Introduction Epidemiologic data supporting the role of organochlorine pesticides in pubertal development are limited. Methods Using a nested case-control design, serum collected during pregnancy from mothers of 218 girls who reported menarche before 11.5 years of age (cases) and 230 girls who reported menarche at or after 11.5 years of age (controls) was analyzed for 9 organochlorines and metabolites. We analyzed the association between in utero organochlorine concentrations and early menarche using multivariate logistic regression controlling for mother's age at menarche, or mother's prenatal BMI. Results We did not observe an association between in utero exposure to HCB, β-HCH, ϒ-HCH, p,p′-DDT, p,p′-DDE, oxychlordane or trans-nonachlor and early menarche. Conclusions This study is the first to examine the association between in utero exposure to HCB, β-HCH, ϒ-HCH, oxychlordane or trans-nonachlor and early menarche. In utero exposure to organochlorine pesticides does not appear to have a role in the timing of menarche in this study.

The incidence of DM is 9.6% in the USA with its prevalence increasing globally (NIDDKD, 2005). A common, but under-recognized complication of DM is hearing difficulty (~ 93%). However, the nature of this often sub-clinical dysfunction is still poorly understood. The aim of this study is to better understand DM-related hearing loss.

Patients with diabetes and multivessel coronary artery disease treated with multivessel percutaneous coronary intervention (MVPCI) have higher mortality, non-fatal myocardial infarction and repeat revascularization rates compared to coronary artery bypass graft surgery (CABG). This is also associated with high hospital costs. The objective of our study was to assess and compare the proportions and trends 2016 Appalachian Student Research Forum Page 83 of MVPCI in diabetic and all PCI patients and the total charges associated with them. Data were retrieved from nationwide inpatient sample from 2006-2011, which is a 20% stratified probability sample of discharges in all community hospitals participating in Healthcare Cost and Utilization Project. International Classification of Diseases 9 codes were used to identify diabetic patients who underwent percutaneous coronary intervention with stents in two or more vessels. Patients with a history CABG surgery, cardiac transplant and those who were below 18 years of age were excluded from this study. Bivariate analyses were computed for demographics and various diagnosis and procedures. Trends were computed for the proportions of diabetic and all patients that received stents in single, 2 or more and 3 or more vessels and for total charges for the 24 quarters. Between 2006 and 2011, a total of 145,349 diabetic patients underwent single vessel PCI with a mean age of 63.96 ± 11.70, 40.9% females and 59.1% males. 41,325 diabetic patients underwent = 2 vessels PCI, mean age 64.63 ± 11.64, 39.1% females and 60.9% males. 2,406 diabetic patients underwent = 3 vessels with a mean age of 64.92 ± 11.81 and 38.5% females and 61.5% males. The mean total charges for all single vessel PCI patients for the period was on a steady rise with a mean of $51,584.06 in the 1st quarter 2006 and $77,075.88 in the 24th quarter, 2011. Likewise, the trend for =2 vessel PCI group steadily increased from a mean of $61,089 to $91,937 and those for =3 vessel PCI group up from $73,532.08 to $105,364 through the period. For the diabetic PCI patients, charges associated with the single vessel PCI were on the upward trend with a mean of $53,217 in the 1st quarter to $81,040 in the 24th quarter. Similarly, the mean total charges associated with =2 vessel diabetic PCI group increased from $62,442 to $93,427 and from $78,401 to $110,015 for the =3 vessel diabetic PCI group across the period. There was a steady increase in the total charges for both single vessel and MVPCI procedures performed on diabetic and all patients between 2006 and 2011. The results of this study can be used to assess health care delivery cost and to inform policy to reduce cost.

PURPOSE: Pregnancy is a physically impactful process in a woman’s life. During this time, a woman will gain weight and research has shown that many women will retain some extra weight after delivery. Because of this, recovery in the postpartum period is pivotal to avoiding the implications of weight retention. The postpartum period is vastly understudied in both the research and medical communities and this gap between pregnancy and postpartum research needs to be bridged. Therefore, the purpose of this study was to investigate metabolic changes from pregnancy to postpartum and to study how factors such as sleep and breastfeeding can impact metabolic values in the postpartum period. METHODS: Women participated in a pregnancy study visit at 32-34 weeks of gestation (n = 25) and attended two subsequent visits at 4-6 months (n = 25) and 12-13 months postpartum (n = 16). At these visits, the women had a baseline blood draw and baseline metabolic measurements taken via indirect calorimetry. At the pregnancy visit, participants completed a demographic survey and a dietary questionnaire (DHQ-II). At the postpartum visits, they completed the same surveys, along with validated sleep and breastfeeding surveys. RESULTS: Absolute resting metabolic rate (RMR) was significantly higher during pregnancy than at 4-6 months postpartum and 12-13 months postpartum (p < 0.001 and p = 0.001, respectively). Accounting for body weight, relative RMR was significantly higher during pregnancy than at 4-6 months postpartum. With regard to sleep, women deemed to be “good sleepers” had a significantly higher relative RMR than those who were deemed “poor sleepers” (23.6 ± 2.5 vs 20.8 ± 2.3, p = 0.009). With regard to breastfeeding, women who breastfed had a relative RMR than the women who did not breastfeed (22.8 ± 2.6 vs 20.4 ± 2.3, p = 0.046). CONCLUSIONS: There are hypermetabolic changes that take place during pregnancy. These values seem to decrease into the postpartum period. Women who demonstrate an improved sleep quality and who opt to breastfeed tend to have improved metabolic responses. This could help combat the struggle with postpartum weight retention that some women face.

The progesterone receptor membrane component 1 (PGRMC1) is a multifunctional protein with a heme-binding domain that promotes cellular signaling via receptor trafficking, and is essential for some elements of tumor growth and metastasis. PGRMC1 is upregulated in breast, colon, lung and thyroid tumors. We expanded the analysis of PGRMC1 in the clinical setting, and report the first analysis of PGRMC1 in human oral cavity and ovarian tumors and found PGRMC1 to correlate with lung and ovarian cancer patient survival. Furthermore, we discovered a specific role for PGRMC1 in cancer stem cell viability. PGRMC1 directly associates with the epidermal growth factor (EGFR) in cancer cells, and we reviewed multiple signaling-associated pathways that are important in trafficking wild-type and mutant EGFR. To better understand the potential of PGRMC1 in receptor tyrosine kinase trafficking, we extended our research to the insulin receptor (IR). Changes in insulin signaling have been linked to multiple diseases, because IR plays a key role in glucose metabolism, cellular survival and proliferation. We found PGRMC1 to co-precipitate with IR in cancer cells and in an adipose model system. PGRMC1 increased IR plasma membrane levels in multiple cancer cell lines, and was also found to increase plasma membrane levels of two glucose transporters. Treatment with a PGRMC1 ligand significantly increased IR levels in human adipocytes. Moreover, we demonstrate that both insulin binding and glucose uptake are dependent on PGRMC1.

[Truncated abstract] The activity of the reproductive endocrine axis is the result of interactions among many organs and tissues, particularly the hypothalamus, pituitary gland and gonad. However, it depends on more than the communication between anatomical structures because it is also affected by genotype, internal factors (e.g., metabolic inputs) and external factors (e.g., photoperiod, socio-sexual cues, stress, nutrition). This multifactorial complexity makes it difficult to use animal experimentation to investigate the pathways and mechanisms involved. Therefore, in this study, I have turned to mathematical modelling. The general hypothesis was that, by modelling the hormonal feedback loop that links the hypothalamus, pituitary gland and gonad, I would be able to discover the critical control points in this homeostatic system. This would allow me to inform and direct research into the processes that control reproduction, including inputs from environmental factors. My studies began with the development of a model of the negative feedback loop through which testosterone controls the secretion of pulses of gonadotrophin-releasing hormone (GnRH) by the hypothalamus. The model incorporated two critical factors: testosterone concentration and a time delay in the inhibition of the activity of the GnRH 'pulse generator' by testosterone. The general assumptions were: i) there are two positive feedforward processes (GnRH pulses stimulate LH pulses, and, in turn, LH pulses stimulate testosterone secretion); ii) testosterone exerts negative feedback that reduces the frequency of GnRH pulses. The model incorporated a group of equations that represent the GnRH pulse generator, through which the inhibitory effect of testosterone acted to reduce GnRH pulse frequency. Simulations were run with various values for the time delay in feedback and, as model development progressed, the simulations were extended to include combinations of time delays and levels of sensitivity of the GnRH pulse generator to inhibition by testosterone. The output of the simulations showed clearly that a time delay in negative feedback, as well as the concentration of testosterone, can greatly affect the frequency of GnRH pulses and the shape of the GnRH secretory profile. Importantly, the effect of the time delay depends on the sensitivity of the pulse generator to testosterone. In addition, the simulations suggested two additional components that might be involved in the control of the GnRH pulse generator: i) a delay in the rate of adaptation to a change in steroid feedback; and ii) a minimum pulse interval (maximum frequency). These studies iii therefore suggest that the regulation of the activity of the GnRH pulse generator, and thus the frequency and profile of GnRH and LH pulses, requires interactions among these four components. These interactions should be tested in animal experimentation. In the next stage, I extended the model so I could test whether the feedback delay might involve the process of aromatization in which testosterone is converted to oestradiol at brain level. ... This information can be used to direct future experimental studies that will help us to understand the factors that underlie the dynamic behaviour of the hypothalamic and pituitary systems that control reproduction.

The prepartum surge in fetal plasma cortisol, essential for the maturation of organs in mammals and the normal timing of parturition in some species, including sheep, may result from an increase in the molar ratio of adrenocorticotropin (ACTH) to pro-opiomelanocortin (POMC) in the fetal circulation. Related to this, the cleavage of POMC to ACTH by the enzyme, prohormone convertase 1 (PC1), may be influenced by corticotrophin releasing hormone (CRH) stimulation. Accumulating evidence suggests that the capacity of individual corticotrophs to process POMC to ACTH may vary and individual corticotrophs are differentially responsive to CRH. It is not known, however, if there are separate corticotroph subpopulations in the fetal sheep pituitary which can be identified by differential colocalisation of POMC, ACTH and the CRH receptor 1, CRHR₁, nor if changes in the relative proportions of such subpopulations play a role in the molecular mechanisms underlying the overall changes in pituitary function described previously during gestation and in response to suboptimal uterine environments. To investigate these hypotheses, it was first necessary to develop novel methods for the simultaneous immunohistochemical labelling of POMC, ACTH and CRHR₁ in individual cells on sections of fetal sheep pituitary. In addition, I developed and validated an automated method to categorise and count individual cells to increase the quantitative power of this study. Pituitary tissue was collected from control fetuses at 53-55 (n=6), 63-85 (n=6), 110 (n=4), 139-141 (n=4) and 144-145 (n=6) days gestation. Two animal models, known to alter pituitary function in the fetal sheep, were used to investigate corticotrophic adaptations to suboptimal uterine environments. For the maternal periconceptional undernutrition (PCUN) model, maternal feed was reduced to 70% of maintenance requirements from at least 45 days before to 7 days after mating and fetal tissues were collected at 53-55 days gestation (n=7). For the placental restriction (PR) model, the majority of the placental attachment sites were removed in five ewes before mating and fetal tissues were collected at 140 (n=4) and 144 (n=4) days gestation. Pituitary sections were simultaneously labelled with antisera raised against full length POMC, ACTH and CRHR₁ and the proportions of pituitary cells with combinations of antisera were quantified. Four subpopulations of corticotrophs were identified, which expressed either: POMC+ACTH+CRHR₁, ACTH+CRHR₁, POMC+ CRHR₁ or POMConly. There was a significant decrease in the proportion of pituitary cells expressing POMC+ACTH+CRHR₁ between 53-55 and 65-85 days gestation, before an increase at 110 days gestation and a further marked decrease between 139-141 and 144-145 days gestation. In fetuses from the PCUN group, the proportion of pituitary cells expressing POMC+ACTH+CRHR₁ in early gestation was reduced. PR resulted in a significantly higher proportion of corticotrophs expressing POMC+ACTH+CRHR₁ during the prepartum period. This work represents the discovery of the differential expression of POMC, ACTH and CRHR₁ in individual corticotrophs of the fetal sheep pituitary and the first insights into the pituitary adaptations to periconceptional nutrient restriction and placental restriction at the level of individual corticotrophs. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1337370 / Thesis (Ph.D.) -- University of Adelaide, School of Molecular and Biomedical Science, 2008

Autoimmune diseases occur when the immune system attacks and destroys healthy body tissue. Autoimmunity is known to cause a wide range of disorders, and is suspected to be responsible for many more. Most autoimmune disorders are chronic and cause severe morbidity for the patients, and are also costly for society. A majority of these disorders are today considered as complex diseases with incompletely known etiology. Hence, model systems for studying the pathogenesis of autoimmunity are important to unravel its causes. Autoimmune Polyendocrine Syndrome Type 1 (APS-1), (OMIM 240300), is a rare autoimmune disorder. Patients with APS-1 progressively develop multiple organ-specific autoimmune lesions involving both endocrine and non endocrine tissues. Typical autoimmune disease components in APS-1 are hypoparathyroidism, Addison’s disease, vitiligo, alopecia and type 1 diabetes. The gene preventing APS-1 has been identified and designated Autoimmune Regulator (AIRE). It has been shown that mutations of AIRE cause loss of tolerance to self-structures, resulting in organ-specific autoimmunity. Although APS-1 is a rare syndrome occurring mainly in genetically isolated populations, the disease components of APS-1 are, in isolated forms, not unusual in the general population and affect many patients. Hence, APS-1 is an attractive model disease for studies of molecular mechanisms underlying organ-specific autoimmunity. This thesis concerns investigations in which two novel autoantigens are identified in APS-1 and used in serological diagnosis of the disease. NALP5, is identified as a parathyroid autoantigen - an important finding since autoimmune hypoparathyroidism is one of the cardinal symptoms of APS-1. Additionally, KCNRG is identified as a bronchial autoantigen in APS-1 patients with respiratory symptoms. Finally, studies that compare the immune response in APS-1 patients and the mouse model for APS-1 are presented.

Background: Cardiovascular disease (CVD) is the leading cause of death among women in Sweden. The risk of CVD increases rapidly after the menopause. A major contributing factor may be the redistribution of adipose tissue, from the peripheral to central depots, associated with menopause. This change in body composition is commonly attributed to declining estrogen levels but may also be affected by tissue-specific alterations in exposure to other steroid hormones, notably glucocorticoids – mainly cortisol in humans. Indeed, adipose tissue-specific overexpression of the glucocorticoid-activating enzyme 11β-hydroxysteroid dehydrogenase type 1 (11βHSD1) induces central obesity, insulin resistance and hypertension in mice. Interestingly, estrogen may regulate this enzyme. The aim of this thesis was to investigate putative links between estrogen and glucocorticoid activation by 11βHSD1. Materials and Methods: 11βHSD1 expression and/or activity in adipose tissue and liver, and adipose estrogen receptor α and β (ERα and ERβ) gene expression, were investigated in lean pre- and postmenopausal women and ovariectomized rodents with and without estrogen supplementation. In lean women measures of 11βHSD1 were correlated to risk markers for CVD. The association between adipose 11βHSD1 and ER mRNA expression was investigated in both lean women and rats and in an additional cohort of obese premenopausal women. In vitro experiments with adipocyte cell lines were used to explore possible pathways for estrogen regulation of 11βHSD1. Results: Subcutaneous adipose tissue transcript levels and hepatic activity of 11βHSD1 were higher in postmenopausal vs. premenopausal women. In rodents, estrogen treatment to ovariectomized rats decreased visceral adipose tissue 11βHSD1, resulting in a shift towards higher subcutaneous (vs. visceral) 11βHSD1 mRNA expression/activity. Increased adipose and hepatic 11βHSD1 were associated with increased blood pressure and a disadvantageous blood lipid profile in humans. We found significant positive associations between 11βHSD1 and ERβ transcript levels in adipose tissue. The in vitro experiments showed upregulation of 11βHSD1 mRNA expression and activity with estrogen or ERβ-agonist treatment at low (corresponding to physiological) concentrations. Conclusions: Our studies show for the first time increased local tissue glucocorticoid activation with menopause/age in women. This may contribute to an increased risk of CVD. Estrogen treatment in rodents induces a shift in 11βHSD1 activity towards the subcutaneous adipose tissue depots, which may direct fat accumulation to this metabolically “safer” depot. The in vitro studies suggest that low-dose estrogen treatment upregulates 11βHSD1 via ERβ. In summary, estrogen - glucocorticoid metabolism interactions may be key in the development of menopause-related metabolic dysfunction and in part mediate the beneficial effects of postmenopausal estrogen treatment on body fat distribution.

It is generally thought that in amphibians, thyroid hormones (THs) regulate metamorphosis, while sex steroids (estrogens and androgens) regulate gonadal differentiation. However, inhibition of TH synthesis in frogs alters gonadal differentiation, suggesting instead that these two endocrine axes interact during development. Specifically, THs may be involved in male development, while estrogens may inhibit tadpole metamorphosis. However, we do not currently know the mechanisms that account for these interactions, let alone how such mechanisms may differ between species. To develop and test new hypotheses on the roles of sex steroids and THs, I first examined transcriptional profiles (mRNA) of enzymes and receptors related to sex steroids and THs during embryogenesis and metamorphosis in Silurana tropicalis. Tadpoles were exposed to either an estrogen synthesis inhibitor (fadrozole) or TH (triiodothyronine, T3) during early larval or tadpole development. Acute exposures of S. tropicalis to fadrozole or T3 during early development resulted in increased expression of androgen- and TH-related genes in whole body larvae, while chronic exposure to fadrozole during metamorphosis affected gonadal differentiation but did not affect tadpole development. On the other hand, acute exposure to T3 during metamorphosis increased the expression of androgen-related transcripts both in the brain and gonad. In S. tropicalis, the results suggested that cross-talk is primarily in one direction (i.e., effect of THs on the reproductive axis) with a strong relationship between TH and androgen status. Lastly, I established developmental transcript profiles and investigated T3 regulation of brain and gonad transcripts in Engystomops pustulosus. I then compared these results with S. tropicalis and an earlier study in Lithobates pipiens. While each species developed with similar profiles, they differed in their response to T3. Exposure to T3 resulted in either an increase in androgen-related genes (S. tropicalis) or a decrease in estrogen-related genes (E. pustulosus and L. pipiens). In conclusion, these data demonstrated that cross-talk mechanisms differ among these three evolutionary separate species, but in all cases, T3 appears to affect the balance of sex steroids, stimulating the androgen system and providing potential mechanisms of the masculinising effects of THs. These results will contribute to understanding the mechanisms of hormone interactions and their evolutionary basis in frogs.