Leszek Markiewicz

In vitro bioassays of non-steroidal phytoestrogens

Some of the isoflavonoids present in human diet as well as in urine are expected to exert biologic effects as they have been reported to bind to estrogen receptors and to be estrogenic in other species. This report describes the in vitro assessment of estrogenic effects of isoflavonoids using human endometrial cells and tissue. The relative estrogenic potencies (EC50 values) of estradiol, 3 dietary isoflavonoids (coumestrol, genistein and daidzein) and one of their metabolites (equol), were estimated by using a recently developed multiwell plate in vitro bioassay based on the estrogen-specific enhancement of alkaline phosphatase (AlkP) activity in human endometrial adenocarcinoma cells of the Ishikawa-Var I line. The maximal AlkP activity elicited by the isoflavonoids tested was as high as that achieved with estradiol and their effects were suppressed by the antiestrogens 4-hydroxytamoxifen and ICI 164,384. These results indicate that estradiol and the isoflavonoids exert their effects on AlkP by similar interactions with the estrogen receptor, with potencies depending on binding affinities. The estrogenic effect of equol was confirmed by another in vitro bioassay, based on the estrogen-stimulated enhancement of prostaglandin F2 alpha output by fragments of human secretory endometrium.

In vitro evaluation of estrogenic, estrogen antagonistic and progestagenic effects of a steroidal drug (Org OD-14) and its metabolites on human endometrium

The human endometrial model for in vitro evaluation of estrogenic, estrogen antagonistic, and progestagenic effects of endogenous steroids, natural products or synthetic drugs was applied to the study of Org OD-14, an analog of norethynodrel developed by Organon International, Oss, The Netherlands, and some of its metabolites. Estrogen antagonistic actions of Org OD-14 and its 4-ene isomer were evident from their ability to suppress the enhancement of PGF2 alpha output elicited by estradiol on fragments of secretory endometrium and to decrease the rate of output of the prostaglandin by proliferative tissue, already stimulated by endogenous estrogens. These inhibitory effects were similar to those obtained with progesterone and do not appear to involve competition for the estrogen receptor since the antiestrogen 4-hydroxyamoxifen was not active in parallel incubations of proliferative endometrium. The progestagenic effects of Org OD-14 and its 4-ene isomer were also evident from their capability to enhance estradiol 17 beta-dehydrogenase activity and glycogen accumulation in specimens of proliferative endometrium. Estrogenic effects of the 3 alpha- and 3 beta-hydroxy metabolites of Org OD-14 were demonstrated by their stimulatory actions on PGF2 alpha output during incubations of secretory endometrium. The estrogenic and progestagenic actions of these compounds are in general agreement with their relative affinity for binding to the estradiol and progesterone receptors, although their actions may be influenced by intracellular metabolism in the endometrial tissue. For instance, the similarity in progestagenic activity of Org OD-14 and the 4-ene isomer, contrasting with their different affinities for the progesterone receptor, may result from in situ isomerization of Org OD-14 to the 4-ene metabolite.

Human endometrial 3β-hydroxysteroid dehydrogenase/isomerase can locally reduce intrinsic estrogenic/progestagenic activity ratios of a steroidal drug (Org OD 14)

In vitro conversion in human endometrial tissue of Org OD 14 [17 alpha-hydroxy-7 alpha-methyl-19-norpregn-5(10)-en-20-yn-3-one, a 3-keto-delta 5-10-19-nortestosterone derivative structurally related to norethynodrel] to its 4-ene isomer was demonstrated and measured spectrophotometrically and by chromatographic separation of the labeled metabolite from the tritiated precursor. The endometrial isomerase catalyzing this conversion is the 3 beta-hydroxy-steroid dehydrogenase/isomerase (3 beta HSD/isomerase), detected by Western blotting as a 42 kDa band, as confirmed by the inhibition of Org OD 14 isomerization with an antibody against this enzyme. The endometrial isomerase activity was found to be higher in secretory than in proliferative tissue and to be influenced by progestins, as suggested by the small but significant increase in activity resulting from exposure of proliferative endometrium to medroxyprogesterone acetate under organotypic culture conditions. In addition to the expected physiologic importance of endometrial 3 beta HSD/isomerase in the local metabolism of circulating steroids of adrenal origin, its presence in the endometrium is likely to have pharmacologic relevance, as illustrated by the local conversion of Org OD 14 to the 4-ene isomer, a metabolite with higher progestagenic and lower estrogenic potencies than those of its precursor. The local, tissue-specific, modification of the precursor would yield intracellular concentration ratios of Org OD 14 to 4-ene isomer in the endometrium significantly lower than those in blood. As a result, the estrogenic effects of Org OD 14 or of its 3-hydroxy metabolites on endometrial cell proliferation are minimized by the local formation of the progestagenic 4-ene isomer. This is a favorable feature of Org OD 14 since it selectively prevents undesirable proliferative stimulation of the endometrium in postmenopausal users while preserving its beneficial effects on other tissues, including bone.

The Role of Progestationally Regulated Stromal Cell Tissue Factor and Type‐1 Plasminogen Activator Inhibitor (PAI‐1) in Endometrial Hemostasis and Menstruation

The physiologic mechanisms whereby the human endometrium maintains hemostasis during endovascular trophoblast invasion, yet permits menstrual hemorrhage, are unknown. This paradoxical relationship was investigated by evaluating endometrial expression of tissue factor (TF), the primary initiator of hemostasis, and plasminogen activator inhibitor-1 (PAI-1), the primary inhibitor of fibrinolysis. We observed increased immunostaining for TF and PAI-1 in sections of decidualized stromal cells from luteal phase and gestational endometrium. To determine whether TF and PAI-1 expression are directly linked to decidualization, both endpoints were monitored in a well described in vitro model of decidualization. Thus, confluent stromal cell cultures were exposed to vehicle control, 10(-8) M estradiol (E2), 10(-8) to 10(-6) M medroxyprogesterone acetate (MPA) or both E2 + MPA for 2-24 days in serum-containing or defined media. The progestin enhanced the content of stromal cell-associated immunoreactive and functionally active TF and PAI-1 released into the medium and elevated levels of stromal cell TF and PAI-1 mRNA. While E2 alone was ineffective, it greatly augmented MPA-enhanced TF and PAI-1 protein and mRNA content. Dose-dependent effects on TF and PAI-1 content were observed between 10(-8) to 10(-6) M MPA +/- E2. Similar results were observed for decidual cells derived from first trimester endometrium and cultured in type 1 collagen gels. Following optimal induction of TF and PAI-1 expression by E2 + MPA in stromal cell cultures, removal of these steroids greatly reduced levels of both TF and PAI-1 protein and mRNA within 4 days. These studies suggest a mechanism whereby endometrial hemostasis is maintained during trophoblast invasion yet reduced at the end of nonfertile cycles to permit menses.

Intrinsic estrogenicity of some progestagenic drugs

The intrinsic estrogenic activity of some progestins cannot be properly evaluated by using hormone responsive systems when the chosen end-points are also sensitive to progestagenic activity, usually antagonistic of estrogenic actions. We have therefore applied to the evaluation of some drugs commonly used in contraceptive and hormone replacement formulations a recently developed in vitro method to estimate estrogenic activities, which is based on measurements of the estrogen-stimulated alkaline phosphatase activity in cells of the Ishikawa-Var I human endometrial adenocarcinoma line, a response not influenced by progestins. Whereas progesterone, medroxyprogesterone acetate and danazol were found to be devoid of estrogenic activity in this assay, Org OD-14, norethynodrel, gestrinone (R 2323), norethindrone and dl-norgestrel provoked half maximal increases in alkaline phosphatase activity at concentrations (EC-50) of 7, 14, 140, 200 and 2900 nM, respectively, under conditions in which the corresponding value for estradiol was 8 pM. This intrinsic estrogenic activity can be inhibited by antiestrogens, as verified by reversing the effect of R 2323 with 4-hydroxytamoxifen. Since prostaglandin F2 alpha output by secretory endometrium is increased by estrogens and diminished by progestins, this end-point can serve to evaluate the net effect of drugs with intrinsic estrogenic and progestagenic activities. For instance, R 2323 showed estrogenic activity in this assay whereas Org OD-14 did not. The same in vitro system can be used to evaluate estrogen antagonistic activities of test compounds, using estradiol as the agonist. These in vitro systems are useful in establishing a profile of activities of a drug on a relevant human target tissue, in the screening of synthetic or natural compounds under investigation, and in studies on structure/action relationships.

Steroid regulation of oncofetal fibronectin expression in human cytotrophoblasts

Oncofetal fibronectin (onfFN) is a uniquely glycosylated form of FN suggested to play a critical role in uterine/placental adherence during pregnancy. In the present study we have examined steroid regulation of onfFN in highly purified preparations (> or = 95%) of cytotrophoblasts isolated from human term placentas. Based on immunoassays, relative to controls, treatment of cytotrophoblasts with 10(-6) M medroxyprogesterone acetate (MPA) down-regulated media levels of onfFN 25, 53, 59, and 62% on days 1, 2, 3 and 4, respectively. The pattern of steroid regulation and levels of total FN were nearly identical to that of onfFN suggesting that chronic steroid treatment regulates synthesis of FN and not its oncofetal glycosylation. MPA treatment induced a 2-fold stimulation in media levels of hCG indicating that increased placental function was associated with steroid-mediated changes in FN expression. Steroid specificity experiments demonstrated that MPA, cortisol, and dexamethasone were potent inhibitors of onfFN expression whereas estradiol (E2), deoxycorticosterone, testosterone, progesterone, and the synthetic progestin OD-14, were not. This suggested that glucocorticoids and not progestins may be the physiologic regulators of placental FN expression and that MPA may mediate its matrix-modifying activity through a glucocorticoid-like mechanism. Treatment of cells with dexamethasone (10(-7) M) did not affect the levels of total protein synthesis or the release of human placental lactogen to the culture medium. This indicated that steroid-mediated down-regulation of onfFN expression in cytotrophoblasts did not result from a general reduction of protein synthesis. Based on densitometric scanning of Western blots, MPA and dexamethasone treatments down-regulated media levels of onfFN 70% relative to control levels. Northern blotting revealed that MPA and dexamethasone mediated a 60-90% reduction in steady state levels of FN mRNA in the presence or absence of E2. Our in vitro model may provide a unique system to evaluate steroidal effects on extracellular matrix (ECM) protein expression. In addition, we suggest that steroids may critically regulate placental ECM protein synthesis, and thus affect trophoblast/uterine adherence throughout pregnancy and expulsion of the placenta and membranes following delivery of the fetus.

C19 adrenal steroids enhance prostaglandin F2α output by human endometrium in vitro

Dehydroepiandrosterone sulfate significantly increased prostaglandin F 2α output by fragments of human secretory endometrium during the first and second 24-hour periods of incubation in Hams F-10 medium containing 10% charcoal-treated calf bovine serum. The effects of dehydroepiandrosterone sulfate were noted at 10 −6 mol/L concentrations, which are close to the normal plasma levels of this compound. For the purpose of comparison, the effects of estradiol at 10 −8 mol/L and those of unconjugated dehydroepiandrosterone, dehydroepiandrosterone acetate, 5-androstene-3β,17β-diol, or 5α-dihydrotestosterone were evaluated at 10 −8 to 10 −6 mol/L concentrations in parallel experiments. All of the Δ 5 -C 19 steroids tested enhanced prostaglandin F 2α output at 10 −6 mol/L but not at 10 −6 mol/L; 5α-dihydrotestosterone was inactive at 10 −6 mol/L but showed a stimulatory effect at 10 −5 mol/L in two experiments. The stimulation of prostaglandin F 2α production by the adrenal steroids was significantly reduced by the antiestrogen 4-hydroxytamoxifen at 10 −6 mol/L (a finding consistent with the reported utilization of the estrogen receptor for their actions on other systems) but was not affected by the antiandrogen 4-hydroxyflutamide at 10 −6 mol/L. Progesterone (10 −7 mol/L) also lowered the effects of dehydroepiandrosterone (10 −6 mol/L) and 5-androstene-3β,17β-diol (10 −6 mol/L), as well as those of estradiol (10 −6 mol/L). Δ 5 -C 19 steroids at 10 −6 mol/L levels did not antagonize the effect of 10 −6 mol/L estradiol, whereas 5α-dihydrotestosterone reduced it by 50% at these concentrations. The significant effect of 5α-dihydrotestosterone points to potential antiestrogenic effects of the C 19 compounds that may be manifested in vivo at particular C 19 /estradiol concentration ratios. The demonstration of direct estrogenic effects of Δ 5 -C 19 steroids, which are not significantly converted to estrogens in vivo, justifies their use in estrogen replacement preparations and indicates that aromatase inhibitors may not eliminate completely the stimulation of estrogen-responsive breast and endometrial tumors by the patients adrenal steroids.

Hormonal effects of PGF2α output by cultures of epithelial and stromal cells in human endometrium

Estradiol stimulation and progesterone inhibition of human uterine PGF2 alpha production were studied using in vitro preparations of endometrial tissue and cells. Measurement of PGF2 alpha levels in media from primary cultures of glandular epithelia and stoma revealed that basal outputs were similar in both cell types but could be increased by estradiol only in epithelial cells. Tamoxifen (Tam) and trans-4-hydroxy tamoxifen (OHTam) did not affect basal PGF2 alpha outputs by secretory endometrium in organ culture and by monolayer cultures of epithelial cells, but counteracted the stimulatory effects of estradiol in both systems. The almost pure antiestrogenic activity exhibited by OHTam was at least 10 times greater than that of Tam, suggesting that the estrogen-stimulated increases in uterine PGF2 alpha output are mediated by specific estrogen receptors. Fragments of endometrium also released lipocortin, a phospholipase A2-inhibiting protein believed to mediate inhibitory effects of glucocorticoids on prostaglandin production in several types of cells. Although dexamethasone increased lipocortin and decreased PGF2 alpha output in secretory endometria in vitro, progesterone inhibited both lipocortin and PGF2 alpha output. The mechanisms by which P inhibits PGF2 alpha production remain to be elucidated.

Prostaglandin F2α output by human endometrium under superfusion and organ culture conditions

Abstract Specimens of proliferative and secretory human endometrium were incubated under organ culture or superfusion conditions and the levels of PGF 2α in the medium were measured by radioimmunoassay. Basal rates of PGF 2α output during short-term superfusions and long-term (1–2 day) batch incubations, performed on the same tissue specimens, were similar. Basal output of PGF 2α by proliferative endometrium (230–280 ng/mg protein × d) was significantly higher than that of secretory tissue under both experimental conditions. Estradiol (10 −8 M) increased PGF 2α output significantly (4-fold) only in secretory endometrium under organ culture conditions; Progesterone (10 −7 M) decreased it significantly (to 1 2 − 1 4 of the basal level) in both types of endometria during long-term incubations and in proliferative endometrium during superfusion. Glands isolated from proliferative and secretory endometrium produced PGF 2α during superfusion at a rate comparable to that of endometrial tissue under similar conditions. PGF 2α output by glands isolated from secretory endometrium increased significantly (3-fold) when estradiol was added to the superfusion medium.

Estradiol enhances prostaglandin synthase activity in epithelial but not in stromal cells of human endometrium.

Exogenous estradiol (E2) has been shown to elevate PGF2 alpha output by explants of human secretory endometrium and in monolayer cultures of glandular epithelial, but not of stromal cells isolated from endometrium. In this study, PGF2 alpha output was measured in each of these cultures in the presence of E2 and the calcium ionophore A23187, added singly or in combination. The ionophore, known to liberate arachidonic acid (AA) by stimulating phospholipase activity, produced a calcium-dependent increase in PGF2 alpha output in the cultures of epithelial cells, whereas greater than additive effects were obtained with mixtures of E2 and A23187. In contrast, PGF2 alpha levels were not elevated by A23187 in the stromal cell cultures even in medium supplemented with CaCl2 or when E2 was added. A calcium-dependent increase in PGF2 alpha output was also observed in fragments of secretory endometrium incubated with A23187. Effects on PGF2 alpha output by endometrial fragments incubated with E2 and A23187 were essentially additive and intermediate between those of the two component cells types. Arachidonic acid produced similar increases in PGF2 alpha output in the epithelial and stromal cell cultures but only in the epithelial cell cultures was there greater utilization of AA in the presence of E2. When mixtures of E2 and AA were added to the cultures of epithelial cells the increase in PGF2 alpha output was 2.5-fold greater than the sum of the increases elicited by E2 or AA alone. In contrast, no enhancement of the AA effect by E2 was observed in the stromal cell cultures. Extrapolation of these results from cell cultures to intact tissue suggests that the epithelium and not the stroma is the primary target for the effects of E2 on PGF2 alpha output by secretory endometrium. The synergistic actions of E2 and either AA, the obligatory precursor of PGF2 alpha, or A23187, an enhancer of AA release from phospholipid stores, point to a stimulatory effect of E2 on prostaglandin synthase activity.