The cortisol levels in the follicular and luteal phases of the healthy menstruating women: a meta-analysis.

OBJECTIVE: The conflicting results of the previous studies regarding the serum cortisol through the menstrual cycle warranted further research. We aimed to detect the cortisol levels in the follicular and luteal phases of healthy menstruating women. MATERIALS AND METHODS: A literature search was conducted by two independent authors according to PRISMA criteria over PubMed, Web of Science and Psych-Info to retrieve the articles published in English from 1990 until 2020 and containing the keywords, Cortisol, Menstrual, Follicular, or Luteal. The quality assessment of the articles/studies was done using the CONSORT and STROBE checklists. The risk bias was assessed by two independent authors using Cochrane risk-bias assessment tool. RESULTS: Twenty-eight (28) articles were included in this meta-analysis. The cortisol levels were significantly higher in the studied-participants' follicular phase compared to the luteal phase (p<0.01). The cortisol levels sub-analysis showed a significant effect of plasma cortisol over the salivary cortisol (p=0.04). The cortisol assay time showed a significant effect of the morning cortisol over the afternoon cortisol (p=0.005). CONCLUSIONS: This meta-analysis found the cortisol levels were significantly higher in the studied-participants follicular phase compared to the luteal phase. The cortisol sub-analysis showed a significant effect of plasma and morning cortisol over the salivary and afternoon cortisol, respectively.

The relation between vitamin D and the adolescents' mid-luteal estradiol and progesterone.

OBJECTIVE: The aim of this study was to detect the effect of vitamin D (Vit. D) intake on the mid-luteal estradiol (E2), and progesterone (P), and the relation between vit. D, and the adolescents' mid-luteal E2, and P. PATIENTS AND METHODS: Eighty-five (85) adolescents were recruited for this cohort study after obtaining informed consent. After a detailed history and clinical examination, the body mass index (BMI) of the studied participants was calculated, followed by pelvic sonography to exclude any pelvic pathology. Participants' blood samples were collected on days 21-22 of the menstrual cycle (mid-luteal) to measure the thyrotropin (TSH) (i.e., to exclude hypothyroidism), prolactin (i.e., to exclude hyperprolactinemia), glycosylated hemoglobin (HbA1C), (i.e., to exclude diabetes), E2, P, and 25(OH)D.  Participants received 50,000 IU of vit. D weekly for two months, and on the 3rd month, the mid-luteal E2, P, and 25(OH)D were measured. The mid-luteal E2, P, and 25(OH)D were compared before and after the vit. D intake to detect the effect of vit. D intake (50,000 IU weekly for 2 months) on the mid-luteal E2 and P (primary outcome). Additionally, the relations between vit. D and the adolescents' mid-luteal E2 and P were detected as secondary outcomes using the correlation analysis (Pearson's correlation). RESULTS: The mid-luteal E2 and P statistically decreased from 109.3±15.7 pg/mL and 9.8±1.01 ng/mL, respectively to 40.7±10.52 pg/mL, and 5.2±0.73 ng/mL, respectively, after vit. D intake (p=0.00015; 95% CI: 64.5, 68.6, 72.7, and p=0.0016; 95% CI: 4.3, 4.6, 4.87, respectively). Significant negative correlations between the 25(OH)D, and both the mid-luteal E2 (r -0.661; p<0.00001), and P (r -0.521; p<0.00001) were detected in this study. CONCLUSIONS: The mid-luteal E2 and P statistically decreased after vit. D intake (50,000 IU of vit. D weekly for 2 months). Significant negative correlations between the 25(OH)D, and both the mid-luteal E2 and P were detected in this study. The relation between vit. D and ovarian steroids, and the effect of vit. D intake on ovarian steroids need further larger studies.

Alterations in enteric calcitonin gene-related peptide in patients with colonic diverticular disease: CGRP in diverticular disease.

Diverticular disease (DD) is one of the most prevalent diseases of the large bowel. Lately, imbalance of neuro-muscular transmission has been recognized as a major etiological factor for DD. Neuronal calcitonin gene-related peptide (CGRP) is a potent gastrointestinal smooth muscle relaxant shown to have a widespread effect within the alimentary tract. Nevertheless, CGRPergic innervation of the enteric ganglia has never been considered in the context of motility impairment observed in DD patients. Changes in CGRP and calcitonin receptor-like receptor (CRLR) abundance within enteric ganglia were investigated in sigmoid samples from symptomatic and asymptomatic DD patients using quantitative fluorescence microscopy. CGRP effect on gastrointestinal smooth muscle was investigated using organ bath technique. We found CGRP levels within the enteric ganglia to be declined by up to 52% in symptomatic DD patients. Conversely, CRLR within the enteric ganglia was upregulated by 41% in symptomatic DD. Longitudinal smooth muscle displayed an elevated (+10.5%) relaxant effect to the exogenous application of CGRP in colonic strips from symptomatic DD patients. Samples from asymptomatic DD patients consistently showed intermediate values across different experiments. In conclusion, the present study demonstrates that CGRPergic signaling is subject to alteration in DD. Our results suggest that a hypersensitization mechanism to gradually decreasing levels of CGRP-IR nerve fibers takes place during DD progression. Alterations to CGRPergic signaling in DD disease may have implications for physiological abnormalities associated with colonic DD.

Oleanolic acid induces relaxation and calcium-independent release of endothelium-derived nitric oxide.

BACKGROUND AND PURPOSE: The present study investigated the mechanisms by which oleanolic acid, a component of olive oil, increases release of nitric oxide (NO). EXPERIMENTAL APPROACH: Measurements of isometric tension, NO concentration, or endothelial cell calcium were made in rat isolated mesenteric arteries. Immunoblotting for endothelial NOS (eNOS) and Akt kinase were performed in primary cultures of human umbilical vein endothelial cells (HUVECs). KEY RESULTS: Oleanolic acid (3-30 microM) evoked endothelium-dependent relaxations in noradrenaline-contracted rat superior and small mesenteric arteries. In rat superior mesenteric arteries, oleanolic acid induced simultaneous increases in NO concentration and relaxation, and these responses were inhibited by an inhibitor of NOS, asymmetric dimethyl-L-arginine (300 microM) and by the NO scavenger, oxyhaemoglobin (10 microM). Oleanolic acid-evoked NO increases were not reduced in Ca(2+)-free solution and in the presence of an inhibitor of endoplasmic reticulum calcium-ATPase, thapsigargin (1 microM). Oleanolic acid evoked relaxation without changes in endothelial cell calcium, but decreased smooth muscle calcium in arterial segments. Oleanolic acid failed to increase calcium in HUVECs, but increased time-dependently phosphorylation of Akt kinase at Serine(473) (Akt-Ser(473)) and eNOS at Serine(1177) (eNOS-Ser(1177)), which was attenuated by inhibitors of phosphoinositide-3-kinase. CONCLUSIONS AND IMPLICATIONS: This study provides direct evidence that a component of olive oil, oleanolic acid, activated endothelium-dependent release of NO and decreased smooth muscle cell calcium followed by relaxation. The oleanolic acid-evoked endothelium-derived NO release was independent of endothelial cell calcium and involved phosphoinositide-3-kinase-dependent phosphorylation of Akt-Ser(473) followed by phosphorylation of eNOS-Ser(1177).

Elevated pressure selectively blunts flow-evoked vasodilatation in rat mesenteric small arteries.

BACKGROUND AND PURPOSE: The present study investigated mechanisms underlying impaired endothelium-dependent vasodilatation elicited by elevating the intraluminal pressure in rat mesenteric small arteries. EXPERIMENTAL APPROACH: Arterial segments (internal diameter 316+/-2 microm, n=86) were mounted in a pressure myograph. The effect of elevating pressure from 50 to 120 mmHg for 1 h before resetting it to 50 mmHg was studied on endothelium-dependent vasodilatation. KEY RESULTS: In arteries constricted with U46619 in the presence of indomethacin, shear stress generated by flow, evoked vasodilatation that was abolished by an inhibitor of nitric oxide (NO) synthase, asymmetric dimethylarginine (1 mM), whereas acetylcholine-induced vasodilatation was unchanged. After elevation of intraluminal pressure for 1 h and then resetting it to 50 mmHg, vasodilatation induced by shear stress and the NO donor, S-nitrosopenicillamine was inhibited, while vasodilatation induced by a guanylyl cyclase activator, BAY 412272, and acetylcholine was unaltered. Superoxide levels sensitive to polyethylene glycol superoxide dismutase were increased in segments exposed to elevated pressure. A superoxide scavenger, tempol (300 microM), a general endothelin receptor antagonist, SB 217242 and the selective ET(A) receptor antagonist, BQ 123 preserved shear stress-evoked vasodilatation. CONCLUSIONS AND IMPLICATIONS: The present study shows that transient exposure to an elevated intraluminal pressure selectively inhibits flow-evoked NO-mediated vasodilatation, probably through activation of endothelin receptors and increased formation of superoxide. In contrast, elevation of pressure did not affect the acetylcholine-evoked endothelium-derived hyperpolarizing factor type vasodilatation in mesenteric small arteries.

Combination of Ca2+ -activated K+ channel blockers inhibits acetylcholine-evoked nitric oxide release in rat superior mesenteric artery.

BACKGROUND AND PURPOSE: The present study investigated whether calcium-activated K+ channels are involved in acetylcholine-evoked nitric oxide (NO) release and relaxation. EXPERIMENTAL APPROACH: Simultaneous measurements of NO concentration and relaxation were performed in rat superior mesenteric artery and endothelial cell membrane potential and intracellular calcium ([Ca2+]i) were measured. KEY RESULTS: A combination of apamin plus charybotoxin, which are, respectively, blockers of small-conductance and of intermediate- and large-conductance Ca2+ -activated K channels abolished acetylcholine (10 microM)-evoked hyperpolarization of endothelial cell membrane potential. Acetylcholine-evoked NO release was reduced by 68% in high K+ (80 mM) and by 85% in the presence of apamin plus charybdotoxin. In noradrenaline-contracted arteries, asymmetric dimethylarginine (ADMA), an inhibitor of NO synthase inhibited acetylcholine-evoked NO release and relaxation. However, only further addition of oxyhaemoglobin or apamin plus charybdotoxin eliminated the residual acetylcholine-evoked NO release and relaxation. Removal of extracellular calcium or an inhibitor of calcium influx channels, SKF96365, abolished acetylcholine-evoked increase in NO concentration and [Ca2+]i. Cyclopiazonic acid (CPA, 30 microM), an inhibitor of sarcoplasmic Ca2+ -ATPase, caused a sustained NO release in the presence, but only a transient increase in the absence, of extracellular calcium. Incubation with apamin and charybdotoxin did not change acetylcholine or CPA-induced increases in [Ca2+]i, but inhibited the sustained NO release induced by CPA. CONCLUSIONS AND IMPLICATIONS: Acetylcholine increases endothelial cell [Ca2+]i by release of stored calcium and calcium influx resulting in activation of apamin and charybdotoxin-sensitive K channels, hyperpolarization and release of NO in the rat superior mesenteric artery.

Angiotensin IV induced contractions in human jejunal wall musculature in vitro.

Angiotensin II (AngII) has been reported to mediate contractile actions in rats and human jejunal wall musculature. However, except for one report showing the angiotensin IV (AngIV) contractile effects on the internal anal sphincter of rats, no data is available describing the action of AngIV on smooth muscle in human small intestine. The aim of this study was to investigate the expression and localization of the enzymes responsible to AngIV formation, as well as the receptor, and to elucidate the contractile function of AngIV in the muscular layer of human jejunum in vitro. Jejunal smooth muscle was taken from 23 patients undergoing Roux-en-Y gastric bypass surgery and was used to record isometric tension in vitro in response to AngIV alone and in the presence of losartan or PD123319. ELISA, western blot and immunohistochemistry were used to investigate the expression and localization of key components for AngIV formation: the enzymes aminopeptidases-A, B, M, and the AngIV receptor insulin-regulated aminopeptidase (IRAP). AngIV elicited concentration-dependent contraction in both longitudinal and circular smooth-muscle preparation. Presence of losartan abolished AngIV-induced contraction, but not PD123319. The main peptide AngII, as well as the enzymes aminopeptidases-A, B and M was detected in all muscle samples. Immunohistochemistry localized the enzymes and IRAP in the myenteric plexus between longitudinal and circular muscle layers. The present study indicates that all enzymes necessary for AngIV formation exist in human jejunal smooth muscle and that the contractile action elicited by AngIV is primarily mediated through the AngII type 1 receptor.

NS11021, a novel opener of large-conductance Ca(2+)-activated K(+) channels, enhances erectile responses in rats.

BACKGROUND AND PURPOSE: Large-conductance Ca(2+)-activated K(+) channels (BK(Ca)), located on the arterial and corporal smooth muscle, are potential targets for treatment of erectile dysfunction (ED). This study investigated whether NS11021 (1-(3,5-Bis-trifluoromethyl-phenyl)-3-[4-bromo-2-(1H-tetrazol-5-yl)-phenyl]-thiourea), a novel opener of BK(Ca) channels, relaxes erectile tissue in vitro and enhances erectile responses in intact rats. The effects were compared with sildenafil, an inhibitor of phosphodiesterase type 5. EXPERIMENTAL APPROACH: Patch clamp was used to record whole cell current in rat isolated corpus cavernosum smooth muscle cells (SMCs) and human umbilical vein endothelial cells (HUVECs). Isometric tension was measured in intracavernous arterial rings and corpus cavernosum strips isolated from rats and men, and simultaneous measurements of intracellular Ca(2+) concentration ([Ca(2+)](i)) and tension were performed in intracavernous arteries. Erectile response was measured in anaesthetized rats. KEY RESULTS: In patch clamp recordings, NS11021 increased currents sensitive to the selective BK(Ca) channel blocker, iberiotoxin (IbTX) in SMCs, but did not modulate K(+) current in HUVECs. NS11021 reduced [Ca(2+)](i) and tension in penile arteries. IbTX inhibited the vasorelaxation induced by NS11021 and sildenafil in human erectile tissue. NS11021 and sildenafil but not vehicle increased erectile responses in anaesthetized rats, an effect which was abolished after pretreatment with tetraethylammonium. CONCLUSIONS AND IMPLICATIONS: NS11021 leads to relaxation of both intracavernous arteries and corpus cavernosum strips primarily through opening of BK(Ca) channels. It is also effective in facilitating erectile responses in anaesthetized rats. These results suggest a potential for use of BK(Ca) openers in the treatment of ED.

Hyperoxia reduces basal release of nitric oxide and contracts porcine coronary arteries.

AIM: The purpose of the present study was to investigate whether changes in nitric oxide (NO) concentration is involved in hyperoxia-induced vasoconstriction in porcine conduit coronary arteries. METHODS: The effect of hyperoxia on NO release and vasoconstriction was evaluated by tension recording, microsensor measurements, and immunoblotting in porcine conduit coronary arteries contracted with U46619 or 5-hydroxytryptamine. RESULTS: In endothelium-intact segments exchanging 20% O2, 5% CO2, 75% N2 (normoxia) for 95% O2, 5% CO2 (hyperoxia) increased contraction. In segments without endothelium hyperoxia-evoked contraction was abolished, but restored by an encircling donor segment with endothelium. An inhibitor of NOS, asymmetric dimethylarginine (ADMA, 300 mum), reduced hyperoxic contraction and basal NO concentration by, respectively, 38 +/- 12% and 46 +/- 3% (P < 0.05, n = 9). A NO donor, S-nitroso-N-acetylpenicillamine (SNAP), increased NO concentration and evoked relaxation to the same levels in normoxic and hyperoxic conditions. beta-actin and endothelial NO synthase (eNOS) protein expression was similar in normoxic and hyperoxic arterial segments. Phosphorylation of eNOS was unaltered in normoxia vs. hyperoxia, but phosphorylation of eNOS-Ser(1177) was increased and phosphorylation of eNOS-Thr(495) decreased by U46619. Blockers of ATP-sensitive, voltage-dependent and calcium-activated K+ channels did not change hyperoxic contraction. However, high extracellular K+ concentration or a second and third exposure to hyperoxia decreased contraction. CONCLUSION: The present study provides direct evidence that hyperoxia reduces basal release of NO leading to depletable endothelium-dependent vasoconstriction in porcine coronary arteries independent of changes in eNOS phosphorylation.