Hormone-Related Cancer and Autoimmune Diseases: A Complex Interplay to be Discovered.

Neoplasic transformation is a continuous process that occurs in the body. Even before clinical signs, the immune system is capable of recognizing these aberrant cells and reacting to suppress them. However, transformed cells acquire the ability to evade innate and adaptive immune defenses through the secretion of molecules that inhibit immune effector functions, resulting in tumor progression. Hormones have the ability to modulate the immune system and are involved in the pathogenesis of autoimmune diseases, and cancer. Hormones can control both the innate and adaptive immune systems in men and women. For example androgens reduce immunity through modulating the production of pro-inflammatory and anti-inflammatory mediators. Women are more prone than men to suffer from autoimmune diseases such as systemic lupus erythematosus, psoriasis and others. This is linked to female hormones modulating the immune system. Patients with autoimmune diseases consistently have an increased risk of cancer, either as a result of underlying immune system dysregulation or as a side effect of pharmaceutical treatments. Epidemiological data on cancer incidence emphasize the link between the immune system and cancer. We outline and illustrate the occurrence of hormone-related cancer and its relationship to the immune system or autoimmune diseases in this review. It is obvious that some observations are contentious and require explanation of molecular mechanisms and validation. As a result, future research should clarify the molecular pathways involved, including any causal relationships, in order to eventually allocate information that will aid in the treatment of hormone-sensitive cancer and autoimmune illness.

Remote sensing of intraperitoneal parasitism by the host's brain: regional changes of c-fos gene expression in the brain of feminized cysticercotic male mice.

Experimental intraperitoneal Taenia crassiceps cysticercosis in mice exhibits distinct genetical, immunological and endocrinological features possibly resulting from the complex interactive network of their physiological systems. Very notable is the tendency of parasites to grow faster in hosts of the female sex. It is also remarkable in the feminization process that the infection induces in chronically infected male mice, characterized by their estrogenization, deandrogenization and loss of sexual and aggressive patterns of behaviour. The proto-oncogene c-fos is a sex steroid-regulated transcription factor gene, expressed basally and upon stimulation by many organisms. In the CNS of rodents, c-fos is found expressed in association to sexual stimulation and to various immunological and stressful events. Hence, we suspected that changes in c-fos expression in the brain could be involved in the feminization of the infected male mice. Indeed, it was found that c-fos expression increased at different times during infection in the hypothalamus, hippocampus, less so in the preoptic area and cortex, and not in several other organs. The significant and distinctive regional changes of c-fos in the CNS of infected mice indicate that the brain of the host senses intraperitoneal cysticercosis and may also announce its active participation in the regulation of the host-parasite relationship. Possibly, the host's CNS activity is involved in the network that regulates the estrogenization and deandrogenization observed in the chronically infected male mice, as well as in the behavioural and immunological peculiarities observed in this parasitic infection.

Evidence that steroid 5alpha-reductase isozyme genes are differentially methylated in human lymphocytes.

The synthesis of dihydrotestosterone (DHT) is catalyzed by steroid 5alpha-reductase isozymes 1 and 2, and this function determines the development of the male phenotype during embriogenesis and the growth of androgen sensitive tissues during puberty. The aim of this study was to determine the cytosine methylation status of 5alpha-reductase isozymes types 1 and 2 genes in normal and in 5alpha-reductase deficient men. Genomic DNA was obtained from lymphocytes of both normal subjects and patients with primary 5alpha-reductase deficiency due to point mutations in 5alpha-reductase 2 gene. Southern blot analysis of 5alpha-reductase types 1 and 2 genes from DNA samples digested with HpaII presented a different cytosine methylation pattern compared to that observed with its isoschizomer MspI, indicating that both genes are methylated in CCGG sequences. The analysis of 5alpha-reductase 1 gene from DNA samples digested with Sau3AI and its isoschizomer MboI which recognize methylation in GATC sequences showed an identical methylation pattern. In contrast, 5alpha-reductase 2 gene digested with Sau3AI presented a different methylation pattern to that of the samples digested with MboI, indicating that steroid 5alpha-reductase 2 gene possess methylated cytosines in GATC sequences. Analysis of exon 4 of 5alpha-reductase 2 gene after metabisulfite PCR showed that normal and deficient subjects present a different methylation pattern, being more methylated in patients with 5alpha-reductase 2 mutated gene. The overall results suggest that 5alpha-reductase genes 1 and 2 are differentially methylated in lymphocytes from normal and 5alpha-reductase deficient patients. Moreover, the extensive cytosine methylation pattern observed in exon 4 of 5alpha-reductase 2 gene in deficient patients, points out to an increased rate of mutations in this gene.

[Tumor suppressor gene p53: mechanisms of action in cell proliferation and death]. / El gen supresor de tumores p53: mecanismos de acción en la proliferación y muerte celular.

Normal development is a balance process, which includes proliferation and cell death. Indeed both proliferation and apoptotic cell death are very complex process that involves the participation of many genes. In both events, the tumor suppressor p53 is one of the most important and studied genes. This transcription factor activates several genes, which results in the arrest of the cellular cycle and cellular repair or apoptosis. Many are the signals that activate p53 function including: DNA damage by gamma or ultraviolet radiation and chemical agents and hypoxia, among others. When p53 is activated it can either induces the expression of p21 (Waf1, Cip-1), which participates in the cellular arrest between G1-S transition, or the expression of bax, PIGs, IGF-BP3, Fas, FasL and DR5. The former genes participate in the cascade of events that induce apoptosis. Cellular arrest or apoptosis depends of the degree of cellular damage. The final outcome of the different mechanisms of action of p53 is to maintain the genomic stability of the cell. Thus, the absence of this protein contributes to genomic instability, the accumulation of mutations and increased tumorigenesis. It has been demonstrated that p53 present mutations in 50-55% of all types of reported human cancer. These mutations are primary located in DNA binding domain of the protein, which results in the loss of its biological activity. Frequently, tumors that present wild type p53 have a better response towards therapy than those that present p53 mutations. This review is focused on the knowledge of the normal p53 cellular pathways and their alterations in cancer. It is clear that the understanding of p53 function in the development of this pathology may give new insights in future therapeutic strategies including gene therapy for cancer.

Progesterone receptor isoforms expression in the prepuberal and adult male rat brain.

Progesterone receptor (PR) isoforms expression was determined in several regions of the prepuberal and adult male rat brain by using reverse transcription coupled to polymerase chain reaction. Rats under a 14:10-h light-dark cycle, with lights on at 0600 h were used. We found that in the hypothalamus of prepuberal animals the expression of both PR isoforms was similar, whereas PR-A expression was higher than that of PR-B in adults. In the cerebellum PR-B expression was predominant in both prepuberal and adult rats. In both ages PR-A and PR-B exhibited a non-significant tendency to be predominant in the hippocampus and the preoptic area respectively. In the frontal cortex and the olfactory bulb PR isoforms were expressed at a similar level. These results indicate a differential expression pattern of PR isoforms in the male rat brain and suggest that the tissue-specific expression of PR-A and PR-B is important for the appropriate response of each cerebral region to progesterone.

Progesterone receptor isoforms expression pattern in human chordomas.

Steroid hormone receptors are involved in the regulation of tumor growth. Two progesterone receptor (PR) isoforms have been identified in humans: a larger form (PR-B) and the N-terminally truncated one (PR-A). PR isoforms can exert opposite functions and are differentially regulated by estrogens. PR have been detected in several brain tumors including chordomas, however, it is unknown which PR isoform is expressed in brain tumors. The aim of this study was to determine by reverse transcription-polymerase chain reaction (RT-PCR) and by immunohistochemistry the expression pattern of PR isoforms in chordomas as well as its correlation with the expression of estrogen receptor a (ER-alpha). All studied chordomas expressed both PR and ER-alpha. PR-B was the predominant isoform in chordomas both at the mRNA and at the protein level. These data suggest that PR-B should be the predominant PR isoform expressed in human chordomas.

Mating modifies c-fos expression in the brain of male and female rabbits.

Copulation in rabbits provokes behavioral and neuroendocrine changes in both sexes. To investigate if the activity of particular brain regions is modified accordingly we quantified, by the reverse transcription-polymerase chain reaction method, c-fos expression in the preoptic area, hypothalamus, hippocampus, and frontal cortex of male and female rabbits before mating, immediately afterwards, and 1 h later. Mating immediately increased c-fos expression in the hypothalamus of both sexes, the frontal cortex of females, and the preoptic area of males. c-fos expression did not change in the hippocampus after mating in either sex but decreased in the preoptic area of females following mating. Results show that mating provokes changes in brain activity, in a gender- and region-specific manner, which may underlie the behavioral and endocrine consequences of copulation in rabbits.

Variations of progesterone receptor and c-fos gene expression in the rat uterus after treatment with norethisterone and its A-ring reduced metabolites.

It has been suggested that some contraceptive derivatives of 19-nor-testosterone possess estrogenic activity that may facilitate the development of breast cancer. The aim of this work was to investigate the estrogenic properties of norethisterone (NET) and its A-ring-reduced derivatives by determining progesterone receptor (PR) and c-fos mRNA content of two estrogen-regulated genes in the uterus of ovariectomized rats. mRNA content was evaluated by Northern blot 1-6 h after 17 beta-estradiol administration. The highest PR and c-fos mRNA content was observed 3 h and 2 h after 17 beta-estradiol administration, respectively. NET did not modify either PR or c-fos mRNA content. In contrast, 5 alpha- and 3 beta, 5 alpha-NET significantly increased mRNA content of both genes. The increase in c-fos mRNA content induced by these reduced compounds was lower than that found with estradiol treatment. The overall results indicate that NET administration can indirectly induce estrogenic effects through the action of its 5 alpha-dihydro and 3 beta, 5 alpha-tetrahydro derivatives.

Immunocytochemical detection of estrogen and progesterone receptors in the rabbit submandibular gland.

Rabbit submandibular glands produce secretions involved in olfactory communication. The histology of these glands and their secretory activity are: sexually dimorphic; vary across the female reproductive cycle; and are modified by gonadectomy. This suggests that gonadal steroids regulate the structure and function of such glands. To further support this idea we assessed by immunocytochemistry the presence of estrogen and progesterone receptors in male and female rabbit submandibular glands. Immunoreactivity was detected only in the nucleus of acini cells. The number of estrogen receptor-immunoreactive cells/field varied among estrus (26 +/- 6; mean +/- S.E.), ovariectomized (19 +/- 2), and ovariectomized-estrogen-treated animals (13 +/- 3). Intact males showed a significantly smaller number of estrogen receptor-immunoreactive cells/field (12 +/- 1) than estrous females. Interestingly, progesterone receptor-immunoreactive cells were more abundant in estrous (32 +/- 7) than in ovariectomized animals (7 +/- 1). Estradiol benzoate (5 micrograms daily for 5 days) increased the number of progesterone receptor-immunoreactive cells/field in ovariectomized females (17 +/- 1). Intact males showed fewer progesterone receptor-immunoreactive cells/field (16 +/- 2) than estrous females. Results show that the rabbit submandibular gland is a target for estrogen and progesterone and support the idea that these hormones participate in regulating the physiology of this gland.

Changes in progesterone receptor mRNA content in the rabbit lung during early pregnancy and after sex steroid hormone treatment.

In this work we determined progesterone receptor (PR) mRNA content in female rabbit lung during the first 5 days of pregnancy and in ovariectomized animals after subcutaneous injection of oestradiol benzoate (25 micrograms/kg) for 2 days or oestradiol benzoate (25 micrograms/kg) for 2 days plus a single dose of progesterone (5 mg/kg) on day three. On each day (0-5) of pregnancy and 24 h after the last dose in the case of the treated animals, animals were killed and lung was excised; total RNA was extracted and processed for Northern blot analysis. The results showed three main PR mRNA transcripts (6.1, 4.4 and 1.8 kb) in rabbit lung. The 4.4 kb species was the most abundant. PR mRNA content was markedly increased by oestradiol benzoate and downregulated by progesterone. It significantly increased on the first day of pregnancy and then diminished progressively, reaching its lowest value on day 5. These findings suggest that PR mRNA content in the rabbit lung is regulated by sex steroid hormones and changes according to the physiological concentrations of oestradiol and progesterone.

Regulation of progesterone receptor gene expression by sex steroid hormones in the hypothalamus and the cerebral cortex of the rabbit.

The effects of estradiol benzoate (EB) and progesterone (P4) upon progesterone receptor (PR) gene expression in the cerebral cortex and the hypothalamus of the rabbit were studied. Ovariectomized adult rabbits were subcutaneously treated with EB (25 micrograms/kg) for 2 days, and with EB (25 micrograms/kg) + a single dose of P4 (5 mg/kg) on day 3. Twenty-four hours after the last dose, the frontal cortex, the hypothalamus and the uterus were excised, total RNA was extracted and processed for reverse transcription-polymerase chain reaction. PR gene expression was induced by EB and down-regulated by P4 both in the frontal cortex and the hypothalamus in a manner similar to that observed in the uterus. The finding that PR gene transcription is regulated by steroid hormones in the cerebral cortex suggests that post-transcriptional processes are involved in the insensitivity of cortical PR protein to steroids regulation previously reported with binding techniques.

[Progesterone and its metabolites in central nervous system function]. / La progesterona y sus metabolitos en el funcionamiento del sistema nervioso central.

Progesterone (P4) and its metabolites are involved in several functions of the central nervous system (CNS). These steroids participate in neuronal excitability, reproduction and sexual behavior. P4 and its metabolites exert their effects on neurons and glial cells through several mechanisms that include the interaction of the steroids with: 1) intracellular specific receptors; 2) modulatory sites located in neurotransmitter receptors; and 3) ionic channels. By these mechanisms, modifications in gene expression, second messengers' production and ion conductance are induced. The activities of the P4 metabolites have been mainly related to membrane effects, whereas for P4, the transcriptional and translational effects are mediated by intracellular receptors. Thus, these steroids can modify the CNS functions at short (milliseconds), medium (minutes) or long term (hours or days) lapses. The knowledge of the molecular mechanisms involved in the actions of P4 and its metabolites in the CNS will contribute to the understanding of fundamental biological processes such as sexual behavior and reproduction, and it will open the possibility of alternative therapies in the treatment of some neurologic and psychiatric disorders such as epilepsy, anxiety, premenstrual syndrome, and cerebral tumors which possess hormonal regulation.

Norethisterone metabolites modulate the uteroglobin and progesterone receptor gene expression in prepubertal rabbits.

Norethisterone (NET) is a synthetic progestin, used as a contraceptive agent, that is biotransformed at target tissues into 5 alpha-NET and 3 beta,5 alpha-NET, which possess different pharmacological properties. The effects of these metabolites on the expression of uteroglobin (UG) and progesterone receptor (PR) genes, both regulated by progesterone (P4), were evaluated in the uterus of prepubertal female rabbits that were simultaneously treated with P4 (1.0 mg) for 5 consecutive days. As determined by Western and Northern blot analyses, 5 alpha-NET inhibited the P4-induced UG gene expression in a dose-dependent manner. A similar inhibition was observed with the administration of RU-486. The estrogenic agent 3 beta,5 alpha-NET and estradiol at a dose of 1.0 mg also inhibited the UG gene expression induced by P4. Both 5 alpha-NET and 3 beta,5 alpha-NET blocked the PR down-regulation induced by P4 as assessed by Western and Northern blot methods. The inhibition of UG synthesis and PR down-regulation by 5 alpha-NET and 3 beta,5 alpha-NET indicates that these NET metabolites possess antiprogestational properties.

Molecular mechanisms of the antihormonal and antiimplantation effects of norethisterone and its A-ring reduced metabolites.

Norethisterone (NET) has been used as a contragestational postcoital agent. It is biotransformed to 5 alpha dihydro-NET (5 alpha-NET) and 3 beta,5 alpha tetrahydro-NET (3 beta,5 alpha-NET) in target tissues. The participation of these metabolites in NET effects is unknown. We have examined the antiimplantation and antiprogestational effects of NET and its metabolites, in adult mated female rabbits, by assessing the number of implantation sites and the expression products of the uteroglobin (UTG) gene in the uterus, and by comparing them with those of RU-486 and estradiol. Steroids were daily administered s.c. at several doses for 7 consecutive days, starting 24 hr after coitus. To assure that fertilization occurred in all animals, the presence of early pregnancy factor was determined. The results demonstrated that high doses (5 mg/kg) of NET reduced both implantation and the expression of the UTG gene. On the other hand, lower doses (1.5 mg/kg) of 5 alpha-NET produced an antiimplantation effect and suppressed UTG synthesis and its mRNA. These effects were similar to those of RU-486. At lower doses (1 mg/kg), both estradiol and the estrogenic metabolite 3 beta,5 alpha-NET were also effective in inhibiting implantation and UTG gene expression. The overall results suggest that NET metabolites exert antiimplantation and antiprogestational effects through their interaction with progesterone and estrogen receptors, and provide an explanation for the molecular mechanisms involved in the postcoital contraceptive action of NET.

[An epidemic of primary bacteremia due to an endemic strain of Serratia marcescens in an intensive care unit]. / Epidemia de bacteremias primarias por una cepa endémica de Serratia marcescens en una unidad de terapia intensiva.

An outbreak of Serratia marcescens bacteremia detected in the intensive care unit (ICU) of a tertiary care center on the last days of October, 1985, is described. The rate of primary S. marcescens nosocomial bacteremia during the pre-epidemic period (January-September 1985) was 6.25 per cent; and for the post-epidemic period compared with the epidemic were significantly different (p < 0.0001). The outbreak strains belonged to the biotype A8b, which has been endemic in our hospital. The responsible organism exhibited an unusual antimicrobial resistance pattern associated to the presence of a specific plasmid (greater than 50 kilobases), which showed similar fragments after restriction endonuclease digestion. No specific risk factors were identified in the case-control study. The outbreak was probably related to a greater influx of infected patients, resulting in less careful infection control measures, due to the emergency situation which suffered the hospital after the earthquakes in 1985. The unusual high rate of blood isolation of S. marcescens at the ICU was the first sign of the outbreak. The prompt reinforcement of infection control policies facilitated its resolution.

Endometrial expression of progesterone receptor and uteroglobin genes during early pregnancy in the rabbit.

The progesterone receptor (PR) plays a pivotal role in the maturation process of the secretory endometrium, implantation and maintenance of pregnancy in rabbits. To determine the dynamics of PR gene expression and its physiological significance, the endometrial expression of PR and PR mRNA were evaluated and compared with the expression of the progesterone-regulated uteroglobin (UG) gene during 0-5 days post-coitus in rabbits. The results of immunoblot experiments indicated the presence of PR in endometrial cell extracts from days 1-4 of pregnancy with maximum PR immunostaining on day 2, followed by a marked diminution until its complete disappearance on day 5. When endometrial PR mRNA content was assessed by Northern blots, the results were similar to those of PR immunostaining, with maximal concentrations on the second day after mating. However, PR mRNA levels were still high on day 3, despite the concomitant decrease in immunostainable PR. Endometrial UG gene expression, on the other hand, exhibited a different time sequence. Thus, the UG content in uterine flushings progressively increased from day 3 after mating, reaching maximal levels on the fifth day. The endometrial UG mRNA content presented a similar profile, as its maximum concentration occurred on days 4-5. The overall results indicate that endometrial PR is down-regulated at both the mRNA and protein levels, possibly by endogenous progesterone during early pregnancy. The striking observation that maximal expression of endometrial UG gene products occurred when PR and its mRNA are no longer detectable suggests an important role for this progesterone-binding uterine protein during the preimplantation period.

Variable expression of the uteroglobin gene following the administration of norethisterone and its A-ring reduced metabolites.

Enzyme-mediated A-ring reduction of norethisterone (NET) results in the transformation of a molecule with potent intrinsic progestational activity into neutral derivatives with estrogen-like effects. To ascertain whether these structural modifications of NET are able to modify the uteroglobin (U) gene (G) expression, a series of experiments assessing the UG products after the administration of NET and its reduced A-ring metabolites were conducted in prepubertal female rabbits. Synthesis of endometrial uteroglobin and its specific mRNA were studied in animals following the administration of NET, 5 alpha-dihydro NET,3 beta,5 alpha-tetrahydro NET and progesterone. Animals treated with either estradiol or vehicle alone served as controls. The uteroglobin content in uterine flushings and cytosols was determined by immunodiffusion and polyacrilamide gel electrophoresis techniques and by a specific double-antibody radioimmunoassay, while the U mRNA synthesis was assessed by its molecular hybridization to [alpha 32P]d-ATP uteroglobin cDNA. NET induced a significant increase of the uterine content of uteroglobin similar to that observed with progesterone with a simultaneous increase on U mRNA synthesis. On the contrary, 5 alpha-NET and 3 beta,5 alpha-NET induced very little, if any uteroglobin synthesis with a concomitantly low U mRNA production as compared with NET; thus exhibiting a similar effect to that observed in estradiol-treated animals. The overall results were interpreted as demonstrating that the enzyme mediated structural changes of NET which occur at the target organs induce variable expression of the uteroglobin gene. The data indicate that the rabbit uteroglobin gene products are suitable molecular markers to evaluate the hormonal potency of contraceptive synthetic progestins and their derivatives.

Oestrogen-insensitive progestin receptors in the central nervous system: physicochemical and immunoreactive characteristics.

Abstract The intracellular effects of progesterone in the central nervous system are exerted via two distinct receptors: The classical oestrogen-regulated progestin receptor and the non-oestrogen-inducible progestin receptor. To assess whether the oestrogen-insensitive receptor is related to the oestrogen-dependent receptor or whether it is a different binding macromolecule, its physicochemical and immunoreactive characteristics (immunoprecipitation with polyclonal anti-uterine progesterone receptor antisera) were studied in neural tissues of the female rat. The results disclosed that the dissociation constant (K(d), 0.4-0.5 +/- 10(-9) M), stereospecificity and sedimentation coefficient (7-8 S) in linear sucrose gradients of the oestrogen-insensitive progestin receptor were identical to those reported for the oestrogen-regulated progestin receptor, although its saturation binding capacity was significantly lower. Results of in vitro nuclear acceptor assays revealed that the progestin receptor complexes from cerebellum and cerebral cortex, were able to specifically bind to cell nuclei preparations in a fashion similar to that observed with the uterine progestin receptor, although to a lesser extent. Interestingly, a similar nuclear uptake of receptor complexes was noticed when standardized cerebellum and uterus cytosol preparations with a similar receptor content were used. The anti-uterine progesterone receptor immunoglobulins used in the immunoprecipitation studies were able to specifically recognize the progestin receptor populations of the anterior pituitary and hypothalamus (oestrogen-regulated receptors) as well as those of the cerebellum and cerebral cortex (oestrogen-insensitive receptors). The results presented show that both the oestrogen-sensitive and the oestrogen-insensitive cytosol progestin receptors in brain bind the same progesterone-like molecules used as radioligands and also react with the same antibody when tested in an immunoprecipitation radioassay. The striking similarities found in binding kinetics, physicochemical characteristics and immunoreactive behaviour in the two progestin receptors studied demonstrated that both macromolecules belong to the same family of proteins in spite of their different sensitivity to oestrogens. The overall data seem to suggest a common origin of the two progestin receptor populations in brain but with different mechanisms of hormonal regulation.