Bo Freyschuss

Biphasic Effects of the Natural Estrogen 17β-Estradiol on Hepatic Cholesterol Metabolism in Intact Female Rats

The protective influence of estrogens in cardiovascular disease is believed to be partly due to beneficial effects on cholesterol metabolism. Much of the experimental data are based on models in which synthetic estrogens have been used in pharmacological doses, and therefore, the physiological role of estrogens in cholesterol metabolism is uncertain. To evaluate this important issue, we performed experiments in intact female rats with use of the natural estrogen 17beta-estradiol (E2) administered either subcutaneously or orally. After physiological doses of E2 (< or =0.04 mg. kg(-1). d(-1)) were administered, plasma levels of high density lipoprotein (HDL) cholesterol and apolipoprotein (apo) A-I were increased. In the liver, 3-hydroxy-3-methylglutaryl coenzyme A reductase and cholesterol 7alpha-hydroxylase activities were increased, as well as cholesterol 7alpha-hydroxylase mRNA levels. These effects were abolished during treatment with higher doses of E2, whereas apo A-I mRNA increased in a dose-dependent way. After treatment with pharmacological doses of E2 (> or =0.2 mg. kg(-1). d(-1)), the number of hepatic low density lipoprotein receptors increased and plasma cholesterol was reduced. These effects were similar after both oral and subcutaneous administration of E2. Our results show that the responses to E2 are biphasic: plasma HDL, apo A-I, and hepatic enzyme activities governing bile acid and cholesterol synthesis increased only at physiological doses of E2. At pharmacological doses of E2, hepatic low density lipoprotein receptors are stimulated and plasma cholesterol is reduced. Therefore, under physiological conditions, E2 exerts its major effects on hepatic cholesterol metabolism through mechanisms other than stimulation of low density lipoprotein receptor expression.

Estrogenic influence on the regulation of hepatic estrogen receptor-α and serum level of angiotensinogen in female rats

The majority of data regarding biological effects of estrogens is based on studies in male rats or ovariectomized (Ovx) female rats. Therefore, in this study, the effects of estradiol treatment on the regulation of the hepatic estrogen receptor and the level of circulating angiotensinogen were examined in the intact female rat. The data were compared with that of the hypophysectomized (Hx) rat. Animals were treated with either low (physiological) or high (pharmacological) doses of estrogen. In intact rats, the hepatic estrogen receptor (ER) level increased with increasing doses of estrogen. This was in contrast to the Hx rats where growth hormone (GH) and dexametasone (Dex) in combination were the sole modulators of the estrogen receptor. The angiotensinogen level increased in normal rats after estrogen administration in a dose dependent manner, regardless of the mode of administration. The pure antiestrogen ICI 182 780 efficiently blocked the increase in circulating angiotensinogen. The conclusion is that in the normal female, estrogens are important modulators of the serum angiotensinogen level.

Regulatory effects of growth hormone, ghicocorticoids, and thyroid hormone on the estrogen receptor level in the rat liver

The multihormonal regulation of the estrogen receptor in the liver of female rats was studied under in vivo conditions. The steroid receptor level was assayed by hormone binding and specific mRNA analyzed by solution hybridization using a 35S-labeled RNA probe complementary to the ligand-binding domain of the estrogen receptor gene. Serum growth hormone levels were measured and correlated to the effects of glucocorticoid and thyroid hormone administration on the estrogen receptor expression. In animals subjected to adrenalectomy plus thyroidectomy, the estrogen receptor concentration was reduced from 59 fmol/mg cytosol protein to 10 fmol/mg protein (i.e., with 87% relative to control animals). Adrenalectomy or thyroidectomy alone caused a decrease with 14% and 66%, respectively. Substitution with 10 micrograms betamethasone and 1 microgram triiodothyronine daily for 9 days completely restored the receptor content to control levels. Substitution with either hormone alone increased, but only partially restored receptor levels. The effect of betamethasone alone was dose dependent from 10 micrograms/d to 100 micrograms/d. This dose dependence was not seen when the animal simultaneously received 1 microgram of triiodothyronine. Superphysiologic doses of triiodothyronine did not raise estrogen receptor levels above those seen in animals treated with physiologic doses. High doses of triiodothyronine (greater than 20 micrograms/d) decreased serum growth hormone levels. The estrogen receptor mRNA levels in livers from hypophysectomized animals were increased after treatment with growth hormone (2.5-fold), thyroid hormone (two-fold), and glucocorticoids (1.5-fold). The results obtained indicate a very complex regulation of liver estrogen receptor.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of estradiol and estradiol sulfamate on the uterus of ovariectomized or ovariectomized and hypophysectomized rats

Estradiol sulfamate (J995), estradiol-17beta with a substituted sulfamate group in position 3, has much higher systemic estrogenic activity after oral administration than 17beta-estradiol (E2) due to reduced hepatic metabolism of the drug. The lower dose necessary for achievement of adequate systemic estrogenic effects results in a substantial reduction of otherwise commonly observed hepatic side-effects. This makes J995 a strong candidate as an estrogen suitable for oral administration. The present study was performed to examine and compare the effects of J995 and E2 on the uterus after oral or subcutaneous administration to ovariectomized or ovariectomized+hypophysectomized female rats, in particular on the levels of the estrogen receptor (ER) (alpha+beta), ERalpha mRNA and insulin-like growth factor-I (IGF-I) mRNA. The ER levels were determined using a ligand binding assay and the mRNA levels using solution hybridization. The doses of J995 or E2 were chosen to achieve comparable uterotrophic activity. The rats were treated with hormones for 7 days and the treatment was initiated 14 days after surgery. We conclude that there are no major differences in the uterine response to treatment with J995 or E2 with respect to the effects on ER and ERalpha mRNA levels. The IGF-I mRNA level though, is more affected by J995 than by E2 after 7 days of treatment, indicating a prolonged effect of J995.

Evidence for a direct effect of thyroid hormones on the hepatic synthesis of estrogen receptors in the rat

The role of thyroid hormones in the regulation of estrogen receptor turnover in the rat liver was studied. Animals subjected to thyroidectomy or hypophysectomy in combination with different hormone substitutions, were used. The receptor level in control animals was 53 fmol/mg cytosol protein. Thyroidectomy for 28 days caused a dramatic reduction to 20 fmol/mg, whereas hypophysectomy for 9 days resulted in an even more substantial reduction to 11 fmol/mg protein. If animals, hypophysectomized for 9 days, were given triiodothyronine (T3) for 9 days the hepatic estrogen receptor concentration was elevated to 22.5 fmol/mg protein. Estradiol given together with T3 did not cause any further increase in the receptor level. We conclude that thyroid hormones affect the hepatic synthesis of estrogen receptors on two levels, via a direct action on the liver and via an indirect modulation of the pituitary hormone synthesis/release.

Effects of thyroid hormones on the receptor level in estrogen target organs

The influence of thyroid hormones on the turnover of cytoplasmic estrogen receptors in the liver, kidney and uterus of intact and ovariectomized female rats was studied under in vivo conditions. Thyroidectomy had no significant effect on the receptor level in the uterus but caused a substantial reduction of the receptor content in the liver and kidney. In livers of intact and ovariectomized animals receptor values were reduced with 70 and 80%, respectively, 30 days after thyroidectomy. Substitution with triiodothyronine (T3) restored the hepatic estrogen receptor concentration in thyroidectomized rats to the preoperative level. If rats that had been both ovariectomized and thyroidectomized were substituted with thyroid hormone for the same time period, the receptor level was increased but did not reach the level seen in animals that had been ovariectomized only. The effects of thyroid hormone substitution was found to be dose dependent and paradoxical. Thus, a high dose of 50 micrograms/day of triiodothyronine given to intact animals for nine days caused a 30% reduction in the hepatic receptor content. The same level of reduction was seen in the ovariectomized rat given a hormone dose of only 1 micrograms/day. When this type of rats was treated with the higher dose of triiodothyronine the reduction in hepatic estrogen receptors was 50%. These results are discussed in relation to existing information concerning the multihormonal regulation of estrogen receptor concentration in the rat liver.

Hormonal regulation of the estrogen receptor in primary cultures of hepatocytes from female rats.

Estrogen treatment affects the hepatic synthesis and/or secretion of several proteins involved in clinically important pathological processes such as atherosclerosis, hypertension, and thrombosis. The endocrine regulation of the estrogen receptor (ER) concentration in primary cultures of rat hepatocytes was studied. Human growth hormone (hGH) and dexamethasone (DEX) in combination increased ER concentration 6-fold and ER mRNA levels 2.5-fold. These effects were not significantly different from those observed after treatment with the purely somatogenic bovine growth hormone (GH) in combination with DEX. Treatment with the lactogen ovine prolactin in the presence or absence of DEX did not significantly affect ER or ER mRNA concentrations. Triiodothyronine treatment at the most effective concentration (50 nM) increased ER and ER mRNA levels twofold. Medium supplementation with estradiol (0.1 nM) throughout the experiment did not affect the response to treatment with hGH and DEX. Treatment with high concentrations of ethinylestradiol in combination with hGH and DEX, however, increased the ER level twice as much as hGH and DEX without addition of estradiol or ethinylestradiol, whereas the ER mRNA concentration was the same in both the GH+DEX group and GH+ DEX+ (estradiol or ethinylestradiol) groups. These data indicate the importance of GH in combination with glucocorticoids for the maintenance of ER concentrations in the rat liver. Thyroid hormones may be of some, although minor importance, whereas the data suggest that prolactin is not directly involved in hepatic ER regulation.

Can secondary osteoporosis be identified when screening for osteoporosis with digital X-ray radiogrammetry? : Initial results from the Stockholm Osteoporosis Project (STOP)

OBJECTIVES To identify causes of low age-adjusted bone mass at digital X-ray radiogrammetry (DXR) in individuals attending an osteoporosis screening program. STUDY DESIGN In a descriptive observational cohort study, women aged 40-75 years who attended a general mammography screening program had their bone mass investigated with DXR and answered a questionnaire regarding several clinical risk factors for osteoporosis. Each month the 2% with the lowest Z-scores were selected for further clinical examination with DXA of the hip and lumbar spine and pre-defined blood tests. MAIN OUTCOME MEASURE Causes of secondary osteoporosis determined by clinical and laboratory evaluation. RESULTS 14,783 women attended mammography screening and had their bone mass evaluated. In total, 327 women had a low DXR BMD and 281 accepted further DXA examination. Of these, 93 (33.1%) had osteoporosis. The diagnosis was new in 79 cases (84.9%) and in 32 (34.4%) a potential underlying cause was identified. Primary hyperparathyroidism was found in 8.6% and secondary hyperparathyroidism in 13.5%. Several self-reported risk factors for osteoporosis, including rheumatic disease, insulin-treated diabetes, cortisone treatment, smoking, reduced mobility, hyperparathyroidism, and malabsorption, were significantly more common among those selected for DXA referral than in the total cohort. For example, rheumatic disease and insulin-treated diabetes were reported 3.4 and 2.3 times as often, respectively. CONCLUSION The prevailing potential cause of secondary osteoporosis according to DXR was primary and secondary hyperparathyroidism. Most of the women with these conditions were previously undiagnosed, indicating that further follow-up of patients with low age-adjusted DXR BMD is justified.