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Reder SR, Fritzen I, Brockmann MA, Hardt J, Elsner K, Petrowski K, Bjelopavlovic M. Comparing a common clavicle maturation-based age estimation method to ordinary regression analyses with quadratic and sex-specific interaction terms in adolescents. Sci Rep 2024; 14:2754. [PMID: 38307929 PMCID: PMC10837444 DOI: 10.1038/s41598-024-52980-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/25/2024] [Indexed: 02/04/2024] Open
Abstract
Established methods of age estimation are based on correlating defined maturation stages of bony structures with tables representing the observed range of biological ages in the majority of cases. In this retrospective monocentric study in southwestern Germany, common age estimation methodology was assessed in n = 198 subjects at the age of 25 or younger by analyzing the influence of age, quadratic age, biological sex and age-sex interaction on the ossification stages of the medial epiphysis fugue. Three readers (ICC ≥ 0.81 for left/right side) evaluated routine care computed tomography images of the clavicle with a slice thickness of 1 mm. By using least square regression analyses, to determine the real biological age a quadratic function was determined corrected for the age estimated by established methods and sex (R2 = 0.6 each side), reducing the mean absolute error and root mean squared error in the age estimation of women (2.57 and 3.19) and men (2.57 and 3.47) to 1.54 and 1.82 for women, and 1.54 and 2.25 for men. In women, the medial clavicle epiphysis seem to fuse faster, which was particularly observable from approximately 18 years of age. Before that age, the estimation method was relatively close to the ideal correlation between assessed and real age. To conclude, the presented new method enables more precise age estimation in individuals and facilitates the determination and quantification of additional variables, quantifying their influence on the maturation of the medial clavicle epiphysis based on the established ossification stages.
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Affiliation(s)
- Sebastian R Reder
- Department of Neuroradiology, University Medical Center, Johannes Gutenberg-University of Mainz, 55131, Mainz, Germany.
| | - Isabel Fritzen
- Department of Prosthetic Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Marc A Brockmann
- Department of Neuroradiology, University Medical Center, Johannes Gutenberg-University of Mainz, 55131, Mainz, Germany
| | - Jochen Hardt
- Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Duesbergweg 6, 55131, Mainz, Germany
| | - Katrin Elsner
- Institute of Legal Medicine, University Medical Center of the Johannes Gutenberg-University of Mainz, Am Pulverturm 9, 55131, Mainz, Germany
| | - Katja Petrowski
- Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Duesbergweg 6, 55131, Mainz, Germany
| | - Monika Bjelopavlovic
- Department of Prosthetic Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
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2
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Anticoli S, Dorrucci M, Iessi E, Chiarotti F, Di Prinzio RR, Vinci MR, Zaffina S, Puro V, Colavita F, Mizzoni K, Meschi S, Vonesch N, Albano C, Ortona E, Ruggieri A, Tomao P. Association between sex hormones and anti-S/RBD antibody responses to COVID-19 vaccines in healthcare workers. Hum Vaccin Immunother 2023; 19:2273697. [PMID: 37961893 PMCID: PMC10760357 DOI: 10.1080/21645515.2023.2273697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/18/2023] [Indexed: 11/15/2023] Open
Abstract
Healthcare workers (HCWs) are the target population for vaccination against coronavirus disease (COVID-19) as they are at a high risk of exposure and transmission of pathogens to patients. Neutralizing antibodies developed after COVID-19 vaccination decline within few months of vaccination. Several factors, including age and sex, can affect the intensity, efficacy, and duration of immune response to vaccines. However, sex-specific analyses of humoral responses to COVID-19 vaccines are lacking. This study aimed to evaluate sex-based differences in anti-S/RBD (Receptor Binding Domain) responses at three different time points after the second dose of mRNA COVID-19 vaccine in HCWs in relation to age, and to investigate the role of sex hormones as potential markers of response. Anti-S/RBD levels after two doses of the mRNA vaccine were collected from 521 HCWs naïve to COVID-19, working at two Italian Clinical Centers. Multiple regression analysis was applied to evaluate the association between anti-S levels and sex, age, and plasma levels of sex hormones. Significantly higher anti-S/RBD response to the COVID-19 vaccination was found in female HCWs, and a significant and more abrupt decline in response with time was observed in women than that in men. A novel, positive association of testosterone plasma levels and higher anti-S levels in male HCWs was found, suggesting its potential role as sex specific marker in males. In conclusion, understanding the sex-based differences in humoral immune responses to vaccines may potentially improve vaccination strategies and optimize surveillance programs for HCWs.
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Affiliation(s)
- Simona Anticoli
- Reference Center for Gender-specific Medicine, Istituto Superiore di Sanità [Italian National Institute of Health], Rome, Italy
| | - Maria Dorrucci
- Department of Infectious Diseases, Istituto Superiore di Sanità [Italian National Institute of Health], Rome, Italy
| | - Elisabetta Iessi
- Reference Center for Gender-specific Medicine, Istituto Superiore di Sanità [Italian National Institute of Health], Rome, Italy
| | - Flavia Chiarotti
- Reference Center for the Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, [Italian National Institute of Health], Rome, Italy
| | | | - Maria Rosaria Vinci
- Occupational Medicine Unit, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy
| | - Salvatore Zaffina
- Occupational Medicine Unit, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy
| | - Vincenzo Puro
- UOC Emerging Infections and CRAIDS, National Institute for Infectious Diseases L. Spallanzani IRCSS, Rome, Italy
| | - Francesca Colavita
- UOC Lab of Virology, National Institute for Infectious Diseases L. Spallanzani IRCSS, Rome, Italy
| | - Klizia Mizzoni
- UOC Lab of Virology, National Institute for Infectious Diseases L. Spallanzani IRCSS, Rome, Italy
| | - Silvia Meschi
- UOC Lab of Virology, National Institute for Infectious Diseases L. Spallanzani IRCSS, Rome, Italy
| | - Nicoletta Vonesch
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | - Christian Albano
- B cell Lab, Immunology Research Area, Bambino Gesù Children’s Hospital, Rome, Italy
| | - Elena Ortona
- Reference Center for Gender-specific Medicine, Istituto Superiore di Sanità [Italian National Institute of Health], Rome, Italy
| | - Anna Ruggieri
- Reference Center for Gender-specific Medicine, Istituto Superiore di Sanità [Italian National Institute of Health], Rome, Italy
| | - Paola Tomao
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
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3
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Mustieles V, D'Cruz SC, Couderq S, Rodríguez-Carrillo A, Fini JB, Hofer T, Steffensen IL, Dirven H, Barouki R, Olea N, Fernández MF, David A. Bisphenol A and its analogues: A comprehensive review to identify and prioritize effect biomarkers for human biomonitoring. Environ Int 2020; 144:105811. [PMID: 32866736 DOI: 10.1016/j.envint.2020.105811] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/24/2020] [Accepted: 05/07/2020] [Indexed: 05/21/2023]
Abstract
Human biomonitoring (HBM) studies have demonstrated widespread and daily exposure to bisphenol A (BPA). Moreover, BPA structural analogues (e.g. BPS, BPF, BPAF), used as BPA replacements, are being increasingly detected in human biological matrices. BPA and some of its analogues are classified as endocrine disruptors suspected of contributing to adverse health outcomes such as altered reproduction and neurodevelopment, obesity, and metabolic disorders among other developmental and chronic impairments. One of the aims of the H2020 European Human Biomonitoring Initiative (HBM4EU) is the implementation of effect biomarkers at large scales in future HBM studies in a systematic and standardized way, in order to complement exposure data with mechanistically-based biomarkers of early adverse effects. This review aimed to identify and prioritize existing biomarkers of effect for BPA, as well as to provide relevant mechanistic and adverse outcome pathway (AOP) information in order to cover knowledge gaps and better interpret effect biomarker data. A comprehensive literature search was performed in PubMed to identify all the epidemiologic studies published in the last 10 years addressing the potential relationship between bisphenols exposure and alterations in biological parameters. A total of 5716 references were screened, out of which, 119 full-text articles were analyzed and tabulated in detail. This work provides first an overview of all epigenetics, gene transcription, oxidative stress, reproductive, glucocorticoid and thyroid hormones, metabolic and allergy/immune biomarkers previously studied. Then, promising effect biomarkers related to altered neurodevelopmental and reproductive outcomes including brain-derived neurotrophic factor (BDNF), kisspeptin (KiSS), and gene expression of nuclear receptors are prioritized, providing mechanistic insights based on in vitro, animal studies and AOP information. Finally, the potential of omics technologies for biomarker discovery and its implications for risk assessment are discussed. To the best of our knowledge, this is the first effort to comprehensively identify bisphenol-related biomarkers of effect for HBM purposes.
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Affiliation(s)
- Vicente Mustieles
- University of Granada, Center for Biomedical Research (CIBM), Spain; Instituto de Investigación Biosanitaria (ibs. GRANADA), Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Spain.
| | - Shereen Cynthia D'Cruz
- Univ Rennes, EHESP, Inserm, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Stephan Couderq
- Evolution des Régulations Endocriniennes, Département "Adaptation du Vivant", UMR 7221 MNHN/CNRS, Sorbonne Université, Paris 75006, France
| | | | - Jean-Baptiste Fini
- Evolution des Régulations Endocriniennes, Département "Adaptation du Vivant", UMR 7221 MNHN/CNRS, Sorbonne Université, Paris 75006, France
| | - Tim Hofer
- Section of Toxicology and Risk Assessment, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, NO-0213 Oslo, Norway
| | - Inger-Lise Steffensen
- Section of Toxicology and Risk Assessment, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, NO-0213 Oslo, Norway
| | - Hubert Dirven
- Section of Toxicology and Risk Assessment, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, NO-0213 Oslo, Norway
| | - Robert Barouki
- University Paris Descartes, ComUE Sorbonne Paris Cité, Paris, France. Institut national de la santé et de la recherche médicale (INSERM, National Institute of Health & Medical Research) UMR S-1124, Paris, France
| | - Nicolás Olea
- University of Granada, Center for Biomedical Research (CIBM), Spain; Instituto de Investigación Biosanitaria (ibs. GRANADA), Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Spain
| | - Mariana F Fernández
- University of Granada, Center for Biomedical Research (CIBM), Spain; Instituto de Investigación Biosanitaria (ibs. GRANADA), Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Spain.
| | - Arthur David
- Univ Rennes, EHESP, Inserm, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France.
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4
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Gaydou L, Rossetti MF, Tschopp MV, Stoker C, Bosquiazzo VL, Ramos JG. Epigenetic regulation of steroidogenic enzymes expressed in peripheral blood mononuclear cells from healthy individuals and from patients with chronic lymphocytic leukemia. J Steroid Biochem Mol Biol 2020; 204:105767. [PMID: 33011313 DOI: 10.1016/j.jsbmb.2020.105767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 10/23/2022]
Abstract
Sex hormone synthesis occurs in various organs and tissues besides the gonads, such as adrenal glands, brain, intestines, skin, fat, bone, and cells of the immune system. Regarding the latter, it is still not clear which pathways are active, and if they are modified in case of illness of the immune system. Our goal in this study was to determine mRNA expression of different steroidogenic enzymes in peripheral blood mononuclear cells (PBMCs) from healthy individuals of both sexes and of different ages, and then to compare their expression between healthy individuals and patients with Chronic Lymphocytic Leukemia (CLL). Furthermore, to elucidate possible mechanisms that regulate enzyme expression, we analyzed epigenetic events like promoter methylation. We determined that normal cells of the immune system, regardless of sex and age, expressed P450 side chain cleavage (P450scc), cytochrome P450 17α-hydroxylase/c17,20-lyase (P45017α), 3β-hydroxysteroid dehydrogenase/Δ5-Δ4-isomerase (3β-HSD), steroid 5 α reductase (5α-R) types 1, 2 and 3, 3α-hydroxysteroid dehydrogenase (3α-HSD) type 3, and 17β-hydroxysteroid dehydrogenase (17β-HSD) types 1, 3 and 5. We also established that 5α-R 1, 5α-R 3, 3α-HSD 3, 17β-HSD 1 and 17β-HSD 5 expression was altered in CLL patients, and that promoter regions of 5α-R 1, 17β-HSD 1 and 17β-HSD 5 were diferentially methylated. These results suggest that steroidogenic pathways may be affected in CLL cells, and this could be related to disease pathogenesis.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Cytochrome P-450 Enzyme System/genetics
- Epigenesis, Genetic
- Estradiol/blood
- Female
- Healthy Volunteers
- Humans
- Hydroxysteroid Dehydrogenases/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/enzymology
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukocytes, Mononuclear/enzymology
- Male
- Middle Aged
- Progesterone/blood
- RNA, Messenger/metabolism
- Testosterone/blood
- Young Adult
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Affiliation(s)
- Luisa Gaydou
- Departamento de Bioquímica Clínica y Cuantitativa, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina; Instituto de Salud y Ambiente del Litoral(ISAL), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral-CONICET, Santa Fe, Argentina.
| | - Ma Florencia Rossetti
- Departamento de Bioquímica Clínica y Cuantitativa, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina; Instituto de Salud y Ambiente del Litoral(ISAL), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral-CONICET, Santa Fe, Argentina.
| | - Ma Virginia Tschopp
- Instituto de Salud y Ambiente del Litoral(ISAL), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral-CONICET, Santa Fe, Argentina; Cátedra de Fisiología Humana, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina.
| | - Cora Stoker
- Departamento de Bioquímica Clínica y Cuantitativa, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina; Instituto de Salud y Ambiente del Litoral(ISAL), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral-CONICET, Santa Fe, Argentina.
| | - Verónica L Bosquiazzo
- Departamento de Bioquímica Clínica y Cuantitativa, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina; Instituto de Salud y Ambiente del Litoral(ISAL), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral-CONICET, Santa Fe, Argentina.
| | - Jorge G Ramos
- Departamento de Bioquímica Clínica y Cuantitativa, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina; Instituto de Salud y Ambiente del Litoral(ISAL), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral-CONICET, Santa Fe, Argentina.
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5
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Aguirre LE, Colleluori G, Robbins D, Dorin R, Shah VO, Chen R, Jan IZ, Qualls C, Villareal DT, Armamento-Villareal R. Bone and body composition response to testosterone therapy vary according to polymorphisms in the CYP19A1 gene. Endocrine 2019; 65:692-706. [PMID: 31325085 PMCID: PMC8077393 DOI: 10.1007/s12020-019-02008-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 07/06/2019] [Indexed: 01/25/2023]
Abstract
PURPOSE To evaluate the influence of single nucleotide polymorphisms (SNPs) of CYP19A1 on the response and susceptibility to side effects from testosterone therapy. This is a prospective, single-arm study of men with low-morning serum testosterone (<10.68 nmol/l) administered testosterone cypionate 200 mg intramuscularly every 2 weeks for 18 months. METHODS We measured areal bone mineral density (aBMD) and body composition by dual energy X-ray absorptiometry, tibial volumetric BMD and geometry by peripheral quantitative computer tomography, bone turnover markers by enzyme-linked immunosorbent assay, testosterone, and estradiol by liquid-chromatography/mass-spectroscopy, genotyping by microarray, CYP19A1 expression by quantitative polymerase chain reaction, hematocrit and prostate-specific antigen (PSA). RESULTS We enrolled 105 men (40-74-years-old). SNPs rs1062033 and rs700518 were associated with significant differences in outcomes at 18 months. The GG genotype in rs1062033 had significant increase in whole body aBMD, but had significant decrease in tibial bone size compared to the CG and CC genotypes. Body composition analysis showed that the CC genotype of rs1062033, and the AA genotype of rs700518, had significant increase in total lean and appendicular lean mass compared to CG and GG, and AG and GG, respectively. The GG genotype of rs700518 had significant increase in PSA (GG = 105.8 ± 23.3% vs. AG + AA = 53.4 ± 11.3%, p = 0.046) while hematocrit changes were comparable among genotypes. CYP19A1 expression was highest in GG genotype in both SNPs. CONCLUSIONS For the first time, we demonstrated that CYP19A1 SNPs influence response to testosterone therapy in hypogonadal men, highlighting the importance of genetic profiling in therapeutics even for common clinical conditions.
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Affiliation(s)
- Lina E Aguirre
- New Mexico VA Health Care System, Albuquerque, NM, USA
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Georgia Colleluori
- Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - David Robbins
- New Mexico VA Health Care System, Albuquerque, NM, USA
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Richard Dorin
- New Mexico VA Health Care System, Albuquerque, NM, USA
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Vallabh O Shah
- New Mexico VA Health Care System, Albuquerque, NM, USA
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Rui Chen
- Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Irum Zeb Jan
- New Mexico VA Health Care System, Albuquerque, NM, USA
| | - Clifford Qualls
- New Mexico VA Health Care System, Albuquerque, NM, USA
- University of New Mexico School of Medicine, Albuquerque, NM, USA
- Biomedical Research Institute of New Mexico, Albuquerque, NM, USA
| | - Dennis T Villareal
- Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Reina Armamento-Villareal
- Baylor College of Medicine, Houston, TX, USA.
- Michael E. DeBakey VA Medical Center, Houston, TX, USA.
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Nowak J, Pawłowski B, Borkowska B, Augustyniak D, Drulis-Kawa Z. No evidence for the immunocompetence handicap hypothesis in male humans. Sci Rep 2018; 8:7392. [PMID: 29743556 PMCID: PMC5943526 DOI: 10.1038/s41598-018-25694-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 04/26/2018] [Indexed: 12/11/2022] Open
Abstract
The observations that testosterone might be immunosuppressive, form the basis for the immunocompetence handicap hypothesis (ICHH). According to ICHH only high-quality individuals can maintain high levels of testosterone and afford the physiological cost of hormone-derived immunosuppression. The animal and human studies that attempted to support the ICHH by precisely defined impairment of immunity associated with high testosterone levels are inconclusive. Furthermore, human studies have used only selected immune functions and varying testosterone fractions. This is the first study examining the relationship between multiple innate and adaptive immunity and serum levels of free testosterone, total testosterone, DHT and DHEA in ninety-seven healthy men. Free testosterone and marginally DHT levels were positively correlated with the strength of the influenza post-vaccination response. Total testosterone and DHEA showed no immunomodulatory properties. Our findings did not support ICHH assumptions about immunosuppressive function of androgens. In the affluent society studied here, men with higher levels of free testosterone could afford to invest more in adaptive immunity. Since the hormone-immune relationship is complex and may depend on multiple factors, including access to food resources, androgens should be treated as immunomodulators rather than implicit immunosuppressants.
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Affiliation(s)
- Judyta Nowak
- Department of Human Biology, University of Wroclaw, Kuźnicza 35, 50-138, Wrocław, Poland.
| | - Bogusław Pawłowski
- Department of Human Biology, University of Wroclaw, Kuźnicza 35, 50-138, Wrocław, Poland
| | - Barbara Borkowska
- Department of Human Biology, University of Wroclaw, Kuźnicza 35, 50-138, Wrocław, Poland
| | - Daria Augustyniak
- Institute of Genetics and Microbiology, University of Wroclaw, Przybyszewskiego 63/77, 51-148, Wrocław, Poland
| | - Zuzanna Drulis-Kawa
- Institute of Genetics and Microbiology, University of Wroclaw, Przybyszewskiego 63/77, 51-148, Wrocław, Poland
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Abstract
PURPOSE OF REVIEW Telomere attrition and dysfunction has become a well established pathway involved in organismal aging, not only because it imposes a limitation to cell division and therefore, tissue regeneration but also because telomere homeostasis influences other pathways involved in aging. However, the implication of telomere biology in ovarian aging and fertility is barely starting to be unveiled. RECENT FINDINGS During the last years, mounting evidence in favor of the relationship between the accumulation of short telomeres and ovarian senescence has emerged. Telomere attrition and the loss of telomerase activity in ovarian cell types is a common characteristic of female infertility. SUMMARY Recent findings regarding telomere attrition in the ovary open the possibility of both, finding new molecular biomarkers related to telomere homeostasis that make possible the early detection of ovarian dysfunction before the ovarian reserve has vanished, and the search of new therapies to preserve or set up ovarian cell types so that new and better quality oocytes can be generated in aged ovaries to improve IVF outcomes.
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8
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Aguirre LE, Colleluori G, Fowler KE, Jan IZ, Villareal K, Qualls C, Robbins D, Villareal DT, Armamento-Villareal R. High aromatase activity in hypogonadal men is associated with higher spine bone mineral density, increased truncal fat and reduced lean mass. Eur J Endocrinol 2015; 173:167-74. [PMID: 26142101 PMCID: PMC8077967 DOI: 10.1530/eje-14-1103] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Because the aromatase enzyme catalyzes the conversion of testosterone to estradiol (E2), the activity of this enzyme could be important in the musculoskeletal health of men with low testosterone. The objective of the present study is to determine the influence of aromatase activity on the bone mineral density (BMD) and body composition of patients with hypogonadism. DESIGN Cross-sectional study. METHODS The baseline data of 90 patients between 40 and 74 years old who participated in a genetic study of response to testosterone therapy in men with low testosterone (i.e., <300 ng/dl) were analyzed. BMD and body composition were measured by dual-energy X-ray absorptiometry. Serum testosterone was measured by automated immunoassay, E2 was measured by ultrasensitive enzyme immunoassay, and sex hormone-binding globulin was measured by enzyme immunoassay. RESULTS Men in the highest tertile of E2 to testosterone ratio (E2:T) had the highest spine BMD (P ≤ 0.037), highest truncal fat (P=0.046), and lowest truncal lean body mass (P=0.045). A similar pattern was observed in the upper extremities; that is, fat mass significantly increased (P=0.047), whereas lean mass significantly decreased (P=0.034) with increasing E2:T tertiles. CONCLUSION The present findings suggest that in men with hypogonadism, aromatase activity could be an important determinant of musculoskeletal health. Men with high aromatase activity are able to maintain a higher BMD despite low circulating testosterone, but they have lower lean and higher truncal fat mass as compared to those with lower aromatase activity.
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Affiliation(s)
- Lina E Aguirre
- New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA
| | - Georgia Colleluori
- New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA
| | - Kenneth E Fowler
- New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA
| | - Irum Zeb Jan
- New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA
| | - Kenneth Villareal
- New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA
| | - Clifford Qualls
- New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA
| | - David Robbins
- New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA
| | - Dennis T Villareal
- New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA
| | - Reina Armamento-Villareal
- New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA New Mexico VA Health Care SystemAlbuquerque, New Mexico, USABiomedical Research Institute of New MexicoAlbuquerque, New Mexico, USAUniversity of New Mexico School of MedicineAlbuquerque, New Mexico, USAUniversity Campus Bio-MedicoRome, ItalyMichael E DeBakey VA Medical Center2002 Holcombe Boulevard, Houston, Texas 77030, USABaylor College of MedicineHouston, Texas, USA
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Pignatti E, Casarini L, Scaltriti S, Wistuba J, Schlatt S, Rossi A, Lachhab A, Taliani E, Carani C, Simoni M. Aromatase expression in human peripheral blood leucocytes (PBLs) and in various tissues in primates: studies in elderly humans and cynomolgus monkeys. J Med Primatol 2012; 41:372-83. [PMID: 22978812 DOI: 10.1111/jmp.12000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous analysis of aromatase gene and protein expression in peripheral blood leucocytes (PBLs), studied in children and adults, was extended to elderly subjects. In addition, we assessed whether aromatase expression in PBLs could be used as a parameter of aromatase expression in other tissues, using the cynomolgus monkey as model. METHODS Real-time PCR analysis of aromatase gene expression and protein evaluation by Western blot was performed in PBLs of human elderly subjects and in various tissues from cynomolgus monkeys. RESULTS No gender-related difference in CYP19A1 mRNA and protein expression in PBLs from human elderly women and men was found. In elderly male cynomolgus monkeys, CYP19A1 mRNA and protein were expressed in all cells and tissues analysed, with the lowest levels in PBLs but no clear-cut correlation with other tissues. CONCLUSIONS Aromatase expression in PBLs in elderly human subjects is not gender-related and cannot be a surrogate of aromatase expression for other tissues.
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Affiliation(s)
- Elisa Pignatti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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10
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Warner J, Osuch JR, Karmaus W, Landgraf JR, Taffe B, O'Keefe M, Mikucki D, Haan P. Common classification schemes for PCB congeners and the gene expression of CYP17, CYP19, ESR1 and ESR2. Sci Total Environ 2012; 414:81-9. [PMID: 22119029 DOI: 10.1016/j.scitotenv.2011.10.044] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Revised: 10/17/2011] [Accepted: 10/21/2011] [Indexed: 05/22/2023]
Abstract
BACKGROUND Reliable techniques to measure polychlorinated biphenyl (PCB) congeners make the clearer definition of their effects on human health possible. Given that PCBs are classified as endocrine disrupters, we sought to explore the expression of some key genes involved in sex steroid metabolism. OBJECTIVES To examine common classification schemes of PCB congeners and determine whether exposure to groups classified by mechanism of action alter the gene expression (GE) of CYP17, CYP19, and ESR1 and ESR2. METHODS GE and exposure to various classifications of lipid-adjusted PCB congeners were examined in 139 daughters of the Michigan Fisheaters' Cohort. Using mixed models analyses and adjusting for age, menopausal status, and current use of oral contraceptives and hormone replacement therapy, GE data were regressed on exposure to PCB congener groupings based on mechanism of action. RESULTS Three novel findings are elucidated: first, that up-regulation of CYP19 expression is associated with exposure to PCB groupings containing dioxin-like, potentially anti-estrogenic, immunotoxic congeners, including PCB IUPAC #74, #105, #118, #138, #156, #157, #158, #167, and #170 from this cohort. Second, that exposure to similar congeners (PCB IUPAC #105, #156, #157, #158, and #167 in this cohort) but using a classification based solely on hormonal mechanisms of action is associated with increased expression of ESR2. Third, that increased expression of CYP17 is of borderline significance when associated with exposure to PCB IUPAC #118, #138, and #156. CONCLUSIONS These findings are both counter-intuitive and intriguing. Rather than exhibiting anti-estrogenic effects alone, they suggest that these congeners up-regulate the major enzyme involved in estrogen synthesis and tend to confirm previous findings of links between AhR and ER signaling pathways. Replication of these findings, expansion of the number of genes examined, exploration of mixtures of environmental chemicals, and subsequent study of health outcomes in a larger cohort are future priorities.
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Affiliation(s)
- Jillian Warner
- Wayne State University School of Medicine, Detroit, MI, United States
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11
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Marin DP, Bolin AP, de Cassia Macedo dos Santos R, Curi R, Otton R. Testosterone suppresses oxidative stress in human neutrophils. Cell Biochem Funct 2010; 28:394-402. [DOI: 10.1002/cbf.1669] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Abstract
Human aromatase deficiency is a very rare syndrome characterized by congenital estrogen deprivation that is caused by loss-of-function mutations in CYP19A1, which encodes aromatase. Here, we review the presentation, diagnosis and treatment of aromatase deficiency in men to provide useful advice for clinical management of the condition. At presentation, all men with aromatase deficiency have tall stature, delayed bone maturation, osteopenia or osteoporosis and eunuchoid skeletal proportions. Diagnosis of the condition is supported by the presence of unfused epiphyses and undetectable serum estradiol levels; the condition can be further substantiated by genetic sequencing of CYP19A1. Transdermal estradiol treatment at a daily dose of about 25 microg might be adequate for lifelong replacement therapy. BMD and levels of serum estradiol, luteinizing hormone and testosterone should be monitored carefully and considered powerful biochemical markers of adequate estrogen substitution in clinical practice. Early diagnosis is important to initiate estrogen therapy as soon after puberty as possible to avoid the skeletal complications that are associated with this condition.
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Affiliation(s)
- Vincenzo Rochira
- Department of Medicine, Endocrinology and Metabolism and Geriatrics, University of Modena and Reggio Emilia, Modena, Italy.
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13
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Calado RT, Yewdell WT, Wilkerson KL, Regal JA, Kajigaya S, Stratakis CA, Young NS. Sex hormones, acting on the TERT gene, increase telomerase activity in human primary hematopoietic cells. Blood 2009; 114:2236-43. [PMID: 19561322 DOI: 10.1182/blood-2008-09-178871] [Citation(s) in RCA: 257] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Androgens have been used in the treatment of bone marrow failure syndromes without a clear understanding of their mechanism of action. Blood counts of patients with dyskeratosis congenita or aplastic anemia with mutations in telomerase genes can improve with androgen therapy. Here we observed that exposure in vitro of normal peripheral blood lymphocytes and human bone marrow-derived CD34(+) cells to androgens increased telomerase activity, coincident with higher TERT mRNA levels. Cells from patients who were heterozygous for telomerase mutations had low baseline telomerase activity, which was restored to normal levels by exposure to androgens. Estradiol had an effect similar to androgens on TERT gene expression and telomerase enzymatic activity. Tamoxifen abolished the effects of both estradiol and androgens on telomerase function, and letrozole, an aromatase inhibitor, blocked androgen effects on telomerase activity. Conversely, flutamide, an androgen receptor antagonist, did not affect androgen stimulation of telomerase. Down-regulation by siRNA of estrogen receptor-alpha (ER alpha), but not ER beta, inhibited estrogen-stimulated telomerase function. Our results provide a mechanism for androgen therapy in bone marrow failure: androgens appear to regulate telomerase expression and activity mainly by aromatization and through ER alpha. These findings have potential implications for the choice of current androgenic compounds and the development of future agents for clinical use.
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Abstract
Aromatase expression in the endometrium seems to play a pivotal role in the development of endometriotic lesions. Because inflammatory mediators such as prostaglandin E2 appear to activate aromatase in the cells of the endometrial stroma, it was hypothesised that the ensuing inflammation caused by the arrival of aromatase-positive cells in the peritoneal cavity would stimulate local estrogen production, which would in turn facilitate the development of endometriotic lesions by suppressing macrophage phagocytosis. Aromatase expression in the eutopic endometrium will also hamper ovum nidation, thus causing infertility. Progestins, such as gestodene and danazol, are potent inhibitors of aromatase expression in the endometrium, and the use of vaginal rings with danazol in doses that do not block ovulation is associated with the occurrence of pregnancy in patients with severe endometriosis without the need for surgery. A local effect on the endometrium suppressing aromatase expression has been suggested as a possible mechanism of action for the danazol ring.
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Affiliation(s)
- Hugo Maia
- Centro de Pesquisas e Assistencia em Reproducao Humana (CEPARH), Bahia, Brazil.
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Abstract
Several lines of evidence indicate that gender affects the susceptibility and course of multiple sclerosis (MS) with a higher disease prevalence and overall better prognosis in women than men. This sex dimorphism may be explained by sex chromosome effects and effects of sex steroid hormones on the immune system, blood brain barrier or parenchymal central nervous system (CNS) cells. The well known improvement in disease during late pregnancy has also been linked to hormonal changes and has stimulated recent clinical studies to determine the efficacy of and tolerance to sex steroid therapeutic approaches. Both clinical and experimental studies indicate that sex steroid supplementation may be beneficial for MS. This could be related to anti-inflammatory actions on the immune system or CNS and to direct neuroprotective properties. Here, clinical and experimental data are reviewed with respect to the effects of sex hormones or gender in the pathology or therapy of MS or its rodent disease models. The different cellular targets as well as some molecular mechanisms likely involved are discussed.
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Abstract
Estrogens exert a wide range of biological effects in both sexes also on non-reproductive systems and organs. Human congenital estrogen deficiency, due to an inactivating mutation of the aromatase gene, leads to the lack of the estrogen synthesis, with gonadotropins and circulating testosterone ranging from normal to elevated. The aromatese-deficient females show hyperandrogenism and virilization at birth with ambiguous genitalia. During childhood there are a dysfunction in the LHRH-LH/FSH axis and a progressive delay in bone age. At puberty they show primary amenorrhea, no breast development, worsening of the virilization and the absence of growth spurt. The clinical phenotype in the male affected subjects comprises tall stature, persistent linear growth and delayed bone age, osteopenia/osteoporosis, eunuchoid body proportion, different degrees of glucose-insulin and of fertility impairment. These phenotypes suggest the physiological role of estrogens on the skeleton, on pituitary function, on the reproductive system, on glucose metabolism, being the precise mechanism on each of these functions not yet known in detail. The estradiol replacement treatment leads to a complete epiphyseal closure and to the skeletal maturation. Moreover, the increasing knowledge on the role of estrogen in several metabolic pathways could be important for a better management of several metabolic diseases.
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Affiliation(s)
- Lucia Zirilli
- Integrated Department of Medicine, Endocrinology and Metabolism, and Geriatrics, University of Modena and Reggio Emilia, Via Giardini 1355, 41100 Modena, Italy
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Maia H, Casoy J, Correia T, Freitas LA, Pimentel K, Athayde C. The effect of oral contraceptives on aromatase expression in the eutopic endometrium of patients with endometriosis. Gynecol Endocrinol 2008; 24:123-8. [PMID: 18335325 DOI: 10.1080/09513590801890816] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To determine the effect of oral contraceptives containing gestodene on aromatase expression in the endometrium of patients diagnosed with endometriosis. PATIENTS AND METHODS Endometrial biopsies were taken at the time of laparoscopy in 40 patients with endometriosis, 16 of whom were using an oral contraceptive containing gestodene at the time of laparoscopy. The remaining 24 patients were receiving no form of treatment for endometriosis. Endometrial biopsies taken from 23 patients with normal echographic signs and no symptoms were used as controls. Aromatase expression was evaluated in endometrial samples using immunohistochemistry. RESULTS In the untreated, symptomatic endometriosis patients, aromatase expression was detected during the proliferative phase in 92% of cases, while in the symptom-free control patients aromatase was expressed in only 9% of cases. In patients with endometriosis who were using oral contraceptives, there were significantly fewer cases of positive endometria compared with the untreated patients with endometriosis (6%). CONCLUSION Oral contraceptives containing gestodene are effective in decreasing aromatase expression in the eutopic endometrium of patients with endometriosis.
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Affiliation(s)
- Hugo Maia
- Centro de Pesquisa e Assistência em Reprodução Humana (CEPARH), Salvador, Bahia, Brazil.
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Rochira V, Madeo B, Zirilli L, Caffagni G, Maffei L, Carani C. Oestradiol replacement treatment and glucose homeostasis in two men with congenital aromatase deficiency: evidence for a role of oestradiol and sex steroids imbalance on insulin sensitivity in men. Diabet Med 2007; 24:1491-5. [PMID: 17976198 DOI: 10.1111/j.1464-5491.2007.02304.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS The role of sex steroids in glucose and insulin metabolism in men remains unclear. To investigate the effects of sex steroids and oestrogen on insulin sensitivity in men, we studied two male adults with aromatase deficiency (subject 1 and subject 2). METHODS The effects of transdermal oestradiol (tE(2)) treatment at different dosages on insulin sensitivity were studied before tE(2) treatment (phase 1), and after 6 months (phase 2) and 12 months of tE(2) treatment (phase 3) by means of homeostasis model assessment-insulin resistance (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI), insulin tolerance test (ITT), and oral glucose tolerance test (OGTT). The latter was performed only in subject 1, as subject 2 suffered from Type 2 diabetes. RESULTS The restoration of normal serum oestradiol led to improved insulin sensitivity, as shown by changes in HOMA-IR and QUICKI. The ITT provided evidence of improved insulin sensitivity during tE(2) treatment. Insulin secretion after OGTT was reduced during tE(2) treatment in subject 1. After 12 months of tE(2) treatment, insulin sensitivity was improved compared with in phases 1 and 2. CONCLUSIONS The study suggests a direct involvement of oestrogens in insulin sensitivity, and supports a possible role of oestradiol : testosterone ratio, which may be as influencial as the separate actions of each sex steroid on glucose homeostasis.
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Affiliation(s)
- V Rochira
- Integrated Department of Medicine, Endocrinology, Metabolism, and Geriatrics, University of Modena and Reggio Emilia, Italy.
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Rochira V, Zirilli L, Madeo B, Aranda C, Caffagni G, Fabre B, Montangero VE, Roldan EJA, Maffei L, Carani C. Skeletal effects of long-term estrogen and testosterone replacement treatment in a man with congenital aromatase deficiency: evidences of a priming effect of estrogen for sex steroids action on bone. Bone 2007; 40:1662-8. [PMID: 17400043 DOI: 10.1016/j.bone.2007.01.022] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2006] [Revised: 01/09/2007] [Accepted: 01/31/2007] [Indexed: 11/18/2022]
Abstract
The relative contribution of each sex steroid (i.e. estrogen and androgen) on bone in men and the relationships among sex steroids and changes in BMD and bone strength are still unknown. A defective BMD of bone tissue is constantly present in men with aromatase deficiency. This study evaluates the effects of different regimens of treatment with sex steroids over 7.3 years follow-up on BMD in an adult man affected by aromatase deficiency and by a concomitant mild hypogonadism, as previously described. The aim of the study is to provide additional data on the relative roles of androgens and estrogens in male bone metabolism. The effects of testosterone (T) treatment alone and estrogen (tE(2)) treatment alone as well as the effects of the combined treatment with testosterone and estradiol (T plus tE(2)) on areal BMD (aBMD) at dual-energy X-ray absorptiometry (DXA) and the effects of T plus tE(2) on volumetric BMD (vBMD), particular at cortical site, measured by peripheral quantitative computed tomography (pQCT), are investigated. Hormones and markers of bone turnover were monitored during all phases of the study. Treatment with tE(2) normalized serum estradiol, but only the combined treatment with T plus tE(2) normalized both serum estradiol and testosterone. Markers of bone turnover reached a pattern close to normality during T plus tE(2). The aBMD was little modified by T, but increased more during tE(2). T plus tE(2) resulted in a further increase in both aBMD at DXA and vBMD at pQCT. Cortical thickness increased during T plus tE(2) both in radius and tibia. Only the combined treatment led to optimal parameters of aBMD suggesting that testosterone needs estrogens as a permissive factor for a direct androgen anabolic action on bone in men.
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Affiliation(s)
- Vincenzo Rochira
- Department of Medicine, University of Modena and Reggio Emilia, Ospedale S. Agostino-Estense di Baggiovara, Via Giardini 1355, Baggiovara, 41100 Modena, Italy
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