Current understanding of selective estrogen receptor modulators

Introduction. The mucociliary apparatus (MCA) of the fallopian tubes (MTр) represents one of the key mechanisms and arms in functioning of female reproductive system. A prominent role of impaired MCA in the pathogenesis of reproductive system diseases and infertility, on the one hand, as well as insufficient knowledge and elucidation of this topic, on the other hand, spurred current study.Aim: to improve our understanding about a role for reproductive system MCA and its impairment in developing diseases and infertility, as well as to identify potential perspectives for their correction.Materials and Methods. We searched for publications and analyzed literature data from 1980 to 2020 using various scientific databases, including Index Medicus, PubMed/MEDLINE, Embase, Cochrane Library and Russian scholarly journals related to gynecology, obstetrics and reproduction.Results. The analysis conducted allowed to originally assess the morpho-functional, structural-genetic features and other important aspects of MCA MTр. In addition, we demonstrated an impact of various factors on developing diverse types of pathological processes, including those capable of causing infertility. Moreover, we also elucidated a state of MCA MTр coupled to various diseases, including genetically determined disorders.Conclusion. The role of impaired MCA MTр in developing pathological process and infertility was of tremendous importance and deserves close attention, because they are often remained undiagnosed by standard methods and require use of morphological and functional research methods for verification. Perspectives for diagnostics and correction of MCA MTр disorders are further discussed.

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Induction of ovarian steroidogenesis as an additional potential risk factor for progression in premenopausal patients with hormone-receptor-positive breast cancer receiving tamoxifen as adjuvant therapy

Goryainova

Stukan

Lymar

et al. 2022

Medicinskij sovet

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Introduction. Patients with hormone-receptor-positive (HR+) breast cancer (BC) over 40 years old who take tamoxifen are not subject to mandatory castration. However this cohort of patients is not homogeneous.Aim. The present study is aimed at studying the features of ovarian steroidogenesis in perimenopausal breast cancer patients receiving adjuvant hormone therapy (HT) with tamoxifen.Materialy and methods. The study included 82 patients aged 42 to 53 years with GH+BC who received HT with tamoxifen 20 mg daily. Within 9 months from the start of HT in patients, the levels of estradiol and follicle-stimulating hormone in the peripheral blood were studied every 3 months.Results. In 66.7% of patients who received chemotherapy (CT), the development of amenorrhea was noted. Half of the patients in the HT-only group demonstrated amenorrhea. Oligomenorrhea was observed in 20.8% and 16.7% in each group, respectively. The incidence of amenorrhea in women treated with chemotherapy was higher (OR 2.02; 95% CI: 0.73-5.67), but the differences were not statistically significant (p = 0.1766). In the general cohort, in 15.7-16.8% of patients, the level of estradiol exceeded 251 pg / ml - the upper limit of the norm of the follicular phase of the menstrual cycle. Differences between groups in the incidence of estradiol levels > 251 pg/ml were statistically significant (p = 0.0293). 3.4-5.6% of patients in the total cohort (depending on the period of observation) had an estradiol level > 649 pg / ml, which corresponded to the highest ovulatory value.Conclusions. Against the background of HT with tamoxifen in some perimenopausal patients hyperestrogenism is observed which indicates the implementation of the effect of induction of ovarian steroidogenesis and can be considered as an additional potential risk factor for the progression of HR+BC. Amenorrhea after CT is not a reliable marker of ovarian suppression.

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Current understanding of selective estrogen receptor modulators

Cited by 3 publications

References 40 publications

Relationship between pregnancy and the risk of malignant neoplasms of the female reproductive system

Relationship between pregnancy and the risk of malignant neoplasms of the female reproductive system

Mucociliary apparatus of the fallopian tubes and related pathogenetic aspects contributing to infertility and prospects for correction (analytical review)

Induction of ovarian steroidogenesis as an additional potential risk factor for progression in premenopausal patients with hormone-receptor-positive breast cancer receiving tamoxifen as adjuvant therapy

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