Wang L, Wang Y-D, Wang W-J, Li D-J
Laboratory for Reproductive Immunology, Hospital & Institute of Obstetrics and Gynecology, Fudan University Shanghai Medical College, 413 Zhaozhou Road, Shanghai, 200011, China.
Osteoporos Int. 2009 Jan;20(1):79-92. doi: 10.1007/s00198-008-0631-1. Epub 2008 Aug 9.
Dehydroepiandrosterone (DHEA) may be useful in the treatment of postmenopausal osteoporosis (PMO). Our present study has found the preferable stimulatory effect of DHEA on bone, in contrast to the proliferative effects of estradiol (E2) on the endometrium and the uterus, which suggests that DHEA has greater potential clinical value than estrogens in prophylaxis and therapeutics for PMO.
A series of findings raise the possibility that DHEA may be useful in the treatment of PMO. Our present study thus aimed at the differential effects of DHEA and E2 on bone and the uterus in ovariectomized mice as well as the involvement of aromatase, ERalpha, ERbeta, and AR in the effects.
Ovariectomized and sham BALB/c mice were given daily treatment with either DHEA or E2 for three months, respectively. Bone mineral density was determined by DEXA after the last treatment. Mice were necropsied in 3 months after the treatment to analyze the ultrastructure of their femur osteoblasts (OBs) with a transmission electron microscope (TEM); DHEA, DHEA sulfate (DHEAS) and E2 levels were assayed by EIA; production in vitro of E2 in the uterus or tibia was assayed to evaluate the profile of P450arom activity; ERalpha and ERbeta mRNA levels in the uterus and tibia were determined by real-time PCR. The primary murine OBs were treated with DHEA and E2, respectively for 72 h. Real-time polymerase chain reaction (PCR) and western blot were carried out to evaluate aromatase, ERalpha, ERbeta and AR expression in OBs.
Both DHEA and E2 significantly improved BMD and OB ultrastructure; E2 but not DHEA has significantly increased uterus wet weight, endometrium epithelial and gland thickness. Dehydroepiandrosterone not only increased serum, femoral DHEA, DHEAS and E2 concentration, but also increased uterine DHEA and DHEAS other than E2 concentration in site, while E2 only increased serum, uterine and femoral E2 concentration, but failed to alter the concentrations of DHEA and DHEAS. Moreover, DHEA significantly increased tibia P450arom enzyme activity, while E2 increased uterine and tibia aromatase activity. Furthermore, DHEA increased uterine ERbeta and ERalpha, and ERbeta transcription in the tibia, while E2 increased ERalpha transcription in the uterus and tibia. Dehydroepiandrosterone increased aromatase, ERalpha, ERbeta and AR expression in OBs, and increased significantly, but E2 apparently decreased the ratio of ERbeta/ERalpha.
Although both DHEA and E2 augment BMD, the proliferative effects of E2 on the endometrium and uterus reflect the different modes of action on bone and the uterus, indicating that the preferable stimulatory effect of DHEA on bone appears to the more potential clinical values than estrogens in prophylaxis and therapeutics for PMO. But applicability of the findings from rodents in humans needs further study.
脱氢表雄酮(DHEA)可能对绝经后骨质疏松症(PMO)的治疗有用。我们目前的研究发现,与雌二醇(E2)对子宫内膜和子宫的增殖作用相比,DHEA对骨骼具有更好的刺激作用,这表明在PMO的预防和治疗方面,DHEA比雌激素具有更大的潜在临床价值。
一系列研究结果提示DHEA可能对PMO的治疗有用。因此,我们目前的研究旨在探讨DHEA和E2对去卵巢小鼠骨骼和子宫的不同作用,以及芳香化酶、雌激素受体α(ERα)、雌激素受体β(ERβ)和雄激素受体(AR)在这些作用中的参与情况。
分别对去卵巢和假手术的BALB/c小鼠每日给予DHEA或E2治疗三个月。最后一次治疗后,通过双能X线吸收法(DEXA)测定骨密度。治疗三个月后对小鼠进行尸检,用透射电子显微镜(TEM)分析其股骨成骨细胞(OBs)的超微结构;通过酶免疫分析(EIA)测定DHEA、硫酸脱氢表雄酮(DHEAS)和E2水平;测定子宫或胫骨中E2的体外生成量以评估P450芳香化酶活性;通过实时聚合酶链反应(PCR)测定子宫和胫骨中ERα和ERβ的mRNA水平。将原代小鼠OBs分别用DHEA和E2处理72小时。进行实时聚合酶链反应(PCR)和蛋白质免疫印迹法以评估OBs中芳香化酶、ERα、ERβ和AR的表达。
DHEA和E2均显著改善骨密度和OB超微结构;E2显著增加子宫湿重、子宫内膜上皮和腺体厚度,而DHEA未增加。DHEA不仅增加血清、股骨中的DHEA、DHEAS和E2浓度,还增加子宫局部的DHEA和DHEAS浓度而非E2浓度,而E2仅增加血清、子宫和股骨中的E2浓度,未改变DHEA和DHEAS浓度。此外,DHEA显著增加胫骨P450芳香化酶活性,而E2增加子宫和胫骨的芳香化酶活性。此外,DHEA增加子宫中的ERβ和ERα以及胫骨中ERβ的转录,而E2增加子宫和胫骨中ERα的转录。DHEA增加OBs中芳香化酶、ERα、ERβ和AR的表达,且显著增加,但E2明显降低ERβ/ERα的比值。
虽然DHEA和E2均能增加骨密度,但E2对子宫内膜和子宫的增殖作用反映了其对骨骼和子宫的不同作用方式,表明在PMO的预防和治疗方面,DHEA对骨骼的更好刺激作用似乎比雌激素具有更大的潜在临床价值。但啮齿动物研究结果在人类中的适用性需要进一步研究。