Skip to main content

Advertisement

Log in

Aromatase enzyme expression in acromegaly and its possible relationship with disease prognosis

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

The purpose of this study was to evaluate aromatase enzyme expression in growth hormone (GH) secreting adenomas and comparison with prolactinomas, nonfunctional adenomas, and normal pituitary tissues. Also the impact of its expression on clinical and prognostic features was evaluated. 38 acromegaly, 26 prolactinoma, and 31 nonfunctional pituitary adenoma and 11 normal pituitary gland samples from autopsies were included. Aromatase and estrogen receptor-alpha (ERα) were evaluated by Immunohistochemical method; demographic, pre- and postoperative features of the patients were noted. Aromatase was expressed in varying degrees in all cases in study including controls. Aromatase expression in patients with acromegaly was significantly higher than patients with prolactinoma, nonfunctional adenoma, and controls (p = 0.04, p = 0.01 and p <0.001, respectively). Taken together two functional adenoma groups, prolactinoma and acromegaly, aromatase expression was negatively correlated with ER-alpha (p = 0.02, r = −0.34). Also, Ki-67 immunohistochemical results were negatively correlated with aromatase expression (p = 0.03, r = −0.27) while positively correlated with ER expression (p < 0.01). Consistent with the growing evidence about testosterone effect on pituitary functions, aromatase expression was found to be higher in GH-secreting pituitary adenoma. Aromatase was expressed in all pituitary tissues including autopsy samples; however, it was highest in patients with acromegaly. In patients with acromegaly and prolactinoma, aromatase expression was negatively correlated with Ki-67 score, and also it was higher in patients with complete postoperative remission than without remission. Therefore, aromatase expression may be a good prognostic marker predominantly in acromegaly.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. G.D. Means, M.W. Kilgore, M.S. Mahendroo, C.R. Mendelson, E.R. Simpson, Tissue-specific promo- ters regulate aromatase cytochrome P450 gene expression in human ovary and fetal tissues. Mol. Endocrinol. 5, 2005–2013 (1991)

    Article  CAS  PubMed  Google Scholar 

  2. H. Nawata, S. Tanaka, S. Tanaka et al., Aromatase in bone cells: association with osteoporosis in postmenopausal women. J. Steroid Biochem. Mol. Biol. 53, 165–174 (1995)

    Article  CAS  PubMed  Google Scholar 

  3. H. Sasano, K. Takahashi, F. Satoh, H. Nagura, N. Harada, Aromatase in the human central nervous system. Clin. Endocrinol. 48, 325–332 (1998)

    Article  CAS  Google Scholar 

  4. H. Akinci, A. Kapucu, K.A. Dar et al., Aromatase cytochrome P450 enzyme expression in prolactinomas and its relationship to tumor behavior. Pituitary 16, 386–392 (2013)

    Article  CAS  PubMed  Google Scholar 

  5. F.J. Hayes, S. DeCruz, S.B. Seminara et al., Differential regulation of gonadotropin secretion by testosterone in the human male: absence of a negative feedback effectof testosterone on follicle-stimulating hormone secretion. J. Clin. Endocrinol. Metab. 86, 53–58 (2001)

    CAS  PubMed  Google Scholar 

  6. J. Bakker, S. Honda, N. Harada, J. Balthazart, Restoration of male sexual behavior by adultexogenous estrogens in male aromatase knockout mice. Horm. Behav. 46, 1–10 (2004)

    Article  CAS  PubMed  Google Scholar 

  7. M. Hiltunen, S. Iivonen, H. Soininen, Aromatase enzyme and Alzheimer’s disease. Minerva Endocrinol. 31, 61–73 (2006)

    CAS  PubMed  Google Scholar 

  8. J. Carretero, G. Vázquez, E. Blanco, Immunohistochemical evidence of the presence of aromatase P450 in the rat hypophysis. Cell Tissue Res. 295, 419–423 (1999)

    Article  CAS  PubMed  Google Scholar 

  9. P. Kadioglu, G. Oral, M. Sayitoglu et al., Aromatase cytochrome P450 enzyme expression in human pituitary. Pituitary 11, 29–35 (2008)

    Article  CAS  PubMed  Google Scholar 

  10. T.J. Spady, D.M.E. Harvell, M.C. Snyder et al., Estrogen-induced tumorigenesis in the Copenhagen rat: disparate susceptibilies to development of prolactin-producing pituitary tumors and mammary carcinomas. Cancer Lett. 124, 95–103 (1998)

    Article  CAS  PubMed  Google Scholar 

  11. K. García-Malpartida, A. Martín-Gorgojo, M. Rocha et al., Prolactinoma induced by estrogen and cyproterone acetate in a male-to-female transsexual. Fertil. Steril. 94(1097), e13–e15 (2010)

    PubMed  Google Scholar 

  12. R. Sodi, R. Fikri, M. Diver et al., Testosterone replacement-induced hyperprolactinaemia: case report and review of the literature. Ann. Clin. Biochem. 42, 153–159 (2005)

    Article  CAS  PubMed  Google Scholar 

  13. M.J. García Barrado, E.J. Blanco, M. Carretero Hernández et al., Local transformations of androgens into estradiol by aromatase p450 is involved in the regulation of prolactin and the proliferation of pituitary prolactin-positive cells. PLoS ONE 9(6), e101403 (2014)

    Article  PubMed Central  PubMed  Google Scholar 

  14. V. Birzniece, S. Sutanto, K.K. Ho, Gender difference in the neuroendocrine regulation of growth hormone axis by selective estrogen receptor modulators. J. Clin. Endocrinol. Metab. 97(4), E521–E527 (2012)

    Article  CAS  PubMed  Google Scholar 

  15. V. Birzniece, U.J. Meinhardt, J. Gibney et al., Differential effects of raloxifene and estrogen on body composition in growth hormone-replaced hypopituitary women. J. Clin. Endocrinol. Metab. 97, 1005–1012 (2012)

    Article  CAS  PubMed  Google Scholar 

  16. A.J. Weissberger, K.K. Ho, Activation of the somatotropic axis by testosterone in adult males: evidence for the role of aromatization. J. Clin. Endocrinol. Metab. 76, 1407–1412 (1993)

    CAS  PubMed  Google Scholar 

  17. J.D. Veldhuis, K.L. Mielke, M. Cosma et al., Aromatase and 5alpha-reductase inhibition during an exogenous testosterone clamp unveils selective sex steroid modulation of somatostatin and growth hormone secretagogue actions in healthy older men. J. Clin. Endocrinol. Metab. 94, 973–978 (2009)

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. J.D. Veldhuis, D.L. Metzger, P.M. Martha et al., Estrogen and testosterone, but not a nonaromatizable androgen, direct network integration of the hypothalamo-somatotrope (growth hormone)-insulin-like growth factor I axis in the human: evidence from pubertal pathophysiology and sex-steroid hormone replacement. J. Clin. Endocrinol. Metab. 82, 3414–3420 (1997)

    CAS  PubMed  Google Scholar 

  19. E.V. Dimaraki, K.V. Symons, A.L. Barkan, Raloxifene decreases serum IGF-I in male patients with active acromegaly. Eur. J. Endocrinol. 150, 481–487 (2004)

    Article  CAS  PubMed  Google Scholar 

  20. S. Detre, G. Saccani Jotti, M. Dowsett, A “quickscore” method for immunohistochemical semiquantitation: validation for oestrogen receptor in breast carcinomas. J. Clin. Pathol. 48, 876–878 (1995)

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. A. Giustina, P. Chanson, M.D. Bronstein et al., A consensus on criteria for cure of acromegaly. J. Clin. Endocrinol. Metab. 95(7), 3141–3148 (2010)

    Article  CAS  PubMed  Google Scholar 

  22. L.A. Nolan, A. Levy, The effects of testosterone and oestrogen on gonadectomised and intact male rat anterior pituitary mitotic andapoptotic activity. J. Endocrinol. 188, 387–396 (2006)

    Article  CAS  PubMed  Google Scholar 

  23. J.C. Prior, T.A. Cox, D. Fairholm et al., Testosterone-related exacerbation of a prolactin-producing macroadenoma: possible role for estrogen. J. Clin. Endocrinol. Metab. 64, 391–394 (1987)

    Article  CAS  PubMed  Google Scholar 

  24. K. Link, R.M. Blizzard, W.S. Evans et al., The effect of androgens on the pulsatile release and the twenty-four-hour mean concentration of growth hormone in peripubertal males. J. Clin. Endocrinol. Metab. 62, 159–164 (1986)

    Article  CAS  PubMed  Google Scholar 

  25. V. Rochira, L. Zirilli, L. Maffei et al., Tall stature without growth hormone: four male patients with aromatase deficiency. J. Clin. Endocrinol. Metab. 95(4), 1626–1633 (2010)

    Article  CAS  PubMed  Google Scholar 

  26. J. Carretero, E.J. Blanco, M. Carretero et al., The expression of AIB1 correlates with cellular proliferation in human prolactinomas. Ann Anat. 195, 253–259 (2013)

    Article  CAS  PubMed  Google Scholar 

  27. L.A. Nolan, A. Levy, The effects of testosterone and oestrogen on gonadectomised and intact male rat anterior pituitary mitotic and apoptotic activity. J. Endocrinol. 188, 387–396 (2006)

    Article  CAS  PubMed  Google Scholar 

  28. J.F. Pereira-Lima, C.P. Marroni, C.B. Pizarro et al., Immunohistochemical detection of ER-alpha in pituitary adenomas and its correlation with cellular replication. Neuroendocrinology 79(3), 119–124 (2004)

    Article  CAS  PubMed  Google Scholar 

  29. D.A. Schreihofer, D.F. Rowe, E.F. Rissman et al., Estrogen receptor-alpha (ERalpha), but not ERbeta, modulates estrogen stimulation of the ERalpha-truncated variant, TERP-1. Endocrinology 143(11), 4196–4202 (2002)

    Article  CAS  PubMed  Google Scholar 

  30. M.A. Shupnik, Oestrogen receptors, receptor variants and oestrogen actions in the hypothalamic-pituitary axis. J. Neuroendocrinol. 14, 85–94 (2002)

    Article  CAS  PubMed  Google Scholar 

  31. M. Bondanelli, M.R. Ambrosio, A. Margutti et al., Activation of the somatotropic axis by testosterone in adult men: evidence for a role of hypothalamic growth hormone-releasing hormone. Neuroendocrinology 77(6), 380–387 (2003)

    Article  CAS  PubMed  Google Scholar 

  32. G.V. Childs, M. Iruthayanathan, N. Akhter et al., Bipotential effects of estrogen on growth hormone synthesis and storage in vitro. Endocrinology 146(4), 1780–1788 (2005)

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  33. I. Balili, A. Barkan, Tamoxifen as a therapeutic agent in acromegaly. Pituitary (2013). doi:10.1007/s11102-013-0534-9

  34. J.C. Stone, J. Clark, R. Cuneo, A.W. Russell, S.A. Doi, Estrogen and selective estrogen receptor modulators (SERMs) for the treatment of acromegaly: a meta-analysis of published observational studies. Pituitary 17(3), 284–295 (2014)

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The study was supported by the Research Fund of the University, project no. 2013/37. This research was not supported by any specific grants from any funding agencies in the public, commercial, or not-for-profit sector. We thank Canan Baydemir of the Department of Biostatistics for her help with our statistical analyses.

Conflict of interest

The authors declare no conflicts of interest that could be perceived as prejudicing the impartiality of this research.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alev Selek.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Selek, A., Cetinarslan, B., Gurbuz, Y. et al. Aromatase enzyme expression in acromegaly and its possible relationship with disease prognosis. Endocrine 49, 250–257 (2015). https://doi.org/10.1007/s12020-014-0445-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-014-0445-1

Keywords

Navigation