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PubMed2003

Coordinate regulation of the production and signaling of retinoic acid by estrogen in the human endometrium.

To determine whether estrogen regulates retinoic acid (RA) production and signaling in the human endometrium as it does in the rodent uterus, we investigated the effects of estrogens on the expression of RA-metabolizing enzymes, retinoid receptors, and biomarker genes in the post- and premenopausal human endometrium. Real-time quantitative PCR revealed that retinaldehyde dehydrogenase (RALDH) 2, a critical enzyme in RA biosynthesis, was induced 4-fold by estrogen replacement therapy with either Premarin or a mixture of estrone and equilin sulfates for 3 months. Estrogen replacement therapy also increased the expression of the RA receptor RAR alpha 1.9-fold. In parallel, there was a marked increase in the expression of two RA-regulated genes, cellular retinoic acid-binding protein II and tissue transglutaminase. In the premenopausal endometrium, the levels of RALDH1, RALDH2, RAR alpha, and cellular retinoic acid-binding protein II were increased in the estrogen-dominated proliferative phase, and the transcripts for the RA catabolic enzyme retinoic acid 4-hydroxylase (CYP26A1) and tissue transglutaminase were significantly increased in the secretory phase. Our results suggest that estrogen coordinately up-regulates RA production and signaling in the human endometrium. This coordinate mechanism may play a role in the antiproliferative effects that counterbalance the estrogen-induced endometrial proliferation.

Aldehyde Oxidoreductases↗
PubMed1993

Antioxidant potential of specific estrogens on lipid peroxidation.

Coronary heart disease (CHD) is the leading cause of death in postmenopause. Estrogen administration in postmenopause lowers the risk of CHD by 50%. A variety of estrogen preparations are currently used in postmenopausal hormone replacement therapy. It is unknown, however, if structural differences in the estrogen molecule influence the cardioprotective effects of estrogens. In this communication we have shown that equine estrogens (especially equilin) exhibit higher antioxidant potency (as measured by fatty acids and sterols oxidation) when compared to estrone and estradiol-17 beta.

Cell Line↗
PubMed1998

Pharmacokinetic comparison between Conpremin (Premarin) and a generic preparation of conjugated estrogens.

OBJECTIVES: To determine the relative bioavailability of the estrogenic components of a generic brand of conjugated estrogens marketed in Chile in comparison to that of Conpremin (Premarin in the United States). METHODS: A randomized cross-over study was conducted on 16 healthy postmenopausal women receiving single oral doses of either two Conpremin 0.625-mg tablets or two 0.625-mg tablets of the generic brand, with a 14-day wash-out interval between doses. A gas chromatography tandem mass spectrometry assay was used to determine estrogen components. RESULTS: The peak plasma concentrations of unconjugated and total estrone and equilin, unconjugated 17 beta-dihydroequilin and 17 beta-estradiol were higher and occurred earlier with the generic conjugated estrogens than with Conpremin. The 90% confidence limits for both variables lay outside the accepted bioequivalence limits of 80-125%. Additionally, no measurable plasma concentration of unconjugated delta 8,9-dehydroestrone or 17 beta-delta 8,9-dehydroestradiol was seen after administration of the generic conjugated estrogens. CONCLUSIONS: These pharmacokinetic results indicate that the generic tablets do not have the modified-release characteristics of Conpremin tablets. In addition, the absence of delta 8,9-dehydroestrone and 17 beta-delta 8,9-dehydroestradiol in the plasma indicates that the generic form is not compositionally equivalent to Conpremin.

Adult↗
PubMed1975

Oestrogens, LH, PMSG, and prolactin in serum of pregnant mares.

Levels of oestrone, equilin and equilenin (E1), oestradiol (E2) LH, PMSG and prolactin were measured by radioimmunoassay in serum from pregnant mares. Levels of E1 were always greater than those of E2. Both E1 and E2 remained at low levels until Day 80, increased significantly (P less than 0-05) by Day 120 to reach peak levels at Day 210 or 240 and then declined until parturition. Maximum levels of oestrogens observed in this study were 828 +/- 151 pg/ml for E1 and 71 +/- 18 pg/ml for E2 at Days 210 and 240 respectively. Spikes of LH release were observed in early pregnancy in most mares. Levels of PMSG were first detectable at Days 32 or 36 and reached a peak of 67-1 i.u./ml 64 days after the last mating. Levels of LH were very low (often non-detectable) from Day 210 of gestation until parturition. Levels of prolactin were extremely variable and showed no clear fluctuating patterns during pregnancy.

Animals↗
PubMed1999

Conjugated estrogens--the natural SERMs.

Tissue selective and metabolite replacement therapy may become a new aspect in hormone replacement therapy (HRT). In addition to the naturally secreted hormones, there are also the later formed metabolites that exert a characteristic pharmacological profile. This mechanism is well known in thyroid replacement therapy, when triiodothyronine, the metabolite of thyroxine, is added to substitution therapy. The same is true for testosterone replacement therapy, when dihydrotestosterone is used for replacement. Also in menopausal HRT these aspects will gain tremendous importance. Progesterone metabolites have a strong clinical potency as neurosteroids, and estradiol metabolites are important factors in angiogenesis and angiostasis. Conjugated estrogens consist of different metabolites such as 16-hydroxy-equilin, which has no angiogenetic effect compared with 16-hydroxy-estrone. Estrone sulfate, the main component in conjugated estrogens, can be activated into estrone and 17 beta-estradiol in a tissue specific manner. This aspect will become of interest in clinical practice with HRT.

2-Methoxyestradiol↗
PubMed2003

Comparison of the proliferative effects of estradiol and conjugated equine estrogens on human breast cancer cells and impact of continuous combined progestogen addition.

OBJECTIVES: So far, most epidemiological studies investigating breast cancer risk and hormone replacement therapy have been conducted with conjugated equine estrogens (CEE). Recent trials indicate that the addition of progestogens may increase breast cancer risk. In the present study, we compared the effects of the human estrogen 17beta-estradiol (E(2)) with those of the main equine components of CEE, i.e. equilin (Eq) and 17alpha-dihydroequilin (Dheq) on the proliferation of human breast cancer cells. The proliferative effect of progestogen addition was also investigated. MATERIALS AND METHODS: The well-established human breast cancer cell line MCF-7 was used as an in vitro model. The proliferative effect of E(2), Eq and Dheq was tested in the concentration range 0.01-10 nmol/l. The progestogens progesterone, medroxyprogesterone acetate (MPA) and norethisterone (NET) were continuously combined with 0.1 nmol/l estrogen at concentrations of 0.01 nmol/l, 1 nmol/l, 0.1 mumol/l and 10 mumol/l. Proliferation was measured after 7 days by the adenosine triphosphate (ATP) chemosensitivity test. RESULTS: All three estrogens increased the proliferation of MCF-7 cells by between 40 and 180%. The most proliferatively potent estrogen was E(2), followed by Eq and Dheq, which showed a slightly lower proliferative activity than E(2). The addition of progesterone inhibited E(2)-induced proliferation by about 30%, but only at the high non-physiological concentration of 10 mumol/l. All three progestogens inhibited Eq-induced proliferation, although their effect tended to be low, with values between 5 and 40%. No progestogen reduced Dheq-induced proliferation by more than 20%. In contrast, MPA slightly increased the proliferation rate by about 5% at the high physiological concentration of 0.1 mumol/l when combined with Dheq. The same held true when MPA and NET were added at the high pharmacological concentration of 10 mumol/l, causing increases of about 10%. CONCLUSIONS: Our results indicate that equine estrogens have a proliferative action similar to that of 17beta-estradiol. Continuous addition of progestogens does not result in any major reduction of proliferative potency. Some progestogens may even enhance the estrogen-induced proliferation of pre-existing breast cancer cells, particularly when combined with certain equine estrogens. However, in none of the tested circumstances do progestogens increase the proliferative effect of estradiol, and progesterone has no deleterious effect even at pharmacological levels, in contrast to progestogens.

Breast Neoplasms↗
PubMedDate not supplied

Pyrene sulphonyl chloride as a reagent for quantitation of oestrogens in human serum using HPLC with conventional and laser-induced fluorescence detection.

A highly sensitive HPLC method with conventional and laser-induced fluorescence detection for the analyses of oestrogens is described. beta-oestradiol (beta-ES) was chosen as a model and derivatized with pyrenesulphonyl chloride (PSCL), a novel derivatizing reagent, using a two-phase system with tetrapentylammonium bromide (TPABR) as a phase transfer catalyst. Derivatization was complete in 30 s at room temperature and concentrations as low as 5 x 10(-10) M could be derivatized and detected. The concentration detection limit PSCL derivatized beta-ES was 2 x 10(-11) M which corresponds to an on-column detection limit of one femtomole using conventional chromatography and detection. The relative standard deviation (n = 6) of the derivatization carried out at 2.5 x 10(-9) M was 4%. No significant loss of peak-height of the derivative was observed at room temperature over 24 h period. Baseline resolution of PSCL derivatized oestrone, equilin and beta-oestradiol was achieved with ACN:H2O (75:25 v/v) using a Bondclone C-18 column. The method described here is sufficiently sensitive for analyses of beta-oestradiol at low pg/mL concentrations in 1 mL of human serum. The PSCL derivatives of oestrogens demonstrate excellent potential for excitation by laser-induced fluorescence using the 351 nm line of an Ar ion laser or the 325 nm line of He-Cd laser. A concentration limit of detection of 4 x 10(-12) M for beta-oestradiol was achieved using the 325 nm line of an He-Cd laser. This corresponds to 0.2 fmol of derivatized beta-oestradiol on-column.

Chromatography, High Pressure Liquid↗
PubMed1995

Benefit/risk of estrogen therapy in cardiovascular disease: current knowledge and future challenges.

In the United States, cardiovascular disease represents the leading cause of death among women. A majority of the deaths are due to coronary disease. In addition, the incidence of heart attacks increases with age. Among those who are 65 years of age or older, the estimated heart attack rate is 374,000 per year for women, compared with 440,000 per year for men. In the past three decades, a number of observational studies have suggested that estrogen therapy can reduce the risk of coronary disease in postmenopausal women. This protective effect appears to be much greater in women who have existing coronary disease. These observational data point to the potential usefulness of estrogen therapy in preventing cardiovascular death among women. Although large, well-controlled, clinical trials are needed to confirm the benefit of estrogen therapy, several important findings strongly support the cardioprotective effect of estrogen therapy. For example, in monkeys estrogen prevents the accumulation of low-density lipoprotein (LDL) cholesterol (a known risk factor for heart disease) in coronary arteries, and estrogen has also been shown to increase high-density lipoprotein (HDL) cholesterol (a known cardioprotective factor). Estrogen also possesses a vasodilating property, which can improve cardiac performance in ischemic heart disease. In addition, recent studies have demonstrated that estrogens (especially equilin) exhibit a high antioxidant effect, which may also be related to cardioprotectivity. Although estrogen therapy has been observed to decrease the risk of coronary disease, long-term estrogen therapy has also been found to increase the risk of uterine carcinoma; the addition of progesterone to estrogen therapy may lessen this undesirable risk, however. On the other hand the addition of progesterone to estrogen therapy may decrease estrogen's beneficial effect on HDL cholesterol. What should be the present position on estrogen therapy in postmenopausal women? What is the best dosage regimen? Should it be used alone or in combination with a progesterone? These important issues are discussed, as are several current clinical trials addressing the issue of estrogen therapy in postmenopausal women.

Aged↗
PubMed1979

Conjugated estrogens bioinequivalence: comparison of four products in postmenopausal women.

The bioequivalence of four conjugated estrogens tablets USP was compared by measurement of seven estrogens or estrogen metabolites in the urine during steady-state dosing in postmenopausal women. Two studies compared three generic products with the innovator's product. The urinary excretion of 17 alpha-dihydroequilin, 17 alpha-dihydroequilenin, and 17 alpha-estradiol were significantly greater in all cases with the innovator's product than with the generic products. Statistically significant differences between products were observed occasionally for other components. The generic products thus were bioinequivalent to the innovator's product, although all products essentially met current compendial specifications. A third study observed no significant differences between three batches of the innovator's product for the seven components. Total conjugated estrogens excretion of all products at the steady state was essentially equal and correlated with neither disintegration time nor dissolution half-time. Bioinequivalence between products is discussed in relation to the need for an improved USP conjugated estrogens monograph. Evidence suggesting the metabolism of a fraction of dosed estrone, equilin, and 17 alpha-dihydroequilin to 17 beta-estradiol, 17 beta-dihydorequilim, and 17 alpha-dihydroequilenin, respectively, is presented.

Biological Availability↗
PubMed1985

The biosynthesis of 3 beta-hydroxy-5,7-androstadien-17-one by the horse fetal gonad.

Horse fetal gonadal tissue was incubated with 3 beta-hydroxy-5,7-pregnadien-20-one and 5,7-cholestadien-3 beta-ol and it was shown that both substrates were converted to 3 beta-hydroxy-5,7-androstadien-17-one. These findings support the proposal that in this tissue there is a 5,7-diene pathway producing 3 beta-hydroxy-5,7-androstadien-17-one, the putative precursor of equilin in the placenta.

Androstadienes↗
PubMed1990

Pharmacokinetics of estrogen.

The main types of pharmacologic therapy used to treat the hormone deficiency of menopause are parenteral and oral administrations of estrogen. Parenteral administration results in predictable absorption without major intermediary metabolism, whereas all oral estrogens are subject to intestinal metabolism before entering the systemic circulation. Various options are available. Injectable estrogens, because of rapid absorption and metabolism, are impractical for long-term replacement therapy. The primary drawback to subcutaneous estradiol pellets is the surgical procedure required for their insertion and removal. Vaginal epithelium is an effective pathway for absorption of estrogen given by solution, tablet, or cream, although only the latter is currently approved for clinical use; relatively constant serum levels of estradiol can be obtained with vaginal rings. Transdermal patches provide controlled hormone levels for up to 3.5 days. Although oral conjugated equine estrogens have been used extensively, they introduce types of estrogen, such as equilin, that are not naturally found in humans and that can produce a pronounced hepatic response. Micronized estradiol, oral estrone, and other estrogens have been used as alternatives to equine estrogens. Clinicians should understand the pharmacokinetics of the various options for replacement therapy and select a course of treatment that is safe, effective, and convenient for the patient.

Drug Administration Routes↗
PubMed1987

Analysis of estrogen sulphate mixtures in pharmaceutical formulations by reversed-phase chromatography.

The relative retention times of estrogen sulphates for reversed-phase, ion-pair and argentous chromatography have been determined. Detector wavelengths of 200 nm, 200 nm and 270 nm were used, respectively. Samples are prepared by dissolution of pharmaceutical formulations in the high-performance liquid chromatography (HPLC) eluent. With reversed-phase chromatography, the estrone, equilin and 17 alpha-dihydroequilin estrogen sulphates are resolved from other estrogen sulphates in 20 min. Any traces of free estrogens which might be present are eluted too slowly for the formation of chromatographic peaks. With ion-pair chromatography, any hydrolyzed estrogens would be eluted before the sulphates with the formation of resolved chromatographic peaks. With argentous chromatography the retention times of the estrogen sulphates varied by nearly a factor of four. The utility of HPLC for the analysis of estrogen sulphates in pharmaceuticals is discussed.

Chromatography, High Pressure Liquid↗
PubMed1996

Separation of pharmaceutically important estrogens by micellar electrokinetic chromatography.

Baseline separation of ten estrogens of the type found in conjugated estrogens tablets from pregnant mares' urine were separated by micellar electrokinetic chromatography with a 20 mM sodium borate-sodium phosphate buffer (pH 8) containing either 75 mM sodium cholate and 15 mM beta-cyclodextrin or 50 mM sodium dodecyl sulfate and 20 mM gamma-cyclodextrin. The system containing sodium cholate was used to identify estrogens in a pharmaceutical tablet formulation of conjugated estrogens and to determine the amounts and ratio of sodium equilin sulfate to sodium estrone sulfate to confirm tablet conformity with regulatory requirements. Baseline separation of the seven ethynyl steroids registered as oral contraceptives in the USA was obtained with the system 20 mM sodium borate-sodium phosphate buffer (pH 8) containing 50 mM sodium cholate and 10% (v/v) methanol. Factors that affect selectivity and reproducibility of the above separation systems are discussed.

Animals↗
PubMed1983

B-ring aromatization of estrogen derivatives.

A novel method of B-ring aromatization of steroid derivatives is reported. Addition of BrCl in methanol to a non-aromatic B-ring double bond results in a rapid double elimination generating the aromatic B-ring. This procedure represents an effective method for conversion of an equilin to an equilenin nucleus.

Bromides↗
PubMed1990

Densitometric determination of conjugated oestrogens in the raw material and in pharmaceutical preparations.

A densitometric method for determination of complex mixtures of conjugated oestrogens in raw material and tablets was developed. The proposed procedure comprised hydrolysis of sodium sulphate esters of oestrone, equilin, 17 alpha-oestradiol, equilenin, 17 alpha-dihydroequilin and 17 alpha-dihydroequilenin, the chloroform extraction of free oestrogens and methyltestosterone (internal standard) and separation on TLC plates using chloroform-cyclohexane-dioxane-triethylamine (4.5:4.1:0.6, v/v) as the solvent for development. Quantitative assay was achieved by direct scanning of the oestrogen spots at 280 nm. The proposed method is simple, rapid, reproducible and adequate to control the content of conjugated oestrogens in the raw material and in pharmaceutical preparations.

Chromatography, Thin Layer↗
PubMed1992

Supercritical fluid chromatography of selected oestrogens.

The separation of selected oestrogens (oestrone, equilin, alpha-oestradiol, beta-oestradiol and d-equilenin) using capillary supercritical fluid chromatography (SFC) was studied. Three different stationary phases (SB-methyl-100, SB-biphenyl-30 and SB-cyanopropyl-50) were studied for the separation of the compounds. A baseline separation of the oestrogens was achieved on a SB-cyanopropyl-50 column using a carbon dioxide density gradient at an oven temperature of 73 degrees C. Typical analysis time on a 7 m column was 21 min. Retention times of each oestrogen decreased with an increase in either mobile phase density or oven temperature. Accuracy and precision of the SFC method were in the 1-5.5% range. The SFC method was applied to three different dosage forms containing oestrogens.

Chromatography, Liquid↗
PubMed2005

Ultrafiltration tandem mass spectrometry of estrogens for characterization of structure and affinity for human estrogen receptors.

Although hormone replacement therapy (HRT) is used by post-menopausal women for the relief of menopausal symptoms and the potential reduction of osteoporosis, HRT also increases their risk of Alzheimer's disease, stroke, breast cancer, and endometrial cancer. Since the majority of these effects are associated primarily with estrogen binding to only one of the estrogen receptors (ER), new assays are needed that can more efficiently evaluate ER-binding and identify ligands selective for ER-alpha and ER-beta. High performance liquid chromatography-tandem mass spectrometry (LC-MS-MS) was combined with ultrafiltration as a new method to investigate the relative binding of compounds to the ERs and to evaluate the structures of these estrogens. Mixtures of estradiol and six equine estrogens, including equilin, equilenin, 8,9-dehydroestrone, and their 17beta-hydroxyl derivatives, were assayed simultaneously to determine their relative binding to human ER-alpha and ER-beta. Estrogens containing a 17beta-OH group were found to have higher relative affinities for the estrogen receptors than their ketone analogs. In addition, 17beta-EN showed selectivity for binding to ER-beta over ER-alpha. The results were compared to the IC50 values obtained by using a conventional radiolabled estradiol competitive binding assay. Finally, the utility of negative ion electrospray tandem mass spectrometry for the unambiguous identification of these estrogen isomers was investigated. Several characteristic recyclization pathways during tandem mass spectrometry were identified, which might be useful for distinguishing related estrogens.

Animals↗
PubMed1997

Cardioprotective effects of individual conjugated equine estrogens through their possible modulation of insulin resistance and oxidation of low-density lipoprotein.

OBJECTIVE: To examine the independent effects on insulin sensitivity and antioxidative activity of the three most prevalent constituents in Premarin (Wyeth-Ayerst Laboratories, Philadelphia, PA): estrone sulfate (E1S), 50%; equilin sulfate (EqS), 25%, and 17 alpha-dihydroequilin sulfate (17 alpha-ES), 15%. DESIGN: Prospective randomized cross-over study. SETTING: University of Southern California Medical Center. PATIENT(S): Eight healthy postmenopausal women, mean age 53 +/- 2 years, and mean body mass index, 26 +/- 2 kg/m2, were enrolled. INTERVENTION(S): Each woman received, in randomized succession, daily oral doses of 17 alpha-ES (0.2 mg), E1S (0.625 mg), and EqS (0.3 mg) for 30 days. MAIN OUTCOME MEASURE(S): Oxidation of low-density lipoprotein (LDL) by negatively charged LDL (LDL-) and lag phase duration and measured the plasma glucose disappearance after insulin administration (K(itt)). RESULT(S): All three estrogen preparations demonstrated antioxidant effects with E1S demonstrating the most significant changes, followed by EqS and 17 alpha-ES. Using E1S, LDL-levels decreased from a baseline of 3.91 +/- 0.9 to 2.05 +/- 0.32 mg/dL and the lag time increased from 24.5 +/- 6.0 to 87.8 +/- 11.8 minutes. Changes in insulin tolerance tests revealed improved insulin action with the various estrogens. With EqS, K(itt) increased from 3.1% +/- 0.3% to 4.3% +/- 0.3% glucose/min, was intermediate with E1S and was least with 17 alpha-ES. CONCLUSION(S): All three conjugated equine estrogens demonstrated antioxidant activity. Also, some improved insulin action was demonstrated. To our knowledge, this is the first in vivo study to examine the effects of these components which may help explain, in part, some of the cardioprotective properties ascribed to Premarin.

Adult↗