Hamburger A W, Parnes H, Gordon G B, Shantz L M, O'Donnell K A, Aisner J
University of Maryland Cancer Center, Johns Hopkins Oncology Center, Baltimore, MD 21201.
Semin Oncol. 1988 Apr;15(2 Suppl 1):76-8.
We recently observed significant weight gain in patients with advanced breast cancer treated with high-dose megestrol acetate. However, the mechanisms of this effect are completely unknown. As the analysis of the action of steroids in vivo is complex, we chose to examine the effects of megestrol acetate on the differentiation of a preadipocyte clone (L1) of the Swiss 3T3 mouse fibroblast cell line. Addition of insulin, fetal bovine serum, dexamethasone, and methyl-isobutylxanthine to confluent 3T3-L1 cells induced adipocyte differentiation, as verified by morphologic studies and analysis of the activity of the enzyme glycerol-3-phosphate dehydrogenase (G-3-PD), a specific and sensitive indicator of lipocyte function. Substitution of megestrol acetate for dexamethasone also resulted in greatly increased lipocyte differentiation. Tumor necrosis factor (TNF) alpha blocked the adipocyte differentiation induced by the combination of insulin, dexamethasone, and methyl-isobutylxanthine. Addition of megestrol acetate failed to reverse the inhibitory effect of TNF. Thus, megestrol acetate, in vitro, is a potent inducer of lipocyte differentiation. Further studies on the regulation of adipocyte differentiation and function in this model system may be important to clarify megestrol acetate's mechanism of action.
我们最近观察到,接受大剂量醋酸甲地孕酮治疗的晚期乳腺癌患者体重显著增加。然而,这种效应的机制完全未知。由于体内类固醇作用的分析很复杂,我们选择研究醋酸甲地孕酮对瑞士3T3小鼠成纤维细胞系前脂肪细胞克隆(L1)分化的影响。对汇合的3T3-L1细胞添加胰岛素、胎牛血清、地塞米松和甲基异丁基黄嘌呤可诱导脂肪细胞分化,这已通过形态学研究以及对甘油-3-磷酸脱氢酶(G-3-PD)活性的分析得到证实,G-3-PD是脂肪细胞功能的一种特异性且敏感的指标。用醋酸甲地孕酮替代地塞米松也导致脂肪细胞分化大幅增加。肿瘤坏死因子(TNF)α可阻断由胰岛素、地塞米松和甲基异丁基黄嘌呤联合诱导的脂肪细胞分化。添加醋酸甲地孕酮未能逆转TNF的抑制作用。因此,在体外,醋酸甲地孕酮是脂肪细胞分化的有效诱导剂。在这个模型系统中对脂肪细胞分化和功能调节进行进一步研究,对于阐明醋酸甲地孕酮的作用机制可能很重要。