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Increased tobacco-related disease among women
News & Comment
TRENDS in Endocrinology & Metabolism Vol.12 No.6 August 2001
241
In Brief
Control of VEGF expression by progestins A recently published report suggests that, in human breast cancer cells, the expression of vascular endothelial cell growth factor (VEGF) (one of the most potent angiogenesis factors currently known) is stimulated by the presence of progestins. Salman M. Hyder et al. (University of Texas Health Science Center, Houston, TX, USA), writing in the International Journal of Cancer (15th May), suggest that anti-progestins might play a role in preventing tumor progression in patients with breast cancer. Hyder et al. looked at the effects of both exogenous and endogenous progestins on the expression of VEGF mRNA in the human breast cancer cell line T47-D. Their results showed that progestins, rather than other endogenous hormones, such as estrogens, glucocorticoids or androgens, induced the expression of VEGF mRNA transcripts in a dose-dependent manner, which was prevented by the addition of actinomycin D. This result indicates that, in response to progestin stimulation, there is an induction of de novo VEGF mRNA expression, which is not dependent on protein synthesis (induction was not inhibited by addition of puromycin). These results suggest that progestin could drive tumor expansion in breast cancer cells that are similar to the T47-D cell line. Given that occult tumors in women, which are initiated by estrogens, subsequently increase angiogenic factor(s) expression on exposure to progestin, there is a great need for studies of the relationship between VEGF and progestins in human breast cancer. Results from this, and further studies, might help to explain why there is an increased risk for breast cancer in women on hormone replacement therapy. LS
Double chance of depression for diabetics Diabetics are twice as likely as nondiabetics to suffer from depression. The extent of the association was apparent from a metaanalysis of 20 studies from the last 25 years that, collectively, comprised 20218 individuals. Ryan Anderson et al. (2001) (Diabetes Care 24, 1069–1078) found that 11% of diabetics presented with major depression and 31% with symptoms of elevated depression. The relationship between the two conditions was unaffected http://tem.trends.com
by gender, type of diabetes or method of assessment. The authors say that ‘better recognition and better treatment of depression are important in themselves, but they could also improve medical outcome in a substantial portion of patients with diabetes’. HN
Increased tobacco-related disease among women In a recent report Women and the Tobacco Epidemic – Challenges for the 21st Century, the WHO stated that, because of smoking or passive smoking, women are developing more tobacco-related diseases. Although ~12% of women smoke, compared with 48% of men, the gap is narrowing, especially among young women, who, the WHO suggest, are often tempted by marketing campaigns that offer low prices, free samples and ‘female’ brands. Japan, Germany and the USA are among the countries where higher rates of smoking among young women have been recorded. Even women who choose not to smoke are being affected by the habit. Passive smoking is exposing women (and men) to the risk of serious health problems – for example, >60% of Asian men smoke, meaning that millions of women and children are at risk of passive smoking. Women who smoke, or who are passive smokers, have a higher risk of developing cancers of the pancreas, mouth, kidney, pharynx, larynx, cervix, oesophagus and bladder, as well as of the lungs. There is also an increased risk for cardiovascular disease, especially if oral contraceptives are used. Other problems include risks for developing lower bone densities, earlier menopause, infertility and delays in contraception. The UN health agency warns that, by 2020, deaths from tobacco could reach eight million people a year, with 70% of those being in the developing world. Women, especially those of childbearing age, are particularly vulnerable, and the issue of tobacco-related disease looks set to become a standard feature of health care throughout the world. LS
FDA extends patent protection for drug giants The US Food and Drug Administration (FDA) has extended patent protection, for paediatric studies, to several of the largest drug companies for an extra six months. The FDA’s paediatric exclusivity provision was established in 1997 to provide marketing incentives to manufacturers who conduct studies of drugs in children. Pharmaceutical giants GlaxoSmithKline will benefit from this six-month exclusivity extension for three of their products, Ziagen (abacavir), Epivir (lamivudine) and Zantac (ranitidine). Abbott Laboratories received protection for Calcijex (calcitriol), Ultiva (remifentanil) and Ultane (sevoflurane). Other companies that will do well by this ruling are Johnson & Johnson, American Home Products, Eli Lilley and Merck. This has generated criticism from companies producing generic drugs that account for ~40% of the US prescription-market, who feel that the FDA’s ruling gives the brand companies an unfair advantage. HN
Low-dose HRT is effective Low doses of estrogen and progesterone can be as effective at treating the symptoms of the menopause as are higher doses, and create fewer side effects. Two reports on the Women’s HOPE (health, osteoporosis, progesterone and estrogen) study are published in the June issue of Fertility and Sterility. The HOPE study was conducted on 57 sites and has involved 2673 healthy, postmenopausal woman who still had their uterus. The research, funded by WyethAyerst Research [part of American Home Products (AHP)], has shown that low-dose combinations of progesterone and estrogen worked about as well as higher doses in reducing hot flushes, maintaining the thickness of the vaginal lining and preventing ‘breakthrough’ bleeding. By the end of the year, AHP hopes to sell a low-dose version of its Pempro, containing 0.45 mg of estrogen and 1.5 mg of progesterone. HN
Synthroid deadline looming The US Food and Drug Administration (FDA) has turned down an application for a popular thyroid-replacement drug to be ‘Generally Regarded as Safe and Effective’ (GRAS/E). Although Synthroid has been on the market for over 35 years, it contains levothyroxine
1043-2760/01/$ – see front matter © 2001 Elsevier Science Ltd. All rights reserved.
TRENDS in Endocrinology & Metabolism Vol.12 No.6 August 2001
241
In Brief
Control of VEGF expression by progestins A recently published report suggests that, in human breast cancer cells, the expression of vascular endothelial cell growth factor (VEGF) (one of the most potent angiogenesis factors currently known) is stimulated by the presence of progestins. Salman M. Hyder et al. (University of Texas Health Science Center, Houston, TX, USA), writing in the International Journal of Cancer (15th May), suggest that anti-progestins might play a role in preventing tumor progression in patients with breast cancer. Hyder et al. looked at the effects of both exogenous and endogenous progestins on the expression of VEGF mRNA in the human breast cancer cell line T47-D. Their results showed that progestins, rather than other endogenous hormones, such as estrogens, glucocorticoids or androgens, induced the expression of VEGF mRNA transcripts in a dose-dependent manner, which was prevented by the addition of actinomycin D. This result indicates that, in response to progestin stimulation, there is an induction of de novo VEGF mRNA expression, which is not dependent on protein synthesis (induction was not inhibited by addition of puromycin). These results suggest that progestin could drive tumor expansion in breast cancer cells that are similar to the T47-D cell line. Given that occult tumors in women, which are initiated by estrogens, subsequently increase angiogenic factor(s) expression on exposure to progestin, there is a great need for studies of the relationship between VEGF and progestins in human breast cancer. Results from this, and further studies, might help to explain why there is an increased risk for breast cancer in women on hormone replacement therapy. LS
Double chance of depression for diabetics Diabetics are twice as likely as nondiabetics to suffer from depression. The extent of the association was apparent from a metaanalysis of 20 studies from the last 25 years that, collectively, comprised 20218 individuals. Ryan Anderson et al. (2001) (Diabetes Care 24, 1069–1078) found that 11% of diabetics presented with major depression and 31% with symptoms of elevated depression. The relationship between the two conditions was unaffected http://tem.trends.com
by gender, type of diabetes or method of assessment. The authors say that ‘better recognition and better treatment of depression are important in themselves, but they could also improve medical outcome in a substantial portion of patients with diabetes’. HN
Increased tobacco-related disease among women In a recent report Women and the Tobacco Epidemic – Challenges for the 21st Century, the WHO stated that, because of smoking or passive smoking, women are developing more tobacco-related diseases. Although ~12% of women smoke, compared with 48% of men, the gap is narrowing, especially among young women, who, the WHO suggest, are often tempted by marketing campaigns that offer low prices, free samples and ‘female’ brands. Japan, Germany and the USA are among the countries where higher rates of smoking among young women have been recorded. Even women who choose not to smoke are being affected by the habit. Passive smoking is exposing women (and men) to the risk of serious health problems – for example, >60% of Asian men smoke, meaning that millions of women and children are at risk of passive smoking. Women who smoke, or who are passive smokers, have a higher risk of developing cancers of the pancreas, mouth, kidney, pharynx, larynx, cervix, oesophagus and bladder, as well as of the lungs. There is also an increased risk for cardiovascular disease, especially if oral contraceptives are used. Other problems include risks for developing lower bone densities, earlier menopause, infertility and delays in contraception. The UN health agency warns that, by 2020, deaths from tobacco could reach eight million people a year, with 70% of those being in the developing world. Women, especially those of childbearing age, are particularly vulnerable, and the issue of tobacco-related disease looks set to become a standard feature of health care throughout the world. LS
FDA extends patent protection for drug giants The US Food and Drug Administration (FDA) has extended patent protection, for paediatric studies, to several of the largest drug companies for an extra six months. The FDA’s paediatric exclusivity provision was established in 1997 to provide marketing incentives to manufacturers who conduct studies of drugs in children. Pharmaceutical giants GlaxoSmithKline will benefit from this six-month exclusivity extension for three of their products, Ziagen (abacavir), Epivir (lamivudine) and Zantac (ranitidine). Abbott Laboratories received protection for Calcijex (calcitriol), Ultiva (remifentanil) and Ultane (sevoflurane). Other companies that will do well by this ruling are Johnson & Johnson, American Home Products, Eli Lilley and Merck. This has generated criticism from companies producing generic drugs that account for ~40% of the US prescription-market, who feel that the FDA’s ruling gives the brand companies an unfair advantage. HN
Low-dose HRT is effective Low doses of estrogen and progesterone can be as effective at treating the symptoms of the menopause as are higher doses, and create fewer side effects. Two reports on the Women’s HOPE (health, osteoporosis, progesterone and estrogen) study are published in the June issue of Fertility and Sterility. The HOPE study was conducted on 57 sites and has involved 2673 healthy, postmenopausal woman who still had their uterus. The research, funded by WyethAyerst Research [part of American Home Products (AHP)], has shown that low-dose combinations of progesterone and estrogen worked about as well as higher doses in reducing hot flushes, maintaining the thickness of the vaginal lining and preventing ‘breakthrough’ bleeding. By the end of the year, AHP hopes to sell a low-dose version of its Pempro, containing 0.45 mg of estrogen and 1.5 mg of progesterone. HN
Synthroid deadline looming The US Food and Drug Administration (FDA) has turned down an application for a popular thyroid-replacement drug to be ‘Generally Regarded as Safe and Effective’ (GRAS/E). Although Synthroid has been on the market for over 35 years, it contains levothyroxine
1043-2760/01/$ – see front matter © 2001 Elsevier Science Ltd. All rights reserved.