review, we discuss the clinical presentation of genitourinary syndrome of menopause as well as the treatment guidelines recommended by the major societies engaged in women’s health. This is followed by a review of available treatment options that includes both hormonal and non-hormonal therapies. We discuss both the systemic and vaginal estrogen products that have been available for decades and remain important treatment options for patients; however, a major intent of the review is to provide information on the newer, non-estrogen pharmacologic treatment options, in particular oral ospemifene and vaginal prasterone. A discussion of adjunctive therapies such as moisturizers, lubricants, physical therapy/dilators, hyaluronic acid, and laser therapy is included. We also address some of the available data on both the patient and healthcare providers perspectives on treatment, including cost, and touch briefly on the topic of treating women with a history of, or at high risk for, breast cancer.
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Affiliation(s)
- Risa Kagan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Affiliated with Sutter East Bay Medical Foundation, Sutter East Bay Medical Group, 2500 Milvia Street, Berkeley, CA, 94704, USA.
| | - Susan Kellogg-Spadt
- Drexel University College of Medicine, Philadelphia, PA, USA.,Center for Pelvic Medicine, Bryn Mawr, PA, USA
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Zhou C, Wu Q, Wang Z, Wang Q, Liang Y, Liu S. The Effect of Hormone Replacement Therapy on Cognitive Function in Female Patients With Alzheimer's Disease: A Meta-Analysis. Am J Alzheimers Dis Other Demen 2020; 35:1533317520938585. [PMID: 32677442 PMCID: PMC10624041 DOI: 10.1177/1533317520938585] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Previous studies have indicated that estrogen may delay disease progression and minimize the cognitive decline in patients with Alzheimer's disease (AD). However, the evidence for an estrogen deficiency in women with dementia and cognitive dysfunction is inconsistent. In the present review, a fixed effect meta-analysis revealed that the hormone replacement therapy (HRT) group exhibited significant improvements in Alzheimer Disease Assessment Scale-Cognitive subscale scores relative to those observed in the placebo group, suggesting that HRT is feasible for treating cognitive decline in patients with AD. However, no significant differences in Mini-Mental State Examination and Clinical Dementia Rating scale scores were observed between the 2 groups. The results of our systematic review indicate that HRT can improve cognitive function in female patients with AD. Due to limitations in sample size and the available literature, further multicenter trials with larger sample sizes are required to support these findings.
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Affiliation(s)
- ChengCheng Zhou
- School of Pharmaceutical Science, Guangzhou University of Chinese Medicine, Guangzhou, China
- ChengCheng Zhou and Qingguang Wu are co-authors and contributed equally to this article
| | - Qingguang Wu
- School of Pharmaceutical Science, Guangzhou University of Chinese Medicine, Guangzhou, China
- ChengCheng Zhou and Qingguang Wu are co-authors and contributed equally to this article
| | - Zongwei Wang
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Qi Wang
- Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Youya Liang
- School of Pharmaceutical Science, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangzhou University of Chinese Medicine, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Sijun Liu
- School of Pharmaceutical Science, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Njoku K, Abiola J, Russell J, Crosbie EJ. Endometrial cancer prevention in high-risk women. Best Pract Res Clin Obstet Gynaecol 2019; 65:66-78. [PMID: 32107136 DOI: 10.1016/j.bpobgyn.2019.12.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 12/24/2022]
Abstract
Endometrial cancer (EC) is the most common gynaecological malignancy, and its incidence is rising alongside the growing prevalence of obesity. Effective risk-reducing interventions hijacking the key mechanisms driving endometrial carcinogenesis may affect EC diagnoses if aimed at those at greatest risk. An understanding of the key risk factors and their role in tumourigenesis is critical in developing such prevention strategies. In this review, we summarise the major risk factors for EC and the evidence for available risk-reducing interventions in high-risk women. We suggest potential prevention strategies and make a case for the need for risk prediction models that identify specific groups of women at a particularly high risk of EC for whom risk-reducing interventions are likely to have a significant impact.
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Affiliation(s)
- Kelechi Njoku
- Division of Cancer Sciences, University of Manchester, School of Medical Sciences, Faculty of Biology, Medicine and Health, 5th Floor Research, St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK.
| | - Joanna Abiola
- Department of Obstetrics and Gynaecology, Tameside General Hospital, Fountain St, Ashton-under-Lyne, OL6 9RW, UK.
| | - Johanna Russell
- University of Manchester Medical School, Oxford Road, Manchester, M13 9PL, UK.
| | - Emma J Crosbie
- Division of Cancer Sciences, University of Manchester, School of Medical Sciences, Faculty of Biology, Medicine and Health, 5th Floor Research, St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK.
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9
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Sexual Health in Menopause. ACTA ACUST UNITED AC 2019; 55:medicina55090559. [PMID: 31480774 PMCID: PMC6780739 DOI: 10.3390/medicina55090559] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 02/07/2023]
Abstract
Sexual function worsens with advancing menopause status. The most frequently reported symptoms include low sexual desire (40–55%), poor lubrication (25–30%) and dyspareunia (12–45%), one of the complications of genitourinary syndrome of menopause (GSM). Declining levels of sex steroids (estrogens and androgens) play a major role in the impairment of sexual response; however, psychological and relational changes related with aging and an increase in metabolic and cardiovascular comorbidities should also be taken into account. Although first-line therapeutic strategies for menopause-related sexual dysfunction aim at addressing modifiable factors, many hormonal and non-hormonal, local and systemic treatment options are currently available. Treatment should be individualized, taking into account the severity of symptoms, potential adverse effects and personal preferences.
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10
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Noirrit E, Buscato M, Dupuis M, Payrastre B, Fontaine C, Arnal JF, Valera MC. Effects of conjugated estrogen and bazedoxifene on hemostasis and thrombosis in mice. Endocr Connect 2019; 8:788-795. [PMID: 31085766 PMCID: PMC6590204 DOI: 10.1530/ec-19-0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 05/14/2019] [Indexed: 11/09/2022]
Abstract
Estrogen-progestin therapy was previously considered as the standard of care for managing bothersome symptoms associated with menopause, but it increases risks of breast cancer and of thromboembolism. The combination of conjugated estrogen (CE) with bazedoxifene (BZA) named tissue-selective estrogen complex (TSEC) was designed to minimize or even abrogate the undesirable effects on breast, while maintaining the beneficial effects such as prevention of osteoporosis and suppression of climacteric symptoms. The risk on thromboembolism associated with TSEC is unknown, although the clinical available data are reassuring. The aim of this study was to define the impact of a chronic administration of CE, BZA or CE + BZA on hemostasis and thrombosis in ovariectomized mice. As expected, CE, but not BZA neither CE + BZA, induced uterine and vagina hypertrophy. As previously demonstrated for 17β-estradiol (E2), we found that CE (i) increased tail-bleeding time, (ii) prevented occlusive thrombus formation in injured carotid artery and (iii) protected against collagen/epinephrine-induced thromboembolism. Thus, whereas BZA antagonized CE action on reproductive tissues, it had no impact on the effect of CE on hemostasis, thromboembolism and arterial thrombosis in mice. CE + BZA shared the anti-thrombotic actions of CE in these mouse models. If a similar process is at work in women, CE combined with BZA could contribute to minimize the risk of thrombosis associated with hormone replacement therapy.
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Affiliation(s)
- Emmanuelle Noirrit
- Inserm U1048 (I2MC), CHU de Toulouse and Université Toulouse III, I2MC, Toulouse, France
- Faculté de Chirurgie Dentaire, Université de Toulouse III, Toulouse, France
| | - Mélissa Buscato
- Inserm U1048 (I2MC), CHU de Toulouse and Université Toulouse III, I2MC, Toulouse, France
| | - Marion Dupuis
- Inserm U1048 (I2MC), CHU de Toulouse and Université Toulouse III, I2MC, Toulouse, France
| | - Bernard Payrastre
- Inserm U1048 (I2MC), CHU de Toulouse and Université Toulouse III, I2MC, Toulouse, France
- CHU de Toulouse, Laboratoire d’Hématologie, Toulouse, France
| | - Coralie Fontaine
- Inserm U1048 (I2MC), CHU de Toulouse and Université Toulouse III, I2MC, Toulouse, France
| | - Jean-François Arnal
- Inserm U1048 (I2MC), CHU de Toulouse and Université Toulouse III, I2MC, Toulouse, France
| | - Marie-Cécile Valera
- Inserm U1048 (I2MC), CHU de Toulouse and Université Toulouse III, I2MC, Toulouse, France
- Faculté de Chirurgie Dentaire, Université de Toulouse III, Toulouse, France
- Correspondence should be addressed to M-C Valera:
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Wei J, Ma L, Lai YH, Zhang R, Li H, Li C, Lin J. Bazedoxifene as a novel GP130 inhibitor for Colon Cancer therapy. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2019; 38:63. [PMID: 30736824 PMCID: PMC6368818 DOI: 10.1186/s13046-019-1072-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 01/30/2019] [Indexed: 12/22/2022]
Abstract
Background Interleukin-11 (IL-11), a dominant IL-6 family cytokine, is involved in tumorigenesis, tumor progression and differentiation in colon cancer cells. IL-11 signaling has been recently identified as a potential therapeutic target in colon cancer. Bazedoxifene, a third- generation selective estrogen modulator approved by the Food and Drug Administration (FDA), is a novel inhibitor of IL-11/GP130 signaling discovered by docking modeling. Methods In this study, the inhibition efficacy of bazedoxifene in colon cancer cells and its potential mechanism were investigated in vitro and in vivo by using MTT cell viability assay, BrdU cell proliferation assay, colony formation assay, wound-healing/cell migration assay, immunofluorescence, western blot assay and the mouse xenograft tumor model. Results Bazedoxifene inhibits phosphorylation of signal transducer and activator of transcription 3 (p-STAT3) and its nuclear translocation induced by IL-11 in colon cancer cells. It also inhibits p-STAT3 induced by IL-6 and IL-11 but not by OSM or STAT1 phosphorylation induced by INF-γ in human colon cancer cells. In addition, bazedoxifene can significantly inhibit phosphorylation of AKT and STAT3 downstream targets. Furthermore, bazedoxifene alone or together with oxaliplatin can significantly induce apoptosis, inhibit cell viability, cell colony formation and cell migration in colon cancer cells. Knock-down of IL-11R can reduce the sensitivity of colon cancer cells to bazedoxifene. IL-11 can reduce the efficacy of oxaliplatin-mediated inhibition of cell viability. Consistent with in vitro findings, bazedoxifene alone also attenuated HCT-15 xenograft tumor burden and reduced p-STAT3, p-AKT and p-ERK in vivo. Its combination with oxaliplatin attenuated DLD-1 xenograft tumor burden and reduced p-STAT3 in vivo. Conclusions Taken together, these results support bazedoxifene as a novel and effective therapeutic agent targeting IL-11/GP130 signaling for human colorectal cancer therapy. Electronic supplementary material The online version of this article (10.1186/s13046-019-1072-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jia Wei
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.,Department of Biochemistry and Molecular Biology, University of Maryland School of Medicine, 108 N. Greene Street, Baltimore, MD, 21201, USA
| | - Ling Ma
- Department of Biochemistry and Molecular Biology, University of Maryland School of Medicine, 108 N. Greene Street, Baltimore, MD, 21201, USA
| | - Yi-Hui Lai
- 33 Linsen Road, Chungshan District, Taipei, Taiwan
| | - Ruijie Zhang
- Department of Biochemistry and Molecular Biology, University of Maryland School of Medicine, 108 N. Greene Street, Baltimore, MD, 21201, USA
| | - Huameng Li
- Biophysics Graduate Program, The Ohio State University, Columbus, OH, 43210, USA
| | - Chenglong Li
- College of Pharmacy, University of Florida, Gainesville, FL, 32610, USA
| | - Jiayuh Lin
- Department of Biochemistry and Molecular Biology, University of Maryland School of Medicine, 108 N. Greene Street, Baltimore, MD, 21201, USA.
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Abstract
PURPOSE OF THE REVIEW To assess the most recent high-quality evidence for endometrial cancer prevention strategies. RECENT FINDINGS Obesity is an established risk factor for endometrial cancer. Weight cycling and weight gain in middle age are risk factors for endometrial cancer. Bariatric surgery reduces the risk of endometrial cancer by up to 81% in obese women who attain and maintain a normal weight. Combined oral contraceptives provide durable protection against endometrial cancer for 30 years or more. Ever use of the levonorgestrel intrauterine system (LNG-IUS) and inert intrauterine devices reduce endometrial cancer risk. The first oestrogen-based non-progestin HRT for non-hysterectomised women that contains estradiol and bazedoxifene has an effective protective effect on endometrium. Bisphosphonates reduce endometrial cancer risk. Weight loss and LNG-IUS would seem to be an effective strategy for preventing the development of obesity-driven endometrial cancer in the highest risk women. Future research may identify other safe and effective chemoprevention interventions, such as aspirin, bisphosphonates or metformin.
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Affiliation(s)
- Michelle L MacKintosh
- Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Emma J Crosbie
- Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK.
- Gynaecological Oncology Research Group, NIHR Manchester Biomedical Research Centre, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, 5th Floor Research, St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK.
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Wang Z, Wang W, Huang K, Wang Y, Li J, Yang X. MicroRNA-34a inhibits cells proliferation and invasion by downregulating Notch1 in endometrial cancer. Oncotarget 2017; 8:111258-111270. [PMID: 29340051 PMCID: PMC5762319 DOI: 10.18632/oncotarget.22770] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 09/20/2017] [Indexed: 02/06/2023] Open
Abstract
MicroRNAs (miRNAs) are small non-coding RNAs composed of 18-25 nucleotides that regulate the expression of approximately 30% of human protein coding genes. Dysregulation of miRNAs plays a pivotal role in the initiation and progression of malignancies. Our study has shown that microRNA-34a (miR-34a) was upregulated in human endometrial cancer stem cells (ECSCs). However, it is unknown how miR-34a regulates endometrial cancer itself. Here, we report that miR-34a directly and functionally targeted Notch1. MiR-34a inhibited the proliferation, migration, invasion, EMT-associated phenotypes by downregulating Notch1 in endometrial cancer cells. Overexpression of miR-34a also suppressed tumor growth in nude mice. Importantly, further results suggested miR-34a was significantly downregulated in endometrial cancer tissues and negatively correlated with Notch1 expression. There was a significant association between decreased miR-34a expression and worse patient prognosis. Taken together, our results suggest that miR-34a plays tumor-suppressive roles in endometrial cancer through downregulating Notch1. Thus miR-34a could be a potential therapeutic target for prevention and treatment of endometrial cancer.
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Affiliation(s)
- Zhen Wang
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, P. R. China.,Department of Gynecology and Obstetrics, Northwest Women's and Children's Hospital, Xi'an 710003, P. R. China
| | - Wei Wang
- Department of Anesthesiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, P. R. China
| | - Kangrong Huang
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, P. R. China
| | - Yueling Wang
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, P. R. China
| | - Jing Li
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, P. R. China
| | - Xinyuan Yang
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, P. R. China
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