Bondi C D, Alonso-Gonzalez C, Clafshenkel W P, Kotlarczyk M P, Dodda B R, Sanchez-Barcelo E, Davis V L, Witt-Enderby P A
Division of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States.
Department of Physiology and Pharmacology, School of Medicine, University of Cantabria, Santander, Spain.
Eur J Obstet Gynecol Reprod Biol. 2014 Mar;174:80-5. doi: 10.1016/j.ejogrb.2013.11.027. Epub 2013 Dec 9.
Melatonin and progesterone levels decline during the perimenopause. Both hormones inhibit estrogen action and endometrial cancer, but little is known about how they act in combination. Therefore, the interplay of progesterone (P4) and melatonin was investigated in intact female mice.
Three P4 doses, low (25mg), mid (50mg), and high (100mg), combined with 0.5mg 17β-estradiol (E), were administered in the diet (per 1800kcal) for 30 days. Hormone therapy (HT) with the low P4 dose (estradiol/low progesterone replacement therapy (EPLRT)) was used to create an excess estrogen environment to mimic perimenopause. Half the mice were treated with melatonin (M) 15mg/L in the drinking water at night.
The unbalanced EPLRT treatment increased estrogen-regulated responses. Specifically, mice treated with EPLRT had significantly higher levels of ovarian aromatase mRNA versus control, which was prevented in the presence of higher doses of P4 and/or the addition of melatonin. The number of days in estrus also increased in EPLRT-treated versus control mice with no change in the length or number of complete estrous cycles. Melatonin, combined with all doses of P4, increased the number of days spent in estrus, but not the length or number of estrous cycles compared to melatonin alone; however, two-way ANOVA revealed a significant interaction between melatonin and P4 dose for days in estrus and for number of cycles. Although none of the E2 and P4 combinations significantly affected uterine weight compared to control, melatonin addition to the low or mid P4 HT resulted in slightly higher uterine weights compared to melatonin-treated mice. Melatonin significantly increased uterine estrogen receptor alpha (ERα) and progesterone receptor A levels compared to control animals. HT, added in combination with melatonin, reduced ERα levels back to control levels, but PR levels remained elevated albeit intermediary to those achieved with melatonin alone.
The findings that melatonin supplementation inhibits ovarian aromatase expression and increases uterine receptors in mice given an HT that mimics perimenopause may have important clinical applications for the improvement of menopause-related conditions, like menorrhagia, associated with high levels of E2 and low levels of P4.
围绝经期期间褪黑素和孕酮水平下降。这两种激素均抑制雌激素作用及子宫内膜癌,但它们联合作用的方式却鲜为人知。因此,本研究在完整雌性小鼠中探究了孕酮(P4)与褪黑素的相互作用。
将三种P4剂量,即低剂量(25mg)、中剂量(50mg)和高剂量(100mg),与0.5mg 17β - 雌二醇(E)组合,通过饮食(每1800千卡)给药30天。采用低剂量P4的激素替代疗法(HT)(雌二醇/低剂量孕酮替代疗法(EPLRT))营造雌激素过量环境以模拟围绝经期。一半小鼠在夜间饮用含15mg/L褪黑素(M)的水。
不平衡的EPLRT治疗增加了雌激素调节的反应。具体而言,与对照组相比,接受EPLRT治疗的小鼠卵巢芳香化酶mRNA水平显著更高,而更高剂量的P4和/或添加褪黑素可预防这种情况。与对照组相比,接受EPLRT治疗的小鼠发情天数也增加,而完整发情周期的长度或数量没有变化。与单独使用褪黑素相比,褪黑素与所有剂量的P4联合使用增加了发情天数,但未改变发情周期的长度或数量;然而,双向方差分析显示,在发情天数和周期数量方面,褪黑素与P4剂量之间存在显著交互作用。尽管与对照组相比,所有E2和P4组合均未显著影响子宫重量,但与接受褪黑素治疗的小鼠相比,在低剂量或中剂量P4的HT中添加褪黑素导致子宫重量略高。与对照动物相比,褪黑素显著增加子宫雌激素受体α(ERα)和孕酮受体A水平。HT与褪黑素联合使用可使ERα水平恢复至对照水平,但PR水平虽保持升高,不过介于单独使用褪黑素时所达到的水平之间。
在给予模拟围绝经期的HT的小鼠中,补充褪黑素可抑制卵巢芳香化酶表达并增加子宫受体,这一发现对于改善与围绝经期相关的病症(如与高E2水平和低P4水平相关的月经过多)可能具有重要的临床应用价值。