Blog dedicated to the continuous education in Gynecology and Endocrinology


Red clover and soy isoflavones – an in vitro safety assessment Petra


Jungbauer, Alois (contact); Reiter, Evelyne; Gerster;

Abstract: Isoflavones from red clover and soy plant extracts are used in highly concentrated food supplements as an alternative to hormone replacement therapy. Because of their estrogenic activity, isoflavones are a focus of safety concerns about their potential to promote the growth of hormone-dependent cancer cells. In this study, isoflavones and plant extracts were tested for their effect on cell proliferation, apoptosis induction, and cell cycle arrest.

Isoflavones and plant extracts were applied in proliferation assays on 11 human cancer cell lines (representing cancers of the colon, prostate, breast, cervix, liver, pancreas, stomach, and ovaries) and a fibroblast line to detect cytotoxic activity. Fluorescence-activated Cell Sorting was used to detect the induction of apoptosis or cell cycle arrest.

Isoflavones and plant extracts significantly reduced the proliferation activity of the treated cancer cell lines. Growth promotion was not observed, but apoptosis or necrosis induction was, as was cell cycle arrest, with genistein as the most potent isoflavone.

Isoflavones and plant extracts from soy and red clover respectively do not promote the growth of human cancer cells but induce decreased cell proliferation, increased apoptosis, and cell cycle arrest. These results indicate that isoflavones can be considered safe compounds.

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Benefits and risks of ovarian function and reproduction for cancer development and prevention

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Altmann, Ariane (contact)

Abstract: Ovarian function and menstrual cycle disturbances, pregnancy and reproductive medicine procedure can either increase gynaecological cancer risk or prevent cancer development. For ovarian cancer development there are two hypothesis, which are connected with ovulation and gonadotropin secretion. Most of the ovarian cancers seem to be derived from displaced ovarian surfice epithelial cells. One year of ovulatory cycles increase the ovarian cancer risk by 6 %. Ovulation between 22 and 29 years of age causes the highest risk increase per year. In contrast, progesterone or progestins appear to create protection. Life style can effect or modify ovarian cancer risk.

Breast cancer risk is very much related to age of menarche and menopause, pregnancy and breast feeding. All of which are related to ovarian function and progestogenic impact which translates either into breast cancer risk increase or decrease. This is modified by BMI, physical activity and life style in general.

The risk of endometrial cancer is most closely related to endogenous progesterone during the menstrual cycle and pregnancy or by exogenous progestogens like in oral contraceptives. These effects are progestogen dose and time dependent. Endometrial cancer risk can also be increased by estrogen producing tumors or long-term estrogen treatment.

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Bone quantitative ultrasound at hand phalanges of women following breast cancer surgery

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Bolanowski, Marek (contact); Chwałczyńska, Agnieszka; Pluskiewicz, Wojciech

Abstract: Breast cancer surgery and adjunctive therapy follow in lymphedema, decreased limb mobility and bone deterioration. The aim was to establish relation of postsurgical limb lymphedema with bone properties assessed by quantitative ultrasound measurement of hand phalanges in postmenopausal women after breast cancer surgery. 63 women aged 62.81±8.83 yrs, after breast cancer surgery were compared with control group of 418 age-matched women. Their skeletal status was assessed by QUS measurements at proximal phalanges using DBM Sonic 1200. There were no statistically significant differences in QUS measurements (Ad-SoS) between groups of operated subjects and the controls, between limbs (operated vs. non-operated side, with and without lymphedema), and regarding method of surgery. Ad-SoS was greater in estrogen treated patients than in non-treated ones at the side with no breast surgery (1994.11±67.83 vs. 1943.27±58.34; p=0.046). Ad-SoS was lower in patients with adjunctive antiestrogen therapy than without this therapy at the side of surgery (1937.35±54.71 vs. 1966.78±59.18; p=0.0449), and non-breast surgery side (1934.55±52.06 vs. 1973.31±57.17; p=0.0066). Conclusions: Breast cancer surgery followed by concomitant therapies does not influence significantly QUS at hand phalanges. This was proven regarding method of surgery, side of surgery and lymphedema. Additional hormonal treatment can influence phalangeal QUS in breast cancer survivors.

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Ornithine Transcarbamylase Deficiency Diagnosed In Pregnancy

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Acbay, Ozer (contact); Celik, Ozlem; Buyuktas, Deram; Aydın, Ahmet

Abstract: Urea cycle enzymes deficiencies are rare metabolic disorders. Ornithine transcarbamylase deficiency is the most common type. The syndrome results from a deficiency of the mitochondrial enzyme ornithine transcarbamylase which catalyses the conversion of ornithine and carbamoyl phosphate to citrulline. It shows X-linked inheritance and typically remains asymptomatic until late infancy or early childhood. The severity of the symptoms depends on the age of the patient and the duration of hyperammonaemia. Female heterozygotes are more difficult to diagnose. They suffer from hyperammonemic periods which can be triggered by trauma, infections, surgery, childbirth, parenteral nutrition and by the initiation of sodium valproate therapy. The prognosis of ornithine transcarbamylase deficiency is better for those with an onset after infancy, but morbidity from brain damage does not appear to be linked to the number of episodes of hyperammonaemia that have occurred. However, early diagnosis and prompt initiation of ammonia-lowering treatment are essential for survival of these patients. This case presents a patient which was diagnosed with ornithine transcarbamylase deficiency following mental confusion during pregnancy.

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VDR FokI polymorphism and its potential role in the pathogenesis of Gestational Diabetes Mellitus and its complications

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Hossein-nezhad, Arash (contact); Aslani, Shilan; Mirzaei, Khadijeh; Maghbooli, Zhila; Najm afshar, Azam; Karimi, Farzaneh

Abstract: The aim of the study is evaluating the associations of FokI Vitamin D Receptor (VDR) gene polymorphisms with Gestational Diabetes Mellitus (GDM), and its relations with postpartum metabolic syndrome.

In a cohort study, 303 women referred to outpatient clinic of Shariati Hospital. The VDR FokI genotypes were determined. All subjects were followed 6-12 weeks after delivery.

The frequencies of Ff, FF and ff genotypes were 30.4% (49), 63.4% (102) and 6.2% (10) respectively in healthy pregnancies and 34.5 %( 49), 54.9% (78) and 10.6 %( 15) respectively in GDM patients. The ff genotype was more common in GDM patients. Healthy individuals had higher frequency of F allele, suggesting that F allele may have a role in decreased incidence of GDM.

Concerning the GDM risk factors, f allele had significant association with pre-pregnancy obesity and Family history of diabetes. In postpartum follow-up women who developed metabolic syndrome were significantly older with higher pre-pregnancy BMI, had more family history of diabetes, and also their ff genotype was two fold more frequent.

Our results indicate a meaningful association between FokI VDR genotypes and an increase risk for GDM in Iranian population as well as its effects on postpartum metabolic syndrome.

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