Canine Vascular Tissues Are Targets for Androgens, Estrogens, Progestins, and Glucocorticoids

Total Page:16

File Type:pdf, Size:1020Kb

Canine Vascular Tissues Are Targets for Androgens, Estrogens, Progestins, and Glucocorticoids Canine vascular tissues are targets for androgens, estrogens, progestins, and glucocorticoids. K B Horwitz, L D Horwitz J Clin Invest. 1982;69(4):750-758. https://doi.org/10.1172/JCI110513. Research Article Sex differences and steroid hormones are known to influence the vascular system as shown by the different incidence of atherosclerosis in men and premenopausal women, or by the increased risk of cardiovascular diseases in women taking birth control pills or men taking estrogens. However, the mechanisms for these effects in vascular tissues are not known. Since steroid actions in target tissues are mediated by receptors, we have looked for cytoplasmic steroid receptor proteins in vascular tissues of dogs. We find specific saturable receptors, sedimenting at 8S on sucrose density gradients for estrogens (measured with [3H]estradiol +/- unlabeled diethylstilbestrol), androgens (measured with [3H]R1881 +/- unlabeled R1881 and triamcinolone acetonide), and glucocorticoids (measured with [3H]dexamethasone +/- unlabeled dexamethasone); they are absent for progesterone (measured with [3H]R5020 +/- unlabeled R5020 and dihydrotestosterone). Progesterone receptors can, however, be induced by 1-wk treatment of dogs with physiological estradiol concentrations (100 pg/ml serum estrogen), indicating a functional estrogen receptor. Receptor levels range from 20 to 2,000 fmol/mg DNA. They are specific for each hormone; unrelated steroids fail to complete for binding. Low dissociation constants, measured by Scatchard analyses, show that binding is of high affinity. Steroid binding sites are in the media and/or adventitia since they persist when the intima is removed. Compared with the arteries, receptor levels are reduced 80% in inferior venae cavae of […] Find the latest version: https://jci.me/110513/pdf Canine Vascular Tissues Are Targets for Androgens, Estrogens, Progestins, and Glucocorticoids KATHRYN B. HORWITZ and LAWRENCE D. HORWITZ, Departments of Medicine and Biochemistry, Biophysics and Genetics, University of Colorado Health Sciences Center, Denver, Colorado 80262 A B S T R A C T Sex differences and steroid hormones progestins, androgens, and glucocorticoids, have im- are known to influence the vascular system as shown portant cardiovascular effects. The incidence of cor- by the different incidence of atherosclerosis in men onary artery disease, which is very low in young and premenopausal women, or by the increased risk women, increases abruptly after menopause when en- of cardiovascular diseases in women taking birth con- dogenous production of estrogens and progestins is trol pills or men taking estrogens. However, the mech- sharply reduced (1-4). Paradoxically, administration anisms for these effects in vascular tissues are not of exogenous pharmacologic estrogen and progester- known. Since steroid actions in target tissues are me- one results in increased susceptibility to myocardial diated by receptors, we have looked for cytoplasmic infarctions and strokes in women and men (5-9). Es- steroid receptor proteins in vascular tissues of dogs. trogen alters hemodynamics in women and in exper- We find specific saturable receptors, sedimenting at imental animals (10-12). Exogenous androgen, estro- 8S on sucrose density gradients for estrogens (mea- gen, or progesterone cause morphological and sured with [3H]estradiol±unlabeled diethylstilbestrol), histochemical changes in animal aortas (13-15). Ex- androgens (measured with [3H]R1881±unlabeled R1881 ogenous glucocorticoids or conditions characterized by and triamcinolone acetonide), and glucocorticoids excessive endogenous glucocorticoid production may (measured with [3Hjdexamethasone±unlabeled dexa- be associated with systemic hypertension (16-18). methasone); they are absent for progesterone (mea- The mechanism by which these steroid hormones sured with [3H]R5020±unlabeled R5020 and dihydro- influence the cardiovascular system is not known. It testosterone). Progesterone receptors can, however, be has been proposed that steroid hormones affect the induced by 1-wk treatment of dogs with physiological cardiovascular system indirectly, either through re- estradiol concentrations (100 pg/ml serum estrogen), lease of vasoactive endogenous substances, such as indicating a functional estsogen receptor. Receptor prostaglandins or histamine (19-21), or through alter- levels range from 20 to 2,000 fmol/mg DNA. They are ations in lipid metabolism (22). specific for each hormone; unrelated steroids fail to In this study we investigated the possibility that ste- compete for binding. Low dissociation constants, mea- roid hormones act directly on the cardiovascular sys- sured by Scatchard analyses, show that binding is of tem through specific protein receptors in the cyto- high affinity. Steroid binding sites are in the media plasm of vascular smooth muscle cells. Such receptors and/or adventitia since they persist when the intima have been demonstrated previously in other steroid is removed. Compared with the arteries, receptor lev- target organs. For example, estrogen (ER)' and pro- els are reduced 80% in inferior venae cavae of females, gesterone receptors (PR) are present in the breast, and are absent in the venae cavae of males. uterus, and pituitary (23), androgen receptors (AR) We hypothesize that steroid hormones can have di- regulate androgen action in male reproductive organs rect effects on vascular tissues mediated by specific (24), and glucocorticoid receptors (GLUC R) are ubiq- receptors present in arterial blood vessel walls. uitous, reflecting the manifold actions of these hor- mones (25). We sought to assess whether portions of INTRODUCTION the vascular bed could also serve as direct target organs There is epidemiological and experimental evidence that most steroid hormones, including the estrogens, I Abbreviations used in this paper: AR, androgen receptor; BSA, bovine serum albumin; ER, estrogen receptor; GLUC Received for publication 25 September 1981 and in re- R, glucocorticoid receptor; PR, progesterone receptor; R1881, vised form 30 November 1981. methyltrienolone; R5020, promegestone. 750 J. Clin. Invest. X The American Society for Clinical Investigation, Inc. * 0021-9738/82/04/0750/09 $1.00 Volume 69 April 1982 750-758 for these steroids. We have used sucrose density gra- nor steroids were obtained from New England Nuclear; dients to show that cytosols prepared from aortas of other steroids were from Sigma Chemical Co. (St. Louis, MO). Radioactive steroids were added in 2 or 3 A1 of ethanol dogs bind the appropriate radioactive hormones, and to 250 pl of cytosol and incubated for 4 h at 4°C. Final contain specific high affinity, low capacity receptors hormone concentrations were: estradiol, 4 nM; R5020, 20 for estrogens, androgens, and glucocorticoids. In ad- nM; dexamethasone, 50 nM; R1881, 20 nM. Parallel samples dition, PR can be induced by estradiol treatment. The also contained radioactive hormones, but they were prein- receptors appear to be located in smooth muscle cells cubated for 15 min wtih a 100-fold excess of unlabeled hor- mones added in 1 il ethanol to assess nonspecific binding: in the media since they persist when the intima is diethylstilbestrol for ER, R5020 for PR, 1881 for AR, and removed and are reduced in number in inferior venae dexamethasone for GLUC R. In addition, because of the cavae in which the media is attenuated. known cross-reactivity of the 19-nor steroids (29), a 10-fold excess of triamcinolone acetonide was added to cytosols being measured for AR with R1881. This masks any pro- METHODS gestin binding (triamcinolone is also a progestin [30]) of R1881. A 10-fold excess of dihydrotestosterone was added to cytosols to mask androgen binding sites when R5020 was Tissues. Mongrel male dogs and intact or spayed female used to measure PR (29). dogs were killed by an overdose of barbiturate. Sections of Pellets were prepared from a 1-ml suspension of dextran- aorta and inferior vena cava were quickly removed and coated charcoal (0.25% Norit A, 0.0025% dextran in 10 mM placed in ice-cold phosphate-buffered saline. Fat and con- Tris-HCI, pH 8.0 at 4°C) by a 10-min centrifugation at 3,200 nective tissue were removed and each vessel was cut into rpm (2,000 g). The supernatant buffer was discarded, and small pieces with sharp scissors, blotted dry, and dropped the labeled cytosol was transferred onto the pellet, mixed, into liquid nitrogen. Frozen tissues were stored in an ultra- and incubated for 10 min to adsorb unbound radioactivity. low freezer (-70°C) Revco, Inc., Scientific & Industrial Div., After centrifugation for 10 min, a 200-Al aliquot of the su- West Columbia, SC for 2-4 wk before assay. All subsequent pernatant cytosol was layered over a linear 5-20% sucrose procedures were performed at 0-4°C using an ice bath in gradient prepared in homogenization buffer. Discontinuous a 4°C cold room. In some studies, aortas were split vertically gradients were prepared manually at room temperature in and the intima was scraped off with a scalpel. Removal of 4.0-ml polyallomer tubes or 5.1-ml Quick Seal tubes (Beck- the intima was confirmed histologically. man Instruments, Inc., Palo Alto, CA) and allowed to diffuse For the PR priming study, intact female dogs were anes- at 4°C overnight. Labeled '4C-BSA (New England Nuclear), thetized with halothane, oophorectomized, and half of the 1,500 cpm/5 Al buffer, was added to each cytosol as an uterus was surgically removed. They were then injected in- internal sedimentation (4.6S) marker. Quick Seal tubes were tramuscularly with estradiol (Estradiol valerate, E. R. Squibb overlain with 100 Al cold water before they were sealed. & Sons, Princeton, NJ, 5 Ag/kg per d) for 7-10 d. At the end Gradients were centrifuged in a Beckman SW 60 rotor at of the treatment period and 24 h after the last injection, the 53,000 rpm (297,000 g) for 16.3 h, or in a Beckman VTi-65 dogs were killed, the rest of the uterus and the aorta was gradient reorienting rotor at 65,000 rpm (404,000 g) for 2 removed, and the tissues were processed as above. Circulat- h. Fractions (200 AI) were collected from the bottom of the ing serum estrogen was 100 pg/ml, on day 7 of treatment.
Recommended publications
  • This Fact Sheet Provides Information to Patients with Eczema and Their Carers. About Topical Corticosteroids How to Apply Topic
    This fact sheet provides information to patients with eczema and their carers. About topical corticosteroids You or your child’s doctor has prescribed a topical corticosteroid for the treatment of eczema. For treating eczema, corticosteroids are usually prepared in a cream or ointment and are applied topically (directly onto the skin). Topical corticosteroids work by reducing inflammation and helping to control an over-reactive response of the immune system at the site of eczema. They also tighten blood vessels, making less blood flow to the surface of the skin. Together, these effects help to manage the symptoms of eczema. There is a range of steroids that can be used to treat eczema, each with different strengths (potencies). On the next page, the potencies of some common steroids are shown, as well as the concentration that they are usually used in cream or ointment preparations. Using a moisturiser along with a steroid cream does not reduce the effect of the steroid. There are many misconceptions about the side effects of topical corticosteroids. However these treatments are very safe and patients are encouraged to follow the treatment regimen as advised by their doctor. How to apply topical corticosteroids How often should I apply? How much should I apply? Apply 1–2 times each day to the affected area Enough cream should be used so that the of skin according to your doctor’s instructions. entire affected area is covered. The cream can then be rubbed or massaged into the Once the steroid cream has been applied, inflamed skin. moisturisers can be used straight away if needed.
    [Show full text]
  • Determination of Triamcinolone Acetonide Steroid on Glassy Carbon Electrode by Stripping Voltammetric Methods
    Int. J. Electrochem. Sci., 3 (2008) 509-518 International Journal of ELECTROCHEM ICAL SCIENCE www.electrochemsci.org Determination of Triamcinolone Acetonide Steroid on Glassy Carbon Electrode by Stripping Voltammetric Methods C. Vedhi, R. Eswar, H. Gurumallesh Prabu and P. Manisankar* Department of Industrial Chemistry, Alagappa University, Karaikudi –630 003,Tamil Nadu, India *E-mail: [email protected] or [email protected] Received: 9 December 2007 / Accepted: 6 February 2008 / Online published: 20 February 2008 A corticosteroid, triamcinolone acetonide was determined by stripping voltammetric procedure using glassy carbon electrode. Cyclic voltammetric behaviour of steroid was studied in 50% aqueous methanol at acid, neutral and alkaline pH conditions. Influence of pH, sweep rate and steroid concentration were studied. An irreversible and adsorption-controlled well-defined reduction peak was observed in all pH conditions. The reduction peak potential shifted cathodically with change in pH. Controlled potential coulometry revealed two-electron reduction of the α,β-unsaturated carbonyl function present in the steroid. A systematic study of the experimental parameters that affect the differential pulse / square wave stripping voltammetric response was carried out and optimized conditions were arrived at. Under optimum conditions, differential pulse and square wave adsorptive stripping voltammetric procedures were developed for the determination of triamcinolone acetonide steroid at pH 13.0. A calibration plots was derived and the lower limit of determination observed are 0.1 µg/mL from DPSV and 0.01 µg/mL from SWSV. Keywords: Triamcinolone acetonide steroid, Cyclic Voltammetry, Stripping Voltammetry, Glassy carbon electrode. 1. INTRODUCTION Corticosteroids are hormones produced naturally by the adrenal glands, which have many important functions on every organ system.
    [Show full text]
  • Pp375-430-Annex 1.Qxd
    ANNEX 1 CHEMICAL AND PHYSICAL DATA ON COMPOUNDS USED IN COMBINED ESTROGEN–PROGESTOGEN CONTRACEPTIVES AND HORMONAL MENOPAUSAL THERAPY Annex 1 describes the chemical and physical data, technical products, trends in produc- tion by region and uses of estrogens and progestogens in combined estrogen–progestogen contraceptives and hormonal menopausal therapy. Estrogens and progestogens are listed separately in alphabetical order. Trade names for these compounds alone and in combination are given in Annexes 2–4. Sales are listed according to the regions designated by WHO. These are: Africa: Algeria, Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Namibia, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, South Africa, Swaziland, Togo, Uganda, United Republic of Tanzania, Zambia and Zimbabwe America (North): Canada, Central America (Antigua and Barbuda, Bahamas, Barbados, Belize, Costa Rica, Cuba, Dominica, El Salvador, Grenada, Guatemala, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Puerto Rico, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago), United States of America America (South): Argentina, Bolivia, Brazil, Chile, Colombia, Dominican Republic, Ecuador, Guyana, Paraguay,
    [Show full text]
  • Dexamethasone Inhibits the Induction of NAD+-Dependent 15
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector Biochimica et Biophysica Acta 1497 (2000) 61^68 www.elsevier.com/locate/bba Dexamethasone inhibits the induction of NAD-dependent 15-hydroxyprostaglandin dehydrogenase by phorbol ester in human promonocytic U937 cells Min Tong 1, Hsin-Hsiung Tai * Division of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, KY 40536-0082, USA Received 29 December 1999; received in revised form 2 March 2000; accepted 9 March 2000 Abstract Pro-inflammatory prostaglandins are known to be first catabolized by NAD-dependent 15-hydroxyprostaglandin dehydrogenase (15-PGDH) to inactive metabolites. This enzyme is under regulatory control by various inflammation-related agents. Regulation of this enzyme was investigated in human promonocytic U937 cells. 15-PGDH activity was found to be optimally induced by phorbol 12-myristate 13-acetate (PMA) at 10 nM after 24 h of treatment. The induction was blocked by staurosporine or GF 109203X indicating that the induction was mediated by protein kinase C. The induction by PMA was inhibited by the concurrent addition of dexamethasone. Nearly complete inhibition was observed at 50 nM. Other glucocorticoids, such as hydrocortisone and corticosterone, but not sex hormones, were also inhibitory. Inhibition by dexamethasone could be reversed by the concurrent addition of antagonist mifepristone (RU-486) indicating that the inhibition was a receptor-mediated event. Either induction by PMA or inhibition by dexamethasone the 15-PGDH activity correlated well with the enzyme protein expression as shown by the Western blot analysis. These results provide the first evidence that prostaglandin catabolism is regulated by glucocorticoids at the therapeutic level.
    [Show full text]
  • Dexamethasone in Patients with Acute Lung Injury from Acute Monocytic Leukaemia
    Eur Respir J 2012; 39: 648–653 DOI: 10.1183/09031936.00057711 CopyrightßERS 2012 Dexamethasone in patients with acute lung injury from acute monocytic leukaemia E´. Azoulay*, E. Canet*, E. Raffoux#, E. Lengline´#, V. Lemiale*, F. Vincent*, A. de Labarthe#, A. Seguin*, N. Boissel#, H. Dombret# and B. Schlemmer* ABSTRACT: The use of steroids is not required in myeloid malignancies and remains AFFILIATIONS controversial in patients with acute lung injury (ALI) or acute respiratory distress syndrome *Medical ICU and #Hematology Dept, Saint-Louis (ARDS). We sought to evaluate dexamethasone in patients with ALI/ARDS caused by acute Hospital, Paris, France. monocytic leukaemia (AML FAB-M5) via either leukostasis or leukaemic infiltration. Dexamethasone (10 mg every 6 h until neutropenia) was added to chemotherapy and intensive CORRESPONDENCE ´ care unit (ICU) management in 20 consecutive patients between 2005 and 2008, whose data were E. Azoulay AP-HP compared with those from 20 historical controls (1994–2002). ICU mortality was the primary Hoˆpital Saint-Louis criterion. We also compared respiratory deterioration rates, need for ventilation and nosocomial Medical ICU infections. 75010 Paris 17 (85%) patients had hyperleukocytosis, 19 (95%) had leukaemic masses, and all 20 had France E-mail: [email protected] severe pancytopenia. All patients presented with respiratory symptoms and pulmonary infiltrates paris.fr prior to AML FAB-M5 diagnosis. Compared with historical controls, dexamethasone-treated patients had a significantly lower ICU mortality rate (20% versus 50%; p50.04) and a trend for less Received: respiratory deterioration (50% versus 80%; p50.07). There were no significant increases in the May 24 2011 Accepted after revision: rates of infections with dexamethasone.
    [Show full text]
  • Guidelines for Management of Acne
    GUIDELINES FOR MANAGEMENT OF ACNE PAGE 1. Classification of Acne 2 2. Medication available at ANMC 2 3. Adjunctive Measures 3 4. Acne treatment by severity or type 3 5. Patient Education 4 Revised by : Jennifer Stroh x3317 Revision Date: 03/01/06 PIC Approval Date: 09/07/06 1 TREATMENT OF ACNE Classification of Acne Severity Papules/Pustules Nodules Comedonal None to few None Mild Few to several None Moderate Several to many Few to several Severe Numerous or extensive Many Medications available at ANMC for acne treatment Topical 1. Bacteriocidal: - Benzoyl peroxide (OTC-non formulary) - antimicrobicidal gel, cream, lotion (2.5, 5, 10%). Apply qhs or bid. May irritate skin resulting in redness and scaling which usually resolves with continued use. 2. Topical antibiotics: - Clindamycin solution. Apply bid - Benzamycin gel* (Erythromycin 3%, Benzoyl peroxide 5%). Apply qhs initially, advance to bid if indicated * Benzamycin gel is second line (restricted per ANMC’s formulary to failed topical clindamycin). 3. Retinoids: - Tretinoin (Retin-A) cream 0.025%, 0.1%. Start with lower strength, applied 2-3 times/wk. Wash skin before bedtime and allow to dry for 30 mins before applying tretinoin. Redness and scaling may occur and acne may worsen over 2-4 weeks. Benzoyl peroxide oxidizes tretinoin, so don’t apply at the same time. Systemic 1. Oral antibiotics. Start with high dose and gradually taper over 2-4 months to lowest maintenance dose required to maintain control. Instruct patients to increase dose with first sign of flare-up. - Tetracycline-250mg, 500mg. Start with 500mg bid, taper monthly to 250 mg bid, then qd or qod.
    [Show full text]
  • Chlormadinone Acetate As a Possible Effective Agent for Congenital Adrenal Hyperplasia to Suppress Elevated ACTH and Antagonize Masculinization
    Endocrine Journal 1995, 42(4), 505-508 Chlormadinone Acetate as a Possible Effective Agent for Congenital Adrenal Hyperplasia to Suppress Elevated ACTH and Antagonize Masculinization YUKIo KAGEYAMA, SATOSHIKITAHARA, TETSUROTSUKAMOTO, TOsHIHIKOTSUJII, SYUITIGOTO ANDHIROYUKI OSHIMA Department of Urology, Tokyo Medical and Dental University School of Medicine, Tokyo 113, Japan Abstract. We report two cases of congenital adrenal hyperplasia (CAH) in which administration of chlormadinone acetate (CMA), a substituted progestational agent for prostatic disease, suppressed ACTH hypersecretion and lowered plasma testosterone levels. Case 1 was 83-year-old male with advanced prostatic carcinoma and CAH due to 21-hydroxylase deficiency. His plasma testosterone did not decrease in spite of a bilateral orchiectomy. Case 2 was 40-year-old female with CAH due to 21- hydroxylase deficiency suffering from virilization after the cessation of cortisol supplement therapy because of her breast carcinoma. In these two cases, 'ral administration of CMA at a daily dose of 75- 100 mg suppressed ACTH and cortisol to subnormal levels and reduced testosterone levels. With the suppressive effect on ACTH excess and antiandrogenic action, CMA may be suitable for patients with CAH suffering from symptoms due to overproduced ACTH or adrenal androgen. Key words: Chlormadinone acetate , Congenital adrenal hyperplasia, ACTH suppression (Endocrine Journal 42: 505-508,1995) CHLORMADINONE acetate (17u-acetoxy-6-chlo- adrenal hyperplasia (CAH). Chlormadinone ace- ro-4,6-pregnadiene-3,20-dione; CMA), a substituted tate, administered for the prostatic carcinoma, progestational agent, has been used in the treat- suppressed hypersecretion of ACTH and lowered ment of benign prostatic hyperplasia (BPH) and plasma testosterone levels. With this experience prostatic carcinoma because of its anti-androgenic in mind, we administered CMA to a female pa- properties.
    [Show full text]
  • Corticosteroids in Terminal Cancer-A Prospective Analysis of Current Practice
    Postgraduate Medical Journal (November 1983) 59, 702-706 Postgrad Med J: first published as 10.1136/pgmj.59.697.702 on 1 November 1983. Downloaded from Corticosteroids in terminal cancer-a prospective analysis of current practice G. W. HANKS* T. TRUEMAN B.Sc., M.B., B.S., M.R.C.P.(U.K.) S.R.N. R. G. TWYCROSS M.A., D.M., F.R.C.P. Sir Michael Sobell House, The Churchill Hospital, Headington, Oxford OX3 7LJ Summary Introduction Over half of a group of 373 inpatients with advanced Corticosteroids have a major role to play in the malignant disease were treated with corticosteroids control of symptoms in patients with advanced for a variety of reasons. They received either pred- malignant disease. They may be employed in a non- nisolone or dexamethasone, or replacement therapy specific way to improve mood and appetite; or they with cortisone acetate. Forty percent of those receiv- may be indicated as specific adjunctive therapy in the ing corticosteroids benefited from them. A higher relief of symptoms related to a large tumour mass or response rate was seen when corticosteroids were to nerve compression. The management of a numberProtected by copyright. prescribed for nerve compression pain, for raised of other symptoms and syndromes may also be intracranial pressure, and when used in conjunction facilitated by treatment with corticosteroids (Table with chemotherapy. No significant difference in 1). efficacy was noted between the 2 drugs. The results, The use of corticosteroids in patients with ad- however, suggest that with a larger sample, dexame- vanced cancer is empirical, as it is in other non- thasone would have been shown to be significantly endocrine indications.
    [Show full text]
  • Combined Estrogen–Progestogen Menopausal Therapy
    COMBINED ESTROGEN–PROGESTOGEN MENOPAUSAL THERAPY Combined estrogen–progestogen menopausal therapy was considered by previous IARC Working Groups in 1998 and 2005 (IARC, 1999, 2007). Since that time, new data have become available, these have been incorporated into the Monograph, and taken into consideration in the present evaluation. 1. Exposure Data 1.1.2 Progestogens (a) Chlormadinone acetate Combined estrogen–progestogen meno- Chem. Abstr. Serv. Reg. No.: 302-22-7 pausal therapy involves the co-administration Chem. Abstr. Name: 17-(Acetyloxy)-6-chlo- of an estrogen and a progestogen to peri- or ropregna-4,6-diene-3,20-dione menopausal women. The use of estrogens with IUPAC Systematic Name: 6-Chloro-17-hy- progestogens has been recommended to prevent droxypregna-4,6-diene-3,20-dione, acetate the estrogen-associated risk of endometrial Synonyms: 17α-Acetoxy-6-chloro-4,6- cancer. Evidence from the Women’s Health pregnadiene-3,20-dione; 6-chloro-Δ6-17- Initiative (WHI) of adverse effects from the use acetoxyprogesterone; 6-chloro-Δ6-[17α] of a continuous combined estrogen–progestogen acetoxyprogesterone has affected prescribing. Patterns of exposure Structural and molecular formulae, and relative are also changing rapidly as the use of hormonal molecular mass therapy declines, the indications are restricted, O CH and the duration of the therapy is reduced (IARC, 3 C 2007). CH3 CH3 O C 1.1 Identification of the agents CH3 H O 1.1.1 Estrogens HH For Estrogens, see the Monograph on O Estrogen-only Menopausal Therapy in this Cl volume. C23H29ClO4 Relative molecular mass: 404.9 249 IARC MONOGRAPHS – 100A (b) Cyproterone acetate Structural and molecular formulae, and relative Chem.
    [Show full text]
  • Dexamethasone and Fludrocortisone Inhibit Hedgehog Signaling In
    This is an open access article published under an ACS AuthorChoice License, which permits copying and redistribution of the article or any adaptations for non-commercial purposes. Article Cite This: ACS Omega 2018, 3, 12019−12025 http://pubs.acs.org/journal/acsodf Dexamethasone and Fludrocortisone Inhibit Hedgehog Signaling in Embryonic Cells † ‡ † ‡ Kirti Kandhwal Chahal,*, , Milind Parle, and Ruben Abagyan*, † Department of Pharmaceutical Sciences, G. J. University of Science and Technology, Hisar 125001, India ‡ Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92037, United States ABSTRACT: The hedgehog (Hh) pathway plays a central role in the development and repair of our bodies. Therefore, dysregulation of the Hh pathway is responsible for many developmental diseases and cancers. Basal cell carcinoma and medulloblastoma have well- established links to the Hh pathway, as well as many other cancers with Hh-dysregulated subtypes. A smoothened (SMO) receptor plays a central role in regulating the Hh signaling in the cells. However, the complexities of the receptor structural mechanism of action and other pathway members make it difficult to find Hh pathway inhibitors efficient in a wide range. Recent crystal structure of SMO with cholesterol indicates that it may be a natural ligand for SMO activation. Structural similarity of fluorinated corticosterone derivatives to cholesterol motivated us to study the effect of dexamethasone, fludrocortisone, and corticosterone on the Hh pathway activity. We identified an inhibitory effect of these three drugs on the Hh pathway using a functional assay in NIH3T3 glioma response element cells. Studies using BODIPY-cyclopamine and 20(S)-hydroxy cholesterol [20(S)-OHC] as competitors for the transmembrane (TM) and extracellular cysteine-rich domain (CRD) binding sites showed a non-competitive effect and suggested an alternative or allosteric binding site for the three drugs.
    [Show full text]
  • Ketoconazole Revisited: a Preoperative Or Postoperative Treatment in Cushing's Disease
    European Journal of Endocrinology (2008) 158 91–99 ISSN 0804-4643 CLINICAL STUDY Ketoconazole revisited: a preoperative or postoperative treatment in Cushing’s disease F Castinetti, I Morange, P Jaquet, B Conte-Devolx and T Brue Department of Endocrinology, Diabetes, Metabolic Diseases and Nutrition, Hoˆpital de la Timone, Centre Hospitalier Universitaire de Marseille and Faculte´ de Me´decine, Universite´ de la Me´diterrane´e, 264 rue St Pierre, Cedex 5, 13385 Marseille, France (Correspondence should be addressed to T Brue; Email: [email protected]) Abstract Context: Although transsphenoidal surgery remains the first-line treatment in Cushing’s disease (CD), recurrence is observed in about 20% of cases. Adjunctive treatments each have specific drawbacks. Despite its inhibitory effects on steroidogenesis, the antifungal drug ketoconazole was only evaluated in series with few patients and/or short-term follow-up. Objective: Analysis of long-term hormonal effects and tolerance of ketoconazole in CD. Design: A total of 38 patients were retrospectively studied with a mean follow-up of 23 months (6–72). Setting: All patients were treated at the same Department of Endocrinology in Marseille, France. Patients: The 38 patients with CD, of whom 17 had previous transsphenoidal surgery. Intervention: Ketoconazole was begun at 200–400 mg/day and titrated up to 1200 mg/day until biochemical remission. Main outcome measures: Patients were considered controlled if 24-h urinary free cortisol was normalized. Results: Five patients stopped ketoconazole during the first week because of clinical or biological intolerance. On an intention to treat basis, 45% of the patients were controlled as were 51% of those treated long term.
    [Show full text]
  • 18-Dehydrogenase Deficiency W
    Arch Dis Child: first published as 10.1136/adc.51.8.576 on 1 August 1976. Downloaded from Archives of Disease in Childhood, 1976, 51, 576. Hypoaldosteronism in three sibs due to 18-dehydrogenase deficiency W. HAMILTON, A. E. McCANDLESS, J. T. IRELAND, and C. E. GRAY From the University Departments of Child Health, Liverpool and Glasgow Hamilton, W., McCandless, A. E., Ireland, J. T., and Gray, C. E. (1976). Archives of Disease in Childhood, 51, 576. Hypoaldosteronism in three sibs due to 18-dehydrogenase deficiency. Three sibs all presented in the early neonatal period with a salt-losing syndrome. The salt-losing form of congenital adrenal hyperplasia was diagnosed and appropriate treatment with glucocorticosteroids, mineralocorticosteroids, and additional dietary salt started. Although early life was maintained with difficulty, with age all3 children required decreasingamounts ofreplace- ment steroids to maintain normal plasma electrolyte balance. They were reinvestigated at the ages of 15 years and 8 years (twins), when cortisol synthesis and metabolism proved normal, but aldosterone synthesis was blocked by deficiency of 18-dehydro- genase. Rational treatment of these cases of a salt-losing syndrome in which aldo- sterone synthesis alone is blocked due to lack of the enzyme 18-dehydrogenase requires the administration of a mineralocorticosteroid drug only. Since deoxycor- ticosterone (acetate or pivalate) requires intramuscular administration, as life-long therapy oral fludrocortisone is preferable. Although fludrocortisone has glucocorti- coid activity, the 'hydrocortisone equivalent' effect of the small dosage used was un- likely to inhibit either pituitary corticotrophin or growth hormone production. Salt-loss of adrenal origin is recognized as a female external genitalia or macrogenitosomia http://adc.bmj.com/ feature of 3/1-hydroxysteroid dehydrogenase de- praecox in the male.
    [Show full text]