The role of soybean extracts and isoflavones in hormone-dependent breast cancer: aromatase activity and biological effects.

Estrogen receptor-positive (ER+) breast cancer is the most common cause of cancer death in women worldwide. Nowadays, the relationship between soya diet and breast cancer is controversial due to the unknown role of its isoflavones, genistein (G) and daidzein (D). In this work, we investigated not only the anti-tumor properties of a soybean extract (NBSE) but also whether the biotransformation of extract (BSE) by the fungus Aspergillus awamori increased its effectiveness. The BSE showed a stronger anti-aromatase activity and anti-proliferative efficacy in ER+ aromatase-overexpressing breast cancer cells. D and G were weak aromatase inhibitors, but inhibited cancer cell growth, being G the isoflavone that contributed to the BSE-induced effects. This work demonstrated that the biotransformation increased the anti-aromatase activity and the anti-tumoral efficacy of soybean extract in breast cancer cells. Moreover, it elucidated the potential use of soya in the prevention and/or treatment of ER+ breast cancer.

Biotransformed soybean extract induces cell death of estrogen-dependent breast cancer cells by modulation of apoptotic proteins.

The process of soybean biotransformation increases the quantity of isoflavones (daidzein and genistein), which besides being considered an alternative to estroprogestive hormone replacement therapy (HRT), are able of hindering the growth and development of tumor cells. We investigated the effects of soybean extract biotransformed by fungus on estrogen-dependent (MCF-7) and nondependent (SK-BR-3) breast cell lines. Cells were treated with different concentrations of biotransformed (BSE) and nonbiotransformed soybean extract (SE), or daidzein (D) and genistein (G) patterns isolated and in combination (D + G). Afterwards, we analyzed cell viability by MTT assay, phosphatidylserine exposure and cell permeability by flow cytometry; expression of apoptotic proteins by Western blotting. BSE promoted reduction in cell viability and increase in DNA degradation in both cell lines. In addition, we verified increase in cell permeability and in the expression of phosphatidylserine, as well as modulation in the expression of apoptotic proteins in MCF-7 cells. The cells did not show any signs of cell death when incubated with the controls (D, G, and D + G). Unknown components found in the BSE induce cell death by apoptosis and necrosis, mainly in MCF-7 cells. These processes depend on the activation of caspase-3 and involve an increase in the expression of proapoptotic molecules.

Comparative study of the effects of combined oral contraceptives in hemostatic variables: an observational preliminary study.

Thrombotic risk is associated with the estrogen dose and type of progestin in combined oral contraceptives. Studies published since 1990 showed that third-generation progestins have larger risk to contribute to thrombosis development than the second-generation. However, there are conflicts in the literature regarding the thrombotic risk associated to the drospirenone progestin. So, this study aimed to evaluate the effects of 3 formulations of contraceptives containing ethinylestradiol (EE) (20 and 30 µg) combined with drospirenone versus levonorgestrel combined with EE (30 µg) in hemostatic parameters. This cross-sectional study included 70 healthy women between 18 and 30 years, BMI 19 to 30 kg/m², not pregnant, non-smokers, and users or non-users (control) of contraceptives for a minimum period of 6 months. The following parameters were assessed: prothrombin time (PT), Factor VII, activated partial thromboplastin time (aPTT), Factor XII, fibrinogen, Factor 1 + 2, Protein C, Protein S, antithrombin, D-dimers, and plasminogen activator inhibitor-1. Significant alterations were found in PT, aPTT, fibrinogen, D-dimers, and protein S, all favoring a state of hypercoagulation for contraceptive containing DRSP/20EE. Both contraceptives containing DRSP/30EE and LNG/30EE promoted changes that favor the hypercoagulability in the coagulant variable PT and in the anticoagulant variables Protein S and Protein C, respectively. We suggest that the progestin drospirenone can contribute to an inadequate balance among procoagulant, anticoagulant, and fibrinolytic factors, since that the contraceptive containing the lowest dose of estrogen and drospirenone (DRSP/20EE) caused a higher number of hemostatic changes.

Estradiol transdérmico e perfil lipídico: efeitos em um grupo específico de mulheres brasileiras pós-menopausadas / Transdermal estradiol and lipid profile: effects on a specific group of brazilian postmenopausal women / Estradiol transdérmico y perfil lipídico: efectos en un grupo específico de mujeres brasileñas posmenopáusicas

Fundamento: Em mulheres pós-menopausadas, mudanças significantes ocorrem, que podem induzir doenças cardiovasculares, tais como o perfil lipídico aterogênico devido a um aumento nos níveis de colesterol total e LDL, e uma diminuição nos níveis de HDL. A terapia de reposição hormonal (TRH) pode evitar essas mudanças no perfil lipídico. Objetivo: Determinar os efeitos da TRH constituída por estradiol transdérmico e acetato de medroxiprogesterona nos parâmetros bioquímicos e lipídicos de mulheres brasileiras pós-menopausadas. Métodos: Este é um estudo prospectivo, longitudinal, aberto, no qual trinta mulheres pós-menopausadas receberam estradiol em gel transdérmico (1 mg/dia) de forma contínua, combinado com acetato de medroxiprogesterona (MPA) (5 mg/dia) por 12 dias/mês. Os seguintes parâmetros foram determinados: colesterol total, triglicérides, lipoproteína de alta densidade (HDL-colesterol), lipoproteína de baixa densidade (LDL-colesterol), lipoproteína de muito baixa densidade (VLDL-colesterol), glicose, aspartato aminotransferase (AST), alanina aminotransferase (ALT), gama-glutamil transferase (GGT) e hormônio folículo estimulante (FSH). Resultados: Os parâmetros do perfil lipídico mostraram uma diminuição não-significante, enquanto os níveis de GGT e FSH apresentaram uma diminuição estatisticamente significante. Conclusões: O tratamento com estradiol em gel transdérmico não mostrou um impacto significante no perfil lipídico, de forma que não resultou em um efeito benéfico nos marcadores de doenças cardiovasculares, sugerindo que a dose, modo de administração e o tempo de tratamento foram importantes para esses resultados. Além disso, o tratamento com dose baixa e modo de administração transdérmico também demonstrou um significante efeito hepático nessa população. Dessa forma, esse tratamento pode fornecer efeitos interessantes sobre o perfil lipídico em mulheres brasileiras pós-menopausadas.

Background: In postmenopausal women, significant changes occur that can induce cardiovascular diseases, such as atherogenic lipid profile, due to an increase in total cholesterol and LDL levels, and a decrease in HDL cholesterol levels. The hormone replacement therapy (HRT) can prevent these changes in lipid profile. Objective: Verify the effects of HRT consisting of transdermal estradiol gel associated with medroxyprogesterone acetate on the lipid profile and biochemical parameters in Brazilian postmenopausal women. Methods: This study is an open prospective longitudinal study, in which thirty postmenopausal women received transdermal estradiol gel (1 mg/day) continuously combined with oral medroxyprogesterone acetate (MPA) (5 mg/day) for 12 days/month. The following parameters were determined: total cholesterol, triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gama glutamyl transferase (GGT) and follicle-stimulating hormone (FSH). Results: The parameters of the lipid profile did not show a significant decrease, while the levels of GGT and FSH had a statistically significant decrease. Conclusions: the treatment with transdermal estradiol gel did not have a significant impact on the lipid profile, thus not resulting in a beneficial effect on cardiovascular disease markers, suggesting that the dose, administration route and the time of treatment were important for these results. Moreover, the treatment using small dose and the transdermal administration route also had a significant hepatic effect in this population. Therefore, this treatment might provide interesting effects on the lipid profile in Brazilian postmenopausal women.

Fundamento: Cambios significantes ocurren en las mujeres posmenopáusicas que pueden inducir enfermedades cardiovasculares, tales como el perfil lipídico aterogénico debido a un aumento en los niveles de colesterol total y LDL y una disminución en los niveles de HDL. La terapia de reemplazo hormonal (TRH) puede evitar esos cambios en el perfil lipídico. Objetivo: Determinar los efectos de la TRH constituida por estradiol transdérmico y acetato de medroxiprogesterona en los parámetros bioquímicos y lipídicos de mujeres brasileñas posmenopáusicas Métodos: Este es un estudio prospectivo, longitudinal, abierto, en el que treinta mujeres posmenopáusicas recibieron estradiol en gel transdérmico (1 mg/día) de forma continua, combinado con acetato de medroxiprogesterona (MPA) (5 mg/día) por 12 días/mes. Se determinaron los seguientes parámetros: colesterol total, triglicéridos, lipoproteína de alta densidad (HDL-colesterol), lipoproteína de baja densidad (LDL-colesterol), lipoproteína de muy baja densidad (VLDL-colesterol), glucosa, aspartato transaminasa (AST), alanina aminotransferasa (ALT), Gammaglutamiltranspeptidasa (GGT) y hormona foliculoestimulante (FSH). Resultados: Los parámetros del perfil lipídico mostraron una disminución insignificante, mientras los niveles de GGT y FSH presentaron una disminución estadísticamente significante. Conclusiones: El tratamiento con estradiol en gel transdérmico no mostró un impacto significante en el perfil lipídico, causando un efecto benéfico en los marcadores de enfermedades cardiovasculares, sugiriendo que la dosis, el modo de administración y el tiempo de tratamiento fueron importantes para esos resultados. Además, el tratamiento con dosis baja y modo de administración transdérmico también demostró un significante efecto hepático en esa población. Así pues, ese tratamiento puede surtir efectos interesantes sobre el perfil lipídico en las mujeres brasileñas posmenopáusicas.

Transdermal estradiol and lipid profile: effects on a specific group of Brazilian postmenopausal women.

BACKGROUND: In postmenopausal women, significant changes occur that can induce cardiovascular diseases, such as atherogenic lipid profile, due to an increase in total cholesterol and LDL levels, and a decrease in HDL cholesterol levels. The hormone replacement therapy (HRT) can prevent these changes in lipid profile. OBJECTIVE: Verify the effects of HRT consisting of transdermal estradiol gel associated with medroxyprogesterone acetate on the lipid profile and biochemical parameters in Brazilian postmenopausal women. METHODS: This study is an open prospective longitudinal study, in which thirty postmenopausal women received transdermal estradiol gel (1 mg/day) continuously combined with oral medroxyprogesterone acetate (MPA) (5 mg/day) for 12 days/month. The following parameters were determined: total cholesterol, triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gama glutamyl transferase (GGT) and follicle-stimulating hormone (FSH). RESULTS: The parameters of the lipid profile did not show a significant decrease, while the levels of GGT and FSH had a statistically significant decrease. CONCLUSIONS: the treatment with transdermal estradiol gel did not have a significant impact on the lipid profile, thus not resulting in a beneficial effect on cardiovascular disease markers, suggesting that the dose, administration route and the time of treatment were important for these results. Moreover, the treatment using small dose and the transdermal administration route also had a significant hepatic effect in this population. Therefore, this treatment might provide interesting effects on the lipid profile in Brazilian postmenopausal women.

Lack of effects of isoflavones on the lipid profile of Brazilian postmenopausal women.

OBJECTIVE: To evaluate the effects of soy isoflavone supplementation on profile lipid and endogenous hormone levels. METHODS: In this double-blind, placebo-controlled study, 47 postmenopausal women 47-66 y of age received 40 mg of isoflavone (n = 25) or 40 mg of casein placebo (n = 22). Cardiovascular risk factors were assessed by evaluating lipid profile at baseline and after 6 mo of treatment. To examine the effects of this regime on endogenous hormone levels, follicle-stimulating hormone and beta-estradiol were measured. Urinary isoflavone concentrations (genistein and daidzein) were measured as markers of both compliance and absorption using high performance liquid chromatography. Baseline characteristics were compared by the unpaired Student's t-test. Within-group changes were determined by paired Student's t-test and comparison between the isoflavone and casein placebo groups were determined by analysis of variance. RESULTS: Lipid levels (low-density lipoprotein and total cholesterol) similarly decreased in both groups. High-density lipoprotein increased significantly in both groups and cannot thus be attributable to treatment; the reason for such variation is unknown and can be attributed to chance or to bias (even that of a real placebo effect in both groups or perhaps in spontaneous changes in exercise and dietary habits of patients after their inclusion). Furthermore, in both groups very low-density lipoprotein and triacylglycerol levels increased in a non-significant manner. CONCLUSION: The results of the present study do not support any biologically significant estrogenic effects of isoflavone on the parameters assessed. Further research will be necessary to definitively assess the safety and efficacy of isoflavone.

Vaginal candidiasis: risk factors

La candidiasis vaginal es uno de los diagnósticos más comunes que hacen los ginecólogos. Han sido estudiados numerosos factores de riesgo para esta infección. En este trabajo fueron evaluados los factores de riesgo e implicancia clínica de la candidiasis vaginal. Se realizó el estudio en 102 mujeres entre 18-59 años con actividad sexual a las cuales se les realizó un Pap. Posteriormente, respondieron un cuestionario sobre los factores de riesgo que incluyeron los siguientes preguntas: anticonceptivos orales (OC), otras drogas, dispositivos intrauterinos, stress, hipertensión, fumadores, embarazos, vestuarios, patologías previas, higiene personal, comportamiento sexual, presencia de diabetes mellitus, hábitos alimenticios y prácticas de protección sanitaria. Los resultados demostraron 45 casos (44 por ciento) de Candidiasis vaginal, algunos de ellos asociados con otras patologías vaginales como: papillomavirus humano, Gardnerella vaginalis, trichomonas vaginalis, patología cervical y candidiasis. Estos casos de candidiasis vaginal están asociados con factores de riesgo como: OC,20.44 por ciento; jeans, 10.22 por ciento candidiasis vaginal previa, 9.2 por ciento y hábitos higiénicos en 6.14 por ciento

Exames colpocitológicos de rotina: aspectos laboratoriais e patológicos / Cervicovaginalis smears of routine: laboratorial and pathological aspects

O objetivo deste trabalho é enfatizar a importância do exame colpocitológico na prevenção e tratamento de doenças ginecológicas. Foram analisadas 133 esfregaços colpocitológicos de pacientes atendidas na rotina de ginecologia. Desta amostragem 80 por cento apresentaram alterações patológicas, assim distribuídas: 26 por cento de candidíase vaginal, 20 por cento de cervicopatias, 13 por cento de metaplasia escamosa, 8 por cento portadoras de Gardnerella vaginalis, 5,5 por cento com colpite química, 4,5 com alterações celulares sugestivas de infecção por papilomavírus huano e 3 por cento das pacientes com alterações hormonais; o restante, 20 por cento das pacientes apresentaram normotrofia epitelial