Navegando por Palavras-chave "selective estrogen receptor modulator"

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    Estrogen receptor (ER) gene polymorphism may predict the bone mineral density response to raloxifene in postmenopausal women on chronic hemodialysis
    (Taylor & Francis Inc, 2005-01-01) Heilberg, I. P.; Hernandez, E.; Alonzo, E.; Valera, R.; Ferreira, L. G.; Gomes, S. A.; Bellorin-Font, E.; Weisinger, JR; Universidade Federal de São Paulo (UNIFESP); Cent Univ Venezuela
    The estrogen receptor (ER) gene has been considered as a candidate genetic marker for osteoporosis, and PvuII and XbaI polymorphisms of the ER alpha gene have been associated with low bone mineral density (BMD). We investigated whether ER polymorphism could predict the response of BMD in 28 postmenopausal women on hemodialysis with marked osteopenia or osteoporosis, randomized to receive raloxifene, a selective estrogen receptor modulator (SERM), or placebo for I year. BMD was assessed by dual X-ray absorptiometry and PvuII and XbaI restriction fragment-length polymorphism of the ER gene was determined using polymerase chain reaction. Baseline lumbar spine or femoral neck BMD parameters were not different between patients presenting either homozygous PP or xx when compared with heterozygous Pp or Xx genotypes. After 1 year, patients on raloxifene, presenting with PP or xx genotypes (but not those with Pp or Xx), showed a significantly higher mean lumbar spine BMD (0.942 +/- 0.18 vs. 0.925 +/- 0.17 2 g/cm(2), p <.01) and lower serum pyridinoline (19.7 +/- 9.7 vs. 30.6 +/- 16.5 nmol/L, p <.02) when compared with baseline values. No changes were detected in the placebo-treated patients or in the femur neck sites. in conclusion, after I year on raloxifene, postmenopausal osteoporotic women on chronic hemodialysis, homozygous for the P or x (PP or xx) alleles of the ER, exhibited a better lumbar spine BMD response and decreased serum pyridinoline values when compared with heterozygous women (Pp or Xx), suggesting that ER alpha allelic variants may explain, at least in part, the different outcomes after treatment of osteoporosis with SERM.
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    Selective estrogen receptor modulators in chronic renal failure
    (Nature Publishing Group, 2003-06-01) Weisinger, Jose R; Heilberg, Ita Pfeferman [UNIFESP]; Hernandez, Eddy; Carlini, Raul; Bellorin-Font, Ezequiel; Univ Munich; Universidade Federal de São Paulo (UNIFESP); San Carlo Borromeo Hosp
    Background. In addition to renal osteodystrophy, postmenopausal women on dialysis could be at risk of osteoporosis. Hormone replacement therapy (HRT) could have beneficial effects as well as potentially serious risks, especially in uremic women, due to the pharmacokinetics of estradiol in renal failure. Therapeutic alternatives, such as the selective estrogen receptor modulators (SERMs), have shown the benefits of estrogen on bone and serum lipid levels, without its adverse effects on the breast and endometrium, in nonuremic women.Methods. Recent data on the effect of the SERM raloxifene in bone and lipid metabolism in osteoporotic postmenopausal women on dialysis is reviewed. Since the estrogen receptor (ER) gene has been suggested as a candidate marker for osteoporosis, we investigated whether ER polymorphism could have predicted the BMD response to raloxifene.Results. Hemodialyzed women on raloxifene demonstrated increased trabecular bone mineral density (BMD) and decreased bone resorption markers. Similarly, LDL-cholesterol values dropped significantly. ER gene polymorphism analysis of baseline BMD parameters did not differ between PP/xx or Pp/Xx groups. Nevertheless, patients on raloxifene with PP/xx genotypes, but not those with Pp/Xx, showed a higher trabecular BMD after one year on treatment, suggesting that homozygous women for P or x alleles of the ER have a better BMD response to raloxifene.Conclusion. Raloxifene and, most likely, other SERMs, could represent a good alternative to HRT in postmenopausal uremic women.