Articoli di riviste: "Steroid contraception"

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Sech, Laura A., e Daniel R. Mishell. "Oral Steroid Contraception". Women's Health 11, n. 6 (novembre 2015): 743–48. http://dx.doi.org/10.2217/whe.15.82.

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Moodley, M., J. Moodley, R. Chetty e C. S. Herrington. "The role of steroid contraceptive hormones in the pathogenesis of invasive cervical cancer: A review". International Journal of Gynecologic Cancer 13, n. 2 (febbraio 2003): 103–10. http://dx.doi.org/10.1136/ijgc-00009577-200303000-00001.

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Invasive cervical cancer remains a leading cause of morbidity and mortality, especially among women in the developing world where screening is either deficient or absent. Of all agents linked to the causation of this disease, high-risk human papillomavirus (HPV) appears to be the strongest factor. However, not all women with HPV develop cervical cancer. Steroid contraception has been postulated to be one mechanism whereby HPV exerts its tumorigenic effect on cervical tissue. Steroids are thought to bind to specific DNA sequences within transcriptional regulatory regions on the HPV DNA to either increase or suppress transcription of various genes. Although some earlier studies were reassuring as no increased incidence of cervical cancer was observed, subsequent research has shown a causative association, especially among long-term users. The role of steroids was further enhanced by the discovery of hormone receptors in cervical tissue. Some earlier studies of oral contraceptive steroids found no increased risk, even after controlling for other risk factors, including smoking and number of partners. However, prospective studies have shown a greater progression of dysplasia to carcinoma-in-situ with more than 6 years of oral steroid contraceptive use. Similar findings were also evident from other work, including the Royal College of General Practitioners Oral Contraception Study. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives showed a relative risk of 1.2 for invasive cancer in users of the long-acting progestational contraceptive, depo-medroxyprogesterone acetate. However, in users of more than 5 years duration, an estimate of 2.4 was reported. The upstream regulatory region (URR) of the HPV type 16 viral genome, mediates transcriptional control of the HPV genome and is thought to contain enhancer elements that are activated by steroid hormones. It has been shown that steroid hormones bind to specific glucorticoid-response elements within HPV-DNA. Experimental evidence has revealed that high–risk type HPV 16 are able to stimulate the development of vaginal and cervical squamous cell carcinomas in transgenic mice exposed to slow-release pellets of 17 β-estradiol in the presence of human keratin-14 promoter. Squamous cell carcinomas developed in a multi-stage pathway only in transgenic mice and not in nontransgenic mice. The E6 oncoprotein of HPV 16 has been shown to bind to the p53 tumor suppressor gene and stimulate its degradation by a ubiquitin-dependent protease system. Steroid hormones are thought to increase the expression of the E6 and E7 HPV 16 oncogenes, which in turn bind to and degrade the p53 gene product, leading to apoptotic failure and carcinogenesis. However, the molecular basis of this remains to be proven.

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Thorogood, Margaret. "Stroke and Steroid Hormonal Contraception". Contraception 57, n. 3 (marzo 1998): 157–67. http://dx.doi.org/10.1016/s0010-7824(98)00015-8.

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van Heusden, A. M. "Residual ovarian activity during oral steroid contraception". Human Reproduction Update 8, n. 4 (1 luglio 2002): 345–58. http://dx.doi.org/10.1093/humupd/8.4.345.

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PETITTI, D. B., G. PIAGGIO, S. MEHTA, M. C. CRAVIOTO e O. MEIRIK. "Steroid Hormone Contraception and Bone Mineral Density". Obstetrics & Gynecology 95, n. 5 (maggio 2000): 736–44. http://dx.doi.org/10.1097/00006250-200005000-00021.

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Sitruk-Ware, Régine. "Transdermal application of steroid hormones for contraception". Journal of Steroid Biochemistry and Molecular Biology 53, n. 1-6 (giugno 1995): 247–51. http://dx.doi.org/10.1016/0960-0760(95)00055-5.

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Reddy, D. Samba. "Recent Advances in Hormonal Contraceptives for Women". International Journal of Pharmaceutical Sciences and Nanotechnology 1, n. 3 (30 novembre 2008): 199–206. http://dx.doi.org/10.37285/ijpsn.2008.1.3.1.

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Currently, Contraceptive agents play a key role in family planning in India. Hormonal contraception is the marketed most common birth control option in women. An estimated 100 million women throughout the world use hormonal contraceptives for prevention of pregnancy. This article briefly describes the recent advances in hormonal contraceptive strategies that may minimize side effects while optimizing effective contraception. There are four types of hormonal contraceptive agents available for birth control. They include oral contraceptives pills (combined and mini-pills), contraceptive patches, hormonal implants, intrauterine devices and hormone injection agents. Oral contraceptives (OCs) are among the most widely used agents because they are highly effective when used properly. Generally, OCs are designed to simulate the 28 days of the menstrual cycle by daily intake of steroid hormones consisting of an estrogen and/or a progesterone. The primary mechanism underlying OC action is inhibition of ovulation. This action is achieved using a variety of OCs with substantially different components, doses, and side effect profile. Two types of OC pills are widely available: combination pills; and progesterone only pills. The combined daily OC pill is composed of low dose of synthetic estrogen and progesterone. They are usually taken for 21 days with a 7 day gap during which menstruation-like bleeding occurs. Recently, there are several new OCs that have been approved to minimize the frequency and/or extent of breakthrough bleeding while achieving reliable means of contraception for the avoidance of unplanned pregnancies.

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Moodley, M., S. Sewart, C. S. Herrington, R. Chetty, R. Pegoraro e J. Moodley. "The interaction between steroid hormones, human papillomavirus type 16, E6 oncogene expression, and cervical cancer". International Journal of Gynecologic Cancer 13, n. 6 (2003): 834–42. http://dx.doi.org/10.1136/ijgc-00009577-200311000-00015.

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Various risk factors have been implicated in the causation of cervical cancer including human papillomavirus (HPV), the early genes (E6 and E7) of which encode the main transforming proteins. Studies have suggested that steroid hormones may enhance the expression of these genes leading to loss of p53 gene-mediated cell apoptosis. A total of 120 cervical tissue samples were obtained from patients with proven cervical cancer. Patients who used depo-medroxyprogesterone acetate steroid contraception were recruited as part of the steroid arm. Only HPV DNA type 16 samples were used for the study. Controls included three cell lines (CaSki, SiHa, & C33A) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was used as an internal housekeeping gene. Of 120 patients, there were 111 patients with HPV type 16 identified. Of this number, RNA was present in 63 samples. There were 30 women (30/63) who used steroid contraception. In relation to patients who used contraception, HPV 16 E6 gene expression was present in 79% (n = 23) and 88% (n = 30) of steroid users compared to nonusers, respectively. In total there were 25 patients (40%) with expression of the HPV 16 E6*I gene and 30 patients with expression of the E6*II gene. There were 57% of steroid users (n = 17) who had expression of the E6*I/E6*II gene, compared to 52% (n = 17) of nonusers (P = 0.800). From a molecular level, this study does not confirm the role of injectable progesterones in cervical carcinogenesis.

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Whaley, Natalie S., Sophie Lanzkron e Anne Burke. "Contraceptive in Women with Sickle Cell Disease: A Survey Study". Blood 126, n. 23 (3 dicembre 2015): 3263. http://dx.doi.org/10.1182/blood.v126.23.3263.3263.

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Abstract Objectives: Despite recognized maternal and neonatal morbidity associated with unplanned pregnancy in women with sickle cell disease (SCD), unmet need for contraception in this population remains high. While low uptake of contraception in women with chronic disease is not unique to SCD, the impact of provider counseling and patient knowledge and attitudes on contraceptive use is unknown. Guidance on contraception for women with SCD is complicated by concerns about the safety of estrogen-containing methods due to increased risk of venous thromboembolism (VTE),[1-3] the potential non-contraceptive benefits of depot medroxyprogesterone acetate (DMPA) on pain[4-6] and the complex relationship between menses and sickle cell crises.[7] The objective of this study was to evaluate contraceptive knowledge, attitudes, and experiences in a sample of women with SCD. Study Design: A convenience sample of women from the adult and pediatric sickle cell clinics at an urban, academic institution in Baltimore completed a self-administered electronic survey. The survey instrument collected comprehensive medical and reproductive health history, explored participant experience with contraception and tested knowledge and attitudes about efficacy and safety of contraceptive methods. Results: 54 women completed surveys. The median age of respondents was 35 years. Over 40% reported they were disabled or unemployed. Seventy percent of women reported a hospital admission for SCD in the past year and 74% reported at least monthly utilization of urgent services for pain crises. Fifty-five percent reported a history of unintended pregnancy, 77% had a history of at least one pregnancy and 74% reported a desire for no further pregnancies. One third of women at risk for pregnancy did not use a birth control method at last intercourse. The most common contraceptive methods were surgical sterilization (30%) and condoms (30%) followed by DMPA (9%). Women were more likely to use estrogen-containing methods (6%) than highly effective long-acting methods like intrauterine devices or contraceptive implants (3%). While the majority of women (83%) were told they had a high-risk pregnancy in the past and 50% were told by a physician they should not be pregnant for their own health in the future, only 23% reported knowledge of safety concerns with some contraceptive methods for women with SCD. Women primarily received contraceptive counseling from gynecologic providers and only 30% reported a provider other than a gynecologist had ever discussed birth control with them. Conclusions: Women with SCD have unmet contraceptive needs. Women with SCD have some knowledge about their obstetric risks, and this knowledge appears to come from their lived experience and provider counseling. Women with SCD were less knowledgeable about the benefits and risks associated with contraceptive use. Implications: Efforts to increase provision of contraception through coordination of care between hematologists, primary care and gynecologic providers has the potential to improve family planning services for women with SCD resulting in improvements in quality of life and a decrease in unintended pregnancy. [1] Haddad L, Curtis K, Legardy-Williams J, Cwiak C, Jamieson D. Contraception for individuals with sickle cell disease: a systematic review of the literature. Contraception 2012;85:527-537. [2] Manchikanti A, Grimes DA, Lopez LM, Schulz KF. Steroid hormones for contraception in women with sickle cell disease. Cochrane Database Systemic Review. 2007 Apr 18;(2):CD006261. Review. [3] Naik R, Streiff M, Haywood C, Nelson J, Lanzkron S. Venous thromboembolism in adults with sickle cell disease: a serious and under-recognized complication. The American Journal of Medicine 2013;126:443-9. [4] Abood M, de Castillo Z, Guerrero F, Espino M, Austin KL. Effect of Depo-Provera or Microgynon on the painful crises of sickle cell anemia patients. Contraception 1997;56:313-6. [5] De Ceulaer K, Gruber C, Hayes R, Serjeant G. Medroxyprogesterone Acetate and homozygous sickle-cell disease. The Lancet 1982;2:229-31. [6] ACOG practice bulletin No. 73: Use of hormonal contraception in women with coexisting medical conditions. Obstetrics and Gynecology 2006;107:1453-72. [7] Yoong WC, Tuck M. Menstrual pattern in women with sickle cell anemia and its association with sickling crises. Journal of Obstetrics and Gynaecology 2002;22(4):399-401. Disclosures No relevant conflicts of interest to declare.

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Leridon, Henri. "Demographic effects of the introduction of steroid contraception in developed countries". Human Reproduction Update 12, n. 5 (14 giugno 2006): 603–16. http://dx.doi.org/10.1093/humupd/dml025.

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Foran, Terri. "A Tale of Two Hormones". Fertility & Reproduction 01, n. 01 (marzo 2019): 39–42. http://dx.doi.org/10.1142/s2661318219500026.

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The development of the steroid hormones currently used in contraception and menopausal hormone replacement provides an interesting story in terms of brilliant research, international rivalry, major advances and sheer serendipity. This paper provides a historical perspective on the use of oestrogens and progestogens in clinical practice from the 1920s until the present day.

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Micks, Elizabeth, Greta B. Raglan e Jay Schulkin. "Bridging progestogens in pregnancy and pregnancy prevention". Endocrine Connections 4, n. 4 (dicembre 2015): R81—R92. http://dx.doi.org/10.1530/ec-15-0093.

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Steroid hormones have been in use for more than a half a century as contraceptive agents, and only now are researchers elucidating the biochemical mechanisms of action and non-target effects. Progesterone and synthetic progestins, critical for women's health in the US and internationally, appear to have important effects on immune functioning and other diverse systems. Apart from the contraceptive world is a separate field that is devoted to understanding progesterone in other contexts. Based on research following a development timeline parallel to hormonal contraception, progesterone and 17-hydroxyprogesterone caproate are now administered to prevent preterm birth in high-risk pregnant women. Preterm birth researchers are similarly working to determine the precise biochemical actions and immunological effects of progesterone. Progesterone research in both areas could benefit from increased collaboration and bringing these two bodies of literature together. Progesterone, through actions on various hormone receptors, has lifelong importance in different organ systems and researchers have much to learn about this molecule from the combination of existing literatures, and from future studies that build on this combined knowledge base.

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Walton, Melanie. "Steroid hormones for contraception in men: systematic review of randomized controlled trials". Journal of Family Planning and Reproductive Health Care 31, n. 3 (1 luglio 2005): 250. http://dx.doi.org/10.1783/1471189054484059.

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Grimes, David A., Maria F. Gallo, Vera Grigorieva, Kavita Nanda e Kenneth F. Schulz. "Steroid hormones for contraception in men: systematic review of randomized controlled trials". Contraception 71, n. 2 (febbraio 2005): 89–94. http://dx.doi.org/10.1016/j.contraception.2004.10.001.

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Braga, Daniela Paes de Almeida Ferreira, Cristiane Schilbach Pizzutto, Derek Andrew Rosenfield, Priscila Viau Furtado, Cláudio A. Oliveira, Sandra Helena Ramiro Corrêa, Pedro Nacib Jorge-Neto e Marcelo Alcindo de Barros Vaz Guimarães. "Suppression of ovarian activity in a captive African Lion Panthera leo after deslorelin treatment". Journal of Threatened Taxa 12, n. 11 (25 agosto 2020): 16469–77. http://dx.doi.org/10.11609/jott.5803.12.11.16469-16477.

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Abstract: With the intent to evaluate the efficiency of a contraceptive treatment for cyclic ovarian suppression in African Lionesses Panthera leo using a Gonadotrophin-Releasing Hormone (GnRH) agonist bioimplant, noninvasive fecal steroid assay associated with the observation of the behavioral estrus were employed for a period of 36 months. Five captive adult females, maintained with a vasectomized male, subcutaneously received a 9.4mg deslorelin acetate implant. The treatment initially stimulated behavioral estrus along with ovarian activity, demonstrated by an estrogen increase in two lionesses. A rise in progesterone concentration in two other animals suggested possible treatment-induced ovulation. After the initial period, deslorelin prevented ovarian activity for at least 22 months. Two females exhibited signs of behavioral estrus after 22 and 31 months. A third lioness with an increased estrogen concentration did not exhibit behavioral estrus signs or a consequent progesterone surge until 33 months after implantation, suggesting a possible resumption of ovarian activity. One female did not exhibit any behavioral estrus signs nor a rise in steroid levels after the “treatment-induced” estrus throughout the entire experiment (36 months). One lioness died after 15 months without exhibiting signs of estrus or an increased progesterone level, however, the estrogen concentration increased 12 months post-implantation, suggesting resumed ovarian activity. The study showed that long-term treatment with a GnRH agonist can be extremely effective as a contraceptive treatment in African lionesses, however, the duration of contraception may vary among individuals and may bear the risk of permanent loss of normal ovarian activity.

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Silveira, Angela, Stella Thomassen, Lars-Olof Hansson, Jan Rosing, Anders Hamsten, Katarina Bremme e Marianne van Rooijen. "Rapid activation of haemostasis after hormonal emergency contraception". Thrombosis and Haemostasis 97, n. 01 (2007): 15–20. http://dx.doi.org/10.1160/th06-09-0540.

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SummaryHormonal emergency contraception (EC) is a well established contraceptive method, recommended to all women, although the effects on haemostais are not fully evaluated. The aim of this study was to evaluate whether exposure to EC has effects on well established cardiovascular risk factors, and also to examine whether differences exist between two EC treatments. In a prospective randomized cross over design 11 women used two different EC methods, one with estrogen and levonorgestrel (EE-EC) and one with levonorgestrel only (LNG-EC). Plasma concentrations of haemostatic factors (APC resistance, antithrombin, fibrinogen, prothrombin fragment 1+2, free protein S, factor VII and PAI-1), sex-hormone-binding globulin (SHBG), the apolipoprotein (apo)B/apoA1 ratio and C-reactive protein (CRP) were followed frequently during the following 48 h A rapid haemostatic activation was induced with both treatments, although more pronounced with EE-EC. Already two hours after EC, the plasma concentrations of haemostatic parameters and SHBG were significantly different from baseline concentrations. An ETP-based APC-resistance method showed increased APC resistance with EE-EC and decreased APC resistance with LNG-EC. The ApoB/ApoA1 ratio was affected in a favourable direction with EE-EC.CRP increased slightly regardless of treatment. Even a very short exposure to exogenous sex hormones causes prompt effects on hepatic protein synthesis and the coagulation system. This must be taken into consideration whenever exogenous steroid hormones are administered, especially to individuals with a genetic predisposition to thrombosis or transiently disturbed haemostasis.

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Hel, Zdenek, Elizabeth Stringer e Jiri Mestecky. "Sex Steroid Hormones, Hormonal Contraception, and the Immunobiology of Human Immunodeficiency Virus-1 Infection". Endocrine Reviews 31, n. 1 (10 novembre 2009): 79–97. http://dx.doi.org/10.1210/er.2009-0018.

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Petitti, D. "Steroid hormone contraception and bone mineral density: a cross-sectional study in an international population". Obstetrics & Gynecology 95, n. 5 (maggio 2000): 736–44. http://dx.doi.org/10.1016/s0029-7844(00)00782-1.

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Africander, Donita, Nicolette Verhoog e Janet P. Hapgood. "Molecular mechanisms of steroid receptor-mediated actions by synthetic progestins used in HRT and contraception". Steroids 76, n. 7 (giugno 2011): 636–52. http://dx.doi.org/10.1016/j.steroids.2011.03.001.

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Wu, Frederick C. W., e R. John Aitken. "Suppression of sperm function by depot medroxyprogesterone acetate and testosterone enanthate in steroid male contraception*†". Fertility and Sterility 51, n. 4 (aprile 1989): 691–98. http://dx.doi.org/10.1016/s0015-0282(16)60623-4.

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Wu, FCW, e RJ Aitken. "Suppression of sperm function by depot medroxyprogesterone acetate and testosterone enanthate in steroid male contraception". International Journal of Gynecology & Obstetrics 30, n. 2 (ottobre 1989): 191. http://dx.doi.org/10.1016/0020-7292(89)90326-3.

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Bhattarai, Aabishkar, Bijaya Karki e Pragya Bhandari. "Fournier’s Gangrene after Bilateral Vasectomy-A Case Report". Birat Journal of Health Sciences 5, n. 2 (1 ottobre 2020): 1122–25. http://dx.doi.org/10.3126/bjhs.v5i2.31527.

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Fournier’s gangrene is an acute, rapidly progressing, potentially fatal necrotizing fasciitis affectingthe external genitalia, perineal or perianal regions and is caused by a mixed infection with aerobic/anaerobic bacteria, which commonly affects the men, but can also occur in women and children. The most common foci of infection are from gastrointestinal tract, genitourinary tract or less commonly from the cutaneous injuries. The common risk factors includediabetes mellitus,alcohol abuse, extremes of age, male gender, chronic steroid use, malnutrition and immunosuppression. Uncommonly, Fournier’s gangrene has been documented after vasectomy operation-a permanent technique for male partner sterilization. Here we present a case of Fournier’s gangrene in an adult male who had undergone bilateral standard vasectomy for permanent contraception and presenting after 7 days with gangrene in the scrotum requiring urgent debridement and broad-spectrum antibiotics.

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Putman, Sarah B., Janine L. Brown, Ashley D. Franklin, Emily C. Schneider, Nicole P. Boisseau, Cheryl S. Asa e Budhan S. Pukazhenthi. "Characterization of Ovarian Steroid Patterns in Female African Lions (Panthera leo), and the Effects of Contraception on Reproductive Function". PLOS ONE 10, n. 10 (13 ottobre 2015): e0140373. http://dx.doi.org/10.1371/journal.pone.0140373.

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Lange, Carol A., e Douglas Yee. "Progesterone and Breast Cancer". Women's Health 4, n. 2 (marzo 2008): 151–62. http://dx.doi.org/10.2217/17455057.4.2.151.

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Progesterone is an ovarian steroid hormone that is essential for normal breast development during puberty and in preparation for lactation and breastfeeding. The actions of progesterone are primarily mediated by its high-affinity receptors, which include the classical progesterone receptor (PR)-A and -B isoforms, located in diverse tissues, including the brain, where progesterone controls reproductive behavior, and the breast and reproductive organs. Progestins are frequently prescribed for contraception or during postmenopausal hormone replacement therapy, in which progestins are combined with estrogen as a means to block estrogen-induced endometrial growth. The role of estrogen as a potent breast mitogen is undisputed, and inhibitors of the estrogen receptor and estrogen-producing enzymes (aromatases) are effective first-line cancer therapies. However, PR action in breast cancer is grossly understudied and remains controversial. Herein, we review existing evidence and discuss the challenges to defining a role for progesterone in breast cancer.

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Pasqualotto, Fábio Firmbach, Antônio Marmo Lucon, Eleonora Bedin Pasqualotto e Sami Arap. "Trends in male contraception". Revista do Hospital das Clínicas 58, n. 5 (2003): 275–83. http://dx.doi.org/10.1590/s0041-87812003000500007.

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Methods that are available for male contraception, namely coitus interruptus, condoms, and vasectomy, have been used since the 19th century. With the exceptions of a few improvements of these methods, no major progress has been made with respect to introducing new male contraceptives since then. It is extremely urgent to develop new, safe, effective, and reversible male contraceptive methods. Among all male contraceptive methods that are being investigated, the hormonal approach is the closest to clinical application. Hormonal contraception provides pregnancy protection by means of spermatogenic suppression. Androgen-progestin regimens currently represent the best available hormonal combination for induction of a profound suppression of spermatogenesis. Further development of new steroids is mandatory for increasing the choices of available contraceptive formulations and to optimize long-term safety of these regimens.

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Fedotov, V. P. "The study of the biological properties of structural analogues of sex steroids in order to create drugs". Problems of Endocrinology 43, n. 4 (15 agosto 1997): 38–42. http://dx.doi.org/10.14341/probl199743438-42.

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Biological properties of structural analogs of sex steroids are studied. Alteration of the chemical structure of sex steroids helped single out a number of potential drugs possessing anabolic, antitumor, and contraceptive effects. Some potent estrogens may be used for replacement therapy. The biological characteristics of nitroxy derivative of ethynylestradiol nistranol are described in detail. This agent is characterized by an extremely high contraception index (4.6 times higher than ethynylestradiol). A new Russian two-component oral contraceptive Nitrogest has been developed, with the gestagenic component acetomepregnol synthesized at the Research Chemical Pharmaceutical Institute and the estrogen nistranol replacing the traditional ethynylestradiol.

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Meng, Chun-Xia, Li-Nan Cheng, Parameswaran Grace Luther Lalitkumar, Lin Zhang, Hui-Juan Zhang e Kristina Gemzell-Danielsson. "Expressions of steroid receptors and Ki67 in first-trimester decidua and chorionic villi exposed to levonorgestrel used for emergency contraception". Fertility and Sterility 91, n. 4 (aprile 2009): 1420–23. http://dx.doi.org/10.1016/j.fertnstert.2008.05.058.

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Felpeto-Santero, Carmen, Beatriz Galán e José Luis García. "Engineering the Steroid Hydroxylating System from Cochliobolus lunatus in Mycolicibacterium smegmatis". Microorganisms 9, n. 7 (13 luglio 2021): 1499. http://dx.doi.org/10.3390/microorganisms9071499.

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14α-hydroxylated steroids are starting materials for the synthesis of contraceptive and anti-inflammatory compounds in the steroid industry. A synthetic bacterial operon containing the cytochrome P450 CYP103168 and the reductase CPR64795 of the fungus Cochlioboluslunatus able to hydroxylate steroids has been engineered into a shuttle plasmid named pMVFAN. This plasmid was used to transform two mutants of Mycolicibacterium smegmatis named MS6039-5941 and MS6039 that accumulate 4-androstene-3,17-dione (AD), and 1,4-androstadiene-3,17-dione (ADD), respectively. The recombinant mutants MS6039-5941 (pMVFAN) and MS6039 (pMVFAN) were able to efficiently express the hydroxylating CYP system of C.lunatus and produced in high yields 14αOH-AD and 14αOH-ADD, respectively, directly from cholesterol and phytosterols in a single fermentation step. These results open a new avenue for producing at industrial scale these and other hydroxylated steroidal synthons by transforming with this synthetic operon other Mycolicibacterium strains currently used for the commercial production of steroidal synthons from phytosterols as feedstock.

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El Amki, Mohamad, Nadine Binder, Riccardo Steffen, Hannah Schneider, Andreas R. Luft, Michael Weller, Bruno Imthurn, Gabriele S. Merki-Feld e Susanne Wegener. "Contraceptive drugs mitigate experimental stroke-induced brain injury". Cardiovascular Research 115, n. 3 (5 ottobre 2018): 637–46. http://dx.doi.org/10.1093/cvr/cvy248.

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AbstractAimsEffective stroke treatments beyond reperfusion remain scant. The natural steroid hormone progesterone has shown protective effects in experimental models of brain injury and cardiovascular disease. However, unfavourable bioavailability limits its clinical use. Desogestrel and drospirenone are new generation progestins with progesterone-like properties, developed as oral contraceptives with excellent bioavailability and safety profile. We investigated the neuroprotective properties of these progestins in vivo using transient middle cerebral artery occlusion (MCAO) and in vitro using an oxygen-glucose deprivation and reoxygenation (OGD/R) model in primary neuronal cells.Methods and resultsMCAO was induced in female, female ovariectomized (modelling postmenopausal females) and male mice. Treatment with the progestins resulted in less severe strokes after MCAO and less neuronal death in OGD/R. Desogestrel and drospirenone induced higher expression levels of GABAAR α4 and delta subunits within the brain, suggesting changes in GABAAR configuration favouring tonic inhibition as potential mechanism of action. Treatment with the GABAAR blocker picrotoxin abolished the protection afforded by the progestins in vivo and in vitro.ConclusionFor the first time, here, we delineate a potential role of desogestrel and drospirenone, both clinically approved and safe drugs in mitigating the consequences of stroke. Contraception with desogestrel and drospirenone in progestin-only preparations may be particularly beneficial for women at risk of stroke.

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Helmerhorst, F. M., F. R. Rosendaal e J. P. Vandenbroucke. "Venous thromboembolism and the pill. The WHO technical report on cardiovascular disease and steroid hormone contraception: state-of-the- art. World Health Organization". Human Reproduction 13, n. 11 (1 novembre 1998): 2981–83. http://dx.doi.org/10.1093/humrep/13.11.2981.

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Bradbury, Charlotte A., Rosemary Greenwood, Julie Pell, Katie Breheny, Rebecca Kandiyali, Jenny Ingram, Ian Thomas et al. "A Multicentre Randomised Trial of First Line Treatment Pathways for Newly Diagnosed Immune Thrombocytopenia: Standard Steroid Treatment Versus Combined Steroid and Mycophenolate. the Flight Trial". Blood 136, Supplement_2 (19 novembre 2020): LBA—2—LBA—2. http://dx.doi.org/10.1182/blood-2020-143563.

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BACKGROUND Immune thrombocytopenia (ITP) is a rare autoimmune condition associated with bleeding risk and fatigue. Current first line ITP treatment is with high dose corticosteroids but frequent side effects, heterogeneous responses and high relapse rates are significant problems, with only 20% remaining in sustained long-term remission. In the UK, mycophenolate (MMF) is frequently used as second line treatment, with retrospective data in ITP suggesting efficacy in 50-80% of patients with good tolerability, although responses are often delayed. The FLIGHT trial aimed to test the hypothesis that MMF combined with corticosteroid is a more effective first line ITP treatment than current standard of care, corticosteroid alone. METHODS In this multicentre, UK based, open label, randomised controlled trial, we randomly assigned 120 patients with ITP requiring first line treatment, to corticosteroid alone (standard care) versus combined corticosteroid and MMF (1:1 ratio). Patients >16 years old, with baseline platelet count <30 x109/L requiring first line treatment were eligible. Exclusions included HIV, Common Variable Immunodeficiency (CVID), pregnancy, breast feeding or an unwillingness to follow contraception advice if assigned to MMF. Dosing of corticosteroid followed international consensus guidance (either dexamethasone pulses or prednisolone initial daily dose of 1mg/kg then taper) and dosing of MMF included a strategy to taper and stop 6 months after starting treatment. The primary efficacy outcome was time from randomisation to treatment failure, defined as platelets <30x109/L and a clinical need for second line treatment (included refractory and relapsed ITP). Secondary outcomes included side effects, bleeding events, and patient reported outcomes (PROM) measured at baseline, 2, 4, 6 and 12 months, by validated questionnaires (SF36v2 (Your health & wellbeing): Quality of life (QoL), FACIT-Fatigue (v4): Fatigue, FACT-Th6 (v4): Bleeding and ICECAP-A v2: QoL) RESULTS Of the 120 ITP patients consented, recruited and randomised (52.4% male, mean age 54 years, range 17-87), mean baseline platelet count was 7 x109/L and mean follow up was for 18 months (maximum follow up 24 months, minimum follow up of 12 months). Patient demographics and baseline values are shown in table 1. Significantly fewer treatment failures occurred in patients randomised to MMF as shown in figure 1 (22% [n=13 of 59] vs 44% [n=27 of 61], aHR=0.41 [0.21, 0.80], p=0.0064, and when secondary ITP patients were excluded, aHR 0.37 [0.19, 0.71] p=0.0029). There were similar rates between the groups of significant adverse events, bleeding events, rescue treatments, hospital admissions and treatment side effects including infection (n=14 in each group), neutropenia (4 patients in corticosteroid group), and gastrointestinal side effects (table 2). However, some aspects of quality of life (QoL) were worse in those patients assigned to the MMF group including physical role, physical function and fatigue. CONCLUSIONS This is the first randomised trial using MMF to treat ITP, demonstrating good efficacy and tolerability, even with the inclusion of elderly patients (27.5% were >70 years, 15.8% >75 years). Therefore, MMF may be considered an effective, well tolerated first line treatment option, alongside a short course of steroids, for some patients with ITP, approximately halving the risk of refractory or relapsed ITP. At final follow up, 56% of patients treated with corticosteroid alone had not required 2nd line treatment, which is higher than previous reports. It is unclear why some aspects of QoL were worse in the MMF group. This is an important reminder that disease response and patient experience may not correlate and emphasises the importance of including PROM outcomes within trials. For ITP, to date, PROMs have only been systematically evaluated in the TPO-RA randomised controlled trials. The FLIGHT trial received ethical approval from NRES Committee South West and is registered, (EudraCT Number: 2017-001171-23. ClinicalTrials.gov number: NCT03156452). This abstract presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0815-20016). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Disclosures No relevant conflicts of interest to declare. OffLabel Disclosure: Mycophenolate is unlicensed for ITP treatment

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Guengerich, F. Peter. "Inhibition of oral contraceptive steroid—metabolizing enzymes by steroids and drugs". American Journal of Obstetrics and Gynecology 163, n. 6 (dicembre 1990): 2159–63. http://dx.doi.org/10.1016/0002-9378(90)90557-n.

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Jung-Hoffmann, Claudia, e Herbert Kuhl. "Pharmacokinetics and pharmacodynamics of oral contraceptive steroids: Factors influencing steroid metabolism". American Journal of Obstetrics and Gynecology 163, n. 6 (dicembre 1990): 2183–97. http://dx.doi.org/10.1016/0002-9378(90)90560-t.

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Guengerich, FP. "Inhibition of oral contraceptive steroid-metabolizing enzymes by steroids and drugs". International Journal of Gynecology & Obstetrics 36, n. 3 (novembre 1991): 259. http://dx.doi.org/10.1016/0020-7292(91)90732-k.

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Jung-Hoffmann, C., e H. Kuhl. "Pharmacokinetics and pharmacodynamics of oral contraceptive steroids: Factors influencing steroid metabolism". International Journal of Gynecology & Obstetrics 36, n. 3 (novembre 1991): 261. http://dx.doi.org/10.1016/0020-7292(91)90738-q.

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Nosik, M. N., K. A. Ryzhov e A. V. Potapova. "REPLICATION OF HIV-1 SUBTYPE A6 IN THE PRESENCE OF HORMONES INCLUDED IN THE MODERN HORMONAL CONTRACEPTIVES". Journal of microbiology epidemiology immunobiology 1, n. 1 (23 agosto 2019): 85–90. http://dx.doi.org/10.36233/0372-9311-2019-1-85-90.

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Aim. To study how female hormones included in oral contraceptives (β-estradiol and progesteron) affect HIV-1 replication and efficacy of antiviral drugs. Material and methods. Peripheral blood mononuclear cells (PBMC) and cell lines MT-4, Jurkat were infected with HIV-1 (subtype A6). Afterwards the cells were cultured for 6 days in the presence of β-estradiol/progesteron with or without the presence of antiretroviral drugs Lamivudin (3TC), Etravirin(ETR) and Indinavir (IDV), which are widely used for HIV treatment. Virus production was monitored by p24 levels in culture supernatants on day 6. The experemints were performed in eight repetitions. Results. There was a 1,3-1,8-fold increase of virus replication in the presence of high concentrations of both hormones (26,136 μg/ml). Incomplete suppression of viral replication was observed when infected cells were co-cultivated in the presence of hormones (26 μg, 136 μg) and antiretroviral drugs. The mean suppression rate of viral replication for β-estradiol was 77.3% and 69.8% for progesterone. However, in the absence of hormones the virus production was completely suppressed by those drugs. Conclusion. The high concentrations of steroid hormones induce HIV-1 replication and as a result reduce the efficacy of antiretroviral drugs NVP and IDV in vitro. Thus it is advisable for women at high risk of HIV infection to monitor hormone levels that change during the menstrual cycle and pregnancy before prescribing hormonal contraception.

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Meng, Yuan-Xiang, Hai-Ying Jiang e Feng-Ying Lu. "The Effects of Long-Term Using Once-A-Month Injectable Contraceptive Norethisterone Enanthate/ Estradiol Valerate on Coagulation in the Chinese". Thrombosis and Haemostasis 64, n. 04 (1990): 548–49. http://dx.doi.org/10.1055/s-0038-1647355.

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SummarySixty-four Chinese women were studied for the effects of injecting once-a-month contraceptive norethisterone enanthate/ estradiol valerate between 2 to 4 1/2 years on certain coagulation and fibrinolytic parameters, and 59 women not receiving any steroidal contraception were controls. In both groups there was no significant change in PT, fibrinogen, factor X activity, AT III antigen, AT III activity and fibrinolytic activity expressed by euglobulin lysis time. There was no significant difference in mean levels of factor VIIIR:Ag between the two groups, although a sub-group women in treatment group had higher than accepted levels of factor VIIIR:Ag.

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Mannowetz, Nadja, Melissa R. Miller e Polina V. Lishko. "Regulation of the sperm calcium channel CatSper by endogenous steroids and plant triterpenoids". Proceedings of the National Academy of Sciences 114, n. 22 (15 maggio 2017): 5743–48. http://dx.doi.org/10.1073/pnas.1700367114.

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The calcium channel of sperm (CatSper) is essential for sperm hyperactivated motility and fertility. The steroid hormone progesterone activates CatSper of human sperm via binding to the serine hydrolase ABHD2. However, steroid specificity of ABHD2 has not been evaluated. Here, we explored whether steroid hormones to which human spermatozoa are exposed in the male and female genital tract influence CatSper activation via modulation of ABHD2. The results show that testosterone, estrogen, and hydrocortisone did not alter basal CatSper currents, whereas the neurosteroid pregnenolone sulfate exerted similar effects as progesterone, likely binding to the same site. However, physiological concentrations of testosterone and hydrocortisone inhibited CatSper activation by progesterone. Additionally, testosterone antagonized the effect of pregnenolone sulfate. We have also explored whether steroid-like molecules, such as the plant triterpenoids pristimerin and lupeol, affect sperm fertility. Interestingly, both compounds competed with progesterone and pregnenolone sulfate and significantly reduced CatSper activation by either steroid. Furthermore, pristimerin and lupeol considerably diminished hyperactivation of capacitated spermatozoa. These results indicate that (i) pregnenolone sulfate together with progesterone are the main steroids that activate CatSper and (ii) pristimerin and lupeol can act as contraceptive compounds by averting sperm hyperactivation, thus preventing fertilization.

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Kumar, Poornima, Rebekah Ahmed, Renu Riat, Kirit M. Ardeshna e Stephen Daw. "Cerebral Venous Thrombosis in Adolescents and Young Adults with Classical Hodgkin Lymphoma". Blood 120, n. 21 (16 novembre 2012): 4784. http://dx.doi.org/10.1182/blood.v120.21.4784.4784.

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Abstract Abstract 4784 Background Patients with classical Hodgkin Lymphoma (cHL) have a relatively high risk of venous thrombo-embolism (VTE); reported incidence 4.6–7% in adults and up to 11.5% in children and adolescents. Most VTE episodes are peripheral or related to central venous catheters, with very limited data on central or life-threatening thromboses in adolescents. There is only 1 reported case series on cerebral venous thrombosis (CVT) in adolescents. We report 4 cases of CVT from our centre, all treated with chemo-radiotherapy. Chemotherapy comprised OEPA (vincristine, prednisolone, doxorubicin, etoposide) and COPP/COPDAC (cyclophosphamide, vincristine, prednisolone, procarbazine/dacarbazine respectively). Results All patients received involved field radiotherapy (IFRT) 19.8 – 30Gy on completing chemotherapy. All were female, aged 12–23. All received norethisterone contraception. All had indwelling central venous catheters (PICC). Patient 4 alone had a raised body mass index. All were exposed to steroids; Patient 4 completed steroid therapy several weeks before developing CVT symptoms. Patients 2 and 4 received treatment dose low molecular weight heparin (LMWH) for 6 weeks after diagnosis of PICC-associated thrombosis, and were not on anticoagulation or thromboprophylaxis when CVT was diagnosed. Regarding other risk factors, 3/4 had no documented prothrombotic tendency. Patient 4 was found to have a moderately positive IgM anti beta 2 glycoprotein antibody present 12 weeks apart, consistent with antiphospholipid syndrome. All patients were therapeutically anticoagulated for 6 months to 1 year. LMWH of choice at our centre was dalteparin. Patient 1 was switched to warfarin upon completion of chemo-radiotherapy, and Patient 4 was commenced on warfarin with dalteparin cover at diagnosis of CVT as she had completed treatment. Patients 1 and 2 had raised intracranial pressure on lumbar puncture, and required therapeutic lumbar punctures and acetazolamide. Patients 2 and 3 both required anticonvulsant therapy for 1 year. Patient 2 was initially treated with phenytoin, and switched to carbamazepine. Patient 3 was also initially managed with phenytoin, and switched to levetiracetam. Neither patient had any subsequent seizures. All 4 patients have recovered completely from CVT with no residual neurological deficits or further thromboses. Conclusion CVT is a rare and potentially life threatening complication in adolescents and young adults with cHL with paucity of data. The risk factors are unclear however all patients in our series were female, received steroids and were on norethisterone. Only 1 patient had a prothrombotic tendency detected on thrombophila screening. CVT is treatable, and complete resolution of signs and symptoms can be expected. More studies are required to elucidate risk factors which may help develop thromboprophylaxis guidance in this group of patients. Disclosures: No relevant conflicts of interest to declare.

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Fraser, IS. "A review of the use of progestogen-only minipills for contraception during lactation". Reproduction, Fertility and Development 3, n. 3 (1991): 245. http://dx.doi.org/10.1071/rd9910245.

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Progestogen-only minipills and other systems for releasing low doses of progestogens alone are widely used for contraception in breast-feeding women around the world. There is good evidence to confirm their acceptability and their lack of effect on milk production, neonatal growth and early development. In contrast, combined oral contraceptives frequently decrease milk production, and may produce minor changes in milk composition. However, even combined oral contraceptives do not appear to produce adverse effects on neonatal well-being and development, although minor reductions in initial growth rate may sometimes occur. Progestogen-only methods may also produce subtle changes in milk composition, although less than combined oral contraceptives. Steroids are transferred from plasma into milk in small quantities, but the amounts are usually very low or insufficient to allow detection in the infants using present-day assays. There has been theoretical concern that these tiny amounts of steroids might affect neonatal reproductive development, but this appears to be unwarranted. Progestogen-only methods are being widely used for post-partum contraception, and they appear to have particular advantages in this situation. They also have few disadvantages; a theoretical concern about a possible effect on later reproductive or sexual development has no evidence to support it. The present licensing situation in Australia, which lists lactation as a relative contraindication to progestogen-only contraceptive use, causes real concern to potential users and appears to lead to frequent errors in compliance.

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Warner, Pamela, e John Bancroft. "Factors Related to Self-reporting of the Pre-menstrual Syndrome". British Journal of Psychiatry 157, n. 2 (agosto 1990): 249–60. http://dx.doi.org/10.1192/bjp.157.2.249.

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Menstrual health questionnaires were completed by a self-selected sample of the readership of a woman's magazine (n = 5457). Sixty-one per cent of subjects described themselves as suffering from pre-menstrual syndrome (PMS) and this was largely corroborated by ratings of symptoms pre-menstrually, menstrually and post-menstrually for the most recent cycle. Mood symptoms were more strongly implicated than physical ones. Self-report of PMS was found to be modestly associated with aspects of parity and oral contraceptive use, but strongly and positively related to the duration of ‘natural’ menstrual cycles (i.e. uninterrupted by pregnancy or steroidal contraception) and to psychosocial stress. There were interactions among psychosocial factors and between psychosocial load and duration of natural cycles.

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Poulter, N. R., C. L. Chang, T. M. Farley e M. G. Marmot. "Reliability of data from proxy respondents in an international case-control study of cardiovascular disease and oral contraceptives. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception." Journal of Epidemiology & Community Health 50, n. 6 (1 dicembre 1996): 674–80. http://dx.doi.org/10.1136/jech.50.6.674.

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Vasetska, A. "Non-surgical methods of regulation reproductive function and contraception males of domestic animals". Ukrainian Journal of Veterinary and Agricultural Sciences 3, n. 3 (3 settembre 2020): 44–50. http://dx.doi.org/10.32718/ujvas3-3.09.

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The regulation of male reproductive function today is not limited to surgical castration; there are many other methods of controlling reproductive function. Non-surgical methods of controlling male reproductive function can be reversible and not reversible, i.e., reproductive function is preserved or completely suppressed. Castration of males or orchiectomy leads to irreversible sterility of the male, when the male completely loses the ability to reproduce. This operation can also entail some side effects: obesity, underdevelopment of the external genital organs, an increased risk of diabetes or hypothyroidism, problems with frequent urination and behavioral problems. Therefore, methods of non-surgical management of reproductive function and contraception in males are being actively developed. The article presents the latest methods of contraception and the management of the reproductive function of male domestic animals (cats, dogs): clinical application GnRH and agonists GnRH, Non-Peptide GnRH Antagonists, GnRH-Toxin Conjugate, GnRH Vaccines and other immune contraceptive vaccines, chemical sterilants for intratesticular injections, calcium chloride, zinc gluconate, chlorhexidine digluconate, hypertonic saline, sex steroids (progestines), gene silencing, kisspeptin and GnIH, targeting delivery of cytotoxins, single-dose hormonal male and female sterilianr, FSH – receptor ligand cytotoxin conjugates, Sperm Protein Reactive with Antisperm Antibodies (SPRASA) Reversible Inhibition of Sperm under Guidance(RISUG).

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Loginova, K. B., G. M. Dyukova, Yu V. Dobrokhotova e A. B. Danilov. "Treatment of premenstrual dysphoric disorders with combined oral contraceptives". Medical alphabet 2, n. 14 (2 dicembre 2019): 23–26. http://dx.doi.org/10.33667/2078-5631-2019-2-14(389)-23-26.

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Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) with severe psycho-emotional disorders. The frequency of occurrence of PMDD in women of the reproductive period of the Russian Federation is estimated at an average of 15.6 %. The development of PMDD is based on the individual sensitivity of neurotransmitters and neuropeptides to fluctuations in the levels of sex steroid hormones of the ovulatory menstrual cycle, therefore, hormone therapy drugs are used for PMDD therapy — combined oral contraceptives (COC) that suppress ovulation.The purpose of this study was to evaluate the effectiveness of COC containing drospirenone in the treatment of PMDD.Materials and methods. 78 women of the reproductive period underwent a comprehensive examination and treatment of PMDD symptoms with contraceptives containing 30 mg of ethinyl estradiol and 3 mg of drospirenone (Midian).Results of the study. The age of patients with PMDD averaged 33.7 years; 55 % of women were between 25–34 years old; 97 % needed contraception; all women represented in the group had higher education, normal menstrual function and body mass index. After 3 months of treatment, there was a statistically significant decrease in pain of various localization, problems with appetite, difficulties in communicating with others, sleep disturbances, and an increase in productivity at work, at home and in school. After 6 months of treatment, COC psycho-emotional symptoms, such as depression, anger, irritation, emotional lability, anxiety, tension, loss of control, significantly regressed, while the effectiveness of therapy reached 50 % relative to the original background. Physical symptoms of PMS, such as swelling of the mammary glands, pain of various locations, sleep disturbances, were stopped on average by 70 %.Conclusions. COC containing drospirenone can be used to treat severe premenstrual syndrome, i. e. PMDD.

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Pennell, Page, e P. Voinescu. "Delivery of a Personalized Treatment Approach to Women with Epilepsy". Seminars in Neurology 37, n. 06 (dicembre 2017): 611–23. http://dx.doi.org/10.1055/s-0037-1608932.

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AbstractPersonalized treatment for women with epilepsy is essential, and requires thorough weighing of the risks and benefits of the initial diagnostic and therapeutic options chosen, with readjustments of the antiepileptic regimen throughout the patient's life.Approximately one-third of women with epilepsy have a catamenial pattern, and the most common pattern is an increase in seizure frequency in the perimenstrual phase. These women are also more likely to experience a decrease in seizure frequency during pregnancy and menopause. A good treatment option for catamenial epilepsy is still lacking.For contraception, an intrauterine device is currently the preferred choice. Prior to conception, it is advisable to review the known impact of different antiepileptic drugs on the developing fetus and to optimize the patient's treatment regimen. Pregnancy registries and observational studies have provided key data and continue to refine our understanding of the risks to the structural and cognitive development of the fetus of specific antiepileptic drugs, including polytherapies and newer medications. Different studies consistently report that valproic acid has notably high relative risks for congenital malformations, lower IQ, and features of autism. During pregnancy, there is growing evidence that therapeutic dose monitoring is beneficial for seizure control. Counseling about seizure safety and minimizing provoking factors during the peripartum period is important for the patient with epilepsy.Clinical studies continue to investigate the complex relationship between cycling sex steroid hormones, epilepsy, and antiepileptic medications, with hopes to better explain drug clearance changes during pregnancy, changes in seizure frequency, and neuroendocrine abnormalities. Thorough understanding of these key factors and a continuous review of literature for updated data on different treatment options will enable optimal treatment recommendations that will improve the health of women with epilepsy and their children.

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Pauli, Samuel A., Hongyan Tang, Jeff Wang, Peter Bohlen, Robert Posser, Tipton Hartman, Mark V. Sauer, Jan Kitajewski e Ralf C. Zimmermann. "The Vascular Endothelial Growth Factor (VEGF)/VEGF Receptor 2 Pathway Is Critical for Blood Vessel Survival in Corpora Lutea of Pregnancy in the Rodent". Endocrinology 146, n. 3 (1 marzo 2005): 1301–11. http://dx.doi.org/10.1210/en.2004-0765.

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The vascular endothelial growth factor (VEGF)/VEGF receptor 2 (VEGFR-2) pathway regulates proliferation, survival, and permeability of vasculature. This pathway is active during the formation of a corpus luteum, a highly vascularized, endocrine organ with a short life span during the nonpregnant state. In the pregnant state, the life span of corpora lutea is much longer because they play a critical role in supporting pregnancy development. We hypothesized that the VEGF/VEGFR-2 pathway plays a critical role in regulating angiogenic events in the corpora lutea of pregnancy. Injection of the neutralizing anti-VEGFR-2 antibody DC101 (ImClone Systems, Inc., New York, NY) on embryonic d 3.5 (preimplantation) or 6.5 (postimplantation) disrupts function of the corpora lutea of pregnancy in CD1 mice, as evidenced by a decrease in organ size, regression of luteal vessels, and a fall in progesterone secretion within 24 h postinjection. Inhibition of the VEGFR-2 caused removal of endothelial cells, mostly through endothelial cell detachment from the vascular basement membrane. Luteal steroid-producing epithelial cells were eliminated through apoptosis secondary to vasculature becoming dysfunctional. Disruption of luteal function caused arrest of embryonic development. The effect of antibody is specific to the ovary, because pregnancy progresses normally in ovariectomized, progesterone-replaced animals treated with anti-VEGFR-2 antibody. Embryonic blood vessels were not affected directly by the antibody, because it did not reach the embryo. Administration of an antibody against VE-cadherin (E4G10), which specifically blocks endothelial proliferation, did not disrupt luteal function and pregnancy development. Thus, VEGFR-2-mediated endothelial cell signals are critical to maintain functionality of luteal blood vessels during pregnancy. Potential clinical applications of inhibitors of the VEGF/VEGFR-2 pathway include emergency contraception and medical treatment of ectopic and abnormal intrauterine pregnancies.

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Pardthaisong, Tieng, Ronald H. Gray, Edwin B. McDaniel e Arida Chandacham. "Steroid contraceptive use and pregnancy outcome". Teratology 38, n. 1 (luglio 1988): 51–58. http://dx.doi.org/10.1002/tera.1420380108.

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D'Arcy, P. F. "Drug Interactions with Oral Contraceptives". Drug Intelligence & Clinical Pharmacy 20, n. 5 (maggio 1986): 353–62. http://dx.doi.org/10.1177/106002808602000504.

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In the very rare cases where a pregnancy occurs during oral contraceptive use, the blame is usually laid against the patient for having forgotten to take the pill. Evidence has started to accumulate to suggest that neither the patient nor the pill is at fault in some contraceptive failures. It may be because the patient is taking other medicines and these may be preventing the pill from suppressing ovulation. Most drug interactions reducing or negating contraceptive activity are due to concomitant use of drugs having microsomal enzyme-inducing activity (e.g., some antibiotics, especially rifampicin, and anticonvulsants, including phenobarbital, Phenytoin, and primidone. Other antibiotics (e.g., tetracycline) may also interact by interruption of the enterohepatic circulation of contraceptive steroids. Less well appreciated, oral contraceptive steroids may themselves modify the metabolism and pharmacological activity of various other drugs (e.g., anticoagulants, benzodiazepines, β-blockers, caffeine, corticosteroids, and tricyclic antidepressants); in this respect the oral contraceptives are acting as enzyme inhibitors. Contraceptive steroids may also interact with drugs that cause enzyme inhibition and this delays the metabolism of the hormonal agents. Interactions of this type would be expected to potentiate the action of the contraceptive steroids. It is suggested that the effects of such interaction might be presented in terms of increased incidence of side effects, including water retention, diabetogenic effects, hypertension, and an increased risk of thromboembolic disorders. The spectrum of interactions with oral contraceptives is presented in three tables.

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Stavrakakis, Christophe, Ronan Colin, Valrie Hquet, Catherine Faur e Pierre Le Cloirec. "Development and Statistical Validation of a Quantitative Method for the Determination of Steroid Hormones in Environmental Water by Column Liquid Chromatography/Tandem Mass Spectrometry". Journal of AOAC INTERNATIONAL 91, n. 1 (1 gennaio 2008): 237–46. http://dx.doi.org/10.1093/jaoac/91.1.237.

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Abstract This paper presents an analytical method applied to the determination of 3 natural steroid hormones, estrone, 17 -estradiol, and 16 -hydroxyestrone, and the contraceptive estrogen, 17 -ethynylestradiol, at the sub-ng/L level in water samples [surface water and wastewater treatment plant (WWTP) samples]. The solid-phase extraction conditions were optimized using C18 cartridges. Identification and quantification were performed using a column liquid chromatographic/tandem mass spectrometric system with electrospray ionization in the negative mode. Before analyzing steroids in complex matrixes, statistical tools permitted a fine validation of the analytical method, and performance was evaluated for spring water in terms of recovery, specificity, trueness, repeatability, and intralaboratory reproducibility. The results showed the accuracy of the method, and limits of detection (LOD) ranged between 0.02 and 0.21 ng/L. The determination of steroids in WWTP effluents, which contain high levels of organic matter, required an additional purification step on silica cartridges. The high efficiency of the purification was proved with LOD <0.3 ng/L from 200 mL sample. Specificity of the entire analytical procedure was shown by repeatable recoveries at low and high levels of the calibration range.

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Shenfield, Gillian M., e Judith M. Griffin. "Clinical Pharmacokinetics of Contraceptive Steroids". Clinical Pharmacokinetics 20, n. 1 (gennaio 1991): 15–37. http://dx.doi.org/10.2165/00003088-199120010-00002.

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