Neuroendocrinology and ovarian aging

The ovarian aging, a dynamic process that precedes the clinical manifestations of menopause, can be assessed using ovarian reserve biomarkers. It is well-known that reproduction during the later years of reproductive life has known limitations that challenge the success of assisted reproduction. Therefore, a review of the neuroendocrine modifications during this critical period of reproductive life may help to elucidate the ovarian aging process and its impact on reproduction. In this review, we aim to further the discussion of neuroendocrine changes taking place during the ovarian aging process that may impact reproductive function.     

Determinants of uterine aging: lessons from rodent models

The uterus is an indispensable organ for the development of a new life in eutherian mammals. The female mammalian reproductive capacity diminishes with age. In this respect, the senescence of uterine endometrium is convinced to contribute to this failure. This review focuses on the physiological function of the uterus and the related influence of aging mainly in rodent models. A better understanding of the underlying mechanisms governing the process of uterine aging is hoped to generate new strategies to prolong the reproductive lifespan in humans.     

Aging of the hypothalamo-pituitary-ovarian axis: hormonal influences and cellular mechanisms

Longitudinal studies employing heterochronic ovarian grafts and long-term ovariectomy indicate that there is no single pacemaker of reproductive aging. Neuroendocrine dysfunction, the declining follicular reserve, and ovarian secretions all contribute to reproductive decline, and their relative importance to the different stages of reproductive aging varies markedly. Moreover, although ovarian secretions during adulthood potentiate certain aspects of the reproductive aging process, their behavior does not fit a simple model of cumulative steroidal damage incurred over the lifespan. Current data are more consistent with temporally distinct windows of steroidal vulnerability for the events affected: cycle lengthening is affected by ovarian secretions during the period of cyclicity, and post-cyclic neuroendocrine failure is potentiated by ovarian secretions during the peri- and post-cyclic period of the lifespan. Recent examination of estradiol receptor dynamics reveals multiple, albeit selective, changes during aging that may contribute to the age-related impairments of tissue sensitivity to estrogen. These changes vary qualitatively and quantitatively among target tissues. Thus, aging of the hypothalamo-pituitary-ovarian axis at the cellular level mirrors, in its multifactorial nature, aging at the organismic level.     

Retrograde and local destination transfer of uterine prostaglandin E2 in early pregnant sow and its physiological consequences

The local destination transfer of prostaglandin E2 (PGE2) from the uterine lymph to arterial blood supplying the ovary and its retrograde transfer to arterial blood supplying the uterine horn and the effect of additional delivery of PGE2 into the ovary on the secretion of steroid hormones was studied in early pregnant gilts. The injection of PGE2 under the perimetrium caused an increase (P<0.001) in PGE2 concentration in both uterine venous effluent and ovarian and uterine arterial blood. The infusion of PGE2 into the ovarian artery increased the concentration of progesterone in ovarian venous blood on day 13 of pregnancy during (P<0.05) and after (P<0.001) infusion, and on day 14 of pregnancy after infusion (P<0.01). In conclusion, local destination transfer of PGE2 from uterine lymph and venous blood to the ovary may affect luteal function, and retrograde transfer of PGE2 to the arterial blood supplying the uterus may contribute to the prevention of regressive changes of the endometrium in early pregnant gilts.     

Potential roles of the aryl hydrocarbon receptor in female reproductive senescence

The transition to reproductive senescence involves changes in neuroendocrine and ovarian functions, and is accelerated by activation of the aryl hydrocarbon pathway by environmental toxicants such as 2,3,7,8-tetrachloro-dibenzo-p-dioxin (TCDD). In this article, studies which provide evidence as to the possible mechanisms by which the aryl hydrocarbon receptor (AhR) acts in this capacity (i.e. disruption of ovarian, hypothalamic or suprachiasmatic nucleus function, or any combination of these) are reviewed, along with the normal physiological changes that occur during the transition to reproductive senescence in female humans and rodents. Based on findings that the AhR is evolutionarily conserved and necessary for normal fertility, we suggest that the AhR has not only a pathological but also a physiological role in the process of aging. Studies of realistic lifelong AhR activation by dioxins on the hypothalamic-pituitary-ovarian axis and its impact on the transition to reproductive senescence in the aging female are a previously neglected area of research that warrants further consideration.     

The reproductive endocrinology of the menopausal transition

The menopause transition is a dynamic process that begins with the first appearance of menstrual irregularity and ends with a woman's final menstrual period. As ovarian follicle numbers dwindle, the hypothalamic-pituitary-ovarian axis enters a state of compensated failure. In this state, elevated FSH is capable of maintaining relatively regular folliculogenesis and ovulation, but fertility is reduced. Eventually, this state of compensated failure cannot be sustained, and the ovary becomes unable to produce functioning follicles. Recent multicenter studies from several countries have addressed the pattern of change in hormones and a model form reproductive aging has been developed that helps explain the changes in hormone patterns and fertility that accompany menopause. Perhaps more important, the hormonal changes of the menopausal transition may be predictive of future disease risk. This review will undertake an explanation of the current literature on this topic.     

Ovarian aging and menopause: current theories, hypotheses, and research models

Aging of the reproductive system has been studied in numerous vertebrate species. Although there are wide variations in reproductive strategies and hormone cycle components, many of the fundamental changes that occur during aging are similar. Evolutionary hypotheses attempt to explain why menopause occurs, whereas cellular hypotheses attempt to explain how it occurs. It is commonly believed that a disruption in the hypothalamic-pituitary-gonadal axis is responsible for the onset of menopause. Data exist to demonstrate that the first signs of menopause occur at the level of the brain or the ovary. Thus, finding an appropriate and representative animal model is especially important for the advancement of menopause research. In primates, there is a gradual decline in the function of the hypothalamic-pituitary-gonadal (HPG) axis ultimately resulting in irregularities in menstrual cycles and increasingly sporadic incidence of ovulation. Rodents also exhibit a progressive deterioration in HPG axis function; however, they also experience a period of constant estrus accompanied by intermittent ovulations, reduced progesterone levels, and elevated circulating estradiol levels. It is remarkable to observe that females of other classes also demonstrate deterioration in HPG axis function and ovarian failure. Comparisons of aging in various taxa provide insight into fundamental biological mechanisms of aging that could underlie reproductive decline.     

Functional analysis of the Drosophila immune response during aging

One of the most dramatic changes associated with aging involves immunity. In aging mammals, immune function declines and chronic inflammation develops. The biological significance of this phenomenon and its relationship with aging is a priority for aging research. Drosophila is an invaluable tool in understanding the effects of aging on the immune response. Similar to the state of chronic inflammation in mammals, Drosophila exhibits a drastic up-regulation of immunity-related genes with age. However, it remains unclear whether immune function declines with age as seen in mammals. We evaluated the impact of aging on Drosophila immune function by examining across age the ability to eliminate and survive different doses of bacterial invaders. Our findings show that aging reduces the capacity to survive a bacterial infection. In contrast, we found no evidence that aging affects the ability to eliminate bacteria indicating that the mechanisms underlying immune senescence are not involved in eliminating bacteria or preventing their proliferation.     

Hypothalamic alterations and reproductive aging in female rats: evidence of altered luteinizing hormone-releasing hormone neuronal function

Prior to the age-related loss of regular estrous cycles, female rats exhibit an attenuated preovulatory LH surge, a sign that reproductive decline is imminent. Numerous studies have revealed an important role for the hypothalamus in aging of the reproductive axis in this species. Because LHRH represents the primary hypothalamic signal that regulates gonadotropin release, assessments of LHRH neuronal activity can provide a window into hypothalamic function during reproductive aging. Studies of the dynamic activity of LHRH neurons during times of enhanced secretion have revealed deficits in middle-aged females. Available data are consistent with a decline in LHRH synthesis, transport, and secretion in middle-aged females during times of increased demand for LHRH output. Moreover, the alterations noted in LHRH neuronal function could account, in part, for the attenuation and eventual loss of the preovulatory LH surge with age. Elements extrinsic to LHRH neurons undoubtedly contribute to the decline in the parameters of LHRH neuronal function observed in middle-aged females. Whether alterations intrinsic to LHRH neurons also play a role in the age-associated reduction in LHRH synthesis and secretion remains to be determined. Recent examinations of hormone profiles during the perimenopausal period suggest that a potential hypothalamic contribution to aging of the reproductive axis in women warrants further examination.     

Neuroendocrine mechanisms and aging.

Evidence describing altered neuroendocrine function during aging from this and other laboratories is reviewed, with focus on changes in the brain-pituitary-ovarian-adrenal-hepatic and in the brain-pituitary-ovarian systems. Difficulties in interpreting the discordant data on age-related changes in pituitary function are discussed. Among mechanisms of reproductive aging are changes at both the ovarian and hypothalamic level (including reduced catecholamine levels, turnover, and synaptosomal uptake). However, it cannot yet be concluded that impairments of hypothalamic catecholamine metabolism are the primary cause for the loss of regular cycles. Evidence for dopaminergic impairments in the basal ganglions of humans and rodents during normal aging suggests that these changes may be a general phenomenon of aging. Although the origins of the changes are not yet known, neuronal cell loss in the substantia nigra would not seem to be the only cause.     

A light microscopic and ultrastructural study on the presence and location of oxytocin in the equine endometrium

It has been reported that oxytocin is produced not only in the hypothalamus and posterior pituitary but also in outside the classical hypothalamo-neurohypophyseal axis such as the ovary, testis, placenta and in some nonreproductive sites. In the mare, oxytocin-mRNA has been identified in the endometrium, and oxytocin and its neurophysin have been identified in the uterus. In the present study, oxytocin was localised in the endometrium of the mare at the light microscopic and ultrastructural level by immunostaining and immunogold labelling of endometrial biopsy specimens collected during estrus.Strong positive immunostaining for oxytocin was found in the secretory vesicles of the secretory (nonciliated) epithelial cells of the uterine lumen and of the superficial glands. Using immunogold labelling, oxytocin was detected in the secretory vesicles of secretory epithelial cells. The vesicles containing immunoreactive oxytocin were present on the luminal surface suggesting that oxytocin is secreted into the uterine lumen by apical exocytosis. There was no positive immunostaining in ciliated epithelial cells of the uterine lumen and endometrial glands, in the stromal cells, or in the basal endometrial glands. To our knowledge, this is the first report of the location of oxytocin in specific secretory cells in the endometrium of any domestic species. This locally synthesised uterine oxytocin may have an important role in the autocrine/paracrine control of uterine contractility and luteolysis in the mare.     

Biological aging and the etiology of aneuploidy

A prevalent hypothesis concerning the cause of the rise in aneuploid conceptions with maternal age is that the changes that accompany normal ovarian aging increase the rate of meiotic errors in the oocyte. Biological aging of the ovary is accompanied by a decline in both the total oocyte pool and the number of antral follicles maturing per cycle, as well as changes in the levels of circulating reproductive hormones. The biological aging hypothesis predicts that aneuploidy rates should be higher in women with a prematurely reduced oocyte pool, and that women with trisomic conceptions should show signs of earlier ovarian aging than women of the same chronological age without trisomic conceptions. Comprehensive studies of aneuploidy in groups of women with known causes of premature ovarian failure remain to be done, though anecdotal evidence does suggest increased rates of pregnancy loss and aneuploidy. Smoking, which is a well-documented cause of earlier ovarian aging, is not associated with an increase in aneuploid conceptions. Evidence from women with unilateral ovariectomies is inconsistent. Support for the biological aging hypothesis was provided by one study showing that menopause occurred about a year earlier in women with a trisomic spontaneous abortion compared to women with chromosomally normal conceptions. Associations between high FSH and pregnancies with Down syndrome and chromosomally abnormal spontaneous abortions have also been reported. However, the most direct test of the hypothesis, which compared antral follicle counts and hormonal levels in women with trisomic pregnancies and those with chromosomally normal pregnancies, failed to find a difference in the expected direction. A prospective study of FSH levels in women with subfertility also failed to find an association with the rate of pregnancy loss. The bulk of evidence thus suggests that, if the processes of biological aging are indeed related to aneuploidy, they probably involve factors other than those measured by oocyte or antral follicle pool size and reproductive hormone levels.     

IGF-1 in the brain as a regulator of reproductive neuroendocrine function

Given the close relationship among neuroendocrine systems, it is likely that there may be common signals that coordinate the acquisition of adult reproductive function with other homeostatic processes. In this review, we focus on central nervous system insulin-like growth factor-1 (IGF-1) as a signal controlling reproductive function, with possible links to somatic growth, particularly during puberty. In vertebrates, the appropriate neurosecretion of the decapeptide gonadotropin-releasing hormone (GnRH) plays a critical role in the progression of puberty. Gonadotropin-releasing hormone is released in pulses from neuroterminals in the median eminence (ME), and each GnRH pulse triggers the production of the gonadotropins, luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These pituitary hormones in turn stimulate the synthesis and release of sex steroids by the gonads. Any factor that affects GnRH or gonadotropin pulsatility is important for puberty and reproductive function and, among these factors, the neurotrophic factor IGF-1 is a strong candidate. Although IGF-1 is most commonly studied as the tertiary peripheral hormone in the somatotropic axis via its synthesis in the liver, IGF-1 is also synthesized in the brain, within neurons and glia. In neuroendocrine brain regions, central IGF-1 plays roles in the regulation of neuroendocrine functions, including direct actions on GnRH neurons. Moreover, GnRH neurons themselves co-express IGF-1 and the IGF-1 receptor, and this expression is developmentally regulated. Here, we examine the role of IGF-1 acting in the hypothalamus as a critical link between reproductive and other neuroendocrine functions.     

Expression and localization of nodal in bovine oviduct and uterus during different functional stages of oestrus cycle and pregnancy

Members of TGF-β superfamily play a major role in the endometrial changes involved in the establishment and maintenance of pregnancy. Their deregulated expression and action could lead to absolute or partial failure of embryo implantation. Nonetheless, the precise function and mechanism of many of these cytokines remain unclear. Nodal, a transforming growth factor beta (TGF-β) superfamily member, was characterized in the human and rodent uterus and implicated in the tissue remodeling events during menstruation and embryo implantation. In order to study its possible role in the cattle reproductive process, we have analyzed Nodal expression pattern and localization in the oviduct and uterine horn during the oestrus cycle and early pregnancy (day 20). Nodal was detected both in oviduct and uterus during either the oestrus cycle or pregnancy; however, it shows a differential expression profile in the uterine horn at dioestrus and pregnancy, decreasing 1.5 and 1.4 folds in comparison with oestrus. Nodal immunostaining intensity was observed in stromal and in epithelial cells of the surface and the glandular epithelium. The staining pattern correlates with the RT-qPCR expression profile. This work is the first to evidence the presence of Nodal in the bovine reproductive tract; our data suggest that Nodal is a novel cytokine that would be involved in the remodelling occurring in the endometrium of cattle during the oestrus cycle and in the embryo implantation. The identification of new molecules that participate in endometrium cycling and/or pregnancy may be useful for predicting the ability of the uterine tissue to establish and maintain pregnancy or for detecting the infertility processes. These results highlight Nodal as a possible novel marker of the fertility process, nevertheless further studies should be done to determine its role in the reproductive system.     

DNA content and the endometrial cellular mitotic activity in the phase of menstrual bleeding

Endometrium obtained during menses from 46 healthy women in reproductive age was investigated morphologically and cytospectrophotometrically in order to solve the problem on the source of the cells reepithelizing the uterine mucous membrane after desquamation. It was stated that desquamation takes place not in the whole functional layer of endometrium, some mucous fragments, covered with persisting luminal epithelium, are always preserved. During endometrial regeneration the cells of the luminal and glandular epithelia and those of endometrial stroma are predominantly diploid. The amount of premitotic cells in population is so small that they cannot secure any intensive cellular proliferation. Mitogenesis in endometrium is stimulated only after a complete restoration of the epithelial layer. It is suggested that persisting luminal epithelium is the source of cells for reepithelization; they migrate towards endometrial "wounds" and repair defects in the uterine mucosa during the regeneration phase.     

Changing hypothalamopituitary function: its role in aging of the female reproductive system

Changes in female reproductive function occur relatively early during the life span in many mammalian species. Therefore, this physiological system is an excellent model system in which to study the effects of age on specific endocrine relationships since changes occur prior to the occurrence of multiple pathologies associated with later stages of aging. Data from several laboratories suggest that changes in hypothalamic, pituitary and ovarian function may contribute to age-related deterioration of fertility in females. We will focus our attention on the role of hypothalamic changes in the cascade of events that eventually lead to acyclicity and infertility. Data suggest that changes in the diurnal rhythmicity of catecholaminergic neurotransmitters and their receptors occur during middle age. These changes may regulate the pattern of release of GnRH since alterations in the pulsatile pattern of LH secretion also become detectable at this age. Some age-related changes in hypothalamic and pituitary function are not irreversible or absolutely determined. Instead it appears that the ovarian steroidal milieu modulates the rate of aging of several aspects of hypothalamohypophysial function. In summary, changes in hypothalamic and pituitary function appear to contribute to the aging of the female reproductive system.     

Glucocorticoids inhibit estradiol-mediated uterine growth: possible role of the uterine estradiol receptor

Stress-related activation of the hypothalamic-pituitary-adrenal axis (HPA) is associated with suppression of the reproductive axis. This effect has been explained by findings indicating that corticotropin-releasing hormone suppresses hypothalamic gonadotropin-releasing hormone (GnRH) secretion via an opioid peptide-mediated mechanism, and that glucocorticoids suppress both GnRH and gonadotropin secretion and inhibit testosterone and estradiol production by the testis and ovary, respectively. To evaluate whether glucocorticoids suppress the effects of estradiol on its target tissues, we examined the ability of dexamethasone to inhibit estradiol-stimulated uterine and thymic growth in ovariectomized rats. Estradiol alone, given daily for 5 days, caused dose-dependent uterine and thymic growth. Dexamethasone alone, given daily for 5 days, caused a dose-dependent decrease in body weight gain and in thymic growth. When estradiol and dexamethasone were administered simultaneously, however, body weight gain and thymic growth were also inhibited (p less than 0.05). Dexamethasone decreased estradiol-induced uterine cytosolic and nuclear estrogen receptor concentrations (E2 R0, p less than 0.05; E2nR0, respectively), but had no effect on estradiol-induced progesterone receptor concentrations (P4R0, p greater than 0.05). Levels of uterine glucocorticoid receptors were not affected by estrogen and/or dexamethasone treatment. These findings suggest that stress levels of glucocorticoids, administered over a 5-day interval, block the estradiol-stimulated growth of female sex hormone target tissues. This effect may be partially mediated by a glucocorticoid-induced decrease of the estradiol receptor concentration. Thus, another mechanism by which the HPA may influence reproductive function during stress is by a direct effect of glucocorticoids on the target tissues of sex steroids.     

The aging reproductive neuroendocrine axis

It is well known that the reproductive system is one of the first biological systems to show age-related decline. While depletion of ovarian follicles clearly relates to the end of reproductive function in females, evidence is accumulating that a hypothalamic defect is critical in the transition from cyclicity to acyclicity. This minireview attempts to present a concise review on aging of the female reproductive neuroendocrine axis and provide thought-provoking analysis and insights into potential future directions for this field. Evidence will be reviewed, which shows that a defect in pulsatile and surge gonadotropin hormone-releasing hormone (GnRH) secretion exists in normal cycling middle-aged female rats, which is thought to explain the significantly attenuated pulsatile and surge luteinizing hormone (LH) secretion at middle-age. Evidence is also presented, which supports the age-related defect in GnRH secretion as being due to a reduced activation of GnRH neurons. Along these lines, stimulation of GnRH secretion by the major excitatory transmitter glutamate is shown to be significantly attenuated in middle-aged proestrous rats. Corresponding age-related defects in other major excitatory regulatory factors, such as catecholamines, neuropeptide Y, and astrocytes, have also been demonstrated. Age-related changes in hypothalamic concentrations of neurotransmitter receptors, steroid receptors, and circulating steroid hormone levels are also reviewed, and discussion is presented on the complex interrelationships of the hypothalamus-pituitary-ovarian (HPO) axis during aging, with attention to how a defect in one level of the axis can induce defects in other levels, and thereby potentiate the dysfunction of the entire HPO axis.