An unhealthy blush - secondary erythrocytosis due to waterpipe smoking.

INTRODUCTION: We present a case of a patient with a chronic carbon monoxide (CO) intoxication with facial plethora due to secondary erythrocytosis. CASE DETAILS: A 22-year-old male was referred by the dermatologist to our outpatient clinic for evaluation of polycythaemia. Laboratory results showed secondary erythrocytosis. After an extensive diagnostic evaluation, we diagnosed a chronic CO intoxication (carboxyhaemoglobin (COHb) level of 21%) without apparent complaints and facial plethora as the only clinical sign. The patient denied smoking tobacco or use of illicit drugs. On inspection of his house by the fire department, a waterpipe was found in his bedroom, which he used daily, according to his father. CO measurements in the house were normal. We treated the patient with high flow oxygen and advised him to quit smoking the waterpipe. Within a few weeks, the erythrocytosis normalised. DISCUSSION: We propose to test for the presence of an elevated COHb in all patients with a normal or high erythropoietin level. The test is not expensive and can easily be included as part of an examination, since CO intoxication has potentially disastrous consequences, and, as is illustrated with this case, chronic CO poisoning can be virtually asymptomatic. Not all individuals consider smoking a waterpipe the same as smoking or drugs, and therefore physicians need to specifically ask for its use.

A diagnostic tool for self-poisoned patients: Analysis of gastric content and lavage fluids.

Approximately 500 patients per year are admitted to the emergency department (ED) of the Erasmus University Medical Center presenting with intoxications with medication. For adequate treatment, it is sometimes important to know which drugs in which quantities were ingested. This can require laboratory analysis of blood or urine samples; however, these samples do not provide information about the possible effects that can still be expected. We performed toxicological screening on the gastric content of three patients admitted to our ED in January and February 2018. These patients underwent gastric lavage or received a gastric tube as part of routine care. The gastric fluid was analysed via UPLC-MS/MS using the Waters method for toxicological screening. In all three patients, we successfully determined drugs in the gastric content. In two patients, we identified more different drugs in the gastric content than in blood plasma. In the other patient, admitted approximately six hours after a severe autointoxication with the betablocker metoprolol, we found significant amounts of metoprolol in the gastric content acquired by gastric lavage. We therefore believe that analysis of gastric content after an intoxication can have multiple applications; for example, it may provide information about symptoms of intoxication that can be expected, it may aid patient care and may provide insight in the toxicokinetics of different drugs. In conclusion, we demonstrate that toxicological screening and quantification of drug levels in gastric content is possible and has potential as an adjunct in patient care, but limitations need to be addressed before implementation in clinical practice.

Maternal protein malnutrition: effects on prostate development and adult disease.

Well-controlled intrauterine development is an essential condition for many aspects of normal adult physiology and health. This process is disrupted by poor maternal nutrition status during pregnancy. Indeed, physiological adaptations occur in the fetus to ensure nutrient supply to the most vital organs at the expense of the others, leading to irreversible consequences in tissue formation and differentiation. Evidence indicates that maternal undernutrition in early life promotes changes in key hormones, such as glucocorticoids, growth hormones, insulin-like growth factors, estrogens and androgens, during fetal development. These alterations can directly or indirectly affect hormone release, hormone receptor expression/distribution, cellular function or tissue organization, and impair tissue growth, differentiation and maturation to exert profound long-term effects on the offspring. Within the male reproductive system, maternal protein malnutrition alters development, structure, and function of the gonads, testes and prostate gland. Consequently, these changes impair the reproductive capacity of the male offspring. Further, permanent alterations in the prostate gland occur at the molecular and cellular level and thereby affect the onset of late life diseases such as prostatitis, hyperplasia and even prostate cancer. This review assembles current thoughts on the concepts and mechanisms behind the developmental origins of health and disease as they relate to protein malnutrition, and highlights the effects of maternal protein malnutrition on rat prostate development and homeostasis. Such insights on developmental trajectories of adult-onset prostate disease may help provide a foundation for future studies in this field.

Transdifferentiation of adult rat stem Leydig cells into prostatic and uterine epithelium, but not epidermis.

Stem Leydig cells (SLCs), precursors of testicular Leydig cells that secrete testosterone required for male sexual differentiation, spermatogenesis, and fertility, were recently identified in rat testes. Various types of stem cells have shown the ability to differentiate into other tissues, but there is no information on the plasticity of adult rat SLCs (rSLCs). This study investigated the ability of rSLCs to transdifferentiate into cell types from all three germ layers-prostatic epithelium (endoderm), uterine epithelium (mesoderm), and epidermis (ectoderm)-under the influence of inductive mesenchyme from fetal and neonatal tissues. To differentiate rSLCs into cells of other lineages, mesenchyme from green fluorescent protein (GFP)-expressing mice was used. Tissue recombinants of urogenital sinus mesenchyme (a potent prostate inducer) and rSLCs grafted into adult male hosts formed ductal structures resembling prostate after 5 weeks. Prostate epithelium was of rSLC origin as determined by absence of GFP expression, and expressed characteristic markers of prostatic epithelium. Similarly, uterine mesenchyme + rSLCs tissue recombinants contained a simple columnar epithelium that was histologically similar to normal uterine epithelium and expressed typical uterine epithelial markers, but was of rSLC origin. In contrast, epidermal tissue was absent in fetal dermis + rSLCs recombinants, suggesting rSLCs did not form skin epithelium. Thus, rSLCs can transdifferentiate into uterine and prostatic epithelium, mesodermal, and endodermal derivatives, respectively, but they may have a limited transdifferentiation potential, as shown by their inability to form epidermis, an ectodermal derivative.

Estrogen imprinting of the developing prostate gland is mediated through stromal estrogen receptor alpha: studies with alphaERKO and betaERKO mice.

Neonatal exposure of rodents to high doses of estrogen permanently imprints the growth and function of the prostate and predisposes this gland to hyperplasia and severe dysplasia analogous to prostatic intraepithelial neoplasia with aging. Because the rodent prostate gland expresses estrogen receptor (ER)-alpha within a subpopulation of stromal cells and ERbeta within epithelial cells, the present study was undertaken to determine the specific ER(s) involved in mediating prostatic developmental estrogenization. Wild-type (WT) mice, homozygous mutant ER (ERKO) alpha -/- mice, and betaERKO -/- mice were injected with 2 microg of diethylstilbestrol (DES) or oil (controls) on days 1, 3, and 5 of life. Reproductive tracts were excised on days 5 or 10 (prepubertal), day 30 (pubertal), day 90 (young adult), or with aging at 6, 12, and 18 months of age. Prostate complexes were microdissected and examined histologically for prostatic lesions and markers of estrogenization. Immunocytochemistry was used to examine expression of androgen receptor, ERalpha, ERbeta, cytokeratin 14 (basal cells), cytokeratin 18 (luminal cells), and dorsolateral protein over time in the treated mice. In WT-DES mice, developmental estrogenization of the prostate was observed at all of the time points as compared with WT-oil mice. These prostatic imprints included transient up-regulation of ERalpha, down-regulation of androgen receptor, decreased ERbeta levels in adult prostate epithelium, lack of DLP secretory protein, and a continuous layer of basal cells lining the ducts. With aging, epithelial dysplasia and inflammatory cell infiltrate were observed in the ventral and dorsolateral prostate lobes. In contrast, the prostates of alphaERKO mice exhibited no response to neonatal DES either immediately after exposure or throughout life up to 18 months of age. Furthermore, neonatal DES treatment of betaERKO mice resulted in a prostatic response similar to that observed in WT animals. The present findings indicate that ERalpha is the dominant ER form mediating the developmental estrogenization of the prostate gland. If epithelial ERbeta is involved in some component of estrogen imprinting, its role would be considered minor and would require the presence of ERalpha expression in the prostatic stromal cells.

Androgen receptor mediates the reduced tumor growth, enhanced androgen responsiveness, and selected target gene transactivation in a human prostate cancer cell line.

The growth and development of the prostate gland are regulated by the androgen and the androgen receptor (AR). Despite our molecular understanding of the roles of the AR regulating; a downstream target gene transcription, the direct or indirect (stromally mediated) actions of the androgen in controlling prostate cell growth and differentiation are still unclear. In this report, an invasive; and metastatic human prostate tumor cell line, androgen-repressed human prostate cancer cell line (ARCaP), either transduced with wild-type human AR (hAR) or a control neomycin-resistant plasmid DNA, was used to evaluate the direct role of AR in regulating prostate tumor cell growth and gene transcription. Results showed that: (a) introduction of wild-type hAR to ARCaP cells restored positive androgen regulation of prostate tumor cell growth in vitro through an enhanced cell-cycle progression from G(0)/G(1) to S and G(2)-M phases; (b) hAR was shown to transactivate glucocorticoid-responsive element but not prostate-specific antigen promoter-directed reporter gene expression; and (c) hAR-transduced ARCaP cells exhibited reduced growth, invasion, and migratory behavior in vitro and tumor growth in vivo. These results suggest that the introduction of hAR into the invasive human prostate cancer ARCaP cell line restored its androgen-regulated cell growth, decreased the rate of tumor growth, and selectively activated AR target gene expression. These cellular functions in response to androgen are commonly associated with increased differentiation of prostate epithelial cells.

Neurodistribution of androgen receptor immunoreactivity in the male frog, Rana esculenta.

Sexual behavior in vertebrates depends on the cyclic release of steroids and their binding to the brain receptors. Previously, we demonstrated the presence of specific binding of (3)H-testosterone and staining with PG-21 in the brain of the adult male frog, Rana esculenta. Here, we report our further receptor characterization using an anti-androgen receptor antiserum, PG-21, and the androgen site of action in frog brain. Nuclei, which contained cells labeled for the androgen receptor (AR), were mainly identified in the olfactory bulbs, preoptic-septal region, infundibulum, amygdala, thalamus, tectum, torus semicircularis, and medulla. The neuroanatomical AR staining appears similar to that in other lower vertebrates.

EDC-2: The Endocrine Society's Second Scientific Statement on Endocrine-Disrupting Chemicals.

The Endocrine Society's first Scientific Statement in 2009 provided a wake-up call to the scientific community about how environmental endocrine-disrupting chemicals (EDCs) affect health and disease. Five years later, a substantially larger body of literature has solidified our understanding of plausible mechanisms underlying EDC actions and how exposures in animals and humans-especially during development-may lay the foundations for disease later in life. At this point in history, we have much stronger knowledge about how EDCs alter gene-environment interactions via physiological, cellular, molecular, and epigenetic changes, thereby producing effects in exposed individuals as well as their descendants. Causal links between exposure and manifestation of disease are substantiated by experimental animal models and are consistent with correlative epidemiological data in humans. There are several caveats because differences in how experimental animal work is conducted can lead to difficulties in drawing broad conclusions, and we must continue to be cautious about inferring causality in humans. In this second Scientific Statement, we reviewed the literature on a subset of topics for which the translational evidence is strongest: 1) obesity and diabetes; 2) female reproduction; 3) male reproduction; 4) hormone-sensitive cancers in females; 5) prostate; 6) thyroid; and 7) neurodevelopment and neuroendocrine systems. Our inclusion criteria for studies were those conducted predominantly in the past 5 years deemed to be of high quality based on appropriate negative and positive control groups or populations, adequate sample size and experimental design, and mammalian animal studies with exposure levels in a range that was relevant to humans. We also focused on studies using the developmental origins of health and disease model. No report was excluded based on a positive or negative effect of the EDC exposure. The bulk of the results across the board strengthen the evidence for endocrine health-related actions of EDCs. Based on this much more complete understanding of the endocrine principles by which EDCs act, including nonmonotonic dose-responses, low-dose effects, and developmental vulnerability, these findings can be much better translated to human health. Armed with this information, researchers, physicians, and other healthcare providers can guide regulators and policymakers as they make responsible decisions.

Executive Summary to EDC-2: The Endocrine Society's Second Scientific Statement on Endocrine-Disrupting Chemicals.

This Executive Summary to the Endocrine Society's second Scientific Statement on environmental endocrine-disrupting chemicals (EDCs) provides a synthesis of the key points of the complete statement. The full Scientific Statement represents a comprehensive review of the literature on seven topics for which there is strong mechanistic, experimental, animal, and epidemiological evidence for endocrine disruption, namely: obesity and diabetes, female reproduction, male reproduction, hormone-sensitive cancers in females, prostate cancer, thyroid, and neurodevelopment and neuroendocrine systems. EDCs such as bisphenol A, phthalates, pesticides, persistent organic pollutants such as polychlorinated biphenyls, polybrominated diethyl ethers, and dioxins were emphasized because these chemicals had the greatest depth and breadth of available information. The Statement also included thorough coverage of studies of developmental exposures to EDCs, especially in the fetus and infant, because these are critical life stages during which perturbations of hormones can increase the probability of a disease or dysfunction later in life. A conclusion of the Statement is that publications over the past 5 years have led to a much fuller understanding of the endocrine principles by which EDCs act, including nonmonotonic dose-responses, low-dose effects, and developmental vulnerability. These findings will prove useful to researchers, physicians, and other healthcare providers in translating the science of endocrine disruption to improved public health.

Neonatal estrogen exposure induces lobe-specific alterations in adult rat prostate androgen receptor expression.

Brief administration of estrogen to newborn rats results in permanent suppression of prostate growth and reduced prostatic responsiveness to testosterone in adulthood. To determine whether this imprinting may be a result of alterations in androgen receptor (AR) expression, the separate adult prostate lobes of neonatally estrogenized rats were examined for AR concentration and distribution. Sprague-Dawley rat pups were given 25 micrograms estradiol benzoate or oil alone on days 1, 3, and 5 and were killed on day 90. Half of the animals received 2-cm testosterone implants 10 days before death to assess the activational response to androgen. In a separate series, neonatally estrogenized rats were given prepubertal dihydrotestosterone pellets for 3 weeks as well as testosterone implants in adulthood to determine if the observed effects of neonatal estrogen on the adult prostate were an indirect result of androgen deprivation during developmentally critical periods. The ventral, dorsal, and lateral prostate lobes were processed for nuclear AR quantitation by [3H]dihydrotestosterone exchange binding assay and for indirect immunocytochemical localization of AR. Weights and DNA contents of the three prostate lobes were significantly reduced in neonatally estrogenized rats, and this decrease was only partially reversed by prepubertal and/or adult androgen replacement. Histologically, the hypoplastic ventral and dorsal lobes exhibited a relative increase in interacinar stromal tissue, disorganized acini with epithelial hyperplasia, luminal sloughing, and an apparent lack of differentiation. The hypoplastic lateral lobe also showed a relative increase in the stromal fraction; however, the acinar epithelium appeared differentiated, with normal basal/apical orientation and luminal secretions. The AR concentration was significantly reduced in the ventral and dorsal prostates of estrogenized rats, but was unaltered in the lateral lobe. Immunocytochemistry revealed a marked reduction or absence of epithelial AR in ventral and dorsal lobes from estrogenized rats, whereas the lateral lobe epithelial cells expressed AR similarly to controls. The incidence of AR-positive fibroblastic stromal cells increased in lateral prostates from 5% in controls to approximately 25% in estrogenized rats. Neonatally estrogenized rats given testosterone for 10 days in adulthood showed increased levels of AR in the ventral and dorsal lobes compared to nonstimulated rats; however, these levels remained well below control values. Lateral lobe epithelial histology and AR expression appeared relatively unchanged in estrogenized rats given testosterone during adulthood, whereas an increased proportion of stromal cells (approximately 35%) were AR positive. In summary, neonatal estrogen administration permanently altered prostatic growth and produced lobe-specific changes in AR expression in the adult gland.(ABSTRACT TRUNCATED AT 400 WORDS)

Neonatal estrogen exposure induces lobe-specific alterations in adult rat prostate androgen receptor expression.

Brief administration of estrogen to newborn rats results in permanent suppression of prostate growth and reduced prostatic responsiveness to testosterone in adulthood. To determine whether this imprinting may be a result of alterations in androgen receptor (AR) expression, the separate adult prostate lobes of neonatally estrogenized rats were examined for AR concentration and distribution. Sprague-Dawley rat pups were given 25 micrograms estradiol benzoate or oil alone on days 1, 3, and 5 and were killed on day 90. Half of the animals received 2-cm testosterone implants 10 days before death to assess the activational response to androgen. In a separate series, neonatally estrogenized rats were given prepubertal dihydrotestosterone pellets for 3 weeks as well as testosterone implants in adulthood to determine if the observed effects of neonatal estrogen on the adult prostate were an indirect result of androgen deprivation during developmentally critical periods. The ventral, dorsal, and lateral prostate lobes were processed for nuclear AR quantitation by [3H]dihydrotestosterone exchange binding assay and for indirect immunocytochemical localization of AR. Weights and DNA contents of the three prostate lobes were significantly reduced in neonatally estrogenized rats, and this decrease was only partially reversed by prepubertal and/or adult androgen replacement. Histologically, the hypoplastic ventral and dorsal lobes exhibited a relative increase in interacinar stromal tissue, disorganized acini with epithelial hyperplasia, luminal sloughing, and an apparent lack of differentiation. The hypoplastic lateral lobe also showed a relative increase in the stromal fraction; however, the acinar epithelium appeared differentiated, with normal basal/apical orientation and luminal secretions. The AR concentration was significantly reduced in the ventral and dorsal prostates of estrogenized rats, but was unaltered in the lateral lobe. Immunocytochemistry revealed a marked reduction or absence of epithelial AR in ventral and dorsal lobes from estrogenized rats, whereas the lateral lobe epithelial cells expressed AR similarly to controls. The incidence of AR-positive fibroblastic stromal cells increased in lateral prostates from 5% in controls to approximately 25% in estrogenized rats. Neonatally estrogenized rats given testosterone for 10 days in adulthood showed increased levels of AR in the ventral and dorsal lobes compared to nonstimulated rats; however, these levels remained well below control values. Lateral lobe epithelial histology and AR expression appeared relatively unchanged in estrogenized rats given testosterone during adulthood, whereas an increased proportion of stromal cells (approximately 35%) were AR positive. In summary, neonatal estrogen administration permanently altered prostatic growth and produced lobe-specific changes in AR expression in the adult gland.(ABSTRACT TRUNCATED AT 400 WORDS)

Prolactin influence on cytosol and nuclear androgen receptors in the ventral, dorsal, and lateral lobes of the rat prostate.

PRL augments testosterone-mediated growth of the prostate in a permissive manner. To elucidate the mechanism of this hormonal interaction, the present study examined the effect of PRL on cytosol and nuclear androgen receptors in the three prostate lobes. Adult male Sprague-Dawley rats were castrated, given 5-mm Silastic implants of testosterone, and either grafted with two anterior pituitary glands under the kidney capsule or sham operated. Three weeks later, animals were killed, serum was collected for PRL and testosterone RIA, and the ventral, dorsal, and lateral prostate lobes were processed for either cytosol or nuclear androgen receptor quantitation. Pituitary grafts significantly elevated the serum PRL concentration and increased the weight and the content of protein and DNA of the lateral prostate lobe compared to control values. There was no effect on these parameters in the ventral or dorsal lobes. Androgen receptor levels and apparent distributions were different in the ventral, dorsal, and lateral lobes of control animals. Unoccupied and total cytosolic androgen receptors in the three separate prostate lobes were not significantly affected by the presence of the grafts. However, an elevated PRL concentration was associated with an increase (P less than 0.005) in nuclear androgen receptor content in the lateral lobe exclusively. The binding affinity was not altered by pituitary grafts in any of the lobes. These findings suggest that PRL promotes lateral prostatic growth by increasing nuclear androgen receptor levels in that tissue and, thus, optimizes its response to circulating testosterone.

Immunocytochemical analysis of androgen receptor along the ducts of the separate rat prostate lobes after androgen withdrawal and replacement.

Autoregulation of androgen receptors (AR) in the rat prostate gland has previously been shown to be lobe specific. Saturation ligand-binding assays revealed that AR fell to very low levels in the ventral and dorsal prostate within 7 days after castration, whereas lateral lobe AR were present at intact levels at that time. To study this differential response further, we herein analyzed AR in the separate prostate lobes by indirect immunocytochemistry after castration and testosterone replacement to adult rats. The ventral and dorsal lobes each contain one type of duct, whereas the lateral lobe is composed of two ductal systems, which were separated as LP1 and LP2. Frozen ducts were sectioned longitudinally to reveal the proximal-distal orientation. Sections were stained for AR with PG-21 antibody against rat AR. Within 2 days after castration, ventral and dorsal lobe immunoreactive nuclear AR was markedly decreased in staining intensity in the secretory epithelium compared to that in the intact rat and was absent in all stromal cells. Epithelial immunostaining continued to decline to a weak punctate nuclear signal by day 7, which further dissipated by day 21. Proximal and intermediate regions of the ducts were largely devoid of AR signal after castration, whereas residual nuclear staining was most apparent in epithelial cells of the distal ductal region. By day 7 and beyond, specific cytoplasmic staining for AR was also observed in distal tip epithelial cells. In the lateral lobe, LP1 ducts rapidly lost all AR immunostaining upon androgen withdrawal. In marked contrast, epithelial cells in the LP2 ducts retained AR immunostaining at all time points after androgen withdrawal at a signal intensity equivalent to that in the intact animal. Within 15 min after testosterone injection to 14-day castrate rats, considerable nuclear AR immunostaining was apparent within the distal tip epithelial cells of the ventral, dorsal, and lateral LP1 lobes. Cytoplasmic signal was noticeably reduced at this time. With increasing time after continued testosterone replacement, nuclear AR signal intensity increased, so that by 72 h, nuclear AR signal in all secretory epithelial cells approached the staining intensity observed in intact rats. AR immunostaining returned to smooth muscle and fibroblastic stromal cells within 1-3 days after testosterone replacement. In summary, immunodetectable AR declined in the ventral, dorsal, and LP1 prostate ducts after castration-induced androgen withdrawal and returned upon testosterone replacement, which further indicates that androgen up-regulates AR protein within these prostatic regions.(ABSTRACT TRUNCATED AT 400 WORDS)

Neonatal estrogen exposure up-regulates estrogen receptor expression in the developing and adult rat prostate lobes.

Neonatal exposure to estrogens results in permanent imprints of the rat prostate gland. To delineate the direct target of estrogen action within that tissue, the present study examined estrogen receptor (ER) expression by immunocytochemistry and in situ hybridization. ER were confined to mesenchymal cells in the urogenital sinus and proximal regions of the budding prostate lobes of newborn control rat prostates, and this expression declined after morphogenesis. Exposure to estradiol benzoate on days 1, 3, and 5 resulted in induction of ER expression in periductal smooth muscle cells from the proximal regions out to the distal tips of the developing prostate lobes. This ER expression was associated with the appearance of ER messenger RNA in those cells; thus, it was concluded that the up-regulation of ER by estrogens is mediated at the message level. Autoregulation of ER expression was next examined in adult prostates that had been exposed to oil or estrogens neonatally. Day 70 rats were castrated and given testosterone with or without estradiol for 7 days before death. Estrogen exposure in adulthood induced low levels of epithelial cell ER in the lateral lobe. Neonatal estrogenization increased the sensitivity of lateral lobe epithelial cells to this autoregulation, as the incidence and intensity of ER immunostaining were markedly increased. No autoinduction of ER was observed in adult ventral or dorsal prostatic lobes. From the present study we conclude that smooth muscle cells are the targets of estrogen action in the developmentally estrogenized prostate and that estrogen amplifies its own effects through auto-up-regulation of ER. In addition, lateral lobe epithelial cells are sensitive to estrogen up-regulation of ER, which may in part account for the lobe-specific effects observed after neonatal estrogenization of the prostate gland.

The developmental pattern of androgen receptor expression in rat prostate lobes is altered after neonatal exposure to estrogen.

Brief administration of estrogen to newborn rats permanently imprints adult prostatic androgen receptor (AR) expression in a lobe-specific manner. To delineate this effect, we examined the immediate effects of early estrogen exposure on the changing AR pattern in the developing ventral, dorsal, and lateral prostate lobes. Antibodies against rat AR (PG-21) were used in combination with several antibodies to cell-specific antigens for positive cellular identification by immunocytochemistry. At birth, mesenchymal cells of the ventral prostate were strongly AR positive (AR+). Epithelial cells stained only for basal cell cytokeratins and, in contrast to earlier reports, many were AR+ on day 1. Between days 3-5, periductal mesenchymal cells differentiated into smooth muscle cells which retained strong AR+ staining, whereas interductal fibroblasts exhibited a decreased incidence of AR+ cells. Between days 5-10, luminal epithelial cells first appeared, and a striking increase in AR staining intensity was noted relative to that in the basal cells. During puberty, basal cells lost their AR immunoreactivity. Similar changes were observed in the dorsal and lateral lobes. Newborn rats were given 25 micrograms estradiol benzoate on days 1, 3, and 5 and were killed thereafter. By day 6, AR staining was markedly decreased to a weak to moderate intensity in all cell types, and by day 10, AR was virtually absent in the separate lobes. Growth and epithelial cytodifferentiation were significantly retarded. Between days 15-30, evidence of luminal cell cytodifferentiation was noted; however, this was frequently not associated with an increase in AR staining. In the ventral and dorsal lobes, a continuous peripheral layer of AR-negative basal cells surrounded the ducts in the central and proximal regions, and this was associated with a permanent inability of luminal epithelial cells to express AR. Epithelial and smooth muscle AR expression was observed only in the distal tips. In contrast, AR expression rapidly returned in all regions of the lateral lobes, except the proximal ducts. We conclude that 1) basal epithelial cells express AR as early as day 1 of life and should be considered as possible direct targets of androgen action during prostate morphogenesis; 2) differentiation into luminal cells is associated with an increase, rather than an induction, of AR expression; and 3) periductal smooth muscle cells retain strong AR expression throughout development and should be considered primary targets for androgen-mediated morphogenesis. Neonatal estrogen initially down-regulates AR expression in all cells of three lobes, which may explain the overall growth retardation.(ABSTRACT TRUNCATED AT 400 WORDS)

Androgen receptor localization in different cell types of the adult rat prostate.

To better understand direct and indirect androgen action on rat prostatic growth and function, the various cell populations within the intact adult ventral, dorsal, and lateral prostate lobes were characterized for the presence or absence of androgen receptor (AR). Polyclonal rabbit antibodies raised against amino acids 1-21 of the rat AR (PG-21) were used in combination with a library of monoclonal antibodies directed against cell-specific antigens for positive cellular identification. Luminal epithelial cells were strongly AR positive, with an order of ventral greater than lateral greater than or equal to dorsal. In the lateral lobe, staining intensity was strongest in the peripheral regions, whereas a similar gradient was not apparent in the ventral and dorsal prostate. Basal epithelial cells were AR negative in all regions of the three lobes. Periacinar smooth muscle was strongly positive for AR, and this staining did not vary with the thickness of the muscle layer. Endothelial cells of the vasculature were AR negative, while the perivascular smooth muscle cells were AR positive. The majority of stromal fibroblasts were AR negative, although a number of AR-positive fibroblastic-appearing cells were observed within the ventral and dorsal lobes. Staining with ED2, a specific marker for tissue macrophages, revealed that fixed macrophages were present in significant quantities in the stroma of intact rat prostate lobes. Since these were frequently identified as AR positive, macrophages may partially account for the appearance of AR-positive stromal cells. Thus, the present findings indicate a complex pattern of AR expression among different cell types of the three prostate lobes. Cells types that express AR can potentially be considered as direct targets of androgen action, whereas those lacking AR should be considered as indirect targets or androgen-insensitive cells.

Effects of neonatal estrogen exposure on prostatic secretory genes and their correlation with androgen receptor expression in the separate prostate lobes of the adult rat.

Brief administration of estrogen to newborn rats permanently restricts prostatic growth and testosterone sensitivity in adulthood. Previous work demonstrated that neonatal exposure to estradiol benzoate produced lobe-specific imprints in prostatic androgen receptor (AR) expression. Epithelial cell AR was markedly reduced or absent in the adult ventral and dorsal lobes, which correlated with a lack of epithelial differentiation and responsiveness. While the lateral lobe also showed reduced growth and testosterone responsiveness after neonatal estradiol benzoate, normal cell differentiation and AR levels were observed within the adult epithelium. To determine the impact that these receptor imprints have on the functional capacity of adult tissue, we herein examined the expression of lobe-specific, androgen-dependent, or androgen-responsive secretory genes in prostates of rats given neonatal estradiol benzoate and directly compared this with epithelial cell AR using histological techniques. Sprague-Dawley rat pups were given 25 micrograms estradiol benzoate or oil on days 1, 3, and 5 and killed on day 90. Prostatic mRNA was analyzed using Northern blots and in situ hybridization. Ventral lobe mRNA was hybridized with a prostate binding protein (PBP) cDNA probe, while lateral and dorsal mRNA were hybridized with RWB (seminal vesicle secretory protein or SVS-II), probasin, and DP1 cDNA probes. Sections adjacent to those used for in situ hybridization were stained for AR by immunocytochemistry. Neonatal estradiol benzoate significantly reduced ventral lobe PBP message on Northern blots, and this was not restored with adult testosterone administration. There was a direct correlation between epithelial cell AR and PBP expression, in that PBP message and protein were only present in epithelial AR-positive cells and were absent in all AR-negative epithelium. In the lateral prostate, probasin expression was unaffected by neonatal estradiol benzoate, whereas RWB was slightly reduced using Northern analysis. By in situ hybridization, these messages were observed at normal levels in lateral lobe epithelial cells of estrogenized rats, which directly correlated with the presence of AR in those cells. In the dorsal prostate, different response patterns to neonatal estradiol benzoate were found for the three secretory genes analyzed. On Northern blots, DP1 message significantly declined, probasin mRNA was modestly suppressed, and RWB expression was significantly elevated compared to those in control tissue. In situ hybridization revealed that RWB expression in estrogenized dorsal lobes was amplified in AR-positive epithelial cells, whereas AR-negative cells appeared unaltered. In summary, prostatic functional activity after neonatal estradiol benzoate exposure is affected in a lobe-specific manner, which correlates with the AR imprints in the separate lobes.

Androgen receptor distribution in rat testis: new implications for androgen regulation of spermatogenesis.

The distribution of the androgen receptor (AR) in the adult rat testis was determined by biotin-streptavidin immunoperoxidase, employing tissue embedded in polyester wax which preserves antigenicity without compromising tissue preservation. The antibody probe used, which has been characterized previously, was an affinity purified, rabbit polyclonal antibody raised to the amino terminus peptide of the rat AR. Within the interstitial compartment, AR immunostaining was detected in some Leydig cells and all smooth muscle cells forming the walls of blood vessels, but endothelial cells of blood vessels were negative. Furthermore, in those Leydig cells that were clearly identified as exhibiting AR immunostaining, the intensity of the reaction varied. In the seminiferous tubules AR immunostaining was observed in all peritubular myoid cell nuclei, but not in the distal layer of lymphatic endothelial cells. In Sertoli cells, nuclear AR immunostaining was stage specific. Moderate AR immunostaining first became evident at late stage IV or early stage V of the cycle, reached a robust peak at stages VII-VIII, and then disappeared completely. Specific AR immunostaining was also discerned in the nuclei of stage XI elongated spermatids, the spermatids in which nuclear elongation is apparent but chromatin condensation has not yet begun. Next, with onset of chromatin condensation, nuclear AR immunostaining in elongated spermatids was not discerned concomitant with its detection in the cytoplasm of the germ cells. These results are interpreted in the following manner: 1) The presence of AR in Leydig cells is consistent with the hypothesis that androgens modify Leydig cell activity in an autocrine fashion. Further, that not all Leydig cells exhibited AR immunostaining at steady state suggests a differential, functional activity of these cells within the population. 2) The intense AR immunostaining of smooth muscle cells present in the interstitium indicates that these cells are targets for androgens. 3) AR immunoreactivity in both Sertoli and peritubular myoid cells suggests their involvement in the androgenic control of spermatogenesis. The stage specific AR immunoreactivity in Sertoli cells, however, may be more indicative of a specific androgen response during these stages, whereas peritubular cells may participate in the tonal maintenance of spermatogenesis. 4) The specific presence of AR in step 11 elongated spermatids may suggest that androgens can act directly on germ cells to regulate spermatogenesis.