James R. Schreiber

Binding of the anti-progestin ru-486 to rat ovary steroid receptors*

RU-486 is a recently synthesized steroid with anti-progesterone and anti-glucocorticoid properties. Its direct anti-progesterone action on the uterus is believed to be the basis for its ability to induce menstruation and early abortion. RU-486 likely antagonizes progesterone action on the uterus progesterone receptor. We have studied the binding of RU-486 to rat ovary steroid receptors in order to learn whether this interesting synthetic compound binds to ovary steroid receptors and thus learn if this antagonist can be used to better define the mechanism(s) of steroid actions on the ovary. Ovaries from estrogen stimulated hypophysectomized immature female rats were homogenized in buffer. The 100,000 x g supernatant was incubated with tritiated steroid agonists (R5020, dexamethasone, or testosterone) alone or with unlabeled steroids including RU-486. Receptor bound, and free steroid, were separated by Sephadex G-200 columns. The relative abilities of the various tested steroids to bind to the rat ovary progesterone receptor were: RU-486 greater than or equal to R5020 greater than progesterone. RU-486 bound to the ovary glucocorticoid receptor with an affinity equal to that of dexamethasone. The affinity of RU-486 for the rat ovary androgen receptor was only about 9% that of testosterone. Thus, RU-486 binds with very high affinity to the rat ovary progesterone and glucocorticoid receptors. This steroid receptor antagonist offers a new tool by which the mechanism(s) of action of these steroids on the ovary can be tested.

Medroxyprogesterone acetate: Receptor binding and correlated effects on steroidogenesis in rat granulosa cells

Medroxyprogesterone acetate (MPA), a widely used synthetic steroid, was studied to determine both its effects on steroid receptors and steroidogenesis in the well-characterized rat ovarian granulosa cell model. Initial receptor binding studies showed MPA was as potent as progesterone and 10-fold less potent than R-5020 (an active synthetic progestin) in binding to progesterone cytosolic receptors in rat ovarian granulosa cells. MPA was 20-fold less potent than testosterone, and 10-fold less potent than dexamethasone in binding to the androgen and glucocorticoid cytosolic receptors, respectively. The binding of MPA to progestrone, androgen and glucocorticoid receptors predicted direct effects of MPA on FSH-stimulated estrogen (E), progesterone (P), and 20 alpha-dihydroprogesterone (DHP) production by cultured rat ovarian granulosa cells. MPA at 10(-7) to 10(-6) M significantly augmented FSH-stimulated P and DHP production (a previously documented progestin, androgen and glucocorticoid effect). This augmentation was blocked by the concurrent addition to cell culture of 10-fold excess RU-486 (a potent anti-progestin and anti-glucocorticoid). At concentrations greater than 10(-6) M, MPA inhibited the production of P and DHP (a progestin effect), and the production of E (a progestin and glucocorticoid effect). MPA, structurally a progestin, has complex steroid hormone effects predicted by its interaction with progesterone, androgen and glucocorticoid receptors.

Treatment of infertility due to retrograde ejaculation: a simple, cost-effective method

Our data indicate that an appropriate therapy for the infertility associated with retrograde ejaculation is isolation of sperm from voided urine after orgasm, plus IUI. This technique is simple and can be performed in the physicians office, in contrast to more complex techniques such as GIFT or in vitro fertilization.

Changes in gap junction connexin-43 messenger ribonucleic acid levels associated with rat ovarian follicular development as demonstrated by in situ hybridization.

OBJECTIVE The purpose was to evaluate the changes in gap junction connexin-43 messenger ribonucleic acid levels associated with rat ovarian follicular development. Gap junctions connect the plasma membranes of adjacent cells through cell-to-cell channels, allowing synchronization of cellular events, including ovarian follicular development. Ovarian gap junctions consist of the protein connexin-43. STUDY DESIGN We used the hypophysectomized immature rat treated with estrogen or gonadotropins as a model to study the ovarian regulation of connexin-43 messenger ribonucleic acid. In situ hybridization with radiolabeled riboprobes was used to localize and quantitate connexin-43 messenger ribonucleic acid. RESULTS We demonstrated that connexin-43 messenger ribonucleic acid was localized to follicular granulosa cells. Estrogen significantly up-regulated connexin-43 messenger ribonucleic acid (91%), whereas gonadotropins that stimulate ovulation and corpus luteum formation completely down-regulated the connexin-43 gene. These results correlate closely with previous immunohistochemical studies of connexin-43 protein. CONCLUSION The positive correlation between follicular development and granulosa cell content of connexin-43 messenger ribonucleic acid is caused by transcriptional activation of the gap junction connexin-43 gene, posttranscriptional stability of connexin-43 messenger ribonucleic acid, or both. Future studies will determine the molecular mechanisms of hormonal regulation of the connexin-43 gene.

Estradiol-induced changes in rabbit luteal cell progestin production and cholesterol and cholesterol ester content

Estradiol deprivation in vivo causes accumulation of cholesterol and cholesterol ester in the corpora lutea of pseudo-pregnant rabbits within 24 hours. These accumulations occur concomitantly with an abrupt cessation of progestin production. Retreatment with estradiol restores progestin production and can block further increases in cholesterol accumulation (per mg total tissue protein). Ample quantities of precursor cholesterol ester and cholesterol substrate are present in corpora lutea when progestin falls because of estradiol deprivation. We conclude therefore that the gonadotropic action of estradiol is, in part, because of its stimulation of cholesterol conversion to progestins.

Effect of high-density lipoproteins with varying ratios of apolipoprotein A-I to apolipoprotein A-II on steroidogenesis by cultured rat ovary granulosa cells

Plasma high-density lipoproteins (HDL) can provide rat ovary steroidogenic tissue with cholesterol for steroid hormone production, but the mechanism of cholesterol transfer is unknown. To test the importance of apolipoprotein A-I (the major HDL apolipoprotein) in HDL-cell interactions, we examined the ability of canine-human HDL hybrids containing various proportions of canine apolipoprotein A-I and human apolipoprotein A-II to stimulate steroidogenesis by cultured rat ovary granulosa cells. We observed that as the apolipoprotein A-II to apolipoprotein A-II ratio decreased, the ability of the hybrid particles to stimulate granulosa cell progestin (progesterone and 20 alpha-dihydroprogesterone) production diminished. However, granulosa cell progestin (progesterone and 20 alpha-dihydroprogesterone) production diminished. However, apolipoprotein A-I was not necessary for cholesterol transfer, since hybrids with less than 5% of their total apolipoprotein mass as apolipoprotein A-I stimulated progestin production 30% as effectively as canine HDL, which contained essentially only apolipoprotein A-I. These data indicate that the delivery of cholesterol from HDL into the rat ovary cell for steroidogenesis is not strictly dependent on the presence of a specific HDL apolipoprotein.

Transvaginal intratubal insemination by tactile sensation: a preliminary report

Transvaginal catheterization of the fallopian tube has gained increased popularity for transfer of embryos and gametes. Forty-five ITIs were performed on 32 patients using the novel approach of tubal transfer via tactile sensation. This group of patients had undergone an average of 5.2 IUIs before ITI. There were a total of 11 pregnancies, 6 occurring with hMG stimulation and 5 with CC-stimulated cycles (34% PR per patient). Three pregnancies ended with spontaneous abortion, and one patient developed acute salpingitis necessitating laparotomy. These data suggest ITI may be effective in assisted reproduction but, as other invasive procedures, is not without risk.

Androgen and FSH synergistically stimulate lipoprotein degradation and utilization by ovary granulosa cells

Androgen can directly modulate the induction of steroidogenic enzymes by FSH (follicle stimulating hormone) in ovary granulosa cells. In studies of its mechanism of action, we examined the androgen effect on granulosa cell interaction with lipoproteins, the physiologic source of cholesterol. After granulosa cells were cultured for 48 hours with and without androgen and/or FSH, the cells were incubated for 24 hours with 125I-lipoproteins [human high density lipoprotein (HDL), rat HDL, or human low density lipoprotein (LDL)]. The media were then analyzed for lipoprotein protein coat degradation products (mainly 125I-monoiodotyrosine) and progestin [mainly 20 alpha-dihydroprogesterone (20 alpha-DHP)]. In the absence of FSH and androgen, 2 X 10(5) granulosa cells degraded basal levels of all three lipoproteins, but produced no measurable 20 alpha-DHP. The addition of 10(-7) M androstenedione (A), testosterone (T), or 5 alpha-dihydrotestosterone (DHT) had no effect on lipoprotein protein degradation or 20 alpha-DHP production. FSH alone stimulated lipoprotein protein degradation by 50 to 300% while the addition of androgen synergistically augmented the FSH-stimulated 20 alpha-DHP production as well as protein coat degradation of all three lipoproteins. DHT and T were both effective, indicating that androgens themselves, and not estrogen products, were responsible for the effect on lipoprotein protein degradation and 20 alpha-DHP production. The addition of a 10-fold excess cyproterone acetate (an anti-androgen) inhibited the effect of T, suggesting that the action of T was mediated by the granulosa cell androgen receptor. Androgen and FSH also synergistically stimulated the production of 3H-progestin when the granulosa cells were incubated with either 3H-cholesterol ester core labeled human HDL or similarly labeled human LDL. This report demonstrates that androgen, in combination with FSH, augments the steroidogenic pathway of the granulosa cell from the degradation of lipoprotein and utilization of the cholesterol ester core, to the production of progestin product.

Acute cutaneous vasculitis associated with prolonged intravenous ritodrine hydrochloride therapy

A patient with twin gestation was hospitalized because of preterm labor and treated with intravenous ritodrine hydrochloride (Yutopar, Astra Pharmaceutical Products, Westborough, Mass.). After greater than 4 weeks of therapy, the patient had a petechial rash and prolonged bleeding time, which were diagnosed and confirmed by skin biopsy at cesarean section as vasculitis. This is the first documented case of vasculitis associated with ritodrine use.

The role of exogenous calcium for gonadotropin-stimulated progesterone production by human granulosa-luteal cells

Previous studies of cells from various species have indicated that exogenous calcium is necessary for gonadotropic stimulation of steroidogenesis. To determine whether this requirement for exogenous calcium is a universal attribute of steroidogenic cells, we studied baseline and stimulated progesterone (P) production by cultured human granulosaluteal cells obtained at the time of oocyte retrieval for in vitro fertilization (IVF). During 4 hours in culture, both cholera toxin (1.25 micrograms/mL) and human chorionic gonadotropin (hCG, 1 IU/mL) stimulated a significant (P less than 0.05) 2- to 4-times increase in P production. Both baseline and stimulated (cholera toxin or hCG) increases in P were unaffected when cellular uptake of exogenous calcium was inhibited by the calcium channel blocker nitrendipine (10 microM), or by culturing the cells in calcium-free medium or in calcium-free medium with [ethylenebis(oxyethylenenitrilo)]-tetra-acetic acid (EGTA, to chelate any possible free extracellular calcium). At later time points (24 and 48 hours), lack of available exogenous calcium began to have an inhibitory effect on P production, and the hCG effect was more sensitive to the lack of exogenous calcium than was the cholera toxin effect. We speculate that this apparent independence from exogenous calcium over a short culture period is due to the prior stimulation of these cells by exogenous gonadotropins employed in IVF cycles.