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LOCAL SUBSTITUTIONAL THERAPY IN POSTMENOPAUSE
8th European Congress on Menopause (EMAS) / Maturitas 63, Supplement 1 (2009) S1–S136
295 IMMUNOHISTOCHEMICAL DETECTION OF GONADOTROPIN RECEPTORS IN THE OVARIES OF POSTMENOPAUSAL WOMEN WHO HAVE APPLIED AND NOT APPLIED HORMONE REPLACEMENT THERAPY M. Laszczynska 1 , A. Brodowska 2 , A. Starczewski 2 , J. Brodowski 3 , M. Piasecka 1 . 1 Pomeranian Medical University, Laboratory of Histology and Developmental Biology, Szczecin, Poland; 2 Pomeranian Medical University, Department of Reproduction and Gynecology, Szczecin, Poland; 3 Pomeranian Medical University, Laboratory of General Practice, Szczecin, Poland Objectives: In ovaries of menstruating women, FSH receptors (FSHRs) are mainly located in granular and stromal cells, while LH receptors (LHRs) are observed in the internal theca and stromal cells. Data on localization and expression of these receptors in postmenopausal women ovaries are very scant. The aim of this study was to examine immunohistochemical expression and localization of FSHRs and LHRs in the ovaries of postmenopausal women who have applied and not applied hormone replacement therapy (HRT). Methods: The material came from 100 postmenopausal women who had their ovaries removed due to non-neoplastic diseases of the uterus. The women were divided into 3 groups (A, B, C) depending on the time from menopause. FSH, LH, estradiol (E2 ) and testosterone (T) in serum were measured. For immunohistochemical detection polyclonal rabbit anti-human FSHR and LHR antibody were used (Sigma, USA). Results: In studied groups FSH and LH serum concentrations were significantly different, and the highest values were observed in group C. LHRs and FSHRs were detected in cytoplasme of ovarian surface epithelium, epithelial inclusive cysts, stromal cells and vascular endothelial cells. Expression of these receptors was the weakest in group C. Conclusions: FSHRs and LHRs were detected in all three groups in the ovaries of postmenopausal women independently on HRT applied. Their expression decreased with age and depended on the time from menopause. The weaker expression of these receptors was in ovaries, the higher FSH and LH concentrations were in blood serum. Keywords: FSH receptors, LH receptors, ovary, postmenopausal women, hormone replacement therapy, immunohistochemistry.
S77
Keywords: Estropipate, conjugated equine estrogen, mammographic density.
297 ENDOGENOUS REGULATION OF SUPEROXIDE DISMUTASE AND CATALASE ACTIVITY CORRELATED TO ESTRADIOL LEVELS IN PATIENTS UNDERWENT TO HYSTERECTOMY AND BILATERAL OVARIECTOMY M. Matteo 1 , G. Scillitani 1 , S. Marrocchella 1 , V. Sestilli 1 , I. Barone 1 , A.D. Romano 2 , F. Bellanti 2 , T. Rollo 2 , P. Greco 1 , G. Serviddio 2 . 1 Ospedaliriuniti, University of Foggia, Institute of Obstetrics and Gynecology, Foggia, Italy; 2 Ospedaliriuniti, University of Foggia, Institute of Internal Medicine, Foggia, Italy
296
Objectives: The study was designed to investigate the effects of hysterectomy and bilateral ovariectomy and estradiol levels on the superoxide dismutase (SOD) and catalase (CAT) activities. Methods: From 10 patients with normal menstrual cycle a blood sample was drawn to evaluate the changes in estradiol levels before and one month after hysterectomy and bilateral ovariectomy. Blood was collected into heparinized blood collection tubes than samples were centrifuged at 500 g and the buffy coat layer was removed. The cells were lysed in TRIzol by repetitive pipetting than total cellular RNA was extracted using a commercial RNA purification kit. A PCR master mix containing the specific primers for human superoxide dismutase 2 (SOD2), catalase (CAT) and subunits M1 (GST-M1) and P1 (GST-P1) of glutathione-S-transferase were made. Real-time quantization of mRNA was performed with a SYBR Green I assay, and evaluated using a iCycler detection system. Results: A significantly increase in CAT expression of about 1,5 folds was found in blood samples collected from patients before hysterectomy and bilateral ovariectomy as compared to blood samples collected one month after surgery (p<0,05). SOD2 expression were reduced of about 0,5 folds as compared to controls (p<0,05); furthermore we observed a marked increase in the expression of GST-P1 and GST-M1 subunits (p<0,03). Conclusions: Preliminary results showed a reduction in SOD activity, an increase in CAT and GST expression suggesting a possible relationship between estradiol levels and the endogenous regulation of the antioxidant pathways. Keywords: SOD, CAT, GST, Estradiol levels.
IMPACT OF MEDROXYPROGESTERONE ACETATE ON MAMMOGRAPHIC DENSITY BY TYPE OF ORAL ESTROGEN COMBINED IN KOREAN POSTMENOPAUSAL WOMEN
298
D.-Y. Lee 1 , H.J. Choi 1 , D. Choi 1 , Y.-K. Min 2 , Y.H. Choe 3 , B.-K. Yoon 1 . 1 Samsung Medical Center/Sungkyunkwan University, Obstetrics and Gynecology, Seoul, Korea, Republic of; 2 Samsung Medical Center/ Sungkyunkwan University, Medicine, Seoul, Korea, Republic of; 3 Samsung Medical Center/Sungkyunkwan University, Radiology, Seoul, Korea, Republic of Objectives: Medroxyprogesterone acetate (MPA) combined with conjugated equine estrogen (CEE) increases mammographic density (MMGD) and risk for breast cancer. Compared with CEE, other estrogens such as esterified estrogen might show better risk profiles of myocardial infarction, stroke, and venous thrombosis. We examined if impact of MPA co-administered with estrogen on MMGD might differ between CEE vs. Estropipate (Ep) in Korean postmenopausal women. Methods: In this retrospective study, 53 healthy postmenopausal women without prior hormone therapy (HT) use were included. Smokers, habitual drinkers, women with body mass index ≥ 27 kg/m2 , history of mammoplasty or hysterectomy were excluded. HT using MPA (n=26) consisted of two groups, i.e. CEE (n=10) and Ep (n=16) groups. Untreated 27 women served as control. Mammography was taken at baseline and one year later and MMGD was assessed, based on breast imaging reporting and data system (BI-RADS), by one radiologist blinded to treatment. Data was analyzed with ANOVA and χ2 test. Results: There were no significant differences in baseline clinical characteristics and MMGD among three groups. After one year of HT, both CEE (70%) and Ep (18.8%) regimens significantly elevated % increase in BI-RADS grade compared with control (0%). In addition, CEE induced higher MMGD increase than Ep (p=0.026). Conclusions: Estropipate+MPA had less stimulating effect on MMGD than CEE+MPA in Korean postmenopausal women. Change in MMGD might depend on the preparations of oral estrogen. Further study on breast cancer risk may be warranted.
LOCAL SUBSTITUTIONAL THERAPY IN POSTMENOPAUSE L. Mrdakovic Todorovic. Health Centre Nis, Organizational Unit for Health Protection of Women, Nis, Serbia Objectives: The aim of paper is study of disappearance of subjective local symptoms in postmenopause and cytological diagnosis for patients after vaginal application of tbl Vagifem (17b-estradiol) Methods: In prospective study we have followed the efficiency of vaginal application of tbl Vagifem with thirty patients in the period of three months. The starting therapy was one vaginal pill per day during three months, and then the maintenance therapy: one pill two times a week.The patients were approximately 59 years old and were in postmenopause for, approximately, 6.2 years. Every patient had pruritus vulvae, the feeling of dry vagina, dispareunia, vaginal irritation. Results: We found the regression of subjective troubles for every treated patient after three-month local application of medicine. Pretherapeutical cythological Papanicolaou smear has been atrophic-senile cervicit et colpit with 80% of patients, and after the therapy with Vagifem we registered normal cytological finding (PAPA II) and adequate degree of moisture of vaginal mucousmembrane with 90% of patients Conclusions: Positive effeciency of local hormonal substitutional therapy with our patients has lasted, in avarage, for a year Keywords: Postmenopause, vagifem
295 IMMUNOHISTOCHEMICAL DETECTION OF GONADOTROPIN RECEPTORS IN THE OVARIES OF POSTMENOPAUSAL WOMEN WHO HAVE APPLIED AND NOT APPLIED HORMONE REPLACEMENT THERAPY M. Laszczynska 1 , A. Brodowska 2 , A. Starczewski 2 , J. Brodowski 3 , M. Piasecka 1 . 1 Pomeranian Medical University, Laboratory of Histology and Developmental Biology, Szczecin, Poland; 2 Pomeranian Medical University, Department of Reproduction and Gynecology, Szczecin, Poland; 3 Pomeranian Medical University, Laboratory of General Practice, Szczecin, Poland Objectives: In ovaries of menstruating women, FSH receptors (FSHRs) are mainly located in granular and stromal cells, while LH receptors (LHRs) are observed in the internal theca and stromal cells. Data on localization and expression of these receptors in postmenopausal women ovaries are very scant. The aim of this study was to examine immunohistochemical expression and localization of FSHRs and LHRs in the ovaries of postmenopausal women who have applied and not applied hormone replacement therapy (HRT). Methods: The material came from 100 postmenopausal women who had their ovaries removed due to non-neoplastic diseases of the uterus. The women were divided into 3 groups (A, B, C) depending on the time from menopause. FSH, LH, estradiol (E2 ) and testosterone (T) in serum were measured. For immunohistochemical detection polyclonal rabbit anti-human FSHR and LHR antibody were used (Sigma, USA). Results: In studied groups FSH and LH serum concentrations were significantly different, and the highest values were observed in group C. LHRs and FSHRs were detected in cytoplasme of ovarian surface epithelium, epithelial inclusive cysts, stromal cells and vascular endothelial cells. Expression of these receptors was the weakest in group C. Conclusions: FSHRs and LHRs were detected in all three groups in the ovaries of postmenopausal women independently on HRT applied. Their expression decreased with age and depended on the time from menopause. The weaker expression of these receptors was in ovaries, the higher FSH and LH concentrations were in blood serum. Keywords: FSH receptors, LH receptors, ovary, postmenopausal women, hormone replacement therapy, immunohistochemistry.
S77
Keywords: Estropipate, conjugated equine estrogen, mammographic density.
297 ENDOGENOUS REGULATION OF SUPEROXIDE DISMUTASE AND CATALASE ACTIVITY CORRELATED TO ESTRADIOL LEVELS IN PATIENTS UNDERWENT TO HYSTERECTOMY AND BILATERAL OVARIECTOMY M. Matteo 1 , G. Scillitani 1 , S. Marrocchella 1 , V. Sestilli 1 , I. Barone 1 , A.D. Romano 2 , F. Bellanti 2 , T. Rollo 2 , P. Greco 1 , G. Serviddio 2 . 1 Ospedaliriuniti, University of Foggia, Institute of Obstetrics and Gynecology, Foggia, Italy; 2 Ospedaliriuniti, University of Foggia, Institute of Internal Medicine, Foggia, Italy
296
Objectives: The study was designed to investigate the effects of hysterectomy and bilateral ovariectomy and estradiol levels on the superoxide dismutase (SOD) and catalase (CAT) activities. Methods: From 10 patients with normal menstrual cycle a blood sample was drawn to evaluate the changes in estradiol levels before and one month after hysterectomy and bilateral ovariectomy. Blood was collected into heparinized blood collection tubes than samples were centrifuged at 500 g and the buffy coat layer was removed. The cells were lysed in TRIzol by repetitive pipetting than total cellular RNA was extracted using a commercial RNA purification kit. A PCR master mix containing the specific primers for human superoxide dismutase 2 (SOD2), catalase (CAT) and subunits M1 (GST-M1) and P1 (GST-P1) of glutathione-S-transferase were made. Real-time quantization of mRNA was performed with a SYBR Green I assay, and evaluated using a iCycler detection system. Results: A significantly increase in CAT expression of about 1,5 folds was found in blood samples collected from patients before hysterectomy and bilateral ovariectomy as compared to blood samples collected one month after surgery (p<0,05). SOD2 expression were reduced of about 0,5 folds as compared to controls (p<0,05); furthermore we observed a marked increase in the expression of GST-P1 and GST-M1 subunits (p<0,03). Conclusions: Preliminary results showed a reduction in SOD activity, an increase in CAT and GST expression suggesting a possible relationship between estradiol levels and the endogenous regulation of the antioxidant pathways. Keywords: SOD, CAT, GST, Estradiol levels.
IMPACT OF MEDROXYPROGESTERONE ACETATE ON MAMMOGRAPHIC DENSITY BY TYPE OF ORAL ESTROGEN COMBINED IN KOREAN POSTMENOPAUSAL WOMEN
298
D.-Y. Lee 1 , H.J. Choi 1 , D. Choi 1 , Y.-K. Min 2 , Y.H. Choe 3 , B.-K. Yoon 1 . 1 Samsung Medical Center/Sungkyunkwan University, Obstetrics and Gynecology, Seoul, Korea, Republic of; 2 Samsung Medical Center/ Sungkyunkwan University, Medicine, Seoul, Korea, Republic of; 3 Samsung Medical Center/Sungkyunkwan University, Radiology, Seoul, Korea, Republic of Objectives: Medroxyprogesterone acetate (MPA) combined with conjugated equine estrogen (CEE) increases mammographic density (MMGD) and risk for breast cancer. Compared with CEE, other estrogens such as esterified estrogen might show better risk profiles of myocardial infarction, stroke, and venous thrombosis. We examined if impact of MPA co-administered with estrogen on MMGD might differ between CEE vs. Estropipate (Ep) in Korean postmenopausal women. Methods: In this retrospective study, 53 healthy postmenopausal women without prior hormone therapy (HT) use were included. Smokers, habitual drinkers, women with body mass index ≥ 27 kg/m2 , history of mammoplasty or hysterectomy were excluded. HT using MPA (n=26) consisted of two groups, i.e. CEE (n=10) and Ep (n=16) groups. Untreated 27 women served as control. Mammography was taken at baseline and one year later and MMGD was assessed, based on breast imaging reporting and data system (BI-RADS), by one radiologist blinded to treatment. Data was analyzed with ANOVA and χ2 test. Results: There were no significant differences in baseline clinical characteristics and MMGD among three groups. After one year of HT, both CEE (70%) and Ep (18.8%) regimens significantly elevated % increase in BI-RADS grade compared with control (0%). In addition, CEE induced higher MMGD increase than Ep (p=0.026). Conclusions: Estropipate+MPA had less stimulating effect on MMGD than CEE+MPA in Korean postmenopausal women. Change in MMGD might depend on the preparations of oral estrogen. Further study on breast cancer risk may be warranted.
LOCAL SUBSTITUTIONAL THERAPY IN POSTMENOPAUSE L. Mrdakovic Todorovic. Health Centre Nis, Organizational Unit for Health Protection of Women, Nis, Serbia Objectives: The aim of paper is study of disappearance of subjective local symptoms in postmenopause and cytological diagnosis for patients after vaginal application of tbl Vagifem (17b-estradiol) Methods: In prospective study we have followed the efficiency of vaginal application of tbl Vagifem with thirty patients in the period of three months. The starting therapy was one vaginal pill per day during three months, and then the maintenance therapy: one pill two times a week.The patients were approximately 59 years old and were in postmenopause for, approximately, 6.2 years. Every patient had pruritus vulvae, the feeling of dry vagina, dispareunia, vaginal irritation. Results: We found the regression of subjective troubles for every treated patient after three-month local application of medicine. Pretherapeutical cythological Papanicolaou smear has been atrophic-senile cervicit et colpit with 80% of patients, and after the therapy with Vagifem we registered normal cytological finding (PAPA II) and adequate degree of moisture of vaginal mucousmembrane with 90% of patients Conclusions: Positive effeciency of local hormonal substitutional therapy with our patients has lasted, in avarage, for a year Keywords: Postmenopause, vagifem