onapristone and lilopristone

Antiprogestins represent a relatively new and promising class of therapeutic agents that could have significant impact on human health and reproduction. In the present work, the pharmacodynamics, pharmacokinetics, and metabolism of mifepristone (MIF), lilopristone (LIL), and onapristone (ONA) in humans are reviewed, and characteristics bearing important clinical implications are discussed. Although MIF has gained notoriety as an "abortion pill," antiprogestins may more importantly prove effective in the treatment of endometriosis, uterine leiomyoma, meningioma, cancers of the breast and prostate, and as contraceptive agents. MIF pharmacokinetics display nonlinearities associated with saturable plasma protein (alpha 1-acid glycoprotein, AAG) binding and characterized by lack of dose dependency for parent drug plasma concentrations (for doses greater than 100 mg) and a zero-order phase of elimination. LIL and ONA pharmacokinetics are less well characterized but ONA does not appear to bind AAG and displays a much shorter t1/2 than the other agents. The three antiprogestins are substrates of cytochrome P450 (CYP) 3A4, an enzyme exceedingly important in human xenobiotic metabolism. Even more implicative of likely drug-drug interactions subsequent to their long-term administration are recent data from our laboratory indicating that they inactivate CYP3A4 in a cofactor- and time-dependent manner, suggesting that complexation and induction of the enzyme may occur in vivo via protein stabilization. Moreover, it has been demonstrated that MIF increases CYP3A4 mRNA levels in human hepatocytes in primary culture, indicative of message stabilization and/or transcriptional activation of CYP3A4 expression. Finally, MIF has also been shown to inhibit P-glycoprotein function. Whether LIL and ONA share these latter two characteristics with MIF has not yet been determined but they illustrate properties that, in addition to diminished antiglucocorticoid activities and altered pharmacokinetic characteristics, warrant consideration during the development of these and never antiprogestational agents.

Topics: Abortifacient Agents; Adult; ATP Binding Cassette Transporter, Subfamily B, Member 1; Breast Neoplasms; Contraceptives, Postcoital, Synthetic; Endometriosis; Estrenes; Female; Gonanes; Hormone Antagonists; Humans; Mifepristone; Progestins

Antiprogestogens, which block the action of progesterone at the cellular level through binding to the progesterone receptor, are proving to be one of the most significant developments in endocrinology in recent years. Several hundreds of such compounds have been synthesized, but only a few of them have been evaluated to any significant extent in biological screening models and, to our knowledge, only three compounds, namely mifepristone, lilopristone (ZK 98.734) and onapristone (ZK 98.299) have been given to humans. Most of the clinical research to date has focused on the use of mifepristone given in combination with prostaglandin for termination of early pregnancy, an indication for which the compound is being used routinely in four countries so far, i.e. China, France, the UK and Sweden. The gynaecological and obstetrical applications in which antiprogestogens have been shown to be of value to date include ripening of the pregnant cervix prior to pregnancy termination, sensitization of the uterus to prostaglandins in second-trimester abortion, and induction of labour. Available data suggest that antiprogestogens have no place in the conservative treatment of ectopic pregnancy or in the treatment of premenstrual tension. In fertility regulation, the sequential combination regimen of mifepristone plus prostaglandin as used for inducing abortion has proved to be effective also for menses induction and can be expected to be an efficacious once-a-month contraceptive. Mifepristone alone, without adjuvant prostaglandin, has yielded promising results as an anti-implantation agent and in emergency contraception. Other potential uses include once-a-week contraception, ovulation inhibition (in a sequential regimen with a progestogen), and as a daily mini-pill. Mifepristone, and other antiprogestogens for which biological data have been reported also bind to the cellular receptors for glucocorticoid hormones and, consequently, possess antiglucocorticoid in addition to their antiprogestational activity. Because of this antiglucocorticoid effect, mifepristone has been employed successfully in the palliative treatment of hypercortisolism due to Cushing's syndrome, and its use has been proposed for treating certain forms of depression and of glaucoma, and in wound healing. However, for scientific and practical reasons, it would be preferable if molecules were developed that have only the antiprogestational or the antiglucocorticoid activity rather than both.

Topics: Abortion, Induced; Antineoplastic Agents; Breast Neoplasms; Contraception; Contraceptives, Oral, Synthetic; Endometrial Neoplasms; Endometriosis; Estrenes; Female; Gonanes; Humans; Labor, Induced; Mifepristone; Pregnancy; Pregnancy Trimester, Second; Progestins; Prostaglandins; Receptors, Progesterone

Topics: Contraceptives, Oral; Contraceptives, Postcoital, Hormonal; Embryo Implantation; Endometrium; Estrenes; Female; Glucocorticoids; Gonanes; Humans; Luteinizing Hormone; Mifepristone; Ovary; Ovulation; Progestins; Receptors, Progesterone

Progesterone receptor antagonists have been developed by substitutions at the 11-beta and 17 side-chain positions of the progestagen norethisterone. The most studied progesterone receptor antagonists are mifepristone (Mifegyne; Roussel-UCLAF; RU486) and ZK98734 and ZK98299 (Schering AG). These compounds bind avidly to the progesterone receptor and glucocorticoid receptor but have essentially no binding to the mineralocortocoid, oestrogen or androgen receptors. Mifepristone also binds avidly to albumin, resulting in a half-life of approximately 24 h after oral administration. Progesterone receptor antagonists can induce menstruation by a direct action upon the endometrium. They have also been shown to exert weak progesterone agonist actions in certain circumstances and to modulate pituitary hormone secretion by antagonizing the feedback actions of progesterone. Moreover, they release prostaglandin F2 alpha and E2 from human endometrium or early pregnancy decidua and reduce the metabolism of these eicosanoids. Clinically, progesterone receptor antagonists have been used in trials of menstrual regulation, abortion and induction of labour, and during treatment of breast or ovarian cancer, some forms of hypertension and meningioma. Progesterone receptor antagonists have been administered to approximately 70,000 women in 18 countries as medical abortifacients. They have been proven, especially when combined with prostaglandin analogues, to be as effective as surgical methods of termination of pregnancy. Progesterone receptor antagonists have focussed international attention on menstrual regulation, abortion and the rights of women to regulate their fertility.

Topics: Abortifacient Agents, Steroidal; Animals; Estrenes; Female; Gonanes; Humans; Menstruation-Inducing Agents; Mifepristone; Pregnancy; Progesterone; Prostaglandins; Receptors, Progesterone

The discovery of the first competitive progesterone antagonist RU 38,486 has initiated an intense search for more potent and more selective anti-progestins. Among several hundreds of compounds under preliminary investigation, biological characterization is most advanced for derivatives RU 38,486, ZK 98,734 and ZK 98,299. These compounds do not only differ in relative potency, but are clearly distinguished by their different behaviour in various animal models. Emphasis is laid on the synthetic problems associated with chemical operations in a sterically crowded environment as represented by structures RU 38,486 and ZK 98,299.

Topics: Chemical Phenomena; Chemistry; Estrenes; Gonanes; Mifepristone; Progestins

Based on previous observations of very short periods of linearity for antiprogestin metabolite formation and the presence of a common tertiary amine moiety in each compound as the principal site of their metabolism, we hypothesized that mifepristone, lilopristone and onapristone are oxidized by cytochrome P450 (CYP) 3A4 to reactive nitroso species that complex the heme of the enzyme, thereby inactivating it. Upon preincubation with human liver microsomes in the presence (but not the absence) of NADPH, mifepristone inhibited midazolam 1'-hydroxylation, a marker of CYP3A4 catalytic activity, very potently (IC50 approximately 3.5 mumol/l) and extensively (by approximately 87%). Lilopristone and onapristone also displayed NADPH and time-dependent inactivation of CYP3A4 with characteristics very similar to mifepristone. These data support antiprogestin-mediated inactivation of CYP3A4 and suggest the potential for drug-drug interactions and time-dependent nonlinearities in pharmacokinetics upon their long-term administration.

Topics: Chromatography, High Pressure Liquid; Cytochrome P-450 CYP3A; Cytochrome P-450 Enzyme Inhibitors; Dose-Response Relationship, Drug; Drug Interactions; Enzyme Inhibitors; Estrenes; Gonanes; Hormone Antagonists; Humans; Microsomes, Liver; Midazolam; Mifepristone; Mixed Function Oxygenases; NADP; Spectrophotometry; Tissue Donors

Our purpose was to assess the effects of labor and antigestagens on production of interleukin 8 by the term human placenta and to localize interleukin 8 in first- and third- trimester placentas.. The study was conducted by the Department of Obstetrics and Gynaecology of the University of Edinburgh. Five placentas were collected after spontaneous and cesarean deliveries. Explants were cultured in the presence of mifepristone, lilopristone, or onapristone. The production of interleukin 8 was determined by specific radioimmunoassay, and the immunolocalization of interleukin 8 was determined in sections of first- and third-trimester placentas.. All explants produced interleukin 8. Production was significantly increased (P < .05) after spontaneous delivery. In placentas delivered spontaneously, onapristone significantly increased production of interleukin 8 (P < .05), whereas in those from cesarean deliveries lilopristone caused a significant increase in production (P < .05). In the third-trimester placenta interleukin 8 was localized in the perivascular area of fetal vessels. In first-trimester villi it was peripherally located in syncytiotrophoblast.. The human placenta at term is capable of producing interleukin 8, which is localized around the perivascular area of the villi. Production is increased after spontaneous labor and to varying degrees by the antigestagens studied. Interleukin 8 may have a role in the onset of parturition by recruiting and activating neutrophils at the placental site.

Topics: Culture Techniques; Estrenes; Female; Gonanes; Hormone Antagonists; Humans; Immunohistochemistry; Interleukin-8; Labor, Obstetric; Mifepristone; Placenta; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Third; Progestins

A number of compounds, antiprogestins, e.g. mifepristone, onapristone and lilopristone, have been developed which compete with progesterone at the receptor level. One of these, mifepristone, is in combination with a prostaglandin analogue currently in use for termination of early pregnancy. The possibility to use these compounds for contraceptive purposes is presently under evaluation.. The possible contraceptive effect of antiprogestins has been evaluated in both clinical and experimental studies.. Administration of antiprogestin during the follicular phase has an inhibitory effect on follicular development and ovulation, and on endometrial development and function if administered during the secretory phase of the menstrual cycle. A high dose of mifepristone, 200 mg, administered immediately following ovulation is highly effective in preventing implantation, most likely due to an effect on endometrial receptivity. It seems that the endometrium is more sensitive to antiprogestin than is the ovulatory process. Low weekly, 2.5 mg to 5 mg, and daily doses, 0.5 mg, of mifepristone did not inhibit ovulation, but a significant effect on endometrial development and especially endometrial function judged from measurement of the expression of a number of markers for endometrial receptivity could be demonstrated.. The effect of mifepristone on the endometrium may be sufficient to prevent implantation, and if so, an oral contraceptive method could be developed which has no effect on ovarian function.. The potential use of antiprogestins such as mifepristone and onapristone for contraceptive purposes is currently under investigation. Administration of antiprogestins during the follicular phase of the menstrual cycle delays the estrogen rise and the luteinizing hormone surge. As long as treatment is continued, follicular development is delayed or arrested and ovulation is inhibited. It is assumed that the inhibitory effect of antiprogestins on ovulation is mediated by a blocking effect of progesterone on the pituitary level. A 200-mg dose of mifepristone, administered immediately after ovulation, is highly effective in preventing implantation. Although a daily dose of 0.5 mg of mifepristone does not inhibit ovulation, it has a significant effect on endometrial development and receptivity. Intermittent administration of mifepristone, together with periodic administration of a gestagen, both inhibits ovulation and induces regular withdrawal bleeding. The current research indicates that the endometrium is more sensitive to mifepristone than is the ovulatory process. If such effects are sufficient to prevent implantation, a contraceptive method based on very low doses of antiprogestin and without any effect on bleeding patterns is feasible.

Topics: Contraceptives, Oral, Synthetic; Endometrium; Estrenes; Female; Gonanes; Hormone Antagonists; Humans; Mifepristone; Pregnancy; Progesterone

The metabolism of two newer antiprogestational agents, lilopristone and onapristone, was investigated using human liver microsomes, and evidence was obtained supporting a principal role of cytochrome P450 (CYP) 3A4 in their N-demethylations. Kinetic studies with microsomes from three organ donors indicated lack of biphasic kinetics at substrate concentrations up to 200 microM, consistent with a single enzyme mediating the oxidations. Selective chemical inhibitors of CYP1A2 (furafylline), CYP2C9 (sulfaphenazole), CYP2D6 (quinidine), and CYP2A6/2E1 (diethyldithiocarbamic acid) did not affect initial rates of metabolism of either steroid. Gestodene and triacetyloleandomycin (selective for CYP3A enzymes) inhibited the demethylations of both antiprogestins by up to 77%. Rabbit polyclonal antibodies to CYP3A4 decreased initial rates of N-demethylation of the antihormones by up to 82%, whereas antibodies to CYP2C9 were not inhibitory. Collectively, these data thus suggest potential drug-drug interactions of these promising new therapeutic agents with concomitantly administered CYP3A4 substrates.

Topics: Adult; Child, Preschool; Cytochrome P-450 CYP3A; Cytochrome P-450 Enzyme Inhibitors; Cytochrome P-450 Enzyme System; Estrenes; Female; Gonanes; Hormone Antagonists; Humans; Male; Microsomes, Liver; Middle Aged; Mixed Function Oxygenases; Norpregnenes; Oxidoreductases, N-Demethylating; Progestins; Troleandomycin

In addition to their antiprogestational activity, the antiprogestins RU486, ZK98.299 and ZK98.734 possess varying antiglucocorticoid as well as androgen-like or antiandrogen-like properties in human mammary cancer cells. The human mammary cancer cell line MFM-223, which contains only androgen receptors, was used as a model to investigate androgen receptor mediated effects of these antiprogestins. Proliferation of MFM-223 cells is inhibited by androgens and does not respond to oestrogens, progestins and glucocorticoids. As shown in proliferation assays, ZK98.734 was a strong inhibitor of cell proliferation. This effect was antagonised by the antiandrogen hydroxyflutamide. ZK98.734 was found to displace [3H]R1881 from the androgen receptor in MFM-223 cells, substantiating the involvement of the androgen receptor. The antiprogestin ZK98.299 failed to influence the proliferation of MFM-223 cells. ZK98.299 did not bind to the androgen receptor and was devoid of androgenic or antiandrogenic activity. RU486 bound to the androgen receptor. It was a weak inhibitor of MFM-223 cell proliferation, but the inhibition of proliferation by RU486 was not antagonised by hydroxyflutamide. This effect was probably not mediated by the androgen receptor. RU486 had antiandrogenic activity in this cell line, as it antagonised the inhibitory effect of dihydrotestosterone at a 100-molar excess. These results were confirmed by transfection experiments with an MMTV-CAT construct in the same cell line, demonstrating the biological function of the ZK98.734-androgen receptor complex. ZK98.299 and RU486 were not able to induce CAT activity. The different androgenic or antiandrogenic properties of the antiprogestins investigated should be considered when selecting antiprogestational properties of the antiprogestins investigated should be considered when selecting antiprogestational compounds for clinical applications, as a partial androgenic activity may be of benefit in breast cancer but can have undesired side-effects in other diseases.

Topics: Androgen Antagonists; Antineoplastic Agents; Binding, Competitive; Breast Neoplasms; Cell Division; Dihydrotestosterone; Estrenes; Flutamide; Gonanes; Humans; Mifepristone; Models, Biological; Progestins; Receptors, Androgen; Transfection; Tumor Cells, Cultured

Mifepristone (RU 486), used clinically for the termination of early pregnancy, and its acetyl and 13-retro (13 alpha) analogs show potent antiproliferative effects against estrogen-dependent human breast tumors and endometriosis. However, there has been no report on direct inhibition of aromatase by antiprogesterones. Aromatase inhibitors have been shown to be effective against estrogen-dependent breast cancer. We evaluated the inhibition of aromatase by various antiprogestins (ZK 112.993, ZK 98.734, ZK 114.043, ZK 98.299, and ZK 114.863). Human placental microsomes were incubated with [1 beta-3H,4-14C] androstenedione (3-114 nM) in the presence of NADPH, with or without putative inhibitors (10-200 microM). Aromatase activity was assessed by tritium release to water from the 1 beta-position of the substrate. ZK 112.993 and ZK 98.734 did not show any inhibitory effect. The statistical analysis of the data using standard errors was obtained from replicate experiments. ZK 114.043 showed slight inhibition with a Ki of 54.8 +/- 6.4 microM (m +/- SE, n = 6) against androstenedione aromatization. The two 13-retro-steroids, ZK 98.299 and ZK 114.863, showed aromatase inhibition with Ki values of 19.0 +/- 1.5 microM (n = 7) and 12.7 +/- 0.94 microM (n = 7), respectively, which is weak with respect to some known potent inhibitors, but significant when compared with the other antiprogestins which were tested. The results suggest that the unnatural 13-retro-antiprogestin conformation may have a better fit to the aromatase active site than the natural 13 beta-antiprogestin conformation. (Steroids 60:234-238, 1995).

Topics: Aromatase Inhibitors; Estrenes; Estrone; Female; Gonanes; Humans; Microsomes; Mifepristone; Placenta; Pregnancy; Progestins

Currently available progesterone antagonists have been suggested to fall into two categories based on differences in how they interact with and inactivate the progesterone receptor (PR). The anti-progestin ZK98299 (Type I) impairs PR association with DNA, while Type II compounds (RU486, ZK112993, ZK98734) promote PR binding to DNA. Type II agents, therefore, appear to inhibit receptor activity at a step downstream of DNA binding, presumably failing to induce conformational changes in PR structure requird for enhancement of transcription. This paper discusses both published and unpublished data supporting the concept of two types of progestin antagonists. Using PR-mediated induction of reporter genes in breast cancer cells as an assay for biological response, both types of anti-progestins, after correction for difference in steroid binding affinity, inhibit progestin induction substoichiometrically. However, Type II anti-progestins are more potent, inhibiting at lower ratios of antagonist to agonist than ZK98299. This suggests that in addition to behaving by classical competitive mechanisms these compounds (in particular Type II) may exhibit additional activity as transrepressors of PR in the same cell bound to hormone agonist. Transrepression may occur by the combined mechanisms of heterodimerization and competition for binding to DNA. In support of this, mixed ligand dimers form readily in solution between a PR subunit bound to agonist and another bound to either type of anti-progestin, whereas these mixed ligand dimers bind poorly, if at all, to specific progesterone response elements (PREs) in vitro. Additionally, when added as a single ligand, Type II agents increase PR dimerization in solution and PR affinity for PREs as compared with single ligand dimers formed by progestin agonist. This contrasts with ZK98299, when given as a single ligand, which reduces PR affinity for PREs without disrupting solution dimerization. Thus the higher affinity of PR for PREs may account for the greater biological potency of Type II compounds as compared with ZK98299. As a further distinction between types of antiprogestins, ZK98299 minimally stimulates phosphorylation of PR whereas RU486 increases site-specific phosphorylation of PR in a manner indistinguishable from that of hormone agonist. Additionally, ZK98299 is not susceptible in vivo to functional switching to a partial agonist by cross talk with cAMP signal transduction pathways, as occurs with Type II compound

Topics: 8-Bromo Cyclic Adenosine Monophosphate; DNA-Binding Proteins; Estrenes; Gonanes; Humans; In Vitro Techniques; Mifepristone; Progesterone; Promegestone; Protein Binding; Protein Conformation; Receptors, Progesterone; Signal Transduction; Transcription Factors; Transcription, Genetic

The ability of ovarian steroids to sensitize and desensitize the pituitary gonadotroph to hypothalamic gonadotrophin-releasing hormone (GnRH) is essential for their modulatory actions on gonadotrophin secretion. The time-dependent actions of progesterone on GnRH-stimulated gonadotrophin secretion from cultured pituitary cells obtained from female rats were examined. Progesterone induced an acute stimulatory effect on luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretion in cell perifusion studies, from as early as 50 min after the onset of progesterone treatment. Long-term incubation (52 h) of pituitary cells in static culture reduced the responsiveness of the gonadotroph to GnRH. The antiprogestins RU486, ZK 98.299, and ZK 98.734 blocked both the acute facilitatory and the long-term inhibitory action of progesterone. In the absence of progesterone, the antiprogestins per se induced marked inhibitory and stimulatory effects on GnRH-stimulated LH secretion. In brief, short-term treatment of non-oestrogen-primed cells with antiprogestins was ineffective (ZK compounds) or reduced LH secretion (RU486), while long-term treatment was stimulatory. Oestrogen-primed cells exerted exclusively inhibitory effects on GnRH-induced LH secretion. In conclusion, antiprogestins are effective antagonists of progesterone actions in the gonadotroph. However, they exert diverse actions on gonadotrophin secretion in the absence of progesterone, which might interfere with their antagonistic properties.

Topics: Animals; Cells, Cultured; Estrenes; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Gonanes; Hypothalamo-Hypophyseal System; Luteinizing Hormone; Mifepristone; Ovariectomy; Pituitary Gland, Anterior; Progesterone; Rats; Rats, Sprague-Dawley; Rats, Wistar

The preimplantation effects of progesterone antagonists on the cell biology of the endometrium, corpus luteum function and interactions between these two organs have been studied. The antagonists lilopristone (ZK 98.734) and onapristone (ZK 98.299) were initially given per os to rabbits early or late in pseudopregnancy in combination with human chorionic gonadotrophin (HCG). These protocols were then modified to include hysterectomy or luteotrophic support with 17 beta-oestradiol. Given alone, the antagonists gave rise to endometrial regression (inhibition of epithelial proliferation and differentiation, increase of apoptosis). The simultaneous addition of oestradiol did not alter these findings. A rapid luteolysis occurred when the antagonists were given in late pseudopregnancy, but not if combined with oestradiol or hysterectomy. The endometrium was capable of renewal and of sustaining implantation if the corpora lutea survived or oestradiol was administered, and transferred blastocysts displayed normal implantation and normal embryonic development. These events did not occur when the antagonists were given during late pseudopregnancy without any steroid supplement. Progesterone antagonists can evidently exert a direct inhibitory effect on the endometrium, possibly with a later indirect luteolytic effect via endometrial mediators. Simultaneous addition of a proper luteotrophic signal results in corpora lutea which are refractory to lysis, so revealing a potential functional dissociation between endometrium and corpus luteum. The endometrium has the capacity to differentiate normally after an interrupted transformation and becomes receptive and sustains normal pregnancy, due to an expanded lifespan of the corpora lutea and a transposition of the implantation window. Uterine secretions from patients undergoing in-vitro fertilization, collected at the onset of the luteal phase, were evaluated by SDS-PAGE densitometry. The protein profiles gave indications of an adequate luteal phase pattern and of a receptive preimplantation phase. These results open the prospect of manipulating the human implantation window.

Topics: Animals; Cell Division; Chorionic Gonadotropin; Corpus Luteum Maintenance; Drug Interactions; Embryo Implantation; Embryo Transfer; Endometrium; Estradiol; Estrenes; Female; Fertility Agents, Female; Gonanes; Humans; Ovary; Pregnancy; Progesterone; Proteins; Pseudopregnancy; Rabbits

The objective of this study was to determine preimplantational effects of progesterone antagonists (PA) on the cell biology of the endometrium, on corpus luteum (CL) function and on the complex interactions between these two organs. The PA onapristone (ZK 98.299) or lilopristone (ZK 98.734) was given to pseudopregnant rabbits at days 5, 6, and 7 p.hCG. Three treatment protocols were investigated: Exp I, onapristone or lilopristone treatment only; Exp II, onapristone treatment after hysterectomy at day 1 p.hCG; Exp III, onapristone treatment together with 17 beta-estradiol, which represents the ultimate luteotropic hormone in the rabbit. In Exp I, onapristone and lilopristone gave rise to endometrial regression (inhibition of epithelial proliferation and differentiation, increase of apoptosis). Simultaneous addition of 17 beta-estradiol in Exp III did not alter these findings. A rapid luteolysis was found in Exp I. In Exp II and III, however, onapristone was unable to impair luteal development and function. Due to the unaffected CL in Exp III and due to the 17 beta-estradiol substitution, the endometrium was capable of starting a new transformation, which met all requirements for receptivity at day 12 p.hCG. Transfers of day 4 p.c. blastocysts from untreated donors into such delayed secretion recipient rabbits at days 12 p.hCG resulted in normal implantations and normal embryonic development. Contrary to Exp III, the missing of any luteotropic substitutions in Exp I resulted in a complete inhibition of further uterine transformation. The present findings suggest that PA can exert a direct inhibitory effect on the endometrium, which is followed by an indirect luteolytic effect via endometrial mediators. The simultaneous addition of a proper luteotropic signal to the PA protocol results in survival of CL. Furthermore, this prolongation of the CL life span can be interpreted as a functional dissociation of the endometrium from the CL.

Topics: Animals; Cell Division; Corpus Luteum; Electrophoresis, Polyacrylamide Gel; Embryo Transfer; Endometrium; Estrenes; Female; Gonanes; Immunohistochemistry; Microscopy, Electron; Microscopy, Electron, Scanning; Ovary; Progesterone; Rabbits; Radioimmunoassay; Receptors, Estrogen; Receptors, Progesterone; Uteroglobin

Progesterone enhances the synthesis of a 42 kDa protein secreted by rabbit endometrial stromal cells in primary culture. The duration of that response, the effects of estrogen and the inhibitory ability of antiprogestin steroid analogs, RU486, ZK98.299 and ZK98.734, were tested. Although there was a progressive decrease in the amount of the 42 kDa protein synthesized during a 6-day culture period, progesterone stimulated its rate of synthesis greater than 2-fold throughout that period. The addition of estrogen did not prevent the progressive decrease in the amount of the protein synthesized, nor did it enhance the progesterone effect when the culture medium contained phenol red. Estrogen alone did slightly induce 42 kDa protein synthesis by cells grown in phenol red-free medium, and the progesterone response was accentuated to the same degree. When present in a concentration that was 100-fold that of the progesterone, RU486, ZK98.299 and ZK98.734 each abolished stimulation. This antagonistic effect was overcome by addition of an equimolar concentration of progesterone. Deoxycorticosterone (DOC) also stimulated 42 kDa protein synthesis. The antiprogestins blocked this stimulatory effect, even when both steroids were in equimolar concentrations. There was no difference in the ability of ZK98.299 or ZK98.734 to block DOC stimulation, even though ZK98.734 exhibits no antiglucocorticoid activity [J. Steroid Biochem. 25 (1986) 835]. Therefore, it is likely that the DOC effect is mediated by the progesterone receptor system. These studies indicate that enhanced synthesis of the 42 kDa protein represents a progesterone receptor mediated event and that the cell culture system described can be used as a bioassay for determination of antiprogestin activity.

Topics: Animals; Cells, Cultured; Endometrium; Estrenes; Estrogens; Extracellular Matrix Proteins; Female; Glucocorticoids; Gonanes; Mifepristone; Progesterone; Progestins; Proteins; Rabbits

The effects of the antiprogestins (APs) ZK 98.299, ZK 98.734 and RU 486 on GnRH-stimulated LH secretion and their antagonistic activity on progesterone (P) actions were investigated in cultured pituitary cells from adult female Wistar rats. P (100 nM) was able to exert a facilitatory effect on GnRH (1 nM)-induced LH secretion after short-term (4 h) treatment of estradiol-primed (1 nM, 48 h) rat pituitary cells. When the APs (10 pM-10 microM) were introduced during the 4 h incubation period with P the facilitatory effect of P was totally abolished at concentrations greater than 10 nM (ZK 98.299, ZK 98.734) and greater than 1 nM (RU 486). Also the APs were shown to block the inhibitory action of P which occurs after long-term incubation of pituitary cells with this steroid. However at concentrations greater than 10 nM (ZK 98.734, RU 486) and greater than 100 nM (ZK 98.299) this antagonistic action of the APs was lost. To evaluate whether the APs have direct effects on GnRH-induced LH secretion in the absence of exogenous P pituitary cells cultivated for 48 h with or without 1 nM estradiol were incubated for 4 or 24 h with increasing concentrations of the APs (10 pM-10 microM). Four hour treatment of non-estradiol-primed cells with ZK 98.299 or ZK 98.734 was without any effect on the LH response to a 1 nM GnRH-stimulus. Only the highest concentration of RU 486 (10 microM) reduced the LH response. Twenty-four hour treatment of the cultures with the APs led to enhancement of GnRH-stimulated LH secretion by up to 113, 37 and 33% for ZK 98.734, ZK 98.299 and RU 486, respectively. When estradiol-primed cells were used for the same experiments we observed exclusively inhibitory effects on GnRH-induced LH secretion after 4 and 24 h treatment periods. It is concluded that these new APs are potent inhibitors of P-actions, but also per se they induce diverse effects on GnRH-stimulated LH secretion in cultured rat pituitary cells which have to be taken into account.

Topics: Animals; Cells, Cultured; Dose-Response Relationship, Drug; Estradiol; Estrenes; Female; Gonanes; Kinetics; Luteinizing Hormone; Mifepristone; Pituitary Gland, Anterior; Progesterone; Progestins; Rats; Rats, Inbred Strains

The objective of these studies was to determine whether treatment of 10-day pregnant rats with a combination of epostane (a progesterone biosynthesis inhibitor) and either ZK 98299 or ZK 98734 (progesterone receptor antagonists) would result in additive or synergistic effects on the interruption of pregnancy. When these compounds were tested individually, the order of potency in interrupting pregnancy was ZK 98734 greater than ZK 98299 greater than epostane (50% effective doses 1.3, 4.0, and 35 mg/kg, respectively). Epostane and ZK 98299 were then tested in combination. When epostane was given either 4 h prior to or concurrently with ZK 98299, the combined drug treatment resulted in a significant additive increase in interceptive activity compared to when ZK 98299 was administered alone. In vitro binding studies showed that ZK 98299 and ZK 98734 bound to the rat uterine progesterone receptor in vitro with approximately equal affinity. ZK 98734 bound to the rat thymus glucocorticoid receptor and to the rat ventral prostate androgen receptor with a greater affinity than ZK 98299. The affinity of ZK 98299 for the rat uterine estrogen receptor was weak while the binding of ZK 98734 was not detectable. Thus, the in vitro receptor binding profiles observed were consistent with the known progesterone and glucocorticoid antagonist activities of ZK 98299 and ZK 98734. Overall these findings show that the interceptive activity of epostane and ZK 98299, agents that exert their interceptive activity via different molecular mechanisms, is additive in the 10-day pregnant rat.

Topics: Abortion, Veterinary; Androstenols; Animals; Dose-Response Relationship, Drug; Estrenes; Female; Gonanes; Pregnancy; Pregnancy, Animal; Progesterone; Rats; Rats, Inbred Strains; Receptors, Progesterone; Time Factors

Progesterone bound with high affinity to the endometrial and myometrial cytosol of ovariectomized bonnet monkeys pretreated with estradiol benzoate and progesterone. The equilibrium dissociation constant (Kd) of 3H-progesterone was 4.5 nM and 5.5 nM and the binding capacity was 1.7 nM and 1.4 nM for the endometrial and myometrial receptors, respectively. This experimental 'model' was used to assess the relative binding affinity (RBA) of progesterone, ZK 98.299 and ZK 98.734. The tested compounds showed competitive binding to cytoplasmic progesterone receptors. The RBA of progesterone in the endometrium (100) was more than that of ZK 98.299 (25.1) and ZK 98.734 (17.8). A similar RBA pattern was observed in the myometrial cytosol. Both ZK 98.299 and ZK 98.734, like progesterone, displaced the 3H-progesterone bound to the receptors. The administration of ZK 98.299 or ZK 98.734, during the mid-luteal phase, has been reported to shorten the cycle length in bonnet monkeys and marmosets, respectively. These compounds, therefore, appear to intercept the progesterone action by blocking progesterone binding sites in the target tissue. Since ZK 98.299 has higher binding affinity than ZK 98.734, it may be a more potent progesterone antagonist.

Topics: Animals; Binding, Competitive; Cytosol; Endometrium; Estrenes; Female; Gonanes; Macaca radiata; Myometrium; Progestins; Receptors, Progesterone

Three antiprogestogens of the RU 38.486, ZK 98.734, and ZK 98.299, were studied at different stages of pregnancy in the guinea pig. Treatment starting on postconception day 4 completely prevented nidation; all three compounds had comparable inhibitory potency. Treatment after nidation, starting on postconception day 8, induced decidual collapse and bleeding, but embryonic tissue was retained in nidation sites. In contrast to results in animals in nonfertile cycles, luteolysis was not induced, indicating that antiprogestogens lack the ability to induce uterine prostaglandin synthesis/liberation. On postconception day 43, RU 38.486 showed marginal abortifacient activity. The other compounds induced expulsion more rapidly and at a higher rate. The comparatively pronounced antiglucocorticoid activity of RU 38.486 may account for this difference. With RU 38.486, a high level of uterine prostaglandin sensitivity and a cervical ripening were induced consistently and fast; spontaneous labor, on the other hand, occurred after several days, if at all. Complete uterine evacuation was induced within hours by otherwise inactive doses of sulprostone in various combinations with ZK 98.299 RU 38.486 but surprisingly not with ZK 98.734. A single dose of ZK 98.299 induced an approximately thirtyfold increase in uterine prostaglandin sensitivity within 24 hours, exceeding that present before term, but did not induce spontaneous labor. This is evidence that endogenous prostaglandins were not activated, analogous to perinidation stages. Observation of antiluteolytic activity of antiprogestogens in nonpregnant animals is considered of major theoretical importance in this context. It seems that inhibition of progesterone leads to suppressed uterine prostaglandin liberation. The same effect in pregnancy could explain the inability of the uterus to expel a seriously compromised conceptus. In conclusion, we suggest that progesterone is a stimulator rather than a depressor of uterine prostaglandins in the late luteal phase and pregnancy. The ability of the conceptus to neutralize this stimulatory action of progesterone is considered to be essential for the rescue of the corpus luteum and uterine motor quiescence in the guinea pig. The clinical significance of these findings is that the high frequency of incomplete abortions and protracted, sometimes heavy bleeding in pregnant women treated with RU 38.486 may reflect decidual compromise and simultaneous uterine prostaglandin deficie

Topics: Abortion, Induced; Animals; Dinoprost; Dinoprostone; Dose-Response Relationship, Drug; Embryo Implantation; Endometrium; Estrenes; Female; Gonanes; Guinea Pigs; Mifepristone; Myometrium; Pregnancy; Pregnancy, Animal; Progesterone; Prostaglandins E, Synthetic; Prostaglandins F; Uterine Contraction