Effects of low-dose combined oral contraceptives and protein S K196E mutation on anticoagulation factors: a prospective observational study.

The association between low-dose combined oral contraceptives (COCs) and anticoagulation factors in Japanese women has been rarely studied. A total of 394 Japanese women with a new beginning cycle of COC use were enrolled, of whom 335 women visited the clinic within 4 weeks after starting the first cycle of COC. Visits occurred in the active phase (272 women) and the placebo phase (63 women). Free protein S (PS) antigen and activity levels and antithrombin activity levels decreased significantly in both the active and placebo phase groups. Protein C (PC) activity levels increased significantly in both groups. Larger reductions in free PS antigen and activity levels occurred with COC comprising either 30 µg ethinylestradiol/desogestrel or 20 µg ethinylestradiol/drospirenone than that comprising 35 µg ethinylestradiol/norethisterone. In four women with the Japanese-specific PS K196E mutation, mean PS activity was 65% before COC use and 57% during COC use, indicating further decrease with COC use. In conclusion, decreased antigen and activity levels of PS and antithrombin and increased activity levels of PC were observed even during the first cycle of low-dose COC use. The effects on PS and PC activities were also observed in the hormone-free interval.

Effectiveness on high-grade cervical abnormalities and long-term safety of the quadrivalent human papillomavirus vaccine in Japanese women.

This study for the first time assessed quadrivalent human papillomavirus (qHPV) vaccine effectiveness against HPV6/11/16/18-related high-grade cervical disease in Japanese women (16-26 years old), as previously demonstrated in overseas trials, and vaccine safety in a longer term (48-month) open-label study (NCT01544478). Participants received three doses of qHPV vaccine (Day 1, Month 2, Month 6). Effectiveness endpoints, assessed in the per-protocol population, included incidence of HPV6/11/16/18-related cervical intraepithelial neoplasia (CIN) Grade 2 or worse (CIN Grade 2 and 3, adenocarcinoma in situ, and/or cervical cancer) as primary endpoint and incidence of external genital lesions (EGLs). Disease related to other high-risk HPV types was also assessed. Adverse events (AEs) and serious AEs (SAEs) were collected from Days 1-15 after any vaccination; vaccine-related SAEs, deaths, and new medical conditions were collected throughout the study. A total of 1030 women received at least one vaccination. No cases of CIN2 or worse or EGLs were reported in the per-protocol population. Injection site-related AEs were reported in 14.5% of participants; most were mild and resolved within 15 days. Vaccine-related systemic AEs occurred in 8.6% of participants, most commonly headache (2.3%), malaise (1.7%), and pyrexia (1.3%). There were no vaccine-related SAEs; one participant discontinued due to a vaccine-related AE of mild uticaria. Overall, qHPV vaccine effectiveness against HPV6/11/16/18-related high-grade cervical disease and EGLs was indicated in Japanese women. The vaccine was well-tolerated, without new safety signals throughout the 48-month study period. Findings are consistent with overseas qHPV vaccine pivotal trials. CLINICAL TRIAL REGISTRY: clinicaltrials.gov; NCT01544478.

Abundant expression of sodium-potassium-activated adenosinetriphosphatase alpha 1 subunit in corpus luteum of porcine ovary.

Follicular development is accompanied by the accumulation of follicular fluid. During corpus luteum formation, follicular fluid is diminished and antrum is replaced by lutein cells. These dynamic changes in fluid distribution suggest the existence of control mechanism of fluid transport and membrane permeability. One of the major factors regulating membrane permeability is the sodium-potassium-activated adenosinetriphosphatase (Na(+)-K(+)-ATPase). To elucidate the possible involvement of Na(+)-K(+)-ATPase in follicular growth and luteinization, immunohistochemical localization of Na(+)-K(+)-ATPase alpha1 subunit and enzyme activity in porcine ovary were investigated. In primordial follicles, Na(+)-K(+)-ATPase alpha1 subunit immunostaining was localized only in the oocyte and the surrounding stromal cells. In preantral follicles, immunostaining for Na(+)-K(+)-ATPase alpha1 subunit became apparent in granulosa and theca cells. As the follicle matured, the staining intensity in the oocyte, theca, and granulosa cells increased, which corresponded with the enzyme activity. Na(+)-K(+)-ATPase alpha1 subunit immunostaining became most abundant in granulosa and theca lutein cells in corpus luteum, and decreased in the regressing corpus luteum. Enzyme activity in corpus luteum was significantly higher than that in the follicles. This is the first study indicating that Na(+)-K(+)-ATPase alpha1 subunit expression is augmented in granulosa cells by follicular growth and most abundant in lutein cells in the corpus luteum, suggesting its possible involvement in corpus luteum formation.

Thyroid hormone synergizes with follicle stimulating hormone to inhibit apoptosis in porcine granulosa cells selectively from small follicles.

To investigate the effect of thyroid hormone on the proliferative activity and apoptosis of granulosa cells at the varying stages of follicular growth, porcine granulosa cells obtained from small (1-2 mm), medium (3-5 mm) and large (6-11 mm) follicles were cultured under a serum-free condition in the presence or absence of follicle stimulating hormone (FSH; 20 ng/ml), with or without triiodothyronine (T3; 10-8M). Relative viability, proliferative activity, and apoptosis of cultured granulosa cells were evaluated with 3-(4.5-dimethylahiazol-2-yl)-2,5-diphenyltetrazolium bromide [MTT] assay, Ki67 expression and activated caspase-3 protein expression, respectively. MTT assay showed that T3 had no significant effect on the relative viability of granulosa cells regardless of the follicle size. Ki67-positive rate in small follicle granulosa cells was augmented by treatment with FSH whereas it was not affected by T3. Furthermore, FSH treatment decreased activated caspase-3 protein-positive rate of small follicle granulosa cells. Relative to the treatment with FSH alone, concomitant treatment with FSH and T3 resulted in further decrease in caspase-3 protein-positive rate in small follicle granulosa cells. Treatment with T3 alone did not affect the caspase-3 protein-positive rate. These results suggest that thyroid hormone synergizes with FSH to inhibit apoptosis in small follicle granulosa cells without affecting the proliferative potential of those cells.