Endocrinology Vol. 143, No. 1 222-227
Copyright © 2002 by The Endocrine Society
Glucocorticoids and Progesterone Prevent Apoptosis in the Lactating Rat Mammary Gland
Melissa N. Berg,
Arun M. Dharmarajan and
Brendan J. Waddell
Department of Anatomy and Human Biology, The University of Western
Australia, Crawley, Perth, Western Australia 6009
Address all correspondence and requests for reprints to: Dr. Brendan Waddell, Department of Anatomy and Human Biology, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009. E-mail: bwaddell{at}anhb.uwa.edu.au
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Abstract
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Apoptosis, a form of noninflammatory cell death, plays a
central role in mammary gland involution after weaning. Previous
studies have shown that apoptosis in the postweaning mammary gland is
substantially reduced by treatment with glucocorticoids or
progesterone, but whether these steroids exert a similar antiapoptotic
effect during normal lactation is not known. Therefore, the present
study used an in vivo rat model to assess the
effects of progesterone and glucocorticoids on apoptosis in the
lactating mammary gland. Rats were untreated, sham operated,
ovariectomized (OVX), and/or adrenalectomized (ADX) on d 10 of
lactation. Additional groups of OVX/ADX rats were treated with either
progesterone or corticosterone. Mammary gland apoptosis was
determined 3 d later by 3'-end labeling of fragmented DNA and by
in situ terminal deoxynucleotidyl
transferase-mediated deoxyuridine triphosphate biotin nick end
labeling analysis (TUNEL). DNA fragmentation was relatively low
in the mammary gland from untreated and sham-operated rats and was
unaffected by either ADX or OVX alone. In contrast, DNA fragmentation
was markedly elevated in OVX/ADX rats (P < 0.01),
but this effect on mammary gland apoptosis was prevented by replacement
with either corticosterone or progesterone. Consistent with these data,
dying cells identified by TUNEL analysis were readily observed in the
alveolar epithelium of mammary tissue from OVX/ADX rats but not in any
of the other groups. These data demonstrate that during normal
lactation, mammary gland apoptosis is inhibited by endogenous
progesterone and glucocorticoids. Importantly, the presence of either
steroid alone was sufficient to prevent apoptosis, suggesting that
their antiapoptotic effects in the lactating mammary gland may be
mediated via similar signaling pathways.
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Introduction
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APOPTOSIS IS A form of noninflammatory,
programmed cell death and plays a central role in mammary gland
involution after weaning (1, 2, 3). The mammary epithelium
terminally differentiates in pregnancy, becomes fully functional under
the influence of lactogenic hormones, and as such is committed to
apoptosis after weaning as part of the involution process
(4). Several factors may play a role in apoptosis
induction during involution, including falls in the levels of systemic
hormones, such as glucocorticoids, and local modulators of lactation
(5) including the physical effects of milk engorgement
(6). Feng et al. (7) have shown
that during the postweaning period, glucocorticoid replacement reduces
the extent of mammary gland apoptosis, but it is not clear whether this
antiapoptotic effect also occurs in the presence of the suckling
stimulus. Such an antiapoptotic action of glucocorticoids during
lactation would be additional to their well-recognized role as
stimulators of milk protein synthesis (8). Progesterone
administration also reduces apoptosis in the postweaning mammary gland
(7), but it is not clear whether progesterone is
antiapoptotic in the lactating mammary gland. Indeed, it is unclear
what role progesterone plays in supporting mammary gland function in
lactation (8). This is despite plasma progesterone levels
during lactation in the rat being comparable to maximal levels in
pregnancy (9). Therefore, the present study examined the
possibility that progesterone and glucocorticoids both serve to limit
mammary gland apoptosis during lactation. This involved measurement of
mammary gland apoptosis by both 3'-end labeling and in situ
analysis (terminal deoxynucleotidyl transferase-mediated deoxyuridine
triphosphate biotin nick end labeling [TUNEL]) after removal
of endogenous progesterone (by ovariectomy) and/or glucocorticoids
(by adrenalectomy).
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Materials and Methods
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Reagents and animals
Corticosterone, progesterone, and bovine
-globulin were
obtained from Sigma (St. Louis, MO). Corticosterone
antiserum (B3-163) was obtained from Endocrine Sciences, Inc. Products (Calabasas, CA).
[1,2,6,7-3H]Corticosterone and
[
-32P]dideoxy-ATP were obtained from
Amersham Pharmacia Biotech Australia (Sydney,
Australia).
Mature nulliparous Wistar rats were obtained from the Animal Resource
Center (Murdoch, Australia) and housed as previously described
(10). Rats were mated overnight and the morning on which a
cervical plug was found was designated as d 1 of pregnancy. In this
colony parturition usually occurs in the morning of d 23. Pregnant rats
were transferred to separate cages 34 d before expected delivery, and
the day of delivery was designated d 0 of lactation. All litters were
standardized to 10 pups within 3 d of birth. All procedures
involving animals were conducted after approval by the Animal Ethics
Committee of The University of Western Australia.
Experimental groups
Mammary gland apoptosis was assessed at d 13 of lactation in
control, sham-operated, and 5 treated groups of rats (total of 7
groups, n = 56 each). Treatments involved adrenalectomy and/or
ovariectomy (11), with or without steroid replacement.
Specifically, adrenalectomy was performed at d 10 of lactation to
remove endogenous corticosterone (ADX group). To reduce endogenous
progesterone, rats were either ovariectomized (OVX) or ovariectomized
and adrenalectomized (OVX/ADX) at d 10 of lactation. Two additional
OVX/ADX groups received replacement of either progesterone (twice
daily, 0.3-ml sc injections of 10 mg/ml progesterone in peanut oil) or
corticosterone (100 µg/ml of corticosterone administered in drinking
water) over d 1013 of lactation.
Surgical interventions
Ovariectomy and/or adrenalectomy were performed via two
dorsolateral incisions under halothane/nitrous oxide anesthesia in the
morning of d 10 of lactation (11). Pups were placed on a
warming pad when separated from their mothers (maximum time of
separation was 45 min). Saline (0.9% NaCl wt/vol) was provided to all
ADX and OVX/ADX rats for drinking ad libitum. Ovariectomy
and adrenalectomy was also carried out in two additional female rats
that were implanted with chronic carotid cannulas for subsequent blood
sampling as previously described (11). These rats received
corticosterone in drinking water as described above, and 72 h
later blood samples (
0.2 ml each) were obtained via the cannula at
3-h intervals for 24 h. These rats were briefly anesthetized with
halothane/nitrous oxide for blood collection, and the cannula was
flushed with heparinized saline (20 IU/ml) after each sample.
Tissue collection and fixation
Mammary tissue from the three left inguinal glands was collected
on the morning of d 13 of lactation (72 h after surgery) and a portion
was snap frozen and stored at -70 C until DNA extraction and
subsequent analysis of DNA fragmentation (12). A portion
of mammary tissue was also immersed in 4% paraformaldehyde in PBS pH
7.4 (13.6 mM NaCl, 2.7 mM KCl, 10.1
mM Na2HPO4, and
1.8 mM KH2PO4),
rotated at 4 C for 1620 h, and then processed for routine paraffin
histology. In addition, blood was collected from the dorsal aorta,
centrifuged at 13,000 x g for 5 min, and plasma collected
and stored at -20 C until analysis of corticosterone and progesterone
concentrations.
Hormone analysis
Plasma progesterone concentrations were determined using a
commercial RIA kit (Coat-a-Count, Diagnostic Products Corp., Los Angeles, CA), and plasma corticosterone levels were
determined by RIA as previously described (10, 13).
Briefly, samples were diluted in assay buffer (0.9% (wt/vol) NaCl,
0.01% bovine
-globulin, 0.01% sodium azide), heat inactivated at
6570 C for 30 min to remove corticosteroid binding globulin activity,
and then incubated at 4 C for 2 h with
[3H]corticosterone and corticosterone antiserum
(final dilution 1:128,000). Free and bound steroids were separated by
incubation with 0.25% charcoal at 4 C for 10 min and radioactivity
determined by liquid scintillation spectrophotometry.
Extraction and analysis of DNA for internucleosomal
cleavage
Genomic DNA was extracted from mammary tissue as previously
described (12, 14). Briefly, the tissue was homogenized
and protein extracted by a series of phenol/chloroform/isoamylalcohol
extractions. The concentration of DNA was determined by
spectrophotometry, and 1 µg DNA from each sample was
labeled on 3'-ends with [
-32P]dideoxy-ATP
(3000 Ci/mmol) using the terminal transferase reaction previously
described (12, 14). DNA fragments of radiolabeled samples
were separated on 2% agarose gels in TAE buffer (Tris-acetate/EDTA)
for 3 h at 60 V. The gels were dried for 2 h without heat and
exposed to X-Omat films (Kodak, Rochester, NY) for
48 h at -70 C. The extent of internucleosomal DNA fragmentation
was measured by the incorporation of
[
-32P]dideoxy-ATP onto the 3'-ends of low
molecular weight (<20 kB) fragments. This was quantified by excising
lowmolecular-weight bands and measuring emissions by liquid
scintillation spectrophotometry.
In situ cell death detection using the TUNEL assay
Cell death was localized in tissue sections by TUNEL
analysis (15). Paraffin tissue sections (4 µm) were
dewaxed by incubation at 60 C for 30 min and washed twice for 5 min in
toluene. Sections were hydrated through a graded series of ethanol and
PBS and then incubated with proteinase K (20 µg/ml in PBS) for 30 min
at 37 C. Thereafter, an Apoptag Plus Peroxidase in situ
apoptosis detection kit (Intergen Discovery Products,
Purchase, NY) was used for nick-end labeling according to the
manufacturers instructions. Nuclei with DNA cleavage were visualized
with DAB (3,3'-diaminobenzidine tetrahydrochloride) and sections were
counterstained with methyl green. Postweaning mammary tissue was
included as a positive control.
Statistical analysis
Treatment effects on plasma steroid concentrations and DNA
fragmentation were assessed by one-way ANOVA. When the F test was
significant (P < 0.05), specific between-group
differences were assessed by least significant differences (LSD)
tests.
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Results
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Plasma steroid concentrations
Plasma progesterone concentrations on d 13 were dramatically
reduced by ovariectomy 3 d earlier (Fig. 1
) and were even lower (P
= 0.02, unpaired t test, see inset in Fig. 1
) in
the OVX/ADX group. Progesterone replacement to OVX/ADX rats raised
plasma levels to about 50% of sham-operated animals. Plasma
corticosterone concentrations on d 13 of lactation were almost
negligible following adrenalectomy on d 10 (Fig.
2), and were partially restored
(P < 0.05) in rats administered corticosterone in
drinking water (see inset in Fig. 2
). To assess whether the
relatively low levels of plasma corticosterone observed after
corticosterone replacement were owing to rats drinking only in the dark
phase of the light cycle, plasma corticosterone levels were measured in
samples obtained from two additional OVX/ADX rats at 3-h intervals over
a 24-h period during corticosterone replacement. Plasma corticosterone
levels were again very low in these animals at 1000 h (11 and 5
ng/ml, respectively) but reached maximal levels of 85 and 96 ng/ml,
respectively, during the dark phase of the light cycle.

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Figure 1. Plasma progesterone concentrations on d 13 of
lactation in control, sham, OVX, ADX, and OVX/ADX rats with or without
corticosterone (Cort) or progesterone (P4) replacement. Values are the
mean ± SEM. There was significant variation among
means (P < 0.001, one-way ANOVA) and for specific
group comparisons, those values without common notations (a, b, or c)
differ significantly (P < 0.05, LSD test).
Inset shows plasma progesterone concentrations on a
reduced scale for OVX and OVX/ADX groups (*, P =
0.02, compared with OVX group, unpaired t test).
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Figure 2. Plasma corticosterone concentrations on d 13 of
lactation in control, sham, OVX, ADX, and OVX/ADX rats with or without
corticosterone (Cort) or progesterone (P4) replacement. Values are the
mean ± SEM. There was significant variation among
means (P < 0.001, one-way ANOVA) and for specific
group comparisons, those values without common notations (a or b)
differ significantly (P < 0.001, LSD test).
Inset shows plasma corticosterone concentrations on a
reduced scale for ADX and OVX/ADX ± corticosterone replacement
groups (*, P < 0.05, compared with the ADX and
OVX/ADX groups, one-way ANOVA, and LSD test).
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Quantitation of DNA fragmentation by 3'-end labeling
DNA fragmentation into 180-bp multiples was clearly evident in
mammary tissue from 2-d postweaning and OVX/ADX rats but not in tissue
from control, sham-operated, OVX or ADX rats (Fig. 3A
). In contrast, mammary tissue from
OVX/ADX rats showed a high level of DNA fragmentation, but this was not
evident in OVX/ADX rats given either progesterone or corticosterone
replacement. This overall pattern of DNA fragmentation was confirmed by
quantitative analysis of 3'-end-labeled low-molecular-weight DNA
fragments, which showed clearly elevated fragmentation in the OVX/ADX
rats, compared with all other groups (P < 0.01; Fig. 3B
).

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Figure 3. DNA fragmentation in mammary on d 13 of lactation
in control, sham, OVX, ADX, and OVX/ADX rats with or without
corticosterone (Cort) or progesterone (P4) replacement. A shows a
representative autoradiograph of 3'-end DNA labeling, including a 2-d
postweaning mammary gland as a positive control, and B shows
quantitation of DNA fragmentation. Values are mean ±
SEM. Those values without common notations (a or b) differ
significantly (P < 0.01, one-way ANOVA and LSD
test).
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In situ cell death detection by TUNEL analysis
Dying cells identified by TUNEL analysis were rarely observed in
sections of mammary tissue from control (Fig. 4A
), sham-operated, OVX, and ADX rats. In
contrast, TUNEL-positive cells were readily apparent in the alveolar
epithelium of mammary tissue from OVX/ADX rats (Fig. 4B
), comparable to
that observed in the postweaning mammary gland (not shown).
Administration of either corticosterone or progesterone to OVX/ADX
rats, however, prevented this increase in alveolar epithelial cell
death (Fig. 4
, C and D).

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Figure 4. TUNEL analysis of rat mammary gland sections from
control lactating (A), OVX/ADX lactating (B), OVX/ADX lactating with
corticosterone replacement (C), and OVX/ADX lactating with progesterone
replacement (D). Examples of TUNEL-positive cells are
arrowed. Scale bars, 200 µm.
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Discussion
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This study investigated the role of glucocorticoids and
progesterone in the prevention of apoptosis in the rat mammary gland
during lactation. Removal of both glucocorticoids and progesterone by
concurrent ovariectomy and adrenalectomy was shown to induce apoptosis,
primarily in the secretory epithelium, but this effect was reversed
after replacement of either progesterone or corticosterone alone. These
findings demonstrate that corticosterone and progesterone suppress
mammary gland apoptosis in the presence of the normal suckling stimulus
during lactation. Moreover, our data indicate that either steroid alone
is sufficient to exert an antiapoptotic effect in the lactating mammary
gland.
Inhibition of apoptosis in the lactating mammary gland by either
progesterone or glucocorticoids is consistent with previous reports
showing that either steroid was sufficient to inhibit apoptosis in the
postweaning mammary gland (7). But these antiapoptotic
steroid effects are complicated by the absence of the suckling stimulus
in the postweaning period and the associated milk stasis, which in
itself has been shown to induce apoptosis even in the presence of
normal systemic lactogenic hormone support (16). Our
observations show that glucocorticoids and progesterone are important
physiological inhibitors of apoptosis in the presence of the normal
suckling stimulus.
Although it is well recognized that glucocorticoids promote
lactogenesis and the maintenance of lactation by stimulation of milk
protein synthesis (8), the present study demonstrates
that, in addition, glucocorticoids support lactation via an
antiapoptotic mechanism. Interestingly, this effect of glucocorticoids
is contrary to their well-recognized proapoptotic effects in the
immune system (17). Progesterone is also known to provide
an important stimulus for mammary gland development during pregnancy,
but the periparturient decline in progesterone provides an important
stimulus to lactogenesis (8). Thereafter, plasma
progesterone concentrations gradually increase owing to the corpora
lutea of lactation, reaching a maximum of more than 100 ng/ml on d 12
of lactation (9), comparable to maximal levels observed
during pregnancy. Our results suggest that inhibition of mammary gland
apoptosis may be a key role for this progesterone in lactation.
Although corticosterone replacement in OVX/ADX rats clearly prevented
apoptosis, plasma corticosterone in these animals was only marginally
elevated, compared with untreated OVX/ADX rats. Although this may
indicate that apoptosis prevention requires only minimal
corticosterone, it is more likely that plasma levels were considerably
higher during the dark phase, when rats are most active and drinking,
than at the time of sample collection (i.e., midmorning).
This is supported by our observation that in chronically cannulated
OVX/ADX rats given corticosterone replacement via drinking water,
plasma corticosterone levels were very low (<20 ng/ml) throughout the
day but peaked at relatively high levels (>80 ng/ml) during the dark
phase of the light cycle. These observations are consistent with
previous studies showing that corticosterone in drinking water elevates
plasma corticosterone levels in ADX rats only during the active phase
and thus partly mimics the normal physiological circadian rhythm
(18).
Progesterone replacement also effectively prevented apoptosis in
OVX/ADX rats, even though plasma levels reached only around 50% of
those in control animals. Interestingly, plasma progesterone
concentrations were significantly lower in OVX/ADX rats, compared with
OVX rats, indicative of adrenocortical progesterone secretion during
lactation. This extends previous observations in the pregnant rat, in
which adrenals were shown to secrete a substantial proportion of
circulating progesterone, particularly under conditions of stress
(11).
The mechanism/s by which progesterone and glucocorticoids inhibit
apoptosis during lactation are unknown, but both steroids may act via
the GR. Recent studies in the rat corpus luteum show that progesterone
and glucocorticoids both suppress 20
-hydroxysteroid dehydogenase
expression via the GR (19), consistent with previous
reports showing progesterone binding to the GR (20).
Alternatively, progesterone may act via its own receptor (PR), but
there is some uncertainty as to whether the PR is expressed in the rat
mammary gland during lactation (21). Regardless of which
specific receptor is involved, activation of either GR or PR may
prevent mammary gland apoptosis by functional inhibition of
proapoptotic transcription factors including AP-1. Feng et
al. (7) previously demonstrated that dexamethasone
inhibits the expression of AP-1-dependent genes in the postweaning
mammary gland and proposed this as one of the mechanisms for the
antiapoptotic effect of dexamethasone. Whether this pathway mediates
the effects of glucocorticoids and progesterone in the lactating
mammary gland awaits further study.
In conclusion, apoptosis was induced in the lactating mammary gland
after removal of both glucocorticoids and progesterone, but the
presence of either steroid alone prevented this effect. Accordingly,
replacement with either glucocorticoid or progesterone alone in ADX and
OVX lactating rats prevented the induction of mammary gland apoptosis.
Our data show that either steroid alone is sufficient to prevent
apoptosis in the lactating mammary gland and thus suggest a degree of
redundancy in the mechanisms of steroid support for lactation.
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Acknowledgments
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The authors are grateful to Mr. Steve Parkinson for technical
assistance and Mr. Tony Felton for expert animal care.
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Footnotes
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This study was supported by the Raine Medical Research Foundation (to
A.M.D.), The Australian Research Council (to A.M.D. and B.J.W.), and
National Health and Medical Research Council of Australia (to B.J.W.).
M.N.B. supported by a University of Western Australia Postgraduate
Scholarship and a Richard Walter Gibbon Supplementary Scholarship
(UWA).
Abbreviations: ADX, Adrenalectomized; LSD, least significant
differences; OVX, ovariectomized; OVX/ADX, ovariectomized and
adrenalectomized; TUNEL, terminal deoxynucleotidyl transferase-mediated
deoxyuridine triphosphate biotin nick end labeling.
Received May 15, 2001.
Accepted for publication September 19, 2001.
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