Pregabalin increases slow-wave sleep and may improve attention in patients with partial epilepsy and insomnia.

UNLABELLED: Insomnia is a common phenomenon particularly in patients with epilepsy. This study was performed to look at the effects of pregabalin, an anticonvulsant known to increase sleep depth and decrease arousals, in patients with insomnia and well-controlled epilepsy. METHODS: This was a double-blind, placebo-controlled, crossover study of subjects with insomnia and epilepsy. Each subject was treated with pregabalin 150 mg BID or placebo for two weeks, followed by a two-week washout period, then the other treatment for two weeks. Polysomnography and neuropsychological testing were performed at baseline and at the end of each treatment arm. RESULTS: There was a significant increase in percentage of slow-wave sleep and a decrease in stage 1 sleep when subjects were taking pregabalin. Sleep efficiency increased during pregabalin treatment, although this was not statistically significant (84.5+/-4.6% for placebo versus 90.4+/-2.6% for pregabalin). There were a significant improvement in attention in the pregabalin group based on trial one of the Rey-Auditory Verbal Learning Test and a trend toward improvement in the psychomotor vigilance task; other neuropsychological measures were not significantly changed. CONCLUSION: Concurrent treatment with pregabalin improves sleep depth in patients with insomnia and epilepsy and improves daytime attention.

Testosterone decreases 3beta-hydroxysteroid dehydrogenase-isomerase messenger ribonucleic acid in cultured mouse Leydig cells by a strain-specific mechanism.

We previously reported a strain-related difference in basal 3beta-hydroxysteroid dehydrogenase-isomerase (3betaHSD) activity in response to testosterone in cultured Leydig cells. The data suggested that the response to testosterone was androgen receptor mediated and that testosterone was acting via a trans-acting factor distal to the androgen receptor to regulate Leydig cell basal 3betaHSD activity. This study was designed to determine whether the previous reported strain-related difference in basal 3betaHSD activity in response to testosterone was due to a difference at the 3betaHSD protein and/or at the mRNA level. In C57BL/6J Leydig cells, 2.0 microM testosterone significantly decreased basal 3betaHSD immunoreactive mass by day 6 in culture. Treatment with 2.0 microM testosterone and 2.0 microM hydroxyflutamide, an androgen receptor antagonist, negated the inhibitory effect of testosterone on C57BL/6J 3betaHSD immunoreactive mass. Treatment with 2.0 microM testosterone also significantly decreased 3betaHSD mRNA content in C57BL/6J Leydig cells, which was detectable on day 3 in culture. In contrast to Leydig cells from C57BL/6J mice, Leydig cells from C3H/HeJ mice were not susceptible to the inhibitory effect of testosterone on 3betaHSD. Treatment with 2.0 microM testosterone had no detectable effect on C3H/HeJ 3betaHSD immunoreactive mass or mRNA content at any time point in culture. These data indicate that the testosterone-induced loss of basal 3betaHSD activity in C57BL/6J Leydig cells can be accounted for by the loss of 3betaHSD immunoreactive mass, which is preceded by the loss of 3betaHSD mRNA, and that the strain-related difference in the regulation of 3betaHSD is present at all three levels. Thus, the putative trans-acting factor involved in the mechanism whereby testosterone decreases basal 3betaHSD is likely to regulate the amount of 3betaHSD mRNA.

Altering culture conditions reveals strain-related differences in activity and immunoreactive isoforms of 3 beta-hydroxysteroid dehydrogenase-isomerase in mouse Leydig cells.

We previously reported that 3 beta-hydroxysteroid dehydrogenase-isomerase (3 beta HSD) activity is higher in Leydig cells from C57BL/6J mice than those from C3H/HeJ mice. This study examines whether the differences in 3 beta HSD activity in Leydig cells from the two strains of mice are due to the expression of different 3 beta HSD isoforms and if a specific isoform corresponds with the amount of 3 beta HSD activity under various culture conditions. Leydig cells were plated in Waymouth's +15% horse serum (HS) medium. Some cultures were terminated 24 h later after plating (day 1) and assayed for 3 beta HSD activity or immunoreactivity. The remaining cultures were maintained in HS or changed to serum-free medium. We demonstrate for the first time that two 3 beta HSD immunoreactive isoforms are expressed in freshly isolated Leydig cells and those cultured for 1 day. The same two 3 beta HSD isoforms are detectable in both strains. Thus, the previously reported strain-related differences in 3 beta HSD activity are not due to the expression of different isoforms. When cultured for 8 days, the higher molecular weight 3 beta HSD immunoreactive band is no longer detectable in Leydig cells from either strain. When maintained in HS, 3 beta HSD activity in C57BL/6J Leydig cells decreases significantly by day 8, while 3 beta HSD activity in C3H/HeJ Leydig cells does not change through day 8. When Leydig cells were cultured in serum-free medium, 3 beta HSD activity is maintained in cultured Leydig cells from C57BL/6J and significantly increases in C3H/HeJ 3 beta HSD by day 8. These data suggest that HS has a strain-specific inhibitory effect on 3 beta HSD activity, causing a significant decrease in C57BL/6J 3 beta HSD activity and preventing an increase in C3H/HeJ. Densitometric analysis reveals a correspondence between changes in 3 beta HSD activity and the lower molecular weight isoform but not the higher molecular weight isoform. Treatment with cAMP induces the immunoreactive mass of the lower molecular isoform but not the higher molecular isoform of 3 beta HSD. Currently, it is unclear what the function of the higher molecular weight 3 beta HSD isoform is in mouse Leydig cells.

Transcription of circular and noncircular forms of Sry in mouse testes.

Although its expression in adult testis was immediately apparent, the role for Sry (sex determining region, Y) in testicular function remains elusive. We have performed transcriptional studies in an effort to elucidate potential roles of Sry by studying the time and location of its transcription in mouse testes. Northern analyses and more sensitive nuclease protection assays detected transcripts in 28-day-old testes and beyond. The highly sensitive technique of reverse transcription polymerase chain reaction (RTPCR) could not detect Sry expression in 14-day testes when primers for the most conserved portion of the gene, the high mobility group (HMG) box, were used, but primers for the circular form detected Sry transcription at all postnatal stages studied. The same HMG box primers were able to detect expression of Sry in XX, Sxra or Sxrb testes. This suggested that Sry is expressed in cells other than germ cells, which was confirmed with studies on fractionated cells--RTPCR detected transcription of Sry in the highly pure interstitial cell fraction. However, Leydig cells and a Leydig cell tumor were negative for Sry expression. We performed in situ studies in an attempt to localize the expression of Sry in the testes. Abundant expression of an Sry cross-hybridizing transcript was found in spermatogonia, in early spermatocytes, and in some interstitial cells with antisense probes to the HMG box or a more specific, 3' region, whereas the sense probe gave little or no hybridization. It is probable that the circular transcripts, which are seen in reverse transcriptase positive (RT+) and RT- reactions by PCR because of the RT activity of Taq polymerase, are responsible for the hybridization seen in spermatogonia and spermatocytes, whereas linear and circular forms are detected later. Thus Sry is expressed in pre- and postmeiotic germ cells and in somatic cells of the testes.

Sites of transcription of the Müllerian inhibiting substance gene in mouse testis.

We have examined the transcription of Müllerian inhibiting substance (MIS) in testis by the sensitive technique of reverse transcription polymerase chain reaction (RTPCR). A developmental study of testis by this nonquantitative technique showed expression at all postnatal stages, including adults while liver and kidney provided negative controls. Cell separation studies indicated that highly purified interstitial cells, as well as less homogeneous Sertoli cell-enriched and germ cell-enriched fractions, contained RNA for MIS. The transcription of MIS in an interstitial cell type was confirmed by finding MIS mRNA in purified Leydig cells. Inasmuch as the germ cell-enriched fraction contains some Sertoli cells, and XX,Sxra and XX,Sxrb which have germ cell-depleted testes, contain MIS mRNA, a Sertoli cell source remains likely for the seminiferous tubule compartment.

Gonadal steroids modulate adrenal fasciculata 3 beta-hydroxysteroid dehydrogenase-isomerase activity in mice.

The observation that adrenal 3 beta-hydroxysteroid dehydrogenase-delta 5----delta 4-isomerase (3 beta HSD) activity is greater in females than in males of both C57BL/6J and C3H/HeJ inbred strains of mice led us to test the hypothesis that this enzyme's activity within the adrenal gland may be modulated by gonadal steroids. Two weeks after sham-operation or castration, no castration effect was seen in adrenal 3 beta HSD activity, but the sex difference had been eliminated in C57BL/6J animals. Gonadal steroids were replaced in castrated animals of both sexes of C57BL/6J and C3H/HeJ mice. Daily injections of androgenic steroids (testosterone propionate or dihydrotestosterone) decreased adrenal 3 beta HSD activity in both sexes of both strains of mouse. Although estradiol benzoate did not alter adrenal 3 beta HSD activity in either sex or strain tested when the activity was expressed on a per adrenal gland basis, it did inhibit adrenal 3 beta HSD activity when expressed on a per milligram of adrenal tissue basis in C57BL/6J but not in C3H/HeJ animals. Histochemical staining for 3 beta HSD and the relationship between adrenal weight and the cross-sectional area of the zona fasciculata suggested that the adrenal zona fasciculata was the target of the inhibitory effects of androgens on adrenal 3 beta HSD activity.

Evidence that testosterone regulates Leydig cell 3 beta-hydroxysteroid dehydrogenase-isomerase activity by a trans-acting factor distal to the androgen receptor.

Leydig cells are a target for their own steroid product, testosterone, and thus could be subject to short-loop feedback regulation by androgens. The authors previously reported that 3 beta-hydroxysteroid dehydrogenase-isomerase (3 beta HSD) activity was higher in freshly isolated Leydig cells from C57BL/6J than those from C3H/HeJ inbred mice. To determine whether this strain-related difference in 3 beta HSD activity could be mediated by differential sensitivity to feedback effects of testosterone, Leydig cells from the two strains were cultured in the presence or absence of testosterone, the synthetic androgen receptor agonist, mibolerone, or the nonaromatizable androgen, dihydrotestosterone. After 7 days of treatment, all three androgens significantly decreased 3 beta HSD activity in Leydig cells from C57BL/6J, but not from C3H/HeJ mice. When Leydig cells were cultured with hydroxyflutamide, an androgen receptor antagonist, the effect of testosterone was negated. To determine whether the strain-related difference in sensitivity to testosterone was mediated by a difference in the androgen receptor protein, Leydig cells from reciprocal F1 hybrid lines of mice were cultured in the presence or absence of testosterone. Testosterone treatment inhibited 3 beta HSD activity in both F1 lines to the same extent as observed for Leydig cells from C57BL/6J mice. Thus, there is a strain-related difference in the response to testosterone, but it cannot account for the strain-related difference in Leydig cell 3 beta HSD activity because the high 3 beta HSD strain (C57BL/6J) is the sensitive strain. Although the effect on C57BL/6J Leydig cells is androgen receptor-mediated, the dominant effect of testosterone on both F1 lines rules out a difference in the androgen receptor protein per se. However, the data are consistent with the difference being in a trans-acting factor distal to the androgen receptor.

Subcellular distribution of 3 beta-hydroxysteroid dehydrogenase-isomerase in bovine and murine adrenocortical tissue: species differences in the localization of activity and immunoreactivity.

Key to the production of biologically active steroids is the enzyme 3 beta-hydroxysteroid dehydrogenase-isomerase. Some controversy has arisen concerning the subcellular distribution of this enzyme within steroidogenic cells. The distribution of 3 beta-hydroxysteroid dehydrogenase-isomerase was assessed in subcellular fractions obtained from homogenates of rat, bovine, and mouse adrenal glands in two ways. The activity of 3 beta-hydroxysteroid dehydrogenase-isomerase was quantitated by measuring the conversion of radiolabeled pregnenolone to radiolabeled progesterone in an aliquot of each of the fractions obtained. The presence of the enzyme was assessed by performing Western analyses on aliquots of each of the fractions obtained with the use of a specific polyclonal antiserum against 3 beta-hydroxysteroid dehydrogenase-isomerase, the characterization of which is described. In control experiments, the degree of contamination of the fractions was determined by assessing the presence of known subcellular fraction markers with Western analysis. In the bovine and mouse adrenal glands, 3 beta-hydroxysteroid dehydrogenase-isomerase appears to be localized solely in the microsomal fraction, while in the rat, 3 beta-hydroxysteroid dehydrogenase-isomerase appears to have dual subcellular distribution: the microsomes and the inner mitochondrial membrane. We conclude that there is a species difference in the subcellular distribution of this important steroidogenic enzyme and that this species difference may be related to the steroidogenic pathway preferred in that species.

Sex vesicle "entrapment": translocation or nonhomologous recombination of misaligned Yp and Xp as alternative mechanisms for abnormal inheritance of the sex-determining region.

Abnormal inheritance of the sex determining region, normally located on Yp, results in about 1 in 20,000 phenotypic males with a 46,XX genotype. Studies to date indicate that many 46,XX males apparently arise due to a balanced, yet abnormal, nonhomologous interchange of Xp and Yp termini. However, 2 of the 5 XX males we report here have 3 copies of the pseudoautosomal locus, MIC2. Thus, they appear to have inherited the sex determining region as a result of Yp sequences being added onto the X pseudoautosomal region. Such an unequal, extremely nonhomologous interchange could alternatively be considered to arise from an unbalanced translocation of Yp to Xp. Our results suggest that very unequal interchange or translocation of Yp sequences onto the X pseudoautosomal region is not as rare a mechanism for XX males as originally thought. We also suggest that sex vesicle "entrapment" favors the association of a Yp fragment to the X pseudoautosomal region over a translocation to either Xq or an autosome.

Northern analyses using single-stranded probes do not support a role for GATA/GACA repeats in sex determination in mice and men.

The possible role of GATA/GACA repeated sequences in mammalian sex determination was investigated using Northern analyses of mouse and human RNA. Brain, liver, and gonadal RNA from three developmental stages of mice of both sexes and also human fetal RNA from various tissues were hybridized to both sense and antisense Bkm riboprobes as well as to the synthetic oligonucleotide (GATA)5. At low levels of stringency, putative transcripts of various sizes were observed in all tissue samples with all probes. At high stringency, only a putative transcript of approximately 12 kb was observed, but this was later shown to consist of contaminating DNA. No sex-specific differences were observed in any tissue or developmental stage. Thus, we find no evidence that the GATA/GACA repeated sequences are specifically expressed in quantities detectable by Northern analyses in a manner important to mammalian sex determination.

Bkm sequences from the human X chromosome contain large clusters of GATA/GACA repeats.

In order to determine whether the regional localizations of Bkm repeats detected on the human X chromosome consisted of typical GATA/GACA repeats, clones were isolated, mapped, and sequenced. Nine Bkm-hybridizing clones from Kunkel's fluorescent-activated, cell-sorted X-chromosome library were all unique. Five were mapped in detail with restriction enzymes and the Bkm-hybridizing segments were localized. Confirmation of X chromosomal homology was obtained for 2 of the clones and Bkm segments from these 2 clones were sequenced. Seventeen contiguous GATA repeats were found in each clone and the overall repeat arrangement showed relatively few differences from previously sequenced Bkm sequences. These are the first sequences of human Bkm repeats. The results, when compared with previously published results, suggest that there may be significant differences between the organization of Bkm repeats on the human X and on the human Y chromosome.

Clarification of chromosomal abnormalities associated with sexual ambiguity by studies with Y-chromosomal DNA sequences.

Cases of gonadal dysgenesis, both Turner syndrome and mixed, were studied with Y centromeric and short-arm probes. The Y-centromeric alphoid repeat clone, Y97, allowed sensitive detection of Y-chromosomal material in marker chromosomes or mosaics by in situ analysis or Southern hybridization with purified DNA. The Y short-arm probe, p75/79, allowed detection of sequences normally associated with proximal Yp by Southern analysis. The presence of DNA fragments characteristic of Yp correlates well with partial male sexual differentiation in the cases of mixed gonadal dysgenesis. Thus, the combined use of molecular and cytogenetic techniques has proven to be a powerful approach to the analysis of chromosomal sex disorders.

An improved method for detecting Y chromosomal DNA.

The DNA probe Y97 was derived from a repeat sequence in the human Y centromere, a region which must be present in a mitotically functional Y chromosome. We have demonstrated that Y97, which detects a Y-specific 5.5-kb EcoRI fragment by Southern analysis, is very useful for the molecular detection of small amounts of Y-derived material and represents a significant improvement over previous tests for molecular diagnosis of sex. The male-female difference in hybridization was unequivocal even when only 25 ng of total DNA was used per lane. Furthermore, in mixing experiments the 5.5-kb EcoRI fragment was detectable even when only 5% of the total DNA was male. By increasing hybridization stringency, we have developed a rapid, sensitive, and accurate method to detect Y chromosomal DNA in unrestricted samples.

Evidence that the same structural gene encodes testicular and adrenal 3 beta-hydroxysteroid dehydrogenase-isomerase.

Thermostability of 3 beta-hydroxysteroid dehydrogenase-isomerase (3 beta HSD) activity was examined in testes and adrenal glands from several inbred lines and feral mice. A thermolabile variant of 3 beta HSD was detected in the feral Brno mice. The thermostability (t1/2) of 3 beta HSD was approximately 7 min for both testes and adrenal glands from C57BL/6J mice, compared with 4 min for both tissues from Brno mice. Comparison of testicular and adrenal 3 beta HSD thermostability in six kinds of mice indicated that the t1/2 of 3 beta HSD was correlated in the two tissues and could be classified into two distinct types, thermolabile and thermostable. In contrast, quantitative variants in 3 beta HSD activity were not correlated in the two tissues. These data are consistent with the hypothesis that testicular and adrenal 3 beta HSD is encoded by the same structural gene but that expression of 3 beta HSD activity is independently controlled in testes and adrenal glands.

Maximal testosterone production in Leydig cells from inbred mice relates to the activity of 3 beta-hydroxysteroid dehydrogenase-isomerase.

We previously described significant differences in maximal testosterone production by Leydig cells from the following strains of inbred mice: C57BL/10J, C57BL/6J, DBA/2J, and C3H/HeJ. To evaluate whether these differences in maximal testosterone production related to the activities of the steroidogenic enzymes of the smooth endoplasmic reticulum of Leydig cells from these strains, the activities of 3 beta-hydroxysteroid dehydrogenase-isomerase, 17 alpha-hydroxylase, C17-20 lyase, and 17-ketosteroid reductase were measured in homogenates of purified Leydig cells using 3H-labeled substrates and measuring the amounts of 3H products formed. Maximal and basal testosterone production were determined by incubating aliquots of Leydig cells for 2 h in the presence or absence of 30 pM hCG. Maximal testosterone production by Leydig cells from C57BL/10J and C57BL/6J mice was significantly greater than that by Leydig cells from DBA/2J and C3H/HeJ mice. No difference in basal testosterone production was observed among the strains. Among the four enzymes studied, only 3 beta-hydroxysteroid dehydrogenase-isomerase activity was significantly correlated with hCG-stimulated testosterone production by Leydig cells from the four strains of mice. In addition, when equivalent numbers of Leydig cells from each strain were incubated with an equal concentration of [3H]pregnenolone, a similar difference in [3H] testosterone production was observed among the four strains, as was seen with hCG-stimulation. Leydig cells from C57BL/10 and C57BL/6J mice left less [3H]pregnenolone unmetabolized and produced higher amounts of [3H]testosterone than Leydig cells from DBA/2J and C3H/HeJ mice. There was a significant negative correlation between the amount of pregnenolone unmetabolized and the amount of testosterone produced. These data suggest that 3 beta-hydroxysteroid dehydrogenase-isomerase may be important in determining the differences in hCG-stimulated testosterone production by Leydig cells from the four strains of mice.

Luteinizing hormone receptors and testosterone production in whole testes and purified Leydig cells from the mouse: differences among inbred strains.

Testicular and Leydig cell function were studied in four inbred strains of mice. Significant strain-related differences were found in the number of LH receptors and in the production of testosterone in vitro in response to increasing concentrations of human CG (hCG) by both decapsulated testes and isolated Leydig cells. Maximal testicular testosterone production was similar in the C57BL/10J and C57BL/6J strains and considerably less in the DBA/2J (DBA) and C3H/HeJ strains, which were similar. However, the number of testicular LH receptors was less in C57BL/6J mice than in all three other strains. The pattern of maximal testosterone production by isolated Leydig cells among the four strains was similar to that observed for whole testes, whereas the number of LH receptors per 10(6) Leydig cells was least for Leydig cells from the DBA strain. When the number of Leydig cells per testis was estimated by dividing the number of testicular LH receptors by the number of LH receptors in 10(6) Leydig cells, it was apparent that testes from DBA mice contain approximately twice as many Leydig cells as those from the other strains. Differences in maximal testicular testosterone production appear to be reflected in differences in maximal testosterone production by isolated Leydig cells from each strain. However, there were no differences in testicular sensitivity to hCG but there were differences in Leydig cell sensitivity to hCG among the four strains. Furthermore, the existence of strain-related differences in well defined functional characteristics of Leydig cells offers the opportunity to study the genetic as well as physiological mechanisms involved in the regulation of Leydig cell function in normal individuals.

Delay in the age of balano-preputial skinfold cleavage and alterations in serum profiles of testosterone, 5 alpha-androstane-3 alpha,17 beta-diol, and gonadotropins in adult rats treated during puberty with luteinizing hormone releasing hormone.

Previous work has shown that chronic treatment of intact, immature male rats with luteinizing hormone releasing hormone (LHRH) decreases sex accessory gland weights and results in retardation of the normal developmental increase in the ratio of serum testosterone (T)/5 alpha-androstane-3 alpha,17 beta-diol (3 alpha-Diol) via an apparent enhancement of testicular 5 alpha-reductase or 3 alpha-hydroxysteroid oxidoreductase activities. In the present work, androgen dependent balano-preputial skinfold cleavage was significantly delayed by approximately one week in intact, immature male rats which were treated daily for two weeks with either 1.0 micrograms, 2.5 micrograms or 5.0 micrograms of LHRH during a discrete phase of pubertal development (28-41 days of age). In intact, adult (62 day old) animals which received LHRH treatments during pubertal development, serum T concentrations and sex accessory gland weights were reduced compared to control animal values. Serum 3 alpha-Diol content in the adult rats was either unaltered or increased significantly depending on the LHRH dosage employed during sexual development. Serum luteinizing hormone concentrations were not different between control and LHRH-pretreated adult rats whereas the highest dosage of LHRH employed (5.0 micrograms) during puberty resulted in a significant elevation of adult serum follicle stimulating hormone levels. It is suggested that chronic LHRH treatment of the male rat during puberty results in a perturbation in testicular androgen biosynthetic activities and an impairment of pituitary-testicular hormone feedback mechanisms which persist at least through early adulthood.

Alteration in the normal pattern of serum testosterone and 5 alpha-androstane-3 alpha, 17 beta-diol in the immature male rat following chronic treatment with luteinizing hormone releasing hormone or luteinizing hormone.

A major component of sexual maturation in the male rat is a progressive decline in serum concentrations of 5 alpha-androstane-3 alpha, 17 beta-diol (3 alpha-diol) and a concomitant increase in testicular testosterone biosynthesis and secretion. Chronic administration of synthetic luteinizing hormone releasing hormone (LHRH) or luteinizing hormone (LH)/human chorionic gonadotropin (hCG) to immature male rats has been shown to result in a delay in sexual maturation as evidenced by decreased sex accessory gland weights and altered testicular testosterone production. We have examined the postulate that such treatments may either reverse or retard the normal developmental pattern of serum testosterone and 3 alpha-diol concentrations. Chronic in vivo treatment of 28 day old immature male rats for 2 weeks with daily injections of either 0.5 micrograms of LHRH, 1.0 micrograms of LHRH, or 30 micrograms of LH was found to result in significant reductions in weights of the seminal vesicles and ventral prostate glands and diminutions in serum testosterone concentrations. Serum content of 3 alpha-diol was either unchanged or slightly elevated in the LHRH treated animals and increased significantly in the LH treated animals. These data suggest that either a reversal of or retardation in the normal developmental pattern of serum testosterone and 3 alpha-diol content has been achieved in the immature male rat by chronic LHRH or LH treatment.