In vitro steroid profiling system for the evaluation of endocrine disruptors.

Endocrine disruptors (ED) are chemicals that affect various aspects of the endocrine system, often leading to the inhibition of steroidogenesis. Current chemical safety policies that restrict human exposure to such chemicals describe often time-consuming and costly methods for the evaluation of ED effects. We aimed to develop an effective tool for accurate phenotypic chemical toxicology studies. We developed an in vitro ED evaluation system using gas chromatography/mass spectrometry (GC/MS/MS) methods for metabolomic analysis of multi-marker profiles. Accounting for sample preparation and GC/MS/MS conditions, we established a screening method that allowed the simultaneous analysis of 17 steroids with good reproducibility and a linear calibration curve. Moreover, we applied the developed system to H295R human adrenocortical cells exposed to forskolin and prochloraz in accordance with the Organization for Economic Cooperation and Development (OECD) guidelines and observed dose-dependent variations in steroid profiles. While the OECD guidelines include only testosterone and 17ß-estradiol, our system enabled a comprehensive and highly sensitive analysis of steroid profile alteration due to ED exposure. The application of our ED evaluation screen could be economical and provide novel insights into the hazards of ED exposure to the endocrine system.

Assessment of the potential of polyphenols as a CYP17 inhibitor free of adverse corticosteroid elevation.

Inhibition of 17α-hydroxylase/17,20-lyase (CYP17), which dictates the proceeding of androgen biosynthesis, is recommended as an effective treatment for androgen-dependent diseases. However, androgen depletion by selective CYP17 inhibition is accompanied with corticosteroid elevation, which increases risk of cardiovascular diseases. In this study, we evaluated the likelihood of polyphenols as a CYP17 inhibitor without cardiovascular complications. All examined polyphenols significantly inhibited CYP17 in human adrenocortical H295R cells, but their effects on androgen and cortisol biosynthesis were diverse. Resveratrol was the most potent CYP17 inhibitor with an approximate IC50 of 4 µM, and the inhibition might weigh on the 17α-hydroxylase activity more than the 17,20-lyase activity. Resveratrol also inhibited 21α-hydroxylase (CYP21) essential for corticosteroid biosynthesis but to a lesser extent, thus preventing the occurrence of cortisol elevation following CYP17 blockade. Although transcriptional down-regulation was important for α-naphthoflavone-mediated CYP17 inhibition, resveratrol inhibited CYP17 and CYP21 mainly at the level of enzyme activity rather than enzyme abundance and cytochrome P450 electron transfer. Daidzein also inhibited CYP17 and CYP21 although less potent than resveratrol. Daidzein was the only polyphenol showing inhibition of 3ß-hydroxysteroid dehydrogenase type II (3ßHSD2). The exceptional 3ßHSD2 inhibition led to dehydroepiandrosterone accumulation alongside daidzein-caused androgen biosynthetic impairment. In contrast, androgen and cortisol secretion was increased or remained normal under α-naphthoflavone and ß-naphthoflavone treatments, suggesting that CYP17 inhibition was counteracted by increased substrate generation. α-naphthoflavone and ß-naphthoflavone also enhanced the formation of cortisol from 17-hydroxyprogesterone and testosterone from androstenedione. Our findings suggest a potential application of resveratrol in androgen deprivation therapy.

The relevance of chemical interactions with CYP17 enzyme activity: assessment using a novel in vitro assay.

The steroidogenic cytochrome P450 17 (CYP17) enzyme produces dehydroepiandrosterone (DHEA), which is the most abundant circulating endogenous sex steroid precursor. DHEA plays a key role in e.g. sexual functioning and development. To date, no rapid screening assay for effects on CYP17 is available. In this study, a novel assay using porcine adrenal cortex microsomes (PACMs) was described. Effects of twenty-eight suggested endocrine disrupting compounds (EDCs) on CYP17 activity were compared with effects in the US EPA validated H295R (human adrenocorticocarcinoma cell line) steroidogenesis assay. In the PACM assay DHEA production was higher compared with the H295R assay (4.4 versus 2.2nmol/h/mg protein). To determine the additional value of a CYP17 assay, all compounds were also tested for interaction with CYP19 (aromatase) using human placental microsomes (HPMs) and H295R cells. 62.5% of the compounds showed enzyme inhibition in at least one of the microsomal assays. Only the cAMP inducer forskolin induced CYP17 activity, while CYP19 was induced by four test compounds in the H295R assay. These effects remained unnoticed in the PACM and HPM assays. Diethylstilbestrol and tetrabromobisphenol A inhibited CYP17 but not CYP19 activity, indicating different mechanisms for the inhibition of these enzymes. From our results it becomes apparent that CYP17 can be a target for EDCs and that this interaction differs from interactions with CYP19. Our data strongly suggest that research attention should focus on validating a specific assay for CYP17 activity, such as the PACM assay, that can be included in the EDC screening battery.

Assessment of the utility of the high-dose dexamethasone suppression test in confirming the diagnosis of Cushing disease.

OBJECTIVE: To determine the utility of high-dose dexamethasone suppression (HDDS) tests to confirm the diagnosis of Cushing disease (CD). METHODS: In this retrospective study, we reviewed medical records of patients who underwent either the overnight 8-mg HDDS test or the 2-day 2-mg HDDS test every 6 hours. The percentage suppression of morning serum cortisol and the percentage suppression of 24-hour urine free cortisol (UFC) were calculated. RESULTS: Of 141 patients with proven CD who underwent HDDS tests, 77 (55%) underwent the overnight 8-mg HDDS test and 64 (45%) underwent the 2-day 2-mg HDDS test every 6 hours. With the overnight 8-mg HDDS test, 73 of 77 patients (95%) had greater than 50% suppression and 48 of 77 patients (62%) had greater than 80% suppression of the morning serum cortisol in comparison with the baseline value. With the 2-day 2-mg HDDS test, only 41 of 64 patients (64%) had greater than 90% suppression of 24-hour UFC. CONCLUSION: We conclude that the overnight 8-mg HDDS test accurately confirmed the diagnosis of CD with a high sensitivity of 95% with use of a criterion of greater than 50% suppression; in contrast, the sensitivity was only 62% with use of a more precise cutoff of greater than 80% suppression. The 2-day 2-mg HDDS test with a criterion of greater than 90% suppression of 24-hour UFC had a sensitivity of 64%. These results confirm the limited precision of the HDDS tests.

Adrenal toxicology: a strategy for assessment of functional toxicity to the adrenal cortex and steroidogenesis.

The adrenal is the most common toxicological target organ in the endocrine system in vivo and yet it is neglected in regulatory endocrine disruption screening and testing. There has been a recent marked increase in interest in adrenal toxicity, but there are no standardised approaches for assessment. Consequently, a strategy is proposed to evaluate adrenocortical toxicity. Human adrenal conditions are reviewed and adrenocortical suppression, known to have been iatrogenically induced leading to Addisonian crisis and death, is identified as the toxicological hazard of most concern. The consequences of inhibition of key steroidogenic enzymes and the possible toxicological modulation of other adrenal conditions are also highlighted. The proposed strategy involves an in vivo rodent adrenal competency test based on ACTH challenge to specifically examine adrenocortical suppression. The H295R human adrenocortical carcinoma cell line is also proposed to identify molecular targets, and is useful for measuring steroids, enzymes or gene expression. Hypothalamo-pituitary-adrenal endocrinology relevant to rodent and human toxicology is reviewed (with an emphasis on multi-endocrine axis effects on the adrenal and also how the adrenal affects a variety of other hormones) and the endocrinology of the H295R cell line is also described. Chemicals known to induce adrenocortical toxicity are reviewed and over 60 examples of compounds and their confirmed steroidogenic targets are presented, with much of this work published very recently using H295R cell systems. In proposing a strategy for adrenocortical toxicity assessment, the outlined techniques will provide hazard assessment data but it will be regulatory agencies that must consider the significance of such data in risk extrapolation models. The cases of etomindate and aminoglutethimide induced adrenal suppression are clearly documented examples of iatrogenic adrenal toxicity in humans. Environmentally, sentinel species, such as fish, have also shown evidence of adrenal endocrine disruption attributed to exposure to chemicals. The extent of human sub-clinical adrenal effects from environmental chemical exposures is unknown, and the extent to which environmental chemicals may act as a contributory factor to human adrenal conditions following chronic low-level exposures will remain unknown unless purposefully studied.

Quantitative ultrasound of the heel and serum and urinary cortisol values in assessment of long-term corticotherapy side effects in female bronchial asthma patients.

Female asthma patients (26) with and without corticotherapy were studied. The control group included 19 healthy women. Skeletal status was assessed by ultrasound measurement of the heel (Achilles, Lunar, Madison, WI, USA) and serum and urinary corisol expressed adrenal function. Ultrasound and hormonal values were significantly lower in patients treated with glucocorticosteroids (GC) than in controls. In patients without GC, cortisol parameters were normal and ultrasound measurements were moderately diminished. 57% of women with and 33% of women without GC-therapy had an ultrasound T-score less than -2.5. Decrease of ultrasound values estimated by linear regression in relationship to time of asthma duration was highest in women with GC therapy. Several significant coefficients of correlation between ultrasound and adrenal function parameters were noted only in patients treated with GC. These data suggest that bone and endocrinological side effects due to steroid therapy in asthma patients show similar trends. Results obtained in present study require further longitudinal investigations.

[Benefits and risks of topical steroids in childhood]. / Nutzen und Risiko topischer Steroide im Kindesalter.

Inhaled glucocorticosteroids have become the cornerstone mode of anti-inflammatory treatment in children, especially with bronchial asthma. Many publications document the clinical efficacy of inhaled steroids and an increasing number of authors point out the possible systemic effects of topical steroids, such as effects on growth, impaired bone metabolism and adrenal suppression. The goal of this review article is to summarize published data. The author stresses possible relevant side effects in relation to dose and inhalation technique and focuses on the most appropriate indications and therapeutic modalities of inhaled steroids. The article yields valuable information for both practitioners and clinicians which will assist them in administering inhaled steroids and in discussing questions of safety with medical professionals and laymen.

On the assessment of the in vitro biopotency and site(s) of action of drugs affecting adrenal steroidogenesis.

Dispersed guinea-pig adrenal cells have been employed in the in vitro estimation of the biological potency and sites of action of drugs acting against the adrenal. The effect of 12 drugs on cortisol secretion from cells stimulated with adrenocorticotrophin (ACTH, 50 ng/L, a 95% saturating dose) has been tested. All the drugs depressed cortisol output in a dose-related fashion. The concentration of drug which inhibited secretion by 50% was (mumol/L, mean +/- SEM): etomidate 0.1 +/- 0.002; epostane 0.44 +/- 0.02: 17-ketotrilostane 0.55 +/- 0.04: trilostane 1.3 +/- 0.1: metyrapone 3.5 +/- 0.6: cyproterone acetate 4.6 +/- 0.2: megestrol acetate 11 +/- 2: danazol 22 +/- 2: aminoglutethimide 41 +/- 5: stanozolol 50 +/- 4: thiopentone 160 +/- 18: propofol 170 +/- 18. The sites of the anti-steroidogenic effect of seven of these drugs have also been established using a method based upon the sequential stimulation by the exogenous precursor steroids of the various steps leading to the biosynthesis of cortisol by adrenal cells. Propofol acts between ACTH binding and pregnenolone production, trilostane, megestrol acetate and cyproterone acetate are 3 beta-hydroxysteroid dehydrogenase inhibitors whereas metyrapone, etomidate and thiopentone act at 11 beta-hydroxylase.