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Bojanowski MW, Stefanovic K, Bergeron D, Farzin B, Létourneau-Guillon L, Chaalala C. Pregnancy as a Subgroup in the Pathophysiologic Classification of Spinal Aneurysms. World Neurosurg 2021; 157:e264-e270. [PMID: 34637940 DOI: 10.1016/j.wneu.2021.10.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Aneurysms of spinal arteries not associated with any known predisposing condition are referred to as isolated spinal aneurysms (SAs). In our series, an SA was found in 2 patients during the postpartum period. The goal of this study is to determine whether an occurrence of an SA may be related to puerperium. METHODS In a retrospective analysis of our consecutive series of 10 cases of SAs from 2008 to 2020, we identified 2 cases of SAs during puerperium. Patients' charts and imaging were reviewed, for potential predisposing factors. RESULTS In both cases, angiography showed fusiform aneurysms of the anterior SA with concomitant bilateral vertebral artery (VA) dissections. Serum vasculitis and inflammatory panel and genetic testing for collagen disorders were negative in both cases. Review of the literature showed that pregnancy is associated with an increased risk of arterial dissections in various locations and supports the hypothesis that hemodynamic and hormonal changes may play a role in the formation of SAs. CONCLUSIONS Pregnancy and peripartum state may be a distinct cause of the formation of SAs, possibly as a result of increased hemodynamic stress and hormonal changes that may alter the arterial wall. It would be appropriate to add pregnancy as a subgroup in the classification of SAs. In our series, both cases were associated with bilateral VA dissections; it is possible that the bilateral VA stenosis may have contributed to the formation of the SAs. It is important to recognize this possibility when considering the occlusion of a dissected VA.
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Affiliation(s)
| | | | - David Bergeron
- Division of Neurosurgery, University of Montreal, Montreal, Canada
| | - Behzad Farzin
- Department of Radiology, University of Montreal, Montreal, Canada
| | | | - Chiraz Chaalala
- Division of Neurosurgery, University of Montreal, Montreal, Canada
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2
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Effects of phosphorylated estrogen receptor alpha on apoptosis in human endometrial epithelial cells. Anat Sci Int 2019; 95:240-250. [PMID: 31823335 DOI: 10.1007/s12565-019-00515-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 11/29/2019] [Indexed: 01/15/2023]
Abstract
It is known that the activities of estrogen receptor α (ERα) can be modulated by epidermal growth factor (EGF) through the phosphatidylinostitol 3-kinase-alpha serine/threonine protein kinase (PI3K-AKT) pathway by phosphorylation. To clarify how ERα functions are regulated in endometrial cells during menstrual cycle, molecules related to phosphorylation of ERα (pERα) were examined. It was found that the expression of phosphorylated AKT on serine 473 (pAKT-Ser473) was increased during the proliferative phase, but decreased in the secretory phase. Although the expression of pAKT on threonine 308 in the proliferative phase was only identified in the wall of arterioles, it was strongly expressed in the cytoplasm of endometrial glandular cells after entering the secretory phase. Further observations revealed that while the expression of pERα-Ser104 was constant, pERα-Ser118 was expressed following a cyclic pattern similar to that of the pAKT-Ser473. Following treatment with specific inhibitors for EGFR-PI3K-AKT pathway, it was found that while the expression of pERα-Ser118 and pERα-Ser167 was inhibited, the induced apoptosis could be antagonized by the addition of estrogen, indicating that a mitochondrial pathway is involved. Therefore, pAKT and pERα or ERα could act cooperatively on coiled arterioles and endometrial cells in order to control menstrual cycle.
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3
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Babischkin JS, Bonagura TW, Udoff LC, Vergara CO, Johnson HW, Atlas RO, Pepe GJ, Albrecht ED. Estrogen stimulates the human endometrium to express a factor(s) that promotes vascular smooth muscle cell migration as an early step in microvessel remodeling. Endocrine 2009; 35:81-8. [PMID: 19016353 PMCID: PMC2792122 DOI: 10.1007/s12020-008-9128-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Revised: 10/13/2008] [Accepted: 10/21/2008] [Indexed: 02/03/2023]
Abstract
Vascular smooth muscle cell (VSMC) migration is a pivotal early step in blood vessel remodeling; however, very little is known about the regulation of this process in the human endometrium during the menstrual cycle. In this study, explants of human endometrium were incubated with estradiol and/or progesterone and the conditioned medium (CM) applied to cultures of VSMC to test the hypothesis that estrogen and progesterone stimulate endometrial cells to secrete a factor(s) that promotes VSMC migration. Endometrial explants were composed of highly organized glands and stroma. VSMC migration (cells migrated in 21 h/mm(2) fibronectin-coated semipermeable membrane) in the presence of CM from human endometrial explants obtained in the proliferative phase of the menstrual cycle and incubated for 24 h with estradiol was approximately threefold greater (P < 0.001) than with medium alone and greater (P < 0.05) than with CM from explants treated with estradiol plus progesterone or progesterone. It is concluded, therefore, that estrogen stimulates endometrial secretion of a factor(s) that promotes VSMC migration as an early step in vessel remodeling within the endometrium.
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MESH Headings
- Angiogenesis Inducing Agents/metabolism
- Angiopoietin-1/genetics
- Angiopoietin-1/metabolism
- Angiopoietin-1/physiology
- Cell Movement/drug effects
- Cell Movement/genetics
- Cells, Cultured
- Culture Media, Conditioned/metabolism
- Culture Media, Conditioned/pharmacology
- Endometrium/blood supply
- Endometrium/drug effects
- Endometrium/metabolism
- Estradiol/pharmacology
- Female
- Follicular Phase/genetics
- Follicular Phase/metabolism
- Follicular Phase/physiology
- Gene Expression/drug effects
- Humans
- Luteal Phase/genetics
- Luteal Phase/metabolism
- Luteal Phase/physiology
- Microvessels/drug effects
- Microvessels/metabolism
- Microvessels/physiology
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/physiology
- Myocytes, Smooth Muscle/drug effects
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/physiology
- Regeneration/drug effects
- Regeneration/genetics
- Time Factors
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Affiliation(s)
- Jeffery S. Babischkin
- Department of Obstetrics, Gynecology and Reproductive Sciences, Center for Studies in Reproduction, University of Maryland School of Medicine, Bressler Research Laboratories 11-019, 655 West Baltimore Street, Baltimore, MD 21201, USA
| | - Thomas W. Bonagura
- Department of Obstetrics, Gynecology and Reproductive Sciences, Center for Studies in Reproduction, University of Maryland School of Medicine, Bressler Research Laboratories 11-019, 655 West Baltimore Street, Baltimore, MD 21201, USA
| | - Laurence C. Udoff
- Department of Obstetrics, Gynecology and Reproductive Sciences, Center for Studies in Reproduction, University of Maryland School of Medicine, Bressler Research Laboratories 11-019, 655 West Baltimore Street, Baltimore, MD 21201, USA
| | - Christine O. Vergara
- Department of Obstetrics and Gynecology, Mercy Medical Center, Baltimore, MD, USA
| | - Harry W. Johnson
- Department of Obstetrics, Gynecology and Reproductive Sciences, Center for Studies in Reproduction, University of Maryland School of Medicine, Bressler Research Laboratories 11-019, 655 West Baltimore Street, Baltimore, MD 21201, USA
| | - Robert O. Atlas
- Department of Obstetrics and Gynecology, Mercy Medical Center, Baltimore, MD, USA
| | - Gerald J. Pepe
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Eugene D. Albrecht
- Department of Obstetrics, Gynecology and Reproductive Sciences, Center for Studies in Reproduction, University of Maryland School of Medicine, Bressler Research Laboratories 11-019, 655 West Baltimore Street, Baltimore, MD 21201, USA
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4
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Nayak NR, Kuo CJ, Desai TA, Wiegand SJ, Lasley BL, Giudice LC, Brenner RM. Expression, localization and hormonal control of angiopoietin-1 in the rhesus macaque endometrium: potential role in spiral artery growth. Mol Hum Reprod 2006; 11:791-9. [PMID: 16390855 DOI: 10.1093/molehr/gah237] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Angiopoietin-1 (Ang-1) is an important angiogenic factor that has not been thoroughly studied in the primate endometrium. We evaluated the endometrial expression of Ang-1 and its receptor, Tie2, during induced menstrual cycles in rhesus macaques. Tie2 expression was confined to the vascular endothelium without marked change during the cycle. However, Ang-1 expression varied considerably during the cycle. In the proliferative phase, Ang-1 was only expressed in the basal zone glands, and this expression was estradiol (E2) dependent. In the early- to mid-secretory phase, Ang-1 expression spread to the upper glands, luminal epithelium and the vascular smooth muscle cells (VSMC) of spiral arteries. In the late secretory phase, the signal disappeared from the glands but remained elevated in the VSMC of spiral arteries. Notably, there was a significant correlation between VSMC proliferation and Ang-1 expression in the VSMC of the spiral arteries. Progesterone (P) withdrawal in the early secretory phase induced a decline in Ang-1 expression in the glands and VSMC of spiral arteries along with a complete suppression of VSMC proliferation. These data suggest, for the first time, that Ang-1 may play a key role in the P-dependent growth of the unique spiral arteries in the primate endometrium.
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Affiliation(s)
- Nihar R Nayak
- Department of Gynecology and Obstetrics, Stanford University, Stanford, CA 94305-5317, USA.
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5
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Affiliation(s)
- Hellmut G Augustin
- Dept. of Vascular Biology & Angiogenesis Research, Tumor Biology Center, Breisacher Str 117, D-79106 Freiburg, Germany.
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6
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Dietrich W, Haitel A, Huber JC, Reiter WJ. Expression of estrogen receptors in human corpus cavernosum and male urethra. J Histochem Cytochem 2004; 52:355-60. [PMID: 14966202 DOI: 10.1177/002215540405200306] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Estrogen, largely produced in testis and adrenal gland, may play important roles in male reproduction. Most of the effects of estrogens are mediated by binding of estrogen to one or both of the two estrogen receptor (ER) subtypes alpha and beta. Recently, they have been described in testis, prostate, and efferent ducts, mostly in rodents. The goal of this study was to prove the evidence of ERs in human corpus cavernosum and male urethra, exploring the protein expression of these receptors by immunohistochemistry. Corpus cavernosum and corpus spongiosum smooth muscle was immunoreactive for the androgen receptor (AR), ER alpha, and strongly for ER beta. Endothelial cells were negative for AR, sporadically positive for ER alpha, and positive for ER beta. Urethral epithelium showed strong nuclear expression of AR, predominantly in the basal cell layer, and nuclear expression of ER alpha in the intermediate cells. ER beta was highly expressed in almost all urethral nuclei and, much more weakly, in cytoplasm. Progesterone receptor (PGR) was negative in all cases and all tissues. These results represent the first report that ER alpha and particularly ER beta are regularly expressed in human penile tissue.
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Affiliation(s)
- Wolf Dietrich
- Division of Gynecologic Endocrinology and Reproductive, University of Vienna Medical School, Vienna, Austria.
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7
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Abstract
Menstrual bleeding disorders are one of the most common problems presenting to the gynaecologist. There is increasing evidence that alterations in human uterine vascular structures are associated with spontaneous and sex steroid-induced changes in menstrual bleeding patterns. This article will discuss the normal anatomy and physiology of uterine vascular growth, breakdown, and repair and will indicate where altered anatomy and function may contribute to menstrual disorder. In particular, impact of low-dose progestogens on the endometrial vasculature and endometrial vascular fragility will be discussed. Disturbances of myometrial vascular growth and remodeling, including fibroids, adenomyosis, implantation, and arterio-venous malformations will also be addressed.
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Affiliation(s)
- Martha Hickey
- University of Western Australia, School of Women's and Infants' Health, King Edward Memorial Hospital, Subiaco, Perth, Western Australia, 6008, Australia.
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8
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Rogers PAW, Abberton KM. Endometrial arteriogenesis: vascular smooth muscle cell proliferation and differentiation during the menstrual cycle and changes associated with endometrial bleeding disorders. Microsc Res Tech 2003; 60:412-9. [PMID: 12567398 DOI: 10.1002/jemt.10279] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The cyclical regrowth of the human endometrial vasculature every 28 days following menstruation provides an excellent opportunity for studying arteriogenesis in a human tissue. Despite this, very little has been published to date about temporal or spatial changes in endometrial arteriolar structure or function. Immunohistochemical studies using vascular smooth muscle cell (VSMC) differentiation markers have identified spatially organised differences in VSMC phenotype. However, these have not significantly increased our understanding of how or when arteriogenesis occurs. Endometrial VSMC proliferation continues at a steady rate throughout the cycle, increasing in the specialised spiral arterioles in the mid and late secretory phases. Although estrogen and progesterone play a dominant role in regulating endometrial growth and regression, their direct involvement in arteriogenesis is less clear. Estrogen and progesterone receptors have been reported in endometrial VSMC, although heterogeneity of expression occurs. The angiopoietin/Tie axis has been investigated in endometrium, although the results of 3 studies published to date are contradictory, making conclusions about a role in arteriogenesis problematic. Abnormalities of arteriogenesis may play a role in disorders such as menorrhagia and breakthrough bleeding in contraceptive and hormone replacement therapy users. There is evidence that VSMC proliferation is reduced in spiral arterioles of women with menorrhagia, along with reduced pulsatility index of the uterine artery as shown by Doppler ultrasound. In women taking progestin-only contraception, endometrial perivascular alpha smooth muscle actin is reduced in those who suffer from breakthrough bleeding compared to those that don't. Considerable work is still required to elucidate when in the cycle, where in the tissue, and what mechanisms regulate endometrial arteriogenesis.
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Affiliation(s)
- Peter A W Rogers
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, 3168, Australia.
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9
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Reynolds LP, Grazul-Bilska AT, Redmer DA. Angiogenesis in the female reproductive organs: pathological implications. Int J Exp Pathol 2002; 83:151-63. [PMID: 12485460 PMCID: PMC2517679 DOI: 10.1046/j.1365-2613.2002.00277.x] [Citation(s) in RCA: 128] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The female reproductive organs (ovary, uterus, and placenta) are some of the few adult tissues that exhibit regular intervals of rapid growth. They also are highly vascular and have high rates of blood flow. Angiogenesis, or vascular growth, is therefore an important component of the growth and function of these tissues. As with many other tissues, vascular endothelial growth factors (VEGFs) and fibroblast growth factors (FGFs) appear to be major angiogenic factors in the female reproductive organs. A variety of pathologies of the female reproductive organs are associated with disturbances of the angiogenic process, including dysfunctional uterine bleeding, endometrial hyperplasia and carcinoma, endometriosis, failed implantation and subnormal foetal growth, myometrial fibroids (uterine leiomyomas) and adenomyosis, ovarian hyperstimulation syndrome, ovarian carcinoma, and polycystic ovary syndrome. These pathologies are also associated with altered expression of VEGFs and/or FGFs. In the near future, angiogenic or antiangiogenic compounds may prove to be effective therapeutic agents for treating these pathologies. In addition, monitoring of angiogenesis or angiogenic factor expression may provide a means of assessing the efficacy of these therapies.
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Affiliation(s)
- Lawrence P Reynolds
- Department of Animal and Range Sciences, North Dakota State University, Fargo, ND 58105-5727, USA.
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10
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Green VL, Richmond I, Maguiness S, Robinson J, Helboe L, Adams IP, Drummond NS, Atkin SL. Somatostatin receptor 2 expression in the human endometrium through the menstrual cycle. Clin Endocrinol (Oxf) 2002; 56:609-14. [PMID: 12030911 DOI: 10.1046/j.1365-2265.2002.01521.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Somatostatin mediates its many inhibitory functions through five G-protein-coupled receptors (sstr1-5); however, it is not known whether somatostatin or its receptors are present in the endometrium. DESIGN We have used immunohistochemistry on formalin-fixed paraffin-embedded sections of normal human endometrium from the menstrual (n = 6), proliferative (n = 15) and secretory (n = 10) stages of the endometrial cycle to determine the pattern of expression of somatostatin receptor (sstr) subtype 2. In addition, we have used quantitative polymerase chain reaction (PCR) to determine the level of expression of the sstr2 mRNA in 17 samples of normal human endometrium. PATIENTS Endometrial tissue had been removed from patients undergoing dilation and curettage (D&C) for menorrhagia and had been determined to be normal histologically. MEASUREMENTS Immunostaining in the epithelium, endothelium and the stroma of the endometrial sections was characterized and was scored positive or negative. The PCR results were analysed using the software provided to standardize the expression of sstr2 against that of constitutively expressed beta-glucoronidase in the same sample. A final percentage value of the level of sstr2 expression was then determined. RESULTS sstr2 was expressed variably throughout all the stages of the menstrual cycle in the epithelium, the endothelium and the stroma. In particular, the position of sstr2 expression varied in the epithelial cells surrounding the endometrial glands from being basal or diffuse in the proliferative and secretory phase to being lumenal in the menstrual stage. Quantitative PCR showed that 15 of 17 samples expressed sstr2 mRNA and the level of expression between individual samples varied dramatically. CONCLUSIONS These data show that sstr2 is present in the endometrium and its location seems to vary through the menstrual cycle.
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Affiliation(s)
- Victoria L Green
- Department of Medicine, Wolfson Building, University of Hull, Cottingham Road, Hull HU6 7RX, UK.
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11
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Affiliation(s)
- S K Smith
- Department of Obstetrics and Gynaecology and Pathology, Addenbrooke's Hospital, Cambridge, UK
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13
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Estrogen Receptor Immunoreactivity in the Human and Macaque Cardiovascular Systems. Appl Immunohistochem Mol Morphol 1999. [DOI: 10.1097/00129039-199903000-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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