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Medical Research Council Human Reproductive Sciences Unit, Center for Reproductive Biology, University of Edinburgh Academic Center (A.R., J.S.F., C.M., R.M.S.), Edinburgh, United Kingdom EH16 4SB; and Institute of Experimental Morphology and Anthropology, Bulgarian Academy of Science (N.A.), 1113 Sofia, Bulgaria
Address all correspondence and requests for reprints to: Dr. Richard M. Sharpe, Medical Research Council Human Reproductive Sciences Unit, Center for Reproductive Biology, 49 Little France Crescent, Old Dalkeith Road, University of Edinburgh Academic Center, Edinburgh, United Kingdom EH16 4SB. E-mail: r.sharpe{at}hrsu.mrc.ac.uk.
| Abstract |
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| Introduction |
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Our own studies have shown that neonatal treatment of male rats with relatively high doses of DES (10 µg) causes a range of reproductive tract abnormalities, including overgrowth/distension of the rete testis and reduced epithelial cell height in the efferent ducts, epididymis, vas deferens, seminal vesicles, and prostate coincident with relative overgrowth of stromal tissue at many of these sites (14, 15, 23, 24, 27). All of these DES-induced changes are associated with a loss of expression of AR in the affected tissues as well as in Sertoli cells in the testis (23, 24). Neonatal treatment with a 100-fold lower dose of DES (0.1 µg) or with environmental estrogens such as bisphenol-A or octylphenol do not induce these changes (23, 24, 27). These findings raised the possibility that the effects of the high dose (10 µg) of DES resulted not from its interaction with ERs, but instead from the parallel suppression of androgen production/action that this treatment also induced (23, 24). However, this conclusion could not be supported, as we were able to show that blockade of androgen production [GnRH antagonist (GnRHa)] or action (flutamide) by neonatal treatment could not reproduce the reproductive tract abnormalities that were induced by 10 µg DES (23, 24).
These findings led us to hypothesize that the changes induced by DES might stem from disturbance of the androgen-estrogen balance. To test this possibility, we coadministered testosterone esters (200 µg) with DES (10 µg) and showed that this combined treatment prevented DES induction of virtually all of the reproductive tract abnormalities as well as prevented the loss of AR expression (24). This was interpreted as evidence in support of the importance of the androgen-estrogen balance. However, a potential criticism of this experimental design was that the dose of testosterone esters administered resulted in supranormal levels of testosterone in vivo that would have accelerated maturational development of the reproductive tract. Theoretically, this change might protect the reproductive tract from the adverse effects of the high estrogen levels resulting from the 10-µg DES treatment. It was therefore reasoned that a more rigorous test of the androgen-estrogen balance hypothesis was to establish whether reproductive tract abnormalities could be induced by lowering androgen production or action in combination with administration of a dose of DES (0.1 µg) that was itself incapable of inducing the reproductive tract abnormalities. This was the aim of the present studies. The results obtained were compared with the major abnormalities induced by treatment with a 100-fold higher dose of DES (10 µg) on its own. To enable accurate comparison, abnormality end points were chosen that could be quantified and that included both anterior (rete, efferent ducts) and more distal (vas deferens) parts of the tract. Finally, as the present findings have implications for the study of endocrine disruptors, we also assessed whether substitution of 0.1 µg DES by the environmental estrogen bisphenol-A in combination with treatment to lower androgen production (GnRHa) was able to induce any effects.
| Materials and Methods |
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Rats from the various treatment groups described above were killed on d 15 or d 18, the age range during which DES-induced reproductive tract abnormalities are at their most prominent (15, 23, 28, 30). Animals were anesthetized with flurothane, and the right testis was dissected out, weighed, and fixed for about 5 h in Bouins fixative. The left testis was removed with the epididymis and proximal vas deferens still attached and similarly fixed.
After fixation, tissue was transferred into 70% ethanol before being processed for 17.5 h in an automated TP1050 processor (Leica Corp., Deerfield, IL) and embedded in paraffin wax. Sections of 5-µm thickness were cut, floated onto slides coated with 2% 3-aminopropyltriethoxy-silane (Sigma), and dried at 50 C overnight before being used for immunohistochemistry and/or image analysis as described below. All of the studies of the rete testis and reproductive tract described below used tissue sections of the left testis with the epididymis attached in order that minimal artifactual distortion was caused to the excurrent duct system.
Antibodies used for immunohistochemistry
Immunolocalisation of AR used a rabbit polyclonal antibody (Santa Cruz Biotechnology, Inc., Santa Cruz, CA) raised against an epitope at the N terminus of human AR and was used at a dilution of 1:200. ER
was immunolocalized using a mouse monoclonal antibody raised against a full-length human ER
recombinant protein (Novocastra, Newcastle upon Tyne, UK) and used at a dilution of 1:20. The specificity of the AR and ER
antibodies has been detailed in our previous studies (6, 24, 27).
Immunohistochemistry
Unless otherwise stated, all incubations were performed at room temperature. Sections were deparaffinized in Histoclear (National Diagnostics, Hull, UK), rehydrated in graded ethanols, and washed in water. At this stage, sections were subjected to a temperature-induced antigen retrieval step (31) in 0.01 M citrate buffer, pH 6.0 (for AR and ER
). After pressure cooking for 5 min at full pressure, sections were left to stand, undisturbed, for 20 min, then were cooled under running tap water before being washed twice (5 min each) in Tris-buffered saline (TBS: 0.05 M Tris-HCl, pH 7.4; and 0.85% NaCl). Endogenous peroxidase activity was blocked by immersing all sections in 3% (vol/vol) H2O2 in methanol (both from BDH Laboratory Supplies, Poole, UK) for 30 min, followed by two 5-min washes in TBS. To block nonspecific binding sites, sections were incubated for 30 min with the appropriate normal serum diluted 1:5 in TBS containing 5% BSA (Sigma). For AR, normal swine serum was used, and for ER
, normal rabbit serum was used (both from Scottish Antibody Production Unit, Carluke, Scotland, UK). Primary antibodies were added to the sections at the appropriate dilution in either normal swine serum/TBS/BSA (for AR) or normal rabbit serum/TBS/BSA (for ER
) and incubated overnight at 4 C in a humidified chamber. After two 5-min washes in TBS, sections were incubated with a secondary antibody, namely a 1:500 dilution in the appropriate blocking serum of biotinylated swine antirabbit IgG (DAKO Corp., High Wycombe, UK) in the case of AR or biotinylated rabbit antimouse IgG (DAKO Corp.) for ER. After two additional 5-min washes in TBS, all sections were incubated for 30 min with avidin-biotin conjugated to horseradish peroxidase (DAKO Corp.) diluted in 0.05 M Tris-HCl, pH 7.4, according to the manufacturers instructions. Sections were washed twice (5 min each time) in TBS, and immunostaining was developed using 0.05% 3,3'-diaminobenzidine (Sigma) in 0.05 M Tris-HCl, pH 7.4, containing 0.01% (vol/vol) H2O2 until staining in positive control tissues was optimal, when the reaction was stopped by immersing all sections in distilled water. All sections were then lightly counterstained with hematoxylin, dehydrated in graded ethanols, cleared in xylene, and coverslipped using Pertex mounting medium (CellPath plc, Hemel Hempstead, UK).
To ensure the reproducibility of findings, tissue sections from a minimum of three to six animals in each treatment group were evaluated; this was performed on at least two separate occasions, and similar results were obtained. Further confirmation was obtained by undertaking immunohistochemistry with tissue sections from control and treated animals on the same slide. The specificity of immunostaining was checked for each antibody using previously established procedures. This involved demonstrating that incubation of the primary antibody with either 10x (wt/wt) of the peptide immunogen (AR; peptide sc-816P, Santa Cruz Biotechnology, Inc.) or with the respective recombinant protein (ER
) (6, 24, 27) overnight at 4 C was able to block immunostaining.
Immunostained sections were examined and photographed using a Provis microscope (Olympus Corp., London, UK) fitted with a Kodak DCS330 camera (Eastman Kodak Co., Rochester, NY). Captured images were stored on a G4 computer (MacIntosh, Apple Computers, Cupertino, CA) and compiled using Photoshop 5.0 before being printed using an Epson Stylus 750 color printer (Seiko Epson Corp., Nagano, Japan).
Measurement of rete testis lumen area (rete testis distension)
Rete testis lumen area was quantified as a measure of rete testis distension/overgrowth. Sections immunostained for ER
as described above were used together with an Olympus Corp. BH2 microscope fitted with a x4 plan Achromat objective and a x3.3 phototube (Olympus Corp.). The image was captured using a SonyxC77CE video camera (Sony, Tokyo, Japan) linked to a personal computer with frame grabber and Image Pro image analysis software (Media Cybernetics, Silver Spring, MD). To ensure consistency regarding the cross-section of the rete testis that was measured, sections were chosen in which the region of the rete testis draining into the efferent ducts could be viewed in the plane of section. Using the count/size tool, the area was measured by drawing around the edges of the rete lumens as shown in Fig. 1
. The total rete area in the plane of sections was determined in at least three to six animals in each treatment group.
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as described above were used, and the quantification method used was similar to that described for rete testis lumen area, except that a x20 plan Achromat objective was used. Only round, symmetrical, efferent ductule cross-sections were selected for measurement to avoid errors due to plane of sectioning of individual ductules. Using the count/size tool, the edges of the lumen of individual ductules were drawn around, and the area was measured as shown in Fig. 1
Measurement of epithelial cell height
To determine whether neonatal treatment altered the height of epithelial cells in the efferent ducts and vas deferens, cross-sections from 315 rats from control and treated cohorts were evaluated using image analysis at each time point. Sections immunostained for ER
as described above were used. The height of the epithelial cells within the efferent ducts and vas deferens was measured using a x40 plan Achromat and x20 objective for the efferent ducts and vas deferens, respectively. Only round or oval cross-sections were selected for measurement. Using the length tool, the height of the epithelium was measured by drawing a line at right angles to the base of the cell adjacent from the basement membrane to the lumenal surface of the cell. After measuring the length, the angle of the line was measured to ensure that it was at 90°. For each animal, at least 24 cells were measured, with sampling from a number of different ductules, and the mean value then calculated for each animal.
Measurement of plasma testosterone levels
Plasma testosterone levels were measured using an ELISA adapted from an earlier RIA method (32). Plasma, to which was added trace amounts of [3H]testosterone (Amersham International, Little Chalfont, UK), was extracted twice with 10 vol hexane-ether (4:1, vol/vol), and the organic phase was dried down under N2 at 55 C. The efficiency of extraction averaged 75%. The second antibody was immobilized to an ELISA plate by addition of 100 µl acid purified donkey antigoat/sheep IgG (250350 mg/ml) diluted in 0.1 M sodium carbonate buffer, pH 9.6. The plate was sealed and incubated overnight at 4 C. The wells were then washed twice with 0.1% Tween 20 and incubated for 10 min at room temperature with 0.2 ml of the same solution to block nonspecific binding sites. Samples in duplicate (50 µl) were assayed after dilution in 0.1 M PBS, pH 7.4, containing 0.1% gelatin (Sigma) and incubated overnight at 4 C with 50 µl sheep antitestosterone-3-carboxymethyloxide-BSA diluted 1:100,000 plus 50 µl testosterone-3-carboxymethyloxide labeled with 1:20,000 diluted horseradish peroxide (Amdex, Amersham Pharmacia Biotech, Uppsala, Sweden). The plate was then washed several times with 0.1% Tween 20 before addition of 0.2 ml substrate (5 mM O-phenylenediamine; Sigma) and 0.03% hydrogen peroxide diluted in 0.1 M citrate-phosphate, pH 5.0, to each well. The plate was incubated in the dark for 1030 min until the color reaction was optimal. The reaction was stopped by the addition of 50 µl 2 M sulfuric acid to each well, and the OD was read at 492 nm in a plate reader. The limit of detection was 12 pg/ml, and the intraassay coefficient of variation was 8.3%. All samples were assayed together in one run.
Statistics
Comparison of the different parameters for the various treatment groups was made using ANOVA after logarithmic transformation of the data to obtain a normal distribution. Where significant differences between groups were indicated, subgroup comparisons also used ANOVA, but used the variance from the experiment as a whole (for that parameter) as the measure of error.
| Results |
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Efferent duct epithelial cell height
Day 15.
All treatments, with the exception of bisphenol-A, caused a significant reduction in epithelial cell height (Figs. 5
and 7
). The biggest reduction (56%) was caused by treatment with 10 µg DES. However, combined treatment with 0.1 µg DES and GnRHa induced a reduction in epithelial cell height of similar magnitude (52%) to that caused by 10 µg DES, and this was significantly greater (P < 0.01) than when either 0.1 µg DES (32% reduction) or GnRHa (32% reduction) was administered alone (Figs. 5
and 7
). In contrast, combined treatment with bisphenol-A and GnRHa (32% reduction) had no greater effect than did GnRHa administered alone (32% reduction; Fig. 7
).
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Epithelial cell height in the proximal vas deferens
Day 15.
All treatments, with the exception of bisphenol-A, caused a significant and similar reduction in epithelial cell height on d 15 compared with controls (Fig. 8
). Combined treatment with 0.1 µg DES plus GnRHa did not cause any greater reduction in epithelial cell height than either treatment given alone. Combined treatment with bisphenol-A and GnRHa had no greater effect than GnRHa administered alone (Fig. 8
).
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Immunoexpression of ER
in the efferent ducts
As reported previously (15, 33, 34), immunoexpression of ER
was constant and very intense in the efferent ducts in control animals on d 15 and 18, and none of the neonatal treatments had any detectable effect on immunoexpression of ER
(Fig. 5
).
Immunoexpression of AR
In control animals on d 15 and 18, there was intense immunoexpression of AR in the testis (not shown) and in epithelial and stromal cells of the efferent ducts (Fig. 9
) and epididymis (not shown). Treatment with 10 µg DES almost completely abolished AR immunoexpression at all of these sites (e.g. Fig. 9
). In contrast to these effects, blockage of androgen production (GnRHa) or action (flutamide) was without effect on AR immunoexpression in these tissues, except that the intensity of AR immunostaining in the testes of flutamide-treated animals was consistently slightly weaker than that in controls (not shown) (24). Neonatal treatment with 0.1 µg DES was without obvious effect on AR immunoexpression (e.g. Fig. 9
). In contrast, combined treatment with 0.1 µg DES and GnRHa or flutamide greatly reduced the intensity of AR immunoexpression in the efferent ducts (Fig. 9
), epididymis, and vas deferens (not shown) on d 15 and 18. The reduction in intensity of AR immunoexpression in these combined treatment groups was not as severe as that induced by treatment with 10 µg DES (e.g. Fig. 9
).
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| Discussion |
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The finding of key importance from the present study is the demonstration that combined treatment with a relatively low dose (0.1 µg) of DES plus treatments to either lower androgen production (GnRHa) or block androgen action (flutamide) was able to induce significantly greater distension of the rete testis or efferent ducts, as measured by lumenal area, than any of the treatments administered alone; of the latter, only 0.1 µg DES had any (minor) effect on its own. Although these contrasting effects were clear-cut, the use of another end point, epithelial cell height in the efferent ducts or proximal vas deferens, resulted in a more complex picture, as all single treatments other than bisphenol-A exerted significant adverse effects. In the efferent ducts it was still clear that combined treatment with 0.1 µg DES plus either GnRHa or flutamide was able to reduce epithelial cell height to a significantly greater extent than any of these treatments individually; indeed, the combined treatments caused an effect of similar magnitude to that induced by treatment with 10 µg DES alone. In contrast, several of the individual treatments (10 or 0.1 µg DES plus GnRHa) induced very similar effects on epithelial cell height in the proximal vas deferens, and combined treatment with 0.1 µg DES and either GnRHa or flutamide was unable to exacerbate this effect compared with administration of 0.1 µg DES or GnRHa alone. This suggests that more posterior parts of the reproductive tract, such as the vas deferens, may be more sensitive to androgens and estrogens than the more anterior parts (rete and efferent ducts) such that all single treatments, other than flutamide and bisphenol-A, induced maximal effects. This makes it fundamentally difficult to test whether the androgen-estrogen balance is as important in the vas as it appears to be in the more anterior regions of the tract.
Although the different responses of epithelial cells from the efferent ducts and vas deferens to altered androgens and estrogens remain to be explained, the fact that normal development of the rete and efferent ducts appear particularly dependent on a normal androgen-estrogen balance may have relevance to findings in ER
knockout (ERKO) mice. The latter exhibit distension of both the rete and efferent ducts (8, 18, 19, 35) in the face of supranormal testosterone levels (7, 9) and the absence of normal expression of ER
in the epithelium of both the rete (30, 35) and efferent ducts (33, 34, 35). This raises the possibility that the abnormalities reported in ERKO males do not result only from the loss of ER
-mediated estrogen action, but might also be affected by disturbance of the androgen-estrogen balance, although in the opposite direction (supranormal androgen plus subnormal estrogen action) to that induced in the present studies. However, this would fail to explain why aromatase knockout mice, which also have elevated testosterone levels, do not show the same structural abnormalities as ERKO mice (16, 17, 36). Nevertheless, the present findings caution that whenever androgen and/or estrogen levels are altered substantially from normal in the developing male, changes resulting from disruption of the androgen-estrogen balance should be kept in mind.
There are examples in the literature indicating a role for the androgen-estrogen balance. For example, gynecomastia in men can be induced either by raising estrogen levels or by lowering androgen levels, such that in either situation the androgen-estrogen balance is altered in favor of estrogens (37, 38, 39). Another example is clover disease, in which castrated rams that fed on Mediterranean clover containing weakly estrogenic phytoestrogens died from urinary retention due to overgrowth of the bulbo-urethral glands (40, 41), which are both an estrogen and an androgen target (41, 42). Intact rams or castrated rams treated with androgens and fed on the same clover showed no overgrowth or ill effects. Thus, in castrated rams with low androgen levels, phtyoestrogens induced a catastrophic effect, whereas in intact rams with high androgen levels or in castrated rams supplemented with androgens, no effect occurred despite exposure to the same "estrogen" level. In many respects this example arises from a situation in which hormonal status would be comparable to that induced in the present studies by combined treatment with 0.1 µg DES plus GnRHa. There may be other examples in which a role for altered androgen-estrogen balance could be important. For example, abnormal prostatic structure and growth induced by neonatal estrogen treatment are known to involve both altered androgen and estrogen action (22, 43, 44), and this may apply also to reproductive tissues in the female (45).
If the relative, rather than absolute, levels of androgens and estrogens are important for normal development and/or function of the testis and reproductive tract, as our findings suggest, how would this work at the cellular level, given that the present understanding is that androgens and estrogens act via separate, if related, signaling systems? There are various possibilities based on published data, although none has been shown to operate physiologically. For example, estrogens can trans-activate the AR/ARA70 complex at high concentrations and thus activate the transcription of androgen-dependent genes, although DES could not exert this effect (26). Interaction between the C-terminal domain of ER
and the AR has been demonstrated using two-hybrid systems, and cotransfection of the two receptors into CV-1 cells has demonstrated a mutual ability of each receptor to antagonize trans-activation mediated by ligand binding to the other receptor (25). An alternative explanation might be activation of the Src-Raf1/Shc-Erk2 pathway, in which androgens and estrogens may induce assembly of a novel ternary complex comprising the AR, ER (either ER
or ERß), and Src (46, 47). This complex triggers activation of the protein kinase domain of Src and downstream effects, such as cell proliferation (46) or inhibition of apoptosis (47). The androgen-AR and estrogen-ER complexes bind to separate domains on the Src protein, and antagonists of either the AR or ER can block activation of this pathway by either androgens or estrogens (46). Our recent findings that expression of classical androgen-regulated genes in the prostate can also be regulated by estrogens and that antiestrogens can block androgen activation of these genes in vivo (48) are consistent with the activation of such a pathway.
Regardless of the pathway involved, the present findings have implications for issues such as endocrine disruptors, in which considerations of risk are focused largely on the absolute dose/level of exposure as opposed to the relative levels of androgen and estrogens. The present study has shown that combined treatment with a weak environmental estrogen, bisphenol-A, plus a GnRHa was unable to induce any of the abnormalities induced by 0.1 µg DES plus GnRHa, suggesting that in this situation the estrogenicity of the bisphenol-A, when injected in moderately high amounts (100 µg/injection), was still insufficient to perturb the androgen-estrogen balance. Whether this balance can be disturbed by higher doses of this or other environmental estrogens or in combination with environmental antiandrogens are obvious questions that need to be addressed.
In summary, the present findings add to the growing evidence of a close interrelationship between the actions of androgens and estrogens in regulating normal and abnormal development of the male reproductive system. Our findings suggest that the balance in action between androgens and estrogens, rather than the absolute levels of either hormone, may be of fundamental importance at least for some regions of the reproductive tract. From a physiological perspective, local regulation of relative levels of androgens and estrogens, for example by differential expression of aromatase or 5
-reductase, may be critical factors that ensure an appropriate steroid milieu for specific regions of the reproductive system.
| Acknowledgments |
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| Footnotes |
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Abbreviations: AR, Androgen receptor; DES, diethylstilbestrol; ED, efferent ducts; ER, estrogen receptor; ERKO, ER
knockout; GnRHa, GnRH antagonist; TBS, Tris-buffered saline.
Received May 21, 2002.
Accepted for publication August 5, 2002.
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and ß proteins in the testes and male reproductive tract of human and non-human primates. Mol Hum Reprod 7:227236
(but not ERß) during postnatal development of the epididymis and vas deferens of the rat and disruption of this pattern by neonatal treatment with diethylstilbestrol. Endocrinology 142:874886
knockout mice. J Androl 21:107121[Abstract]
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(ER
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ERKO and ßERKO mice. Cancer Res 61:60896097This article has been cited by other articles:
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