our results do not support the hypothesis that greater metabolism of oestrogen via the 2-OH pathway, relative to the 16α-OH pathway, protects against endometrial cancer. Indeed our results are more suggestive of an increase in risk, rather than a decrease, with higher levels of 2-OHE1
women with a higher 2-OHE1 : 16α-OHE1 ratio did not have a decreased risk of endometrial cancer as compared with women with a lower ratio
The findings from this first prospective epidemiological study of oestrogen metabolites and endometrial cancer are in line with results from prospective studies on breast cancer, another oestrogen-related cancer. None of the seven studies on breast cancer reported significant associations overall
On the whole, prospective epidemiological data do not support the hypothesis that the 2-hydroxyestrogen pathway is protective, and the 16α-hydroxyestrogen pathway harmful, in hormone-dependent cancers
Both 2- and 4-hydroxyestrogens are catecholestrogens, and it has been suggested that catecholestrogens increase risk of oestrogen-mediated cancers through direct genotoxic effects, rather than through stimulation of cell proliferation via binding to oestrogen receptors
the evidence is stronger for 4-hydroxyestrogens than for 2-hydroxyestrogens
a significant increase in risk of breast cancer with levels of 2-OHE1 has also been reported previously, although it was limited to hormone receptor-negative tumours
aromatase inhibition in men to increase Testosterone:Estradiol ratio. Men with infertility have a low Testosterone:Estradiol ratio. Aromatase inhibitors inhibit Testosterone to Estradiol conversion
Alterations in the HPA and hypothalamic-pituitary-gonadal axes with a resultant decrease in testosterone:cortisol ratios have been implicated in OTS. Proinflammatory cytokines are potent activators of the HPA system, which cause release of corticotropin-releasing hormone, adrenocorticotropic hormone, and cortisol. These cytokines suppress testosterone through central inhibition
Some have suggested that a decreased testosterone:cortisol ratio can be diagnostic of NFO and/or OTS. However, the ratio represents the physiologic strain of training rather than the athlete’s maladaption to that stress
Cortisol (catabolic and anti-inflammatory) is converted to inactive cortisone by 11β-HSD2
A prospective study found a clinically significant increase in overnight urinary cortisol:cortisone ratio during a high training load period in triathletes, who subsequently underperformed and reported fatigue
It is proposed that cytokines may inhibit 11β-HSD2 activity and result in relative increases in cortisol and, hence, catabolism
This study looked at T:E2 levels in men for seasonal fluctuations. What is interesting, is that the T:E2 ratio is at it's lowest during the fall months and highest during the summer months. This does conflict somewhat with studies that have looked at seasons fluctuations of T alone. But, it does correlate with changes in body habitus and activity levels.
excessive carb restriction in athletes can lower Testosterone levels and negatively impact Testosterone to cortisol ratio. This will limit performance and hinder recovery.
We report here the first evidence that tumorous breast tissue exhibits
elevated 5α-reductase activity, which promotes significant increases
in 5α-pregnanes, especially
5αP,4
whereas the normal (nontumorous) breast tissue produces more
4-pregnenes, especially 3αHP
3αHP and other 4-pregnenes
inhibit, whereas 5αP and other 5α-pregnanes stimulate, breast cell
proliferation and detachment
it is evident that breast tissue can convert progesterone into two
classes of metabolites: the δ-4-pregnenes (which retain the
C4–5 double bond), and the 5α-reduced
21-carbon steroids (5α-pregnanes)
in normal (nontumorous) breast tissue, the 4-pregnene metabolites
of progesterone greatly exceeded the 5α-pregnanes, whereas in
tumorous tissue, 5α-pregnanes exceeded 4-pregnenes.
These
differences in 5α-pregnane and 4-pregnene amounts were largely
attributable to differences in 5αP and 3αHP production in tumorous
and nontumorous tissues
the metabolic
activities were in general similar, regardless of the age and ER state
of the patient or whether she was pre- or postmenopausal.
These findings suggest greatly elevated 5α-reductase activity in
tumorous, as compared with nontumorous, breast tissue.
progesterone metabolites that retain the C-4 double bond
(i.e., the 4-pregnenes) exert an antiproliferative effect in
the three cell lines that were tested, whereas the 5α-pregnanes
stimulate breast cell line proliferation.
the degree of
mitogenicity would be determined by the ratio of
5α-pregnanes:4-pregnenes. Tissues with a high
4-pregnene:5α-pregnane ratio would maintain a higher degree of
normalcy, whereas those with a high 5α-pregnane:4-pregnene ratio
would tend toward tumorigenicity
The observations that progesterone
metabolites affect both ER-positive and ER-negative cells as well as
tumorigenic (MCF-7) and nontumorigenic (MCF-10A) cells strengthen the
argument that these factors may be endocrinologically relevant for all
forms of breast cancer.
progesterone metabolites
as the active endocrine/paracrine/autocrine factors
Estrogen-based
therapies elicit responses in only one-third of all breast cancer
patients, and most of these show relapse.
the metabolic
activities were in general similar, regardless of the age and ER state
of the patient or whether she was pre- or postmenopausal.
Different progesterone metabolites shown to have different tumor effects. Implications are that, just as estrogen metabolism effects cancer risk, so does progesterone metabolism.
This study showed that abdominal obesity was associated with a smaller brain volume. Specifically, a high waist to hip ratio was associated with a 27% reduction in hippocampal volume.
in vitro studies had shown that the progesterone metabolites, 5α-dihydroprogesterone (5αP) and 3α-dihydroprogesterone (3αHP), respectively, exhibit procancer and anticancer effects on receptor-negative human breast cell lines
Onset and growth of ER/PR-negative human breast cell tumors were significantly stimulated by 5αP and inhibited by 3αHP
When both hormones were applied simultaneously, the stimulatory effects of 5αP were abrogated by the inhibitory effects of 3αHP and vice versa
Treatment with 3αHP subsequent to 5αP-induced tumor initiation resulted in suppression of further tumorigenesis and regression of existing tumors
Tumorigenesis of ER/PR-negative breast cells is significantly enhanced by 5αP and suppressed by 3αHP, the outcome depending on the relative concentrations of these two hormones in the microenvironment in the breast regions
The findings show that the production of 5αP greatly exceeds that of 3αHP in ER/PR-negative tumors and that treatment with 3αHP can effectively block tumorigenesis and cause existing tumors to regress
hypothesis that a high 3αHP-to-5αP concentration ratio in the microenvironment may foster normalcy in noncancerous breast regions.
a large proportion (about 30% to 60%) of breast tumors are ER and/or PR negative
about 90% of normal proliferating breast epithelial cells are receptor negative
Our previous in vitro studies had shown that breast tissues and cell lines readily convert progesterone to 5α-pregnanes, such as 5αP, and delta-4-pregnenes, such as 3αHP (Figure (Figure1),1), and that tumorous breast tissues [15] and tumorigenic breast cell lines [16] produce higher levels of 5αP and lower levels of 3αHP than do normal breast tissues and nontumorigenic cell lines
The progesterone metabolism studies suggested that increases in 5αP and decreases in 3αHP production accompany the shift toward breast cell neoplasia and tumorigenicity
In vitro studies on five different human breast cell lines showed that cell proliferation and detachment are significantly increased by 5αP and decreased by 3αHP
the prevailing theory of hormonal regulation of breast cancer, as well as hormone-based therapies, revolves around estrogen and/or progesterone and ER/PR-positive breast cells and tumors.
Not only do these "receptor-negative" breast cancers fail to benefit from current hormonal therapies, but they also generally exhibit more-aggressive biologic behaviors and poorer prognosis than the receptor-positive ones
The results of the studies reported here show for the first time that the progesterone metabolites, 5αP and 3αHP, act as hormones that regulate ER/PR-negative breast tumor formation, growth, and regression
The onset of the ER/PR-negative human breast cell tumors in mice was considerably accelerated, and the growth significantly stimulated, by just one or two applications of 5αP
In contrast, 3αHP retarded onset of tumor formation, suppressed tumor growth, and inhibited or regressed existing 5αP-induced tumors
When both hormones were administered simultaneously, the effects of one were abrogated by the effects of the other.
The 5αPR and 3αHPR (which are associated with the plasma membranes of both ER/PR-positive [19] and ER/PR-negative [29] cells) are distinct from each other and from known ER, PR, androgen, and corticosteroid receptors, and lack affinity for other steroids, such as progesterone, estrogen, androgens, corticosteroids, and other progesterone metabolites
Levels of 5αPR are upregulated by 5αP itself and estradiol, and downregulated by 3αHP in both ER/PR-positive and -negative cells
ndications are that 5αP acts via the surface receptor-linked mitogen-activated protein kinase (MAPK; Erk1/2) pathway; 5αP significantly stimulates activation of Erk1/2 [30], increases the Bcl-2/Bax expression ratio [18] and actin depolymerization [31], and decreases expression of actin and adhesion plaque-associated vinculin [31], resulting in decreased apoptosis and increased mitosis and cell detachment
3αHP appears to suppress protein kinase C (PKC), phospholipase C (PLC), Ca2+ mobilization (unpublished observations), and the Bcl-2/Bax expression ratio [18], and increases expression of the cell-cycle inhibitor p21 [18], resulting in increased apoptosis and decreased proliferation and detachment of breast cell lines.
serum from mice with tumors had significantly more 5αP than 3αHP
the tumors, which on average had about threefold higher concentrations of 5αP than the respective sera, and >10-fold higher 5αP than 3αHP levels
Previous in vitro metabolism studies showed that human breast tumor tissues convert significantly more progesterone to 5α-pregnanes like 5αP and less to 4-pregnenes like 3αHP than do paired normal (nontumorous) tissues
Similar differences in progesterone metabolism and enzyme gene expressions were observed between tumorigenic and nontumorigenic breast cell lines
breast carcinomas are able to synthesize progesterone
The current findings, along with the previous in vitro studies, suggest that the relative concentrations of 5αP and 3αHP in the breast microenvironment constitute important autocrine/paracrine determinants not only for tumorigenesis but also for potential regression of tumors and the maintenance of normalcy of ER/PR-negative breast cells/tissues.
Evidence presented here shows that a high concentration of 5αP, relative to 3αHP in the microenvironment, promotes initiation and growth of tumors, whereas a higher concentration of 3αHP, relative to 5αP, suppresses tumorigenesis and promotes normalcy
5α-reductase and 5αPR levels are upregulated by 5αP
in the 3αHP-treated mice, the elevated 3αHP levels, relative to 5αP, in the microenvironment could have opposed progression to xenograft neoplasia by its inherent anticancer actions and the suppression of 5αP synthesis and 5αPR expression
the opposing actions of the progesterone metabolites also appear to exert some control over the estrogen-regulated effects on breast cancer by their ability to modulate ER numbers in ER-positive cells
because both ER/PR-negative and ER/PR-positive, as well as normal and tumorigenic human breast cell lines, have been shown to respond to 5αP and 3αHP in vitro, it is suggested that these endogenously produced progesterone metabolites may also play regulatory hormonal roles in ER/PR-positive breast cancers, as well as in the maintenance of normalcy in nontumorous breast tissues.
The in vivo data provide further evidence that progesterone metabolites, such as 5αP and 3αHP, deserve to be considered as active hormones in their own right, rather than inactive waste products
This article summarizes it all. With age, Testosterone declines and estrogen production, through elevated aromatase activity, increases. This results in a decline in the Testosterone:estradiol ratio. This has been clearly implicated in both benign and disease states of the prostate. The evidence points to aromatase activity and estrogen in the prostate to poor prostate health. Additionally, this article points out the impact of ER alpha and ER beta on the translation of the message of Estrogen.
ER beta expression and the ratio of ER alpha/ER beta is important in prognosis and effectiveness of SERM therapy like tamoxifen. This study looked at the aromatase inhibitor anastrazole as well.
ApoE4 allele is known to increase Alzheimer's disease by 10 fold. One mechanism is through a lowering of SirT1 and an increase in the SirT1:SirT2 ratio. This SirT1 is the target of resveratrol in red wine.
a decreasing Testosterone:Estradiol ratio leads to decreased sperm production. This effectively occurs through the interaction of the elevated Estradiol and the HPA.