Oestrogen supplementation following castration promotes stromal remodelling and histopathological...
Transcript of Oestrogen supplementation following castration promotes stromal remodelling and histopathological...
ORIG INAL ART ICLE
Oestrogen supplementation following castration promotesstromal remodelling and histopathological alterations in theMongolian gerbil ventral prostate
Wellerson Rodrigo Scarano*, Daniel Emıdio de Sousa�, Silvana Gisele Pegorin Campos�,
Lara Silvia Corradi*, Patricia Simone Leite Vilamaior� and Sebastiao Roberto Taboga�
*Cell Biology Department, Biology Institute, UNICAMP, Campinas, Sao Paulo, Brazil,�Department of Biology, Microscopy and
Microanalysis Laboratory, Sao Paulo State University – IBILCE ⁄ UNESP, Sao Jose do Rio Preto, Sao Paulo, Brazil and�Rio Preto
Universitary Center – UNIRP, Biological Sciences School, Sao Jose do Rio Preto, Sao Paulo, Brazil
Oestrogens regulate the prostate development and func-
tion at several stages by indirect and direct mechanisms.
Prostate growth, differentiation and functions are primarily
controlled by androgens (ARs) but oestrogens modulate
these effects in several ways. The most important routes
of indirect oestrogen regulation are interference in AR
INTERNATIONAL
JOURNAL OF
EXPERIMENTAL
PATHOLOGY
Received for publication:
22 June 2007
Accepted for publication:
22 July 2007
Correspondence:
Sebastiao Roberto Taboga
Department of Biology
IBILCE ⁄ UNESP
R. Cristovao Colombo
2265 - Jardim Nazareth
Sao Jose do Rio Preto, SP 15054-000
Brazil
Tel.: +55 17 32212386
Fax: +55 17 32212390
E-mail: [email protected]
Summary
The effect of oestradiol on the intact and castrated adult gerbil prostate was evalu-
ated by focussing on stromal and epithelial disorders, and hormonal receptor immu-
noreactivity. The experimental animals were studied by histological, histochemical
and immunohistochemical techniques, morphometric–stereological analysis and
transmission electron microscopy. Epithelial alterations in the oestradiol-treated
animals were frequent, with an increase in epithelial cell height, areas of intense dys-
plasia and hyperplasia and formation of prostatic intraepithelial neoplasia (PIN).
Another aspect that did not depend on the presence of testosterone was the arrange-
ment of the fibrillar and non-fibrillar elements of the extracellular matrix among
smooth muscle cells (SMC), suggesting a possible role of these cells in rearrangement
and synthesis of these components, after oestrogenic treatment. In the castrated
animals, an accumulation of extracellular matrix elements under the epithelium was
evident, while in the intact animals the same compounds were dispersed and scarce.
In the groups of intact and castrated animals, SMC and fibroblasts exhibited a secre-
tory phenotype, which was accentuated after oestradiol administration. There was
an increase of the immunoreactivity to a-oestrogen and androgen receptors in hyper-
plastic areas compared to normal epithelium, revealing the involvement of these ste-
roid receptors in the hyperplasia and PIN development.
Keywords
castration, epithelium, gerbil, oestradiol, prostate, stroma
Int. J. Exp. Path. (2008), 89, 25–37
doi: 10.1111/j.1365-2613.2007.00559.x
� 2007 The Authors
Journal compilation � 2008 Blackwell Publishing Ltd 25
production by repression of the hypothalamic-pituitary-
gonadal axis and direct effects on testis. Oestrogens also
clearly have direct effects on the prostate, which may be
elicited by external hormones or by oestradiol produced by
local aromatization of testosterone (Harkonen & Makela
2004). Oestrogen regulation has also been considered as one
of the hormonal risk factors in association with development
of benign prostate hyperplasia and prostate cancer (Bosland
2000; Henderson & Feigelson 2000). Exogenous oestrogens
given during the perinatal period elicit abnormalities in pros-
tate growth (Naslund & Coffey 1986), differentiation (Arai
et al. 1977), function (Prins et al. 1993), AR metabolism
(Santii et al. 1991), expression of AR receptors (Prins et al.
1993) and may lead to prostate cancer (Santii et al. 1990;
Prins 1997).
Squamous metaplasia, dysplasia and prostatic intra-
epithelial neoplasia (PIN) are direct effects of oestrogen on the
prostate induced by long-term exposure to high levels of exo-
genous or endogenous oestrogens (Risbridger et al. 2001;
Scarano et al. 2004). For example, the squamous metaplasia
of the prostate epithelium is characterized by the total replace-
ment of the columnar secretory epithelium by layers of strati-
fied squamous cells (Risbridger et al. 2001). The oestrogen
hormone effects are mediated through a-oestrogen (ERa) sig-
nalling. Stromal–epithelial interactions and a requirement of
both epithelial and stromal ERa contributed to elicit oestro-
gen-induced prostate normal epithelial growth and pathologi-
cal disorders. Presumably, the development of prostate
epithelial disorders involves the stimulation of epithelial pro-
liferation mediated by stromal ERa and an epithelial differen-
tiation mediated by epithelial ERas (Cunha et al. 2002).
Previous studies have indicated that following the oestro-
gen administration the smooth muscle cells (SMC) increased
in size and number, in the rat prostate (Thompson et al.
1979). Castrated and intact adult guinea-pig prostates
showed an increased density and thickness of the collagen
fibrils after oestradiol treatment (Neubauer & Mawhinney
1981; Mariotti & Mawhinney 1982; Scarano et al. 2005).
These effects are directly associated with the presence of oes-
trogen receptors (a-ER) in the stroma and stimulation of the
stromal cells by means of autocrine and paracrine mecha-
nisms (Droller 1997).
The Mongolian gerbil (Meriones unguiculatus) has been
recognized as experimentally useful in some biomedical sci-
ences, such as immunology (Nawa et al. 1994), physiology
(Nolan et al., 1990 ) and morphology (Pinheiro et al. 2003;
Santos et al. 2003, 2006; Corradi et al. 2004; Custodio
et al. 2004 ). More recently, the gerbil has also been sug-
gested as a suitable model for studies on mammalian ageing
and neoplasic prostate lesions (Pegorin de Campos et al.
2006; Campos et al. 2007). The gerbil prostate has compact
lobes, somewhat similar to the human prostate, unlike rats
and mice, which have distinct lobes (Pinheiro et al. 2003;
Goes et al. 2006). Previous data from our laboratory have
demonstrated that histological, histochemical and ultrastruc-
tural features of the adult gerbil ventral prostate are compa-
rable to the human prostate. Also, we have observed that
old gerbils (12 months) may spontaneously develop benign
prostate hyperplasia, cancer and other prostate disorders,
mainly in ventral prostate (Pegorin de Campos et al. 2006).
Morphological studies on the oestrogenic effects in the
prostate gland had been performed in many commonly used
experimental animals, including mouse (Triche & Harkin
1971), rat (Kjaerheim et al. 1974; Thompson et al. 1979)
and guinea-pig (Neubauer & Mawhinney 1981; Scarano
et al. 2005), however, these studies focus on more general
aspects of the gland, related to the epithelial comportment
at most times and they used more simple morphological
methodologies.
In the present study, we evaluated in intact and castrated
gerbils the influence of oestrogen in epithelial and stromal
prostate compartments to establish the effects of this hor-
mone in this new animal model and to compare the results
obtained in other experimental models.
Material and methods
Animals and hormone treatments
Twenty adult (120 days) male M. unguiculatus gerbils were
randomly divided into four experimental groups: intact con-
trol (C), intact oestradiol-treated (E), castrated (Ca) and cas-
trated oestradiol-treated (CaE). The Ca and CaE groups
were submitted to bilateral orchiectomy by abdominal surgi-
cal incision. The deferent ducts were sectioned and tied and
the two testes were removed by abdominal cavity. After the
surgery, the animals of these groups were placed in individ-
ual boxes and submitted to the treatments after 7 days. The
E and CaE groups received, during 21 days, alternately, sub-
cutaneous injections of oestradiol benzoate (Sigma Chemical
Co., St Louis, MO, USA) diluted in corn oil (10 mg ⁄ ml), at
a dose of 0.1 ml ⁄ application ⁄ animal (1 mg ⁄ application),
while C and Ca groups received only vehicle.
After 21 days of treatment, the animals were lightly
anesthetized by CO2 inhalation, weighed and immediately
decapitated for blood collection. The ventral prostate was
removed, weighed in an analytical balance, and immediately
processed for light and electron microscopic studies.
Animal handling and experiments were carried out
according to the ethical guidelines of the Sao Paulo State
26 W.R. Scarano et al.
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Journal compilation � 2008 Blackwell Publishing Ltd, International Journal of Experimental Pathology, 89, 25–37
University (Unesp), following the ‘Guide for Care and Use
of Laboratory Animals’. The number of individuals
employed in this work was justified by the large number of
analytical procedures employed.
Serum hormonal levels
Circulating serum testosterone levels were determined by
immunochemical assays. After 21 days of treatment, blood
was collected by decapitation from the ruptured cervical
vessels and the serum was separated by centrifugation (300 g)
and stored at )20 �C for subsequent hormone assay. The
determination of serum testosterone levels was performed
by luminescence immunoassay (mouse anti-testosterone
antibodies; Johnson & Johnson, Orthoclinical Diagnostics
Division, Amersham, UK) in an automatic analyzer:
Vitros-ECi (Johnson & Johnson, Orthoclinical Diagnostics
Division, USA) for ultrasensitive chemiluminescence detec-
tion. The intra-assay and inter-assay variation were 4.6% and
4.3% respectively. The tests are linear from 0 to 30 ng ⁄ ml
(detection level).
Histochemistry
Ventral prostates of the four experimental groups were cut
into fragments of 5 lm, selected from the gland distal seg-
ment. Same ventral prostatic fragments samples were sepa-
rated from these to be proceeded for transmission electron
microscopy. The remaining fragments were immediately
fixed by immersion in Karnovsky’s fixative (0.1 m Sorensen
phosphate buffer pH 7.2 containing 5% paraformaldehyde
and 2.5% glutaraldehyde) for 24 h. Fixed tissue samples
were dehydrated in a graded ethanol series and embedded in
glycol methacrylate resin (Leica historesin embedding kit).
Histological sections (3 lm) were subjected to haematoxy-
lin–eosin (H&E) staining for general studies, to Gomori’s
reticulin (Gomori 1937) staining for collagen and reticular
fibres analyses and to the Feulgen reaction (Mello & Vidal
1980) for nuclear study. Histopathological analyses were
performed on Zeiss-Jenaval or Olympus photomicroscopes,
and the microscopic fields were digitized using the software
Image-Pro�Plus version 4.5 for Windows� software
(Media Cybernetics, Bethesda, MD, USA).
Morphometric and stereological analysis
Using an imaging analysis system (Image-Pro�Plus version
4.5 for Windows� software), H&E and Feulgen sections
were studied. Randomly H&E images of 100 histological
fields per experimental group were captured and analysed by
the stereological method, such that histological fragments of
all animals were evaluated equally (20 per animal). Stereolo-
gical analyses were obtained by Weibel’s multipurpose gra-
ticulate, with 120 points and 60 test lines (Weibel 1979) to
compare the relative volume among the prostate components
(epithelium, stroma and acinar lumen) in the experimental
groups.
Morphometric analysis was performed to evaluate epithe-
lial height, SMC layer thickness surrounding the acini, and
nuclear area and nuclear perimeter (kariometry) of the secre-
tory epithelial cells. For this comparative study, 200 random
group measures in normal acini (free of hyperplasic pro-
cesses) were performed for each parameter.
To quantify the density of cells positive for ERa and AR,
cells from normal and hyperplasic epithelial regions (if pres-
ent) were selected and analysed per experimental animal
(200 ⁄ each region) totalling 1000 cells per group ⁄ region
(n = 5), and the percentage of cells negative and positive for
hormonal receptor immunoreactivity were estimated.
Statistical analysis
The effects of oestradiol on gerbil ventral prostate were evalu-
ated by analysing mean ± standard deviation (SD). The statis-
tical analysis was performed with the statistica 6.0 software
(StatSoft, Tulsa, OK, USA). The anova hypothesis test and
Tukey honest significant difference (HSD) test were employed
and P £ 0.05 was considered statistically significant.
Transmission electron microscopy
Ventral prostates fragments of the experimental groups were
processed for transmission electron microscopy as described
previously (De Carvalho et al. 1994), employing the fixation
procedure of Cotta-Pereira et al. (1976). Briefly, ventral pros-
tate fragments, selected from the distal segment of the gland,
were fixed in 0.25% tannic acid plus 3% glutaraldehyde in
Millonig’s buffer, dehydrated in acetone and embedded in
Araldite resin. After selecting the area of interest in the distal
region of the prostate by trimming of the material using a
glass knife, silver sections (50–75 nm) obtained with a dia-
mond knife were collected and stained by uranyl acetate and
lead citrate. Observation and electron micrographs were made
with a LEO–Zeiss 906 transmission electron microscope
(Leo-Zeiss, Cambridge, UK).
Immunohistochemistry (IHC)
Androgen (SC-816, 1:100 dilution; rabbit polyclonal
antibody), ERa (SC-542, 1:50 dilution; rabbit polyclonal
Oestrogen effects on gerbil’s ventral prostate stroma 27
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Journal compilation � 2008 Blackwell Publishing Ltd, International Journal of Experimental Pathology, 89, 25–37
antibody) (Santa Cruz Biotechnology, Santa Cruz, CA, USA)
and chondroitin sulphate-anti-SC56 (Sigma Chemical Co.)
were used for IHC. The immunohistochemical reaction was
performed using the avidin–biotin complex (ABC) kit (Santa
Cruz Biotechnology). For the immunohistochemical tech-
nique, ventral prostate fragments selected from the gland
distal segment were fixed in 10% formaldehyde, dehydrated
in alcohol and embedded in paraplast. The sections (4 lm)
were dewaxed and then rehydrated in graded alcohol and
distilled water. Antigenic recuperation was realized in citrate
buffer at high temperature (100 �C) for 45 min. Endogenous
peroxidase activity was blocked with 0.3% hydrogen perox-
ide in methanol for 45 min, followed by a quick rinse in dis-
tilled water and phosphate-buffered saline (PBS). Sections
were incubated with normal goat and primary antibody at
4 �C overnight. The slides were then incubated with biotiny-
lated anti-rabbit at 37 �C followed by peroxidase-conjugated
ABCs and diaminobenzidine (DAB). The sections were then
counterstained with Harris’s haematoxylin. For negative
control, the primary antibody was replaced with the corre-
sponding normal isotype serum.
Results
Structure and ultrastructure
C group. The prostate of the intact adult gerbil presented
glandular units, with simple cylindrical epithelium, adjacent
to and a fine smooth muscle, which delimited the lumen
of the gland (Figure 1a,b). Among the acini was noted a
dispersed and loose connective vascularized tissue. The epi-
thelial cells of the gland possessed evident secretory charac-
teristics, revealed by the presence of the secretion organelles
above the nucleus (Figure 13). Adjacent to the epithelium
and interspersed with the SMC, there was scanty extra-
cellular matrix fibres (Figures 1b, 5a and 14). Alteration in
body weight was not verified among the experimental
groups (Table 1).
E group. In E animals, absolute and relative weights of the
prostatic gland decreased when compared with the C group
(Table 1). The acinar lumen was also decreased. However,
increases in the epithelial height and in the smooth muscle
layer were noted (Figure 2c). The nuclear area was also sta-
tistically significantly increased, and the nuclear perimeter,
although not statistically significant, was also increased
(Table 1). Ultrastructurally, the epithelial secretory cells
appeared with a large number of dilated cisternae (Figure 22)
and with circular endoplasmic reticulum (Figure 21). Areas
containing frequent hyperplasia and dysplasia presented
elongated epithelial cells with nuclei of different sizes and
heights (Figure 2a,b). In the epithelial compartment, due to
intense dysplasia, areas with cells dislocated to the apical
regions were noted, implying a possible detachment
(Figure 2b). In some acini, the presence of PIN was docu-
mented at the light microscopy (Figure 2d). At the transmis-
sion electron microscopy the epithelial stratification with
loose chromatin and conspicuous nucleolus were observed
Table 1 Quantitative analysis from experimental groups
Experimental groups
C E Ca CaE
Morphometry (lm)
Epithelium height 13.08a ± 2.14 22.32b ± 4.80 10.16a ± 2.73 19.42b ± 3.24
SMC layer thickness 8.51a ± 1.85 11.87b ± 2.00 12.38b ± 2.43 11.75b ± 2.48
Kariometry of secretory cells
Nuclear area (lm2) 23.15a ± 3.84 30.06b ± 4.27 21.15a ± 4.51 27.80b ± 4.96
Nuclear perimeter (lm) 21.27a ± 2.80 22.96a ± 3.20 19.61a ± 2.61 21.94a ± 2.74
Relative volume of tissue components (%)
Epithelium 19.84a ± 2.64 28.15b ± 2.66 17.87a ± 4.64 33.90b ± 12.47
Stroma 38.77a ± 10.04 38.42a ± 5.34 50.13b ± 7.85 41.20a ± 10.25
Lumen 43.89a ± 10.52 33.46b ± 6.19 32.0b ± 11.99 24.90c ± 13.52
Body weight (g) 80.0 ± 8.7 79.5 ± 7.0 78.8 ± 8.5 81.2 ± 6.5
Prostate weight (g) 1.04a ± 0.25 0.55b ± 0.16 0.64b ± 0.11 0.76b ± 0.17
Relative prostate weight (g prostate ⁄ g body weight)2 0.013a ± 0.002 0.007b ± 0.001 0.008b ± 0.001 0.009b ± 0.001
Statistical analyses based on anova and Tukey tests. Lower case letters (a, b, c, d) indicate statistically significant difference (P £ 0.05).
C, control; Ca, castrated; E, oestradiol-treated; CaE, catrated oestradiol-treated animals).
28 W.R. Scarano et al.
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Journal compilation � 2008 Blackwell Publishing Ltd, International Journal of Experimental Pathology, 89, 25–37
(Figure 20). These morphological parameters were
considered here as PIN lesions. Morphologically, the stroma
of the E group presented less elongated and more fusiform
SMC compared with the C group (Figure 2c). The ultra-
structure showed hypertrophic SMC with well-developed
secretory organelles (Figure 24). Besides, fibroblasts acti-
vated with large quantities of endoplasmic reticulum and
Golgi complex were observed (Figure 26). Extracellular
(1a)
(1b)
(2a)
(2c)
(2b)
(2d)
(3a)
(3b)
(4a)
(4c)
(4b)
(4d)
Figures 1–4 Histological sections stained by haematoxylin–eosin. 1(a,b): Intact control group (C) – 1(a) general aspect of the prostate
acinus; 1(b) detail of the epithelium (e) and smooth muscle cells layer (SMC) of adult prostate acinus. 2(a–d): Oestradiol-treated
group (E) – 2(a) general aspect of a prostate acinus with high epithelium and dysplasia; 2(b) cells dislocated to the apical regions
(arrow), simulating a possible detachment and secretory granules in the lumen were observed; 2(c) detail of the transition epithelium-
stroma; arrow point the subepithelial stroma and the fusiforms smooth muscle cells. Between the SMC conjunctive tissue was
observed; 2(d) a high-grade prostate intraepithelial neoplasia (PIN). 3(a,b): Castrated group (Ca) – 3(a) prostate acinus with a low
epithelium (ep), SMC and evident subepithelial conjunctive stroma (arrow); 3(b) detail of the prostate acinus where a prominent sub-
epithelial conjunctive stroma (arrow) and SMC with irregular aspect were noticed. 4(a–d): Oestradiol-treated castrated group (CaE) –
4(a) prostate acinus showing the epithelial enfolding (ep). Arrow points to subepithelial connective stroma; 4(b) arrows point to basal
membrane with sinuous aspect (e) abundant conjunctive stroma. Arrow head show the SMC with irregular spine-like cytoplasmic
projections. Notice the high epithelial cells (ep); 4(c) presence of PIN and abundant subepithelial stroma (arrow) and a substantial
layer of SMC; 4(d) detail of epithelium-stroma transition showing the subepithelial connective tissue (arrow), the SMC and the
dysplasic epithelium (ep).
Oestrogen effects on gerbil’s ventral prostate stroma 29
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matrix compounds appeared in an expressive feature, with
an increase in elastic and collagen fibres mainly adjacent to
SMC. An intimate relationship was observed between syn-
thesized fibrils and stromal cells, including the formation of
cytoplasmic compartments through elongation of fibroblasts
and SMC (Figures 6a, 29 and 30). Furthermore, non-fibrillar
components of chondroitin sulphate had a predominantly
inter-SMC demarcation and distribution (Figure 6b).
Ca group. The prostate gland of the Ca group showed acini
with cubic ⁄ short cylindrical epithelium, surrounded by a
thick connective tissue and SMC concentrically arranged
(Figure 3a,b). The short epithelial cells assumed, a flat aspect
(Figure 3a,b), increasing the nucleus–cytoplasm ratio. An
irregular and wavy basal membrane was noted in most of its
extension, forming a semi-pleated arrangement (Figures 3b,
7a, 15 and 17). Adjacent to the epithelium and filling out
the irregularities of the basal membrane, a thick connective
subepithelial tissue was observed (Figures 3b, 7a, 15 and
17). This connective stroma had abundant extracellular
matrix fibres, mainly collagen (Figures 7a, 15 and 17) and
reticular ones (Figure 7a). Strongly immunoreactive non-
fibrillar components, such as chondroitin sulphate revealed
(9a)
(9b)
(9c)
(10a)
(10b)
(10c)
Figures 9 and 10 Histological sections submitted to ERa IHC –
9(a) intact control group; 9(b–c) oestradiol-treated group; 10(a)
castrated group; 10(b–c) oestradiol-treated castrated group.
Brown stain means positive demarcation.
(11a)
(11b)
(12a)
(12b)
Figures 11 and 12 Histological sections submitted to AR IHC –
11(a) intact control group; 11(b) oestradiol-treated group; 12(a)
castrated group; 12(b) oestradiol-treated castrated group. Brown
stain means positive demarcation.
(5a) (5b)
(6b)(6a)
(7a) (7b)
(8b)(8a)
Figures 5–8 5(a), 6(a), 7(a) and 8(a) Histological sections
stained by Gomori’s reticulin; 5(b), 6(b), 7(b) and 8(b): histolog-
ical sections submitted to chondroitin sulphate IHC – 5(a,b)
intact control group; 6(a,b) oestradiol-treated group; 7(a,b) cas-
trated group; 8(a,b) oestradiol-treated castrated group. Arrows
point positive demarcation to reticulin fibres and chondroitin
sulphate respectively. *collagen fibres; ep, epithelium; l, lumen.
30 W.R. Scarano et al.
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Journal compilation � 2008 Blackwell Publishing Ltd, International Journal of Experimental Pathology, 89, 25–37
Table 2 Relative frequencies (%) of AR
and ERa positive cells obtained by anti-
AR and anti-ERa immunohistochemical
method
Experimental groups
C E Ca CaE
AR positive cells
Normal epithelium 49.5 ± 4.5 52.2 ± 5.1 45.8 ± 3.9 51.5 ± 4.8
Hyperplasic epithelium – 72.4* ± 6.0 55.5 ± 5.9 77.2* ± 6.5
ERa positive cells
Normal epithelium 35.2 ± 3.2 42.5 ± 5.2 36.2 ± 4.8 39.5 ± 3.5
Hyperplasic epithelium – 71.5* ± 7.2 37.2 ± 4.5 69.8* ± 7.2
Statistical analyses based on Tukey test. *Statistically significant difference (P £ 0.05).
(13) (14)
(15) (16) (17)
(18)
(21)
(19) (20) (22)
Figures 13–22 Transmission electron
microscopy: ultrastructural aspects –
(13) epithelial cells (ep) from intact con-
trol prostate. Arrow points to secretion
organelles, bar = 2.60 lm; (14) epithe-
lium-stroma transition. Arrow point to
basal laminae; in the stroma the smooth
muscle cells (SMC), fibroblasts (fib) and
scarce collagen fibres (col); intact con-
trol group, bar = 0.94 lm; (15) abun-
dance of bunches of collagen fibres (col)
in the subepithelial stroma and fibro-
blasts (fib), epithelium (ep), Ca group,
bar = 1.56 lm; (16) detail of the acti-
vated fibroblast (fib) with dilated
endoplasmic reticulum cisternae
(arrow), Ca group, bar = 0.72 lm; (17)
sinuous aspect of basal laminae (bl)
with collagen deposition (col) in the
subepithelial stroma, Ca group,
bar = 0.72 lm; (18) irregular arrange-
ment of SMC and collagen fibres (col),
Ca group, bar = 1.56 lm; (19) epithe-
lial cells from oestradiol-treated cas-
trated prostate, bar = 2.60 lm; (20)
PIN in oestradiol-treated prostate. The
epithelial stratification with loose chro-
matin and conspicuous nucleolus were
used here as morphological parameters
for PIN diagnosis, bar = 3.36 lm; (21)
detail of an epithelial cell from
oestradiol-treated prostate, showing the
circular endoplasmic reticulum,
bar = 0.56 lm; (22) a high epithelial
cell from oestradiol-treated group. The
arrow points to dilated cisternae,
bar = 2.01 lm. n, nuclei; ep,
epithelium; st, stroma; SMC, smooth
muscle cells.
Oestrogen effects on gerbil’s ventral prostate stroma 31
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Journal compilation � 2008 Blackwell Publishing Ltd, International Journal of Experimental Pathology, 89, 25–37
by IHC, were also noted in this subepithelial region (Fig-
ure 7b). It is interesting that in this experimental group the
extracellular matrix components, despite being markedly dis-
tributed in the periacinar region, were concentrated mainly
in the adjacent area to the basal lamina (Figures 7a, 15 and
17) where fibroblasts presented high synthetic activity
(Figure 16). In the concentrically smooth muscle arranged
around acini, the SMC formed irregular layers (Figure 3a)
among the extracellular matrix fibres (Figure 3b) of the sub-
epithelial stroma. These cells assume a spinous and irregular
phenotype (Figures 3b and 18), different from the elongated
fusiform aspect usually found in the layers of the C group
prostates (Figure 3a).
CaE group. After oestradiol administration for 21 days to
castrated animals, we observed an increase in the amount of
epithelium, besides a decrease in the amount of the lumen,
when compared with the Ca group (Table 1). Significant
alterations in the secretory activity of CaE prostates were
observed. The epithelium was predominantly cylindrical,
which culminated in an increase in the height of the epithe-
lium (Table 1). An increase in the nuclear area of secretory
epithelial cells was also observed (Table 1). After the treat-
ment, dysplastic areas with an increase in cellular size were
observed (Figure 4b,d). Besides, there were areas with occur-
rence of PIN characterized by agglomerated epithelial cells
with heterogeneous phenotypes (Figure 4c). Yet the basal
membrane was observed, as found in the Ca group, with a
wavy and semi-pleated arrangement (Figures 4b,d and 8a).
Accumulation of collagen fibres (Figure 8a) was observed
adjacent to the epithelium, accompanying the confluences
of the basal membrane and interspersed with SMC.
(23)
(25)
(26)
(27) (28) (30)
(29)
(24)
Figures 23–30 Transmission electron
microscopy – ultrastructural aspects –
(23) general aspect of stromal compart-
ment showing the SMC with ER promi-
nent in oestradiol-treated castrated
prostate, bar = 1.21 lm; (24) the SMC
with dilated Golgi apparatus cisternae
(arrow), E group, bar = 0.56 lm; (25)
the SMC with irregular spine-like
cytoplasmic projections surrounded by
collagen fibres (col), CaE group,
bar = 1.21 lm; (26) the activated
fibroblast replete of ER and with
dilated Golgi apparatus cisternae (Ga).
Notice the prominent nucleolus, E
group, bar = 1.21 lm; (27 and 28)
detail of SMC prolongations and colla-
gen (col) arrangement between them.
elastic fibers (el), CaE group; (27)
bar = 1.56 lm; (28) bar = 1.21 lm;
(29 and 30) detail of SMC showing the
intimate contact with elastic fibres (el)
in cytoplasmic prolongations and
collagen fibres (col), E group; (29)
bar = 0.72 lm; (30) bar = 0.94 lm.
n, nuclei; nu, nucleolus.
32 W.R. Scarano et al.
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Apparently, a preferential deposition of collagen fibres
occurred among the SMC in this experimental group
(Figures 8a, 27 and 28). Besides, there was also a discreet
increase in the fibrous bunches that permeate SMC and in
chondroitin sulphate (Figure 8b). The arrangement of the
SMC resembles that observed in the Ca group because they
assumed an elongated fusiform phenotype, forming concen-
tric bunches of fibres (Figure 4a), and irregular spine-like
cytoplasmic projections, unwrapped by the extracellular
matrix (Figures 4b and 25).
Immunohistochemistry
The expression of AR and ERa, in all experimental groups,
presented positive and negative reaction in the epithelial and
stromal cells (Figures 9a, 10a, 11a and 12a). The immuno-
reactivity was heterogeneous, demonstrating that some
cellular clones are more sensitive to the action of those hor-
mones. After oestradiol treatment, the density of ERa and
AR positive cells was greater in hyperplastic and dysplastic
epithelial areas (Figures 9b,c, 10b,c, 11b and 12b; Table 2),
when compared with areas in normal epithelium (Table 2).
The IHC assays for the demarcation of chondroitin sul-
phate, a glycosaminoglycan of the stromal extracellular
matrix, in the C group (Figures 7 and 8) demonstrated a dif-
fuse demarcation, with moderate intensity of reaction, in the
areas adjacent to the epithelial base and SMC. Besides, in
some acini the specific demarcation in the epithelial cells,
especially in the Golgi complex, was observed due to the
production of sulphated residues. Immunoreactivity of chon-
droitin sulphate in E and CaE groups (Figures 6b and 8b)
showed localization less diffuse than in C and Ca groups,
with strong reaction mainly in the areas adjacent to the
basal lamina and among the SMC. A preferential deposition
of chondroitin occurred among the SMC (Figures 6b and
8b), what was similar to the collagen fibres in the E and
CaE groups.
Hormonal levels. Serum testosterone levels varied signifi-
cantly (P £ 0.05) between C, E, Ca and CaE groups, which
confirmed an expected decrease in hormonal concentrations
in each experimental group in comparison to the intact C
group (Figure 31).
Discussion
Understanding the role of oestrogens in the prostate and
how it acts to modulate prostate development growth and
disease is of immense interest. In this work, we investigate
the influence of oestradiol benzoate in the ventral prostatic
stroma and epithelium and demonstrated the direct activity
of oestrogens on stromal cells and extracellular elements
resulting in compositional changes in the stromal
compartment.
Oestrogen has been implicated in the pathogenesis of
prostate diseases by their direct and indirect effects. Promi-
nent among the direct effects is the anti-androgenic action
caused by repression of the hypothalamic-pituitary-gonadal
axis and direct effect on the testis. Oestrogens also clearly
have direct effect on the prostate, which may be elicited by
external hormone or by oestradiol produced by local aroma-
tization of testosterone (Harkonen & Makela 2004).
The effects of orchiectomy have been studied under vari-
ous aspects in several experimental animals, mainly as a
model of studying the rearrangement of extracellular matrix
architecture (Carvalho & Line 1996; Vilamaior et al. 2000;
Antonioli et al. 2004). Along with these studies, researches
using oestrogen have been accomplished to define its role
more precisely in hypoandrogenic prostate tissue (Tam &
Wong 1991; Pelletier 2002) and in physiological conditions
(Scarano et al. 2004).
According to Pegorin de Campos et al. (2006) and Scar-
ano et al. (2006), the prostatic acinus of intact adult gerbil
presents simple cylindrical epithelium, with the presence of
secretion granules in the lumen, and prominent chromo-
phobes areas adjacent to the nucleus, identified as Golgi
apparatus.
Our results showed that the epithelium of the Ca group
was found short and cubic, with scarce secretion vesicles in
Figure 31 Mean ± SD values of serum testosterone levels
(ng ⁄ ml) from experimental groups (C, control; Ca, castrated; E,
oestradiol-treated; CaE, catrated oestradiol-treated animals).
Statistical analysis based on anova and Tukey tests. Different
superscript letters (a, b) indicate statistically significant
difference (P £ 0.05).
Oestrogen effects on gerbil’s ventral prostate stroma 33
� 2007 The Authors
Journal compilation � 2008 Blackwell Publishing Ltd, International Journal of Experimental Pathology, 89, 25–37
the luminal border and relatively high nucleus–cytoplasm
ratio. There was no significant decrease in the height of the
epithelium in Ca when compared with C, but it was an evi-
dent morphological and quantitative tendency to this. This
regression of the prostate was frequent in androgenic abla-
tion, which agrees with the data obtained previously by
Pelletier (2002) with mice and after experimental chemical
castration with guinea-pig (Cordeiro et al. 2004) and also
with adult gerbil (Corradi et al. 2004).
The surgical castration process also reveals an increase in
stromal compartment, when comparing with intact animals
(Vilamaior et al. 2000). In the Ca group, a great amount of
extracellular matrix fibres was observed in the subepithelial
stroma, in addition to structural modifications of SMC.
According to Vilamaior et al. (2000), the androgenic defi-
ciency promotes a rearrangement of extracellular matrix
fibres, and possibly, synthesis of constituents of this matrix.
This rearrangement occurs probably due to alterations in
SMC synthetic capacity, which might play a more synthetic,
than contractile, role.
Horsfall et al. (1994) demonstrated in guinea-pigs that
during the ageing process, SMC increases its synthetic capac-
ity, thus modifying its morphological structure. Similarly,
experimental studies using orchiectomy and chemical castra-
tion showed an increase in extracellular matrix components
allied with phenotypic alterations of SMC that started to
exhibit an irregular and spinous arrangement (Antonioli
et al. 2004; Corradi et al. 2004). The phenotypic transition
of SMC, in this case, involves a process denominated dedif-
ferentiation previously described in androgenic blockade
processes (Corradi et al. 2004) and after oestrogen treat-
ments (Zhao et al. 1992), where the muscle cells assume an
essentially secretory phenotype (Vilamaior et al. 2005).
Alterations in prostatic nuclei structure during the castra-
tion, hormonal recovering and in prostatic lesions by quanti-
tative nuclear morphometry (kariometry) may be an
excellent histopathological tool for microscopic diagnosis.
The kariometric data revealed that even the E and CaE
groups had increased the nuclear area, besides an increase of
the epithelial height, as was previously observed by Scarano
et al. (2004) and could be related with increase of the syn-
thetic and ⁄ or metabolic cell activity. Nuclear parameters can
be efficient to compare some epithelial modifications (Martı-
nez-Jabaloyas et al. 2002; Taboga et al. 2003), but it is not
effective in diagnosis of prostate lesions and should be inter-
preted together with other results. Recent research employing
40 quantitative nuclear morphometric parameters suggested
with those parameters as a new biomarker for prostatic can-
cer and histopathological gradation (Veltri et al. 2007). Fur-
thermore, dysplastic processes with alteration of the
epithelial structure and hyperplasia in determinate regions of
the ventral prostate contributed to the relative increase of the
epithelium verified in these animals. Scarano et al. (2004)
described intraepithelial alterations in guinea-pigs treated
with oestradiol, and observed the occurrence of PINs with
relative increase in the epithelial compartment.
The histopathological classification of the epithelial altera-
tions in this work were based to the model proposed by
Campos et al. (2007) to the prostate lesions in the aged ger-
bil that classify and compare normal epithelium, hyperplasic
epithelium, PIN and adenocarcinoma. According to Campos
et al. (2007) and Bar Harbor Classification System for the
mouse prostate, developed by National Cancer Institute
Mouse Models of Human Cancer Consortium Prostate
Steering Committee (Shappell et al. 2004), PIN was charac-
terized by agglomerations of heterogeneous epithelial cells
with probable atypical function and cytoplasmic projections
can extend towards the extracellular matrix, compressing
the basement membrane.
The cytoplasm of epithelial cells presented dilated endo-
membranes in some areas and circular endoplasmic reti-
culum, in E group, was also noted. This circular structure
had been described by Kjaerheim et al. (1974) in castrated
animals, where reduction was observed in the size of
synthesis organelles and number of ribosomes.
Receptors specific for oestrogen were identified in both
the epithelium and stroma (Prins & Birch 1997). Experimen-
tal studies have demonstrated that oestrogen is involved in
the induction of premalignant and malignant alterations
(Weihua et al. 2001; Scarano et al. 2004). According to
Cunha et al. (2002), the epithelial alterations, such as squa-
mous metaplasia, require oestrogen action through stromal
ERa, in a paracrine mechanism, as well as by the ERa epi-
thelial route. Such results concur with the data obtained in
this study, where higher density of ERa-positive cells was
found in hyperplasic areas, showing that oestrogen has
affected routes that do not depend on androgenic levels. In
spite of that, it is important to emphasize that the treatments
with oestradiol exhibited larger AR expression. According to
Droller (1997), oestrogen induces stromal fibroblasts to
express receptors for both epidermal growth factor (EGF-R)
and fibroblast growth factor (FGF-R), besides increasing the
level of AR. The androgenic effects on normal epithelium
are explained by paracrine factors produced by stromal AR-
positive cells (Cunha et al. 2002). However, androgenic reg-
ulation of prostate epithelial cells during malignant transfor-
mation of prostate epithelial cells appears to involve
conversion from a paracrine to an autocrine mechanism
of AR-stimulated growth (Gao et al. 2001). Perhaps this
mechanism of autocrine performance explains the increased
34 W.R. Scarano et al.
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Journal compilation � 2008 Blackwell Publishing Ltd, International Journal of Experimental Pathology, 89, 25–37
density of AR-positive cells in the hyperplasic areas and in
PINs.
Droller (1997) identified ER in stromal cells. According to
this author, oestrogen induces receptor expression for spe-
cific growth factors, increasing the synthetic activity of those
cells and also of the SMC. This incentive may be responsible
for the increase in synthesis of extracellular-matrix fibres
and for the apparent increase in the stromal compartment of
the oestrogenized animals, observed in both E and CaE
groups. However the increase in synthetic capacity may be
related to the sensitive decrease in intra-prostate androgenic
levels, which was provoked by the oestrogenic supplementa-
tion previously described by Harkonen and Makela (2004).
Despite verifying that castration increased the stromal
compartment as much as oestrogenic treatments and that
both situations have stimulated the synthesis of fibrillar and
non-fibrillar extracellular matrix components, it should be
emphasized that their distributions were different, castration
promoted a preferential deposition of connective tissue in
the sub-epithelial area while oestrogenic treatments caused
an accumulation of connective tissue around the SMC. This
observation exposes a possible role of SMC in the arrange-
ment of the constituents of the extracellular matrix during
the rearrangement process caused by oestradiol (Scarano
et al. 2005) and in BPH (Cardoso et al. 2004). Besides, it
was observed that in the intact animals treated with oestra-
diol, the frequency of elastic fibres was higher, in agreement
with the data obtained previously by Scarano et al. 2005.
This work revealed two important data: one that the ger-
bil is a good experimental model to study prostatic diseases
of hormonal aetiology and that oestradiol has direct effects
on gerbil prostate, independently of the androgenic levels.
Such effects are represented mainly by the proliferative and
dysplastic epithelial alterations and by the architecture of
the extracellular matrix constituents. This new micro-
environment may be achieved possibly by the fundamental
role of SMC in the post-treatment arrangement. Besides,
hormonal receptors seem to have a fundamental role in the
expression of altered epithelial phenotypes.
Acknowledgements
This paper is part of the thesis presented by WRS to the
Institute of Biology, UNICAMP, in partial fulfilment of the
requirements for a PhD degree, and was supported by grants
from the Brazilian agencies CNPq – Brazilian National
Research and Development Council (fellowship to WRS and
SRT – Proc. Nr. 301111 ⁄ 2005-7) and FAPESP – Sao Paulo
State Research Foundation (Proc. Nr. 02 ⁄ 12942-6 and fel-
lowship to DES and SGPC). The authors wish to thank Mrs
Rosana S. Sousa MS and Mr Luis Roberto Faleiros Jr for
their technical assistance, as well as all other researchers at
the Microscopy and Microanalysis Laboratory. Comments
provided by the anonymous referees helped improve our ori-
ginal manuscript. Special acknowledgement is also due to
Mr James Welsh and Mr Davi A. Pontes for English
language revision of this paper.
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