Evidence of ERalpha and ERbeta selectivity and partial estrogen agonism in traditional Chinese medicine
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RESEARCH
Open Access
Evidence of ERalpha and ERbeta selectivity and partial estrogen agonism in traditional Chinese medicine Dov Tiosano1†, Françoise Paris2,3,4†, Marina Grimaldi4, Vera Georgescu6, Nadège Servant3, Zeev Hochberg1,5, Patrick Balaguer4 and Charles Sultan2,3*
Abstract The use of complementary and alternative medicine and herbal products, especially traditional Chinese medicines, is progressively rising for both adults and children. This increased use is based on the popular belief that these medicines are safe and harmless. In this report, we describe the results of a bedside-to-bench study that involved a short-statured 4-year-old boy with deficiencies in growth hormone, thyroid stimulating hormone, and adrenocorticotropic hormone due to an ectopic posterior pituitary gland and invisible pituitary stalk. Although the boy was given replacement therapy with hydrocortisone and L-thyroxin, the parents refused to treat him with growth hormone and consulted a naturopath who prescribed a traditional Chinese medicine (TCM) to stimulate the boy’s growth. From the age of 20 months, the child’s growth was regularly monitored while he was being treated with hydrocortisone, thyroxin, and the TCM. Over a 36-month period, the child’s growth velocity accelerated (3 cm/year to 8 cm/year), his height increment substantially increased (-2 SD to -0.8 SD), and his bones matured. In the laboratory investigation, estrogen receptor (ER)alpha and ERbeta reporter cell lines were used to characterize the estrogenic activity of the TCM medicine and its 18 components, and the results established that the medicine and some of its components have estrogen receptor ERalpha and ERbeta selectivity and partial estrogen agonism. Partial estrogenic activity of the TCM was confirmed using whole-cell competitive binding, cell proliferation, and endogenous gene expression assays in the ERalpha-positive breast cancer cell lines. Although the presence of evidence is not always evidence of causality, we have concluded that this traditional Chinese medicine contains ingredients with estrogenic activity that can sustain bone growth and maturation without affecting other estrogen-dependent tissues. Keywords: Estrogen receptors, Traditional Chinese medicines
Background Over the past few decades, the use of traditional Chinese medicines (TCMs) has become internationalized. Although most components in TCMs are derived from plants, some are also derived from animals. Irrespective of the source of their components, TCMs are generally perceived as being safe and easy to use [1-5].
* Correspondence: [email protected] † Equal contributors 2 Unité d’Endocrinologie Pédiatrique, CHU Arnaud de Villeneuve, Montpellier, France 3 Département d’Hormonologie, CHU Lapeyronie, et Université Montpellier 1, Montpellier, France Full list of author information is available at the end of the article
Our interest in TCMs and their possible effect on growth began when a short-statured 4-year-old boy with multiple pituitary hormone deficiencies, whose pare
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