However, more recent patient-centered studies revealed an increase in the incidence of breast cancer in women receiving menopausal hormone therapy with estrogen plus progestin rather than estrogen alone. hypothesis, we compared the estradiol alone or in combination with our novel SPRMs, EC312 and EC313. The compounds were effectively controlled E2 mediated cell proliferation and induced apoptosis in T47D breast cancer cells. The observed effects were found comparable that of BZD and reduced E2 induced mammary gland proliferation, evidenced as reduced ductal branching and terminal end bud growth and has been reported, like RU 486, Onapristone and ZK 230211. . However, all of these compounds belong to the class of pure progesterone receptor antagonists that lack partial agonistic activity. Such compounds are therefore not suited for a combination therapy with estrogens because this would lead to unopposed estrogenicity in the endometrium, leading to conditions such as hyperplasia Sarsasapogenin or endometrial cancer [21, 22]. Patients who received Sarsasapogenin up to Mouse monoclonal to Metadherin four, 3-month long, courses of Ulipristal acetate (UPA) 10 mg daily, immediately followed by 10-day double-blind treatment with NETA (10 mg daily) or placebo, effectively controlled bleeding and fibroids shrunk in patients with symptomatic fibroids. Ulipristal is, however, approved only for 3 month treatment . On the other hand, Asoprisnil developed as the first mesoprogestin, or SPRM, was given to women for 2 years without occurrences of hyperplasia . A more recent approach for the treatment of menopausal symptoms is described in the US patent 6,479,535. A combination of conjugated estrogens (CE) with selective estrogen receptor modulator (SERM) like Bazedoxifene (BZD) emerged as a novel approach. This combination has been described to have positive effects on menopausal symptoms, and the ability to block the growth of occult breast cancer neoplasms in postmenopausal women which would lead to an overall reduction in tumor incidence [25, 26]. The disadvantage of the above combination might be inferior bleeding profile compared to standard estradiol progestin combinations but to prove in years to come with long term studies. In a group of postmenopausal women, the incidence of irregular bleeding during cycle 9 is 11% for a 1mg E2/0.5mg NETA combination, and 25. 8% for 0.625mg CE (conjugated estrogen)/ 5 mg MPA. The cumulative rate of amenorrhea in postmenopausal women is about 90%, and is around 80% in perimenopausal women . Bazedoxifene / conjugated estrogens showed only an 83% incidence of amenorrhea in the first year of treatment in postmenopausal women . Hence, there is a high medical need for an effective treatment of menopausal symptoms which offers excellent bleeding control for postmenopausal and perimenopausal women. In addition, such treatment should also provide a preventive effect on the occurrence of breast cancer . In the current study, we hypothesize that our novel SPRMs, EC312/313 antagonize the effect of E2 on breast cancer growth and benign mammary gland proliferation assay system (Invitrogen-Life Technologies) as described in our previously published studies [21, 22, 31]. Determination of apoptosis by cell death by Caspase-Glo assay Caspase-3/7 activity was measured using Caspase-Glo assay kit (Promega), as described before . Briefly, the cells were treated with test compounds and homogenized in homogenization buffer (25 mmol/L HEPES, pH 7.5, 5 mmol/L MgCl2, and 1 mmol/L EGTA), protease inhibitors (Sigma, and the homogenate was centrifuged at 13,000 rpm at 4C for 15 minutes. To 10 L of the supernatant containing protein was Sarsasapogenin added to an equal volume of the assay reagent and incubated at room temperature for 2 hours. The luminescence was measured using Fluorskan-FL fluorescence/ luminescence plate reader (Thermo-Fisher scientific, Austin, TX). Determination of gene expression by quantitative real-time PCR T47D cells grown in 60-mm dishes were cultured in phenol red-free RPMI medium with 5% DCC-FBS for 24 hours and treated with BZD, E2 and EC compounds for 24hours before RNA extraction. Total RNA was extracted and purified using the Qiagen RNeasy plus (Valencia, CA, USA) with a genomic DNA removal step as per manufacturers protocol. Reverse transcription (RT) was carried out using the Applied Biosystems kit (Foster City, CA, USA). Real-time PCR and subsequent analyses were carried out using Smartmix PCR beads (Cepheid, Sunnyvale, CA, USA) with SybrGreen in the Cepheid SmartCycler to detect testing genes and the housekeeping gene (GAPDH) transcripts, as described previously . The primer sets used for the study were listed as supporting information (S1 Primers). PCR reactions using testing genes and GAPDH primer sets gave unique melt peaks, indicative.
However, more recent patient-centered studies revealed an increase in the incidence of breast cancer in women receiving menopausal hormone therapy with estrogen plus progestin rather than estrogen alone