Estrogens and Women's Health - Benefit or Threat?

(1999, NS 113)
June 29-July 1, 1999
Bofors Hotel, Karlskoga, Sweden
Organizers: Professors Jan-Åke Gustafsson and Jan Carlstedt-Duke, Karolinska Institutet

Attending the symposium were 46 people, including 26 lecturers. Invited lecturers included the foremost researchers in this field from Europe and the United States (among them Bert O'Malley, Donald Pfaff, Evan Simpson, Kathryn Horwitz, Benita Katzenellenbogen and Craig Jordan).

The symposium discussed estrogens and women's health, currently one of the most intensively discussed medical problems, both nationally and internationally and among physicians as well as the general public. It focused in particular on issues related to post-menopausal hormone replacement therapy and associated elevated risk of breast and uterine cancer. Many other crucial estrogen-related themes were discussed as well. They included the role of so-called xenoestrogens (chemicals that contaminate nature and that have an estrogenic effect) in the supposed decline in sperm counts and the rising incidence of testicular cancer among Western men, the role of phytoestrogens (plant estrogens that we ingest via food) in protecting against breast cancer, and the effectiveness of estrogenic drugs against fragile bones, cardiovascular diseases, Alzheimer's disease, etc.

Female sex hormones have widespread clinical use for a variety of indications, and there is a continuous debate concerning possible harmful effects due to such treatment. The symposium discussed the key importance of developing more selective drugs with agonistic or antagonistic estrogenic effects. In recent years, new knowledge has greatly changed our view of the effects of estrogen. Various new data were presented at the meeting. For example, persuasive evidence was presented for the view that the new estrogen receptor ERbeta has a biological function different from that of ERalpha. ERbeta thus seems to have an anti proliferative effect both in the prostate and the uterus; if these findings can be confirmed, they may open up interesting new possibilities for the treatment of prostate and uterine cancer.

The symposium volume was published in the Journal of Steroid Biochemistry and Molecular Biology during 2000.

Program
June 29 - Tuesday	Bofors Hotel
8.00 a.m.-8.40 a.m.	The estrogen receptor family and its ligands Chairmen: Elwood Jensen, Håkan Eriksson Kathryn Horwitz, University of Colorado Health Science Center, Denver: "Growth regulation and steroid hormone resistance in breast cancer"
8.40 a.m.-9.20 a.m.	Jan-Åke Gustaffson, Karolinska Institutet, Stockholm: "ERB-a new paradigm in estrogen mechanism of action"
9.20 a.m.-10.00 a.m.	Roderick Hubard, University of York, York: "Structural aspects of agonism and antagonism in the estrogen receptor"
10.30 am-11.10 am	Donald McDonnell, Duke University Medical Center: "Mechanistic distinctions among the selective estrogen receptor modulators"
11.10 am-11.50 pm	Benita Katzenellenbogen, University of Illinois: "Molecular mechanisms of estrogen action: Selective ligands and receptor pharmacology"
13.30 pm - 14.10 pm	Kenneth Korach, National Institute of Environmental Health Sciences, Research Triangle Park: "Estrogen receptor knock-out mice: Molecular and endocrine phenotypes"
14.10 pm - 14.50 pm	Kennet Setchell, Univreisty of Cincinnati Medical Center, Cincinnati
15.20 pm - 16.00 pm	Peter Kushner, University of California, San Francisco: "Tamoxifen behavior and misbehavior"
June 30 - Wednesday	Björkborn Manor
	The physiology and pathology of estrogen action Chairmen: Etienne-Emile Baulieu, Thomas Perlmann
8.00 am - 8.40 am	Bert O'Malley, Baylor College of Medicine, Houston: "Role of steroid receptor co-activators in transcriptional regulation"
8.40 am - 9.20 am	Gordon Hager, National Cancer Institute, Bethesda: "Subcellular trafficking and intranuclear targeting of steroid receptors in living cells"
9.20 - 10.00 am	Adriana Maggi, University of Milan, Milan: "Estrogen effect on neural cell functions"
10.30 am - 11.10 am	Martin Ritzén, Karolinska Institutet, Stockholm: "Estrogens and human growth"
11.10 am - 11.50 am	Donald Pfaff, Rockefeller University, New York: "Effects of estrogens on brain and behavior"
13.30 pm - 14.10 pm	Michael Mendelsohn, Tufts University School of Medicine, Boston: "Mechanisms of estrogen action in the cardiovascular system"
July 1 - Thursday	Bofors Hotel
	Benefits and risks of estrogens Chairmen: Luciano Martini, Britt-Marie Landgren
8.40 am - 9.20 am	Lewis Kuller, University of Pittsburgh School of Public Health, Pittsburgh: "Estrogens and women's health"
9.20 am - 10.00 am	John Stevenson, Imperial College School of Medicine, London: "Cardiovascular effects of estrogens"
10.30 am - 11.10 am	Ingemar Persson, Karolinska Institutet, Stockholm: "Estrogens in the causation of breast, endometrial and ovarian cancers. Evidence and hypotheses from epidemiological findings"
11.10 am - 11.50 am	Jonathan Reeve, Cambridge University School of Public Health, Cambridge: "How do women develop fragile bones?"
13.30 am - 14.10 pm	Håkan Olsson, University of Lund, Lund: "Tumour biology of a breast cancer at least partly reflect the biology of the tissue/epithelial cell of origin at the time of initiation - a hypothesis"
14.10 pm - 14.50 pm	Craig Jordan, Northwestern University Medical School, Chicago: "Tamoxifen, raloxifene and the prevention of breast cancer"

Participants
Dr. Monica Ahlberg Karolinska Institutet NOVUM, Huddinge, Sweden	Dr. Lena Magnell Karolinska Institutet NOVUM, Huddinge, Sweden
Dr. Tova Almlöf Karolinska Insititutet NOVUM, Huddinge, Sweden	Dr. Sari Mäkelä Karolinska Institutet Huddinge, Sweden
Dr. Göran Andersson Karolinska Institutet Huddinge Hospital Huddinge, Sweden	Dr. Luciano Martini Univ. Degli Studi Milan Milan, Italy
Dr. Etienne-Emile Baulieu Ints. National de la Santé et de Collège de France INSERM U488, France	Dr. Donald P. McDonnell Duke University Medical Center, USA
Dr. Thomas Bergman Karolinska Institutet NOVUM, Huddinge, Sweden	Dr. Michael E. Mendelsohn New England Medical Center, USA
Dr. Jan Carlstedt-Duke Karolinska Institutet NOVUM, Huddinge, Sweden	Dr. Stefan Nilsson NOVUM, Huddinge Sweden
Dr. Hans Carlsten University of Göteborg Göteborg, Sweden	Dr. Bert O'Malley Baylor College of Medicine USA
Dr. Eva Enmark Karolinska Institutet Huddinge, Sweden	Dr. Claes Ohlsson Göteborg University Göteborg, Sweden
Dr. Håkan Eriksson Karolinska Institutet Karolinska Hospital Stockholm, Sweden	Dr. Håkan Olsson Universitetssjukjuset Lund, Sweden
Dr. Jan-Åke Gustafsson Karolinska Institutet NOVUM, Huddinge, Sweden	Dr. Thomas Perlmann Karolinska Institutet Stockholm, Sweden
Dr. Kerstin Hagenfeldt Karolinska Institutet Stockholm, Sweden	Dr. Ingemar Persson Karolinska Institutet Stockholmm, Swedem
Dr. Gordon Hager National Cancer Institute Bethesda, USA	Dr. Donald W. Pfaff The Rockefeller University USA
Dr. Kathryn B. Horwitz University of Colorado Denver, USA	Dr. Jonathan Reeve Cambridge University Cambridge, UK
Dr. Rod E. Hubbard University of York U K	Dr. Martin Ritzén Karolinska Hospital Stockolm, Sweden
Dr. Elwood Jensen Karolinska Institutet NOVUM, Huddinge, Sweden	Dr. Shigehira Saji Karolinska Institutet NOVUM, Huddinge, Sweden
Dr. Lotta Johansson Karolinska Institutet NOVUM, Huddinge, Sweden	Dr. Risto Santi University of Turku Turku, Finland
Dr. Craig Jordan Northwestern University Medical School Chicago, USA	Dr. Kenneth Setchell Children's Hospital & Medical Center, Cincinnati, USA
Dr. Benita S. Katzenellenbogen University of Illinois Urbana, USA	Dr. Maria Sjöberg Karolinska Institutet Stockholm, Sweden
Dr. Kenneth Korach NIH-NIEHS USA	Dr. Olle Söder Karolinska Institutet Astrid Lindgren Children's Hospital, Stockholm, Sweden
Dr. Lewis H. Kuller University of Pittsburg Pittsburg, USA	Dr. John C. Stevenson Imperial College of Science, Technology, London, UK
Dr. Peter Kushner University of California San Francisco, USA	Dr. Anders Ström Karolinska Institutet NOVUM, Huddinge, Sweden
Dr. Britt-Marie Landgren Karolinska Institutet Huddinge, Sweden	Dr. Eckardt Treuter Karolinska Institutet NOVUM, Huddinge, Sweden
Dr. Jörg Leers Karolinska Institutet Huddinge, Sweden	Dr. Michel Tujague Karolinska Institutet NOVUM, Huddinge, Sweden
Dr. Adriana Maggi University of Milan Milan, Italy	Dr. Margret Warner Karolinska Institutet NOVUM, Huddinge, Sweden