Estrogen status

Davison S, Davis SR (2003) New markers for cardiovascular disease risk in women impact of endogenous estrogen status and exogenous postmenopausal hormone therapy. J Clin Endocrinol Metab 88 2470-2478... 

The vaginal-cervical epithelium system was therefore used to probe pcr in order to understand mechanisms that control and regulate / lis- Data summarized below suggest that both estrogen status and aging may critically affect the 7 lis of vaginal-cervical cells in women. 

When the cause of amenorrhea is unclear after the initial assessment, relative estrogen status should be determined. 

S. Beer, M. Reincke, M. Krai, S.Z. Lie, S. Stcinhaucr, H.H. Schmidt, B. Allolio and S. Neubauer, Susceptibility to cardiac ischemia /reprfusion injury is modulated by chronic estrogen status, J. Cardiovasc. Pharmacol. 40, 420-428 (2002). 

The measurement of ER has become a standard assay in the clinical management of breast cancer. The presence of ERa identifies those breast cancer patients with a lower risk of relapse and better clinical outcome. Receptor status also provides a guideline for those tumors that may be responsive to hormonal intervention. But only about half of ER-positive patients respond to hormonal therapies. Of those who respond initially, most will eventually develop an estrogen unresponsive disease following a period of treatment even though ERa is often still present. Mutant receptors and constitutively active r eceptors as well as hormone-independent activation of the ERa are discussed. The involvement of ER 3 isoforms is under investigation. 

Hormone-receptor status. Patients with negative-estrogen-receptor (ER) and negative-progesterone-receptor (PR) tumors have a worse prognosis. 

After a lipid abnormality is confirmed, major components of the evaluation are the history (including age, gender, and, if female, menstrual and estrogen replacement status), physical examination, and laboratory investigations. 

It is also important to note that, as happened with tamoxifen, this decrease in risk concentrated exclusively in ER(+) tumors. ER status was determined for 88 cases, and 75% of these were considered positive. The decrease in risk in-ducedby raloxifene administration during the total 8 years of MORE plus CORE reached 76% of the invasive ER(+) cases, compared with the placebo group (0.8 vs. 3.2 cases per 1000 woman-years HR=0.24 95% Cl = 0.15 to 0.40). There was no influence of the raloxifene treatment on the incidence of ER(-) invasive tumors (0.53 versus 0.51 cases per 1000 woman-years HR = 1.06 95% Cl = 0.43 to 2.59). This confirms the hypothesis that raloxifene exerts its protective effect through its binding to breast cell ERs, avoiding the proliferative effect of estrogens to take place. Consequently ER(-) tumors cannot be influenced by the presence of raloxifene in the blood, and no difference in its incidence should be expected between placebo and treated groups (Cauley et al. 2001) (Fig. 10.11). 

Age, calcium intake, hormonal status, exercise and vitamin status have all been implicated in the development of osteoporosis. Estrogen levels represent an important factor in skeletal calcium retention and homeostasis. In therapeutic trials in which post-menopausal women were given daily doses of estrogens, such therapy has been demonstrated to be partially effective in reducing the rate of bone resorption. However, this therapy has the concomitant hazard of endometrial cancer (10). Vitamin D and its hormones have been given considerable attention in the more recent studies. Without adequate dietary and tissue levels of such vitamins, calcium absorption and bone status will be impaired. 

Van Bogart, L. (1985) Present status of estrogen-receptor immunohistochemistry. 

Goulding, H., Finder, S., Cannon, P., Pearson, D., Nicholson, R., Snead, D., Bell, J., Elston, C. W., Robertson, J. E., Blarney, R. W., et al. (1995) A new immuno-histochemical antibody for the assessment of estrogen receptor status on routine formalin-fixed tissue samples. Hum. Pathol. 26, 291-294. 

---