Contraception with LHRH agonists, a new physiological approach

The paradoxical antifertility effects of luteinizing hormone releasing hormone (LHRH) agonists in experimental male and female animals have been reported. Treatment with LHRH induces luteolysis and inhibits ovulation in normal women; in men, the same treatment decreases testicular steroidogenesis. This paper examines the mechanisms responsible for the paradoxical antifertility effects of LHRH agonists. A series of experiments was conducted in rats to determine the following: 1) the effect of lower and more physiological doses of the LHRH agonist on testicular gonadotropin receptors, 2) the time course of the effect of daily administration of 1 mcg of LHRH agonist on testicular and plasma concentration of steroid intermediates, 3) cellular changes occurring in the testis during longterm administration of the agonist, and 4) characteristics of LHRH receptors in the testis. The results show that LHRH agonists: 1) produce an inhibiting effect on testicular prolactin receptor concentrations, 2) can cause a dramatic fall in testicular androstenedione and testosterone concentration following treatment, 3) induce degenerative cellular changes in rat testis during longterm administration, and 4) may play a role in the physiological control of gonadal functions by a locally produced LHRH-like molecule. Similar experiments on the ovarian functions in female rats show that relatively low doses of LHRH agonist leads to marked loss of ovarian LH (luteinizing hormone) receptor accompanied by a decreased plasma progesterone concentration and uterine weight. The presence of specific ovarian LHRH receptors raises the possibility that LHRH secreted locally could be involved in the control of ovarian activity. In 6 normal men, a single intranasal administration of a potent LHRH agonist clearly showed inhibition of testicular steroidogenesis while studies on the luteolytic and antiovulatory activity in normal women demonstrated a luteolytic action of LHRH and its agonists. Progesterone secretion from the corpus luteum is important for the implantation and the maintenance of early pregnancy. The intranasal route of administration of LHRH agonists offers the advantage of easy, routine application by the general population.     

Sensitivity differences in reproductive/endocrine organs to chronically administered LHRH agonists in female rats

The acute and chronic effects of two LHRH agonists on reproductive endocrine target organs were examined in female rats. Animals were injected twice daily with [(ImBzl)-D-His6,Pro9-NEt]LHRH (histrelin) or [D-Trp6,Pro9-NEt]LHRH for 1, 3, 5, 7, 11 or 28 days at 1, 10, 100 or 1000 micrograms/kg/day beginning in the luteal phase. The responses observed with the two agonists were similar. An initial stimulatory phase was observed on the first day of treatment with substantial increases in serum LH and progesterone levels. A significant diminution of hormone response was seen by day 3. Only 1000 micrograms/kg abolished the pituitary LH response at later treatment periods. Estrous cyclicity, ovarian and uterine weight, and progesterone and estradiol levels were inhibited in a time and dose dependent manner. The results demonstrate target organ sensitivity differences. In contrast to the relatively high doses needed to inhibit the pituitary response and decrease ovarian weight, doses as low as 1 microgram/kg were sufficient to decrease uterine weight. If these findings extrapolate to humans, it may be that conditions in which the desired therapeutic action is suppression of uterine tissue, may be treated with lower doses of LHRH agonists than conditions requiring complete gonadal suppression.     

Hypothalamic luteinizing hormone-releasing hormone (LHRH) and LH secretion in aging female rats

Age-related changes in hypothalamic luteinizing hormone-releasing hormone (LHRH) and luteinizing hormone (LH) secretion were studied in young (6 months), middle-aged (12 months) and old (18 months) female rats. The LHRH levels in the mid-hypothalamic area were higher in intact middle-aged and old females than in young ones. Additionally, there was no age difference in the hypothalamic LHRH levels in male rats. In order to clarify the significance of this age-related increase in female rats, we examined the effects of progesterone treatment in estrogen-primed ovariectomized young and old rats on the LHRH levels in the median eminence (ME) and on plasma LH levels. We found phasic changes in ME-LHRH and plasma LH levels in estrogen-primed rats following progesterone treatment in rats of both ages, but the progesterone-induced change in ME-LHRH levels tended to be delayed in old rats compared with young females. This delay may correspond to the delayed onset, slow and low magnitude of plasma LH increase in old females. The ME-LHRH levels were generally higher in old rats than in young rats. Nevertheless, we found that the increase in plasma LH in response to progesterone treatment in estrogen-primed ovariectomized females was smaller in old rats than young rats. These results suggest that the LHRH secretory mechanism changes with age in female rats. Such alterations may result in the accumulation of LHRH in the mid-hypothalamic area and an increase in ME-LHRH.     

Changes in pituitary and ovarian LHRH receptors after active immunization of female rats against LH or LHRH

The hypothalamic-pituitary-ovarian axis of female rats was disrupted at the site of LHRH stimulation by active immunization against LHRH or at the site of LH action by active immunization against LH. Active immunization against LH was associated with an increase in pituitary LHRH receptors to levels comparable to control values at pro-oestrus whereas immunization against LHRH led to a marked reduction in receptor numbers. Ovarian LHRH receptor concentrations were increased by both treatments. It is concluded, therefore, that (1) LHRH receptors in the pituitary and ovary are not concomitantly controlled, and (2) pituitary receptor numbers are primarily under positive autoregulatory control by LHRH and that ovarian LHRH receptor concentrations may be under long-term influence of LH.     

Functional and morphological changes in the hypothalamo-pituitary-gonadal axis of aged female rats.

Age-related functional and morphological alterations in the hypothalamo-pituitary-gonadal axis were investigated in old recurrently pseudopregnant (RPP) female rats, and these alterations were compared with those in young diestrous rats. LHRH in the median eminence (ME) and mediobasal hypothalamus (MBH) as well as plasma FSH, LH, and progesterone were measured by RIA. LHRH in the lateral ME (LME) and pituitary FSH and LH were evaluated by morphometry and densitometrical immunocytochemistry. Furthermore, by light microscopy, we classified and counted the number of ovarian follicles and corpora lutea. LHRH concentrations in the ME and MBH were similar in old and young rats, whereas in old rats, plasma FSH was markedly increased, LH was moderately increased, and plasma progesterone was unchanged. The number and the total area and immunoreactivity of LHRH-labeled axon cross sections in the LME were reduced in old rats. The number of nucleated FSH-labeled cells and total FSH area and immunoreactivity were almost twice in old compared with young animals. The measurements of LH-labeled cells were not different between the two groups. In old rats, the numbers of ovarian follicles and corpora lutea were reduced and that of atretic follicles increased. In conclusion, age-related morphological impairments of LHRH axons associated with an increased number of FSH gonadotropes and higher plasma FSH in our old RPP rats suggest hypothalamic and pituitary disturbances, which may largely contribute to the complex hormonal disarrangement responsible for the decline of reproductive functions in old female rats.     

Role of prostaglandin E2 receptor subtypes in ovarian follicle growth in the rat in vivo. Correlation with interleukin-8 and neutrophils

This study was conducted to elucidate the role of three of prostaglandin E2 (PGE2) receptor subtype (EP2, EP3, and EP4) agonists in the process of follicular growth. The influence of these agonists on ovarian expression of intimately related factors to follicle development (neutrophils and interleukin-8 (IL-8)) was also investigated. Immature female Wistar rats were injected once with these agonists and killed 48 hours later. Another group of rats were injected pregnant mare serum gonadotrophin. For evaluation of follicle growth, morphometric assessment of antral and ovulatory follicles was performed in serial ovarian sections. The study demonstrated that, EP2 and EP4 agonists showed the maximum follicle counts and diameters versus the control. EP2 and EP4 agonists mimicked PMSG induced follicle growth. Injection of the three agonists induced neutrophil infiltration into theca layer. EP4 agonist showed the most intense ovarian neutrophil accumulation. In addition, dense ovarian IL-8 expression was observed only after EP4 agonist injection. CONCLUSIONS: Our data suggests that: 1) EP2 and EP4 receptors are the key PGE2 receptors engaged in follicle growth. 2) Ovarian IL-8 expression and neutrophil infiltration are chiefly mediated via the EP4 receptor. EP2 and EP4 receptor agonists may be candidates for promising reagents that induce follicle maturation in clinical or agricultural fields. This knowledge could provide numerous targets for manipulation of fertility.     

Effect of chronic treatment with [D-Ala6, des-Gly-NH2 10]LHRH ethylamide on ovarian histology in the rat

Summary The effect of chronic treatment with the LHRH agonist [D-Ala₆, des-Gly-NH₂ ¹⁰]LHRH ethylamide (LHRH-A) on ovarian histology was studied in adult female rats injected with 5 g of the peptide, once every second day, for 0, 2,4 or 8 weeks. Using light microscopy, we examined the number of small, medium, large and atretic follicles, as well as the number of normal and regressing corpora lutea. Using the point-counting method, we measured the relative surface occupied by luteal cells. It was found that treatment with LHRH-A for up to 8 weeks led to no significant change in any of the parameters studied. Moreover, resumed meiotic maturation of an abnormally high number of atypical fragmentations of the ova could not be observed. At least at the dose used, the LHRH agonist does not appear to induce any histological alteration in ovarian morphology and supports the potential clinical use of LHRH agonists as a new approach in femal contraception and for the treatment of estrogendependent pathologies.     

Effects and interactions of LH and LHRH agonist on testicular morphology and function in hypophysectomized rats

The effects of single or combined daily treatment with an LHRH agonist and low or high doses of LH upon the testes of adult hypophysectomized rats were studied for up to 2 weeks in which changes in testicular histology, particularly the interstitial tissue, were examined by morphometry and related to functional assessment of the Leydig cells in vivo and in vitro. Compared to saline-treated controls, LHRH agonist treatment did not alter testis volume or the composition of the seminiferous epithelium or any of the interstitial tissue components although serum testosterone and in-vitro testosterone production by isolated Leydig cells were significantly reduced. With 2 micrograms LH for treatment, testis volume was increased, spermatogenesis was qualitatively normal, total Leydig cell volume was increased, serum testosterone values were initially elevated but subsequently declined and in-vitro testosterone production was enhanced. Testis volume with 20 micrograms LH treatment was unchanged compared to saline treatment, the seminiferous epithelium exhibited severe disruption but total Leydig cell volume was greatly increased due to interstitial cell hyperplasia. This group showed elevated serum testosterone concentrations and major increases in testosterone production in vitro. Treatment with LHRH agonist with either dose of LH resulted in reduced testis volume, moderate to very severe focal spermatogenic disruption and increased total Leydig cell volume although serum testosterone values and in-vitro testosterone production were markedly reduced compared to control rats. It is concluded that, in the absence of the pituitary, LHRH agonist fails to disrupt spermatogenesis and the previously described antitesticular action of LHRH agonists in intact rats is therefore dependent upon the presence of LH, which alone or in combination with LHRH agonist, may focally disrupt spermatogenesis in hypophysectomized rats whereas the Leydig cells undergo hyperplasia. The findings show that impairment of spermatogenesis is accompanied by alterations of the interstitial tissue and suggest that communication between these two compartments is involved in the regulation of testicular function.     

Nitro(w)-arginine methyl ester treatment delayed the onset of puberty in female rats

It is well documented that nitric oxide (NO) stimulates LHRH, LH and GH release. Present experiments were carried out to analyse whether the blockade of NO generation can affect body growth and puberty onset in female rats. Prepubertal female rats were treated with L-nitro(w) arginine methyl ester (NAME), a blocker of nitric oxide synthase, from day 25 to first estrous (400 or 800 mg/L in drinking water). We measured body growth, age and body weight at vaginal opening and first estrous, and the ovarian and uteri weights and serum LH and FSH concentrations the day of first estrous. Females treated with NAME showed a normal body growth pattern and a delayed puberty. Serum LH concentrations were increased in groups treated with NAME. This stimulatory effect was also observed in 30 and 90 day-old females decapitated 60 min after NAME administration (40 mg/Kg i.p.). We conclude that blockade of NO generation delays puberty in female rats by mechanism(s) other than its effects on LH release.     

Distribution of luteinizing hormone-releasing hormone receptors in the rat ovary

The distribution of luteinizing hormone-releasing hormone (LHRH) receptors was studied in the adult rat ovary using autoradiography after injection of the stable LHRH agonist ¹²⁵I-labelled [D-Ser(TBU)⁶,des-Gly-NH₂¹⁰]LHRH ethylamide (Buserelin) and by radioreceptor assay using the same tracer. In intact cycling female rats, no differences in ovarian LHRH receptor levels could be observed between day diestrus I and day proestrus. Moreover, similar levels are observed in total ovarian homogenate, corpora lutea and the remaining ovarian tissue in adult animals treated with PMSG (pregnant mare's serum gonadotropins) and hCG (human chorionic gonadotropin). Radioautographic data show a comparable distribution of grains over theca interna and externa, granulosa and luteal cells. The present findings indicate the presence of LHRH receptors in both the interstitial and follicular cells throughout all stages of cellular differentiation.     

Pharmacokinetics and endocrine effects of slow release formulations of LHRH analogues

The LHRH agonists are antigonadotropic agents for reversible ovarian suppression in gynaecology and in oncology. In oncology, pituitary inhibition is maintained with high release rates preferably by implant or microcapsule injection. The pharmacokinetics of buserelin after injection, infusion, and during implant treatment (controlled release) are described. The release rate is monitored by urinary buserelin excretion (fractional excretion of 30% of the daily dose). During therapy, LHRH agonists in serum are measured by specific radioimmunoassays, with or without extraction. A more convenient non-invasive procedure is to measure the amount of buserelin in 24-h urine samples (during injections or nasal spray), or the urinary buserelin/creatinine ratio in morning urine samples (during infusions or implants). After high dose injection, buserelin has a half-life of 80 min, therapeutic plasma concentrations are maintained for 8–12 h. In long-term maintenance with buserelin implants (polylactide-glycolide, 75:25), serum concentrations and urinary excretion showed an extended plateau phase indicating a suitable dose interval of 2–3 months. In endometriosis and leiomyoma, the minimum release rate (urinary buserelin) required for maintenance of steroid suppression was established (buserelin excretion of about 0.5 μg/g creatinine). Buserelin implants in prostate carcinoma are effective for 2 or 3 months, after a single dose of 6.6 or 10 mg buserelin, respectively. A consistent suppression of serum testosterone secretion was confirmed for more than 2 yr. Buserelin microparticles are effective in rhesus monkeys to completely suppress follicular maturation and oestrogen secretion during 4–6 weeks after a single dose of 3.6 mg buserelin. Recent results on the controlled release of an LHRH antagonist (Hoe 013) from biodegradable microparticles in rats with DMBA-induced mammary tumours indicate that tumour suppression by LHRH antagonists is well tolerated and highly effective. The local tolerance at the injection site of antagonist microparticles is excellent as in the case of LHRH agonists like buserelin.     

Role of growth factors, steroid and peptide hormones in the regulation of human prostatic tumor growth

Previous work carried out in the authors' laboratory has shown that LHRH agonists directly inhibit the proliferation of hormone-responsive and hormone-independent human prostatic cancer cell lines (respectively LNCaP and DU145). In addition, the hormone-dependent LNCaP cells respond to a challenge with testosterone with an increase in growth rate. The following experiments have been performed to investigate whether the LHRH agonists might act by interfering with the stimulatory actions of either the EGF/TGF system or androgens. The results obtained in LNCaP and DU145 cells show that LHRH agonists counteract the mitogenic action of the EGF/TGF system. This effect is mediated by a decrease in the concentration of EGF receptors. In addition, in the hormone-dependent LNCaP cells, the treatment with LHRH agonists antagonizes the proliferation promoting effect of testosterone, which in turn appears to be mediated by the activation of the locally expressed EGF/TGF system. Finally, the results suggest the presence in LNCaP cells of a soluble peptidase able to degrade LHRH. In conclusion, the present data suggest an intimate interplay among the actions of LHRH agonists, of androgens and of growth factors, thus, supporting the hypothesis that LHRH agonists may interfere with the EGF/TGF stimulatory loop and with androgens in the control of the proliferation of human prostatic tumors.     

LHRH-receptors and LHRH-agonist treatment in ovarian cancer: An overview

Considerable evidence exists that ovarian cancer might be gonadotrophin-dependent. Receptors for LH and FSH have been discovered in these tumors. Proliferation of ovarian cancer cells in vitro could be stimulated by gonadotrophins. Withdrawal of LH and FSH in animal models of ovarian cancer inhibited growth of these tumors. Phase-II clinical studies have shown that suppression of endogenous gonadotrophins by LHRH-agonists can be beneficial in women with advanced ovarian cancer. Respective controlled clinical trials are performed at present. Also direct effects of LHRH analogues on ovarian tumors have been reported. An LHRH like protein was found in human ovarian tissue. We discovered a specific LHRH binding site (mol. wt 63.2 kDa) in ovarian cancer tissue which is very similar to other human extrapituitary LHRH binding sites, of the low-affinity, high-capacity type, e.g. in breast cancer and the placenta. In the latter tissues, LHRH or a related substance has been proposed as an autocrine regulator of cellular function. If this was also the case in ovarian cancer, direct effects of LHRH analogs on the tumor cells could be used as additional therapeutical points of attack.     

Immunoreactive LHRH in chronic starved rats

The effects of chronic starvation (1/4 of ad libitum food intake) for 21 or 30 days were studied on the hypothalamic and serum concentrations of LHRH, the pituitary and serum concentrations of LH, and the weights of the anterior pituitary, ovary and uterus in adult female Wistar rats (chronic starved group, CSG). Control female rats were fed ad lib. for the same periods (control group, CG). On day 22 or 31, half of the rats of each group were weighed and sacrificed by decapitation. Since there were no difference on above parameters between the experiments on 22nd and 31st day, the results were combined for each parameters. At the time of sacrifice, the body weight of CSG was on the average 44% lower than that of CG rats, and also marked reduction in anterior pituitary (44%), ovarian (61%) and uterine weights (69%) was observed. Serum LH concentrations (mean +/- SE; 5.67 +/- 0.67 versus 33.30 +/- 6.00 ng/ml, P less than 0.001) and pituitary LH content (286.7 +/- 19.4 vs 451.0 +/- 32.8 micrograms, P less than 0.001) were significantly decreased in CSG than in CG rats. However, pituitary LH concentration was not reduced because of the proportional reduction to the pituitary weight of CSG rats. Hypothalamic immunoreactive LHRH (IR-LHRH) content in CSG showed a significant increase as compared to CG rats (5.77 +/- 0.52 vs 4.41 +/- 0.27 ng/hypothalamic extract, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Dynamic tests and FSH biological activity in female rats with acute nephrotic syndrome

To investigate the pituitary-ovarian status during the acute state of the nephrotic syndrome, a sequence of experiments were undertaken in adult female rats after a single dose of the puromycin aminonucleoside (PAN). The functional condition of the hypophyseal-ovarian unit was determined in control and nephrotic rats by two dynamic tests. In the first one, 10 days after PAN or placebo administration female rats were stimulated with LHRH (300 ng/100 g body wt) and samples were collected at 0, 20, 40, 60 and 80 min after releasing factor administration. The second dynamic test, which was performed in control and nephrotic rats, consists of one (day 10 after PAN) or four (between days 7-10 after PAN) doses of hCG (8 UI), respectively. In all cases, serum samples were collected on day 10. In addition, the relative in vitro biological activity of FSH from control and nephrotic rats before and after LHRH stimulus was determined. The results reveal that after a stimulatory dose of LHRH the secretion of LH was significantly diminished in nephrotic rats at all registered times. By contrast, normal response was observed in terms of FSH secretion in nephrotic females. On the other hand, no ovarian response, in terms of progesterone or estradiol synthesis, was observed in nephrotic rats after either one or four stimuli with hCG Interestingly, in spite of the normal or high concentrations of FSH, the biological activity of FSH was totally abolished in nephrotic rats. On the whole, the results from this study indicate that the nephrotic syndrome had a harmful effect on the pituitary-ovarian unit, and strongly suggest that the endocrine dysfunction could be initiated at the hypophysial level; even though a specific ovarian damage is also predictable.     

Effects of LHRH-analogues on mitogenic signal transduction in cancer cells

The expression of luteinizing hormone-releasing hormone (LHRH) and its receptors has been demonstrated in a number of human malignant tumors, including cancers of the breast, ovary, endometrium and prostate. These findings suggest the presence of an autocrine regulatory system based on LHRH. Recent studies in our laboratory have demonstrated that the function of LHRH produced by ovarian cancer cells is the inhibition of their proliferation. Dose-dependent antiproliferative effects of LHRH-agonists have been observed by several laboratories in cell lines derived from the above cancers. Interestingly, also LHRH-antagonists have marked antiproliferative activity in most of the ovarian, breast and endometrial cancer cell lines tested so far, indicating that the dichotomy of LHRH-agonists/LHRH-antagonists is not valid for the LHRH-system in cancer cells. In addition, our data suggest that the classical LHRH receptor signal transduction mechanisms known from the pituitary (phospholipase-C, protein kinase C, adenylyl cyclase) are not involved in the mediation of LHRH effects in cancer cells. Data obtained by several groups, including ours, rather suggest that LHRH analogs interfere with the signal transduction of growth-factor receptors and related oncogene products associated with tyrosine-kinase activity. The mechanism of action is probably an LHRH-induced activation of a phosphotyrosine phosphatase, counteracting the effects of receptor associated tyrosine kinase. In our hands, LHRH analogs virtually blocked the EGF-induced MAP-kinase activity of ovarian and endometrial cancer cells. The pharmacological exploitation of this mechanism might provide promising new therapies for these cancers.     

Further characterization of the direct inhibitory effect of LHRH agonists at the testicular level in the rat

To further clarify the relative importance of the pituitary and gonadal sites of LHRH action, intact and hypophysectomized adult male rats were treated with hCG for 7 days, in the presence or absence of simultaneous treatment with increasing doses of the LHRH agonist [D-Ser(TBU)6des-Gly-NH2(10)]LHRH ethylamide, Buserelin (0.025, 0.25, 2.5 or 25 micrograms/rat, twice daily). Daily treatment of intact adult rats with hCG (25 IU) markedly increased ventral prostate and seminal vesicle weight, while a dose-dependent inhibition of the effect was observed following combined administration of Buserelin. In hypophysectomized rats, treatment with hCG resulted in a partial restoration of ventral prostate and seminal vesicle weight, while combined treatment with a high dose of the LHRH agonist (25 micrograms, twice daily) partially (P less than 0.05) inhibited the stimulatory effect of hCG. LH/hCG receptors were almost completely inhibited after hCG injection alone and a further decrease was observed in the presence of simultaneous LHRH agonist treatment. The hCG-induced stimulation of GH/PRL receptors was counteracted by Buserelin treatment in hypophysectomized animals. The present data demonstrate that although LHRH-induced LH release has been shown to play a major role in the loss of testicular functions induced by low doses of LHRH agonists in the rat, a direct inhibitory action of LHRH agonists can be exerted at the testicular level at high doses of the peptide.     

The luteinizing hormone-releasing hormone (LHRH) agonist, [D-Trp6, des-Gly-NH2(10)]-LHRH ethylamide, has no direct effect on spermatogenesis in the rat

Treatment of intact rats with luteinizing hormone-releasing hormone (LHRH) agonists has been shown to produce atrophy of a variable number of testicular seminiferous tubules. These findings raised the question of a possible direct versus indirect action of LHRH agonists on spermatogenesis. To answer this question, we treated hypophysectomized rats with the LHRH agonist [D-Trp6, des-Gly-NH2(10)]-LHRH ethylamide, dihydrotestosterone (DHT), or a combination of these two compounds for a period of 1 mo. Treatment of hypophysectomized animals with the LHRH agonist alone had no significant effect on the atrophy of seminiferous tubules found after hypophysectomy. DHT, however, maintained spermatogenesis at 80% of the level seen in intact animals. When DHT and the LHRH agonist were administered in combination, the stimulatory effects of DHT were observed with no significant interference caused by the LHRH agonist. This study shows that an LHRH agonist has no direct effect on the morphology of the seminiferous tubules in the absence of the pituitary gland and strongly suggests that the atrophy observed in the testis after LHRH agonist treatment in intact animals is mediated by the LHRH agonist-induced changes in luteinizing hormone secretion and/or direct action of the peptide on Leydig cells.     

Endothelin-1 contributes to the sexual differences in renal damage in DOCA-salt rats

We investigated whether gender differences in renal damage in DOCA-salt hypertension are associated with effects of ovarian hormones and/or endothelin-1 (ET-1). Renal injuries and renal pre-pro-ET-1 mRNA expression were enhanced in male and female ovariectomized (OVX) DOCA rats versus female DOCA rats. Treatment with estrogen plus progesterone or progesterone, but not estrogen alone, attenuated renal damage and pre-pro-ET-1 mRNA expression in OVX DOCA rats. The ETA antagonist BMS182874 greatly ameliorated renal damage in male and OVX DOCA rats. In conclusion, the ovarian hormones have a protective role on the renal structural alterations in female DOCA rats by modulating effects of ET-1, via ETA receptors.