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Review article
Sex steroids and growth hormone interactions
Esteroides sexuales e interacciones con la hormona de crecimiento
Leandro Fernández-Péreza,
Corresponding author
leandrofco.fernandez@ulpgc.es

Corresponding author.
, Mercedes de Mirecki-Garridoa, Borja Guerraa, Mario Díazb, Juan Carlos Díaz-Chicoa
a Institute for Research in Biomedicine and Health (IUIBS), University of Las Palmas de Gran Canaria, Molecular and Translational Pharmacology – BioPharm Group, Las Palmas de G.C., Spain
b Department of Animal Biology, University of La Laguna, Laboratory of Membrane Physiology and Biophysics, La Laguna, Spain
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Signaling pathways used by GH to regulate growth and metabolism&#46; GH binds to a preformed GHR dimmer which results in activation of JAK2 tyrosine kinase&#46; Simultaneously&#44; Src kinase is also activated&#46; Canonical JAK2 signaling via STAT5 involves phosphorylation of key tyrosine residues in the cytoplasmic domain of GHR&#44; which recruit STATs to the activated JAK2 and thus facilitating their tyrosine phosphorylation and subsequent dimerization and translocation to the nucleus to regulate gene transcription&#46; ERK can be activated either by SRC and&#47;or PLC&#947; and Ras&#44; or by JAK2 via the adaptors proteins&#46; The PtdIns 3-kinase and the serine-threonine-protein kinase mTOR pathway is activated by JAK2 via IRS phosphorylation&#46; These signaling pathways influence transcription of genes involved in growth and metabolism&#46; Abbreviations&#58; ERK&#44; extracellular signal-regulated kinase&#59; FAK&#44; focal adhesion kinase&#59; Grb&#44; growth factor receptor-bound protein&#59; IRS&#44; insulin receptor substrate&#59; JAK2&#44; Janus Kinase 2&#59; JNK&#44; c-Jun N-terminal kinase&#59; MEK&#44; dual specificity mitogen-activated protein kinase kinase 2&#59; mTOR&#44; mammalian target of rapamycin&#59; PI3K&#44; phosphoinositide 3-kinae&#59; PKC&#44; protein kinase C&#59; PLC&#947;&#44; phospholipase C&#947;&#59; SHC&#44; SH2-domain containing transforming protein&#59; SOCS&#44; suppressor of cytokine signaling&#59; SOS&#44; son of sevenless&#59; SRC&#44; proto-oncogene tyrosine-protein kinase Src&#59; STAT&#44; signal transducer and activator of transcription&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">GH is the main regulator of somatic growth&#44; metabolism&#44; and gender-differentiated functions in liver&#46;<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">1&#8211;6</span></a> GH is predominantly linked to linear growth during childhood&#44; but continues to have important metabolic actions throughout life&#46; Interestingly&#44; deficiency of GH-GH receptor &#40;GHR&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">6</span></a> estradiol &#40;E2&#41;-Estrogen Receptor &#945; &#40;ER&#945;&#41;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">7&#8211;11</span></a> or testosterone &#40;T&#41;&#47;Androgen Receptor &#40;AR&#41;<a class="elsevierStyleCrossRefs" href="#bib0415"><span class="elsevierStyleSup">11&#8211;15</span></a> signaling in adults causes a similar metabolic-like syndrome &#40;i&#46;e&#46;&#44; fatty liver&#44; visceral adiposity&#44; insulin resistance&#44; decreased muscle mass&#41;&#44; a phenotype that can be ameliorated by GH or sex hormones replacement&#46; E2 and T can modulate GH actions in the liver by acting both centrally&#44; regulating pituitary GH secretion&#44;<a class="elsevierStyleCrossRefs" href="#bib0440"><span class="elsevierStyleSup">16&#44;17</span></a> and&#44; peripherally&#44; modulating GH signaling&#46;<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">18</span></a> Most previous studies have been focused on the influence of E2 and T on gender-specific pituitary GH secretion&#44; which has a great impact on hepatic transcriptional regulation&#46; In addition&#44; the liver is a direct target of sexual hormones because it expresses ER&#945; and AR&#44; and the signaling pathways linked to these receptors are connected with lipid and glucose homeostasis&#44;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">11</span></a> liver growth and regeneration&#44;<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">19</span></a> body growth&#44;<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">20</span></a> drug-induced hepatotoxicity&#44;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">21</span></a> hepatic carcinogenesis&#44;<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">22</span></a> or fertility&#46;<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">23</span></a> Notably&#44; E2 has been shown to modulate GH actions in the liver through induction of Suppressor of Cytokine Signaling &#40;SOCS&#41;-2&#44; which in turn negatively regulates GHR-Janus Kinase &#40;JAK&#41;-2-Signal Transducer and Activator of Transcription &#40;STAT&#41;-5 signaling pathway&#46; Interactions between T and GHR-JAK2-STAT5b-SOCS2 signaling pathways might also play a relevant role to regulate hepatic metabolism&#46;<a class="elsevierStyleCrossRefs" href="#bib0480"><span class="elsevierStyleSup">24&#44;25</span></a> This phenomenon is clinically relevant because its importance in the regulation of endocrine&#44; metabolic&#44; and gender-differentiated actions of GH in the liver&#46; Notably&#44; disruption of the GHR-JAK2-STAT5-SOCS2 signaling pathway is associated with disorders in somatic growth<a class="elsevierStyleCrossRefs" href="#bib0385"><span class="elsevierStyleSup">5&#44;6</span></a> and gender dimorphism&#44;<a class="elsevierStyleCrossRefs" href="#bib0445"><span class="elsevierStyleSup">17&#44;26</span></a> and with liver diseases such as non-alcoholic fatty liver&#44; insulin resistance&#44; fibrosis&#44; or hepatocellular carcinoma&#46;<a class="elsevierStyleCrossRefs" href="#bib0495"><span class="elsevierStyleSup">27&#8211;30</span></a> However&#44; the specific roles of the E2&#47;ER and T&#47;AR signaling for the regulation of liver physiology and&#44; particularly&#44; GHR-JAK2-STAT5-SOCS2 signaling pathway are still largely unknown&#46; Furthermore&#44; the novel discovery of JAK2 as a negative regulator of ER&#945; suggests a more complex level of crosstalk between E2&#47;ER&#945; and GH-mediated signaling pathways&#46;<a class="elsevierStyleCrossRef" href="#bib0515"><span class="elsevierStyleSup">31</span></a> In the general population&#44; the endocrine and metabolic consequences of long-term exposition to sex hormones-related compounds and their influence on the pituitary &#40;GH&#41;-liver axis are also largely unknown&#46; In this review&#44; we will summarize the current status of the influence of sex hormones on GH actions in the liver&#46; A better understanding of this complex interaction in physiological and pathological states will contribute to prevent health damage and improve clinical management of patients with growth&#44; developmental and metabolic disorders&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Regulation of pituitary GH secretion</span><p id="par0010" class="elsevierStylePara elsevierViewall">GH is a polypeptide mainly secreted by the somatotroph cells&#44; but also produced in extra-pituitary tissues&#59; therefore&#44; GH also has paracrine-autocrine effects&#44; distinct from its classic endocrine somatotropic effects&#46;<a class="elsevierStyleCrossRefs" href="#bib0520"><span class="elsevierStyleSup">32&#44;33</span></a> The regulation of pituitary GH secretion involves a complex neuroendocrine control system that includes the participation of several neurotransmitters and the feedback of hormonal and metabolic factors&#46; Pituitary GH secretion is regulated by two hypothalamic peptides&#58; GHRH and the inhibitory hormone somatostatin &#40;SS&#41;&#46; The balance of these peptides is&#44; in turn&#44; indirectly affected by many physiological stimulators &#40;i&#46;e&#46;&#44; exercise&#44; sleep&#44; nutrients&#44; thyroid hormones&#44; sex hormones&#41; and inhibitors &#40;i&#46;e&#46;&#44; glucocorticoids&#44; IGF-I&#44; GH&#41;&#46; The final integration of these signals occurs in the hypothalamus&#46; Pituitary GH secretion is mainly reduced by the negative feedback of two circulating signals&#58; pituitary GH itself&#44; and liver-derived IGF-I stimulated by GH&#46; In addition to hypothalamic and endocrine factors&#44; other peripheral factors influence pituitary GH release &#40;i&#46;e&#46;&#44; free fatty acids &#40;FFA&#41;&#44; insulin&#44; glucose&#44; amino acids&#44; leptin&#44; neuropeptide Y&#44; ghrelin&#41;&#46; These factors are primarily related to or derived from the metabolic status of the organism&#44; which is consistent with the role of GH in regulating substrate metabolism&#44; adiposity&#44; and growth&#44; and appear to coordinate the metabolic status of the organism with GH secretion&#46; This is exemplified by adiposity&#44; which is a powerful negative regulator of GH secretion&#58; GH can stimulate FFAs mobilization&#44; which inhibit GH release and complete a feedback loop among pituitary and adipose tissue&#46; Conversely&#44; leptin&#44; which is also produced in adipose tissue&#44; and ghrelin&#44; from endocrine cells of the stomach&#44; are inducers of pituitary GH secretion&#46; Sex steroids are also physiological regulators of pituitary GH secretion&#46;<a class="elsevierStyleCrossRefs" href="#bib0440"><span class="elsevierStyleSup">16&#44;17</span></a> Neonatal and post-pubertal sex steroids control the ability of the hypothalamus to drive the sexually dimorphism of pituitary GH secretion seen in adulthood&#44; both in rats and humans&#44; which could explain gender-dimorphism in liver physiology&#46; Sexual dimorphism in rodents seems to be regulated by E2 secretion in adult females and by T secretion&#44; both neonatally and during adulthood&#44; in males&#46; Neonatal exposure to T imprints the male program of neuroendocrine control of the pulsatile pituitary GH secretion that is first seen at puberty&#44; when the adult pattern of GH secretion becomes evident&#44; and continues throughout adulthood&#46; In post-pubertal rats&#44; the blood male pattern consists of high and regular amplitude pulses spaced near 3&#8211;4<span class="elsevierStyleHsp" style=""></span>h apart with no measurable trough levels&#46; In contrast&#44; the female pattern shows lower and erratic amplitude pulses&#44; and GH is always present in blood&#46; If such an androgen re-programming does not occur&#44; the secretion pattern will remain as the feminine pattern&#46; Interestingly&#44; depletion of liver-derived IGF-I &#40;LID&#41;<a class="elsevierStyleCrossRef" href="#bib0525"><span class="elsevierStyleSup">33</span></a> or SOCS2 deletion<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">29</span></a> in male mice&#44; or exposition of adult male rats to E2<a class="elsevierStyleCrossRef" href="#bib0530"><span class="elsevierStyleSup">34</span></a> can cause liver feminization of some of the GH-regulated biomarkers of gender dimorphism&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">GH-STAT5 signaling in liver physiology</span><p id="par0015" class="elsevierStylePara elsevierViewall">GH mediates its intracellular effects via the GHR which is ubiquitously expressed&#44; especially in liver&#44; fat&#44; and muscle&#46; GHR belongs to a family of receptors without intrinsic kinase activity&#46; However&#44; the GH molecule interacts with preformed dimmers of identical GHR pairs which results in a conformational change in the GHRs and associated tyrosine kinase JAK2 molecules<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">3</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; This event unmasks the catalytic domain of JAK2&#44; which is masked by its pseudokinase domain in the inactive state&#44; and results in activation of adjacent JAK2 molecules by transphosphorylation&#46; Activated JAK2 phosphorylates the GHR cytoplasmic domain on tyrosine residues and subsequent JAK2-dependent and -independent intracellular signal transduction pathways evoke cell responses including changes in gene transcription&#44; proliferation&#44; cytoskeletal re-organization&#44; and lipid and glucose metabolism&#46; STAT5 phosphorylation by JAK2 results in their dissociation from the receptor&#44; dimerization&#44; and translocation to the nucleus&#44; where they modulate the transcription of target genes such as IGF-I&#44; SOCS2&#44; CYP2C12 and HNF6&#46;<a class="elsevierStyleCrossRefs" href="#bib0535"><span class="elsevierStyleSup">35&#8211;38</span></a> STAT5b is a key transcription factor in GH regulation of target genes associated with body growth&#44; intermediate metabolism &#40;e&#46;g&#46;&#44; lipid metabolism&#41; and gender dimorphism&#44; even though STAT1&#44; 3&#44; and 5a have also been shown to be recruited by the GHR&#46; In addition&#44; many transcripts are regulated independently from STAT5b as a result of GHR activation of Src&#44; ERK&#44; and PI3K-mTOR signaling pathways&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The analysis of the molecular mechanisms involved in inactivation of GHR-dependent signaling pathway is also imperative for understanding GH physiology&#46; This is clearly illustrated in the case of hepatic GHR-JAK2-STAT5b activation where signal duration regulates gender differences in liver gene expression&#46;<a class="elsevierStyleCrossRef" href="#bib0550"><span class="elsevierStyleSup">38</span></a> Studies in primary hepatocytes and several cell lines have shown that GH-induced JAK2-STAT5b activation is transient&#44; with maximal activation achieved within the first 30<span class="elsevierStyleHsp" style=""></span>min of stimulation&#44; followed by a period of inactivation&#46; This period is characterized by an inability to achieve maximal JAK2-STAT5 activation by GH in the following 3&#8211;4<span class="elsevierStyleHsp" style=""></span>h&#44; unless GH is withdrawn from the media&#46;<a class="elsevierStyleCrossRef" href="#bib0555"><span class="elsevierStyleSup">39</span></a> As mentioned above&#44; the male pattern of pituitary GH secretion in rats is episodic with peaks every 3&#8211;4<span class="elsevierStyleHsp" style=""></span>h and no measurable trough levels&#46; Consequently&#44; intracellular activation of STAT5b is also episodic and periods with low GH circulating levels are required to achieve maximal activation of STAT5b&#46; Female rats&#44; which exhibit a more continuous GH secretion pattern with higher basal levels and smaller and irregular intermittent peaks show reduced STAT5b activation compared with males&#46; As expected&#44; protein phosphatases are involved in negative regulation of GH signaling&#46; In addition&#44; the level of cell surface GHRs can be influenced by transcriptional&#44; translational and posttranslational factors &#40;e&#46;g&#46;&#44; nutritional status&#44; endocrine context&#44; developmental stage&#44; and sex steroids&#41; which&#44; thereby&#44; regulate cell sensitivity to GH actions&#46; GHR translocation is also directly inhibited by IGF-I&#44; likely contributing to a local feedback loop to hamper GH sensitivity&#46; An early step in the termination of GH-dependent signaling is removal of GHRs by mechanisms of endocytosis and ubiquitination&#46; In this context&#44; SOCS2&#44; an ubiqutin ligase&#44; has been shown to be a key component of negative regulation of GHR-JAK2-STAT5 signaling pathway&#46;<a class="elsevierStyleCrossRef" href="#bib0560"><span class="elsevierStyleSup">40</span></a> In general&#44; SOCS2 protein level is constitutively low&#44; but its expression is rapidly induced by GH which is followed by SOCS2 binding to GHR complex to promote its ubiquitination and subsequent proteasomal degradation&#46; Clinically relevant&#44; SOCS2 is a key negative regulator of GH-dependent control of body growth<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">1</span></a> and lipid and glucose homeostasis&#46;<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">29</span></a> Furthermore&#44; several cytokines&#44; growth factors &#40;e&#46;g&#46;&#44; insulin&#41;&#44; xenobiotics &#40;e&#46;g&#46;&#44; dioxin&#44; statins&#41;&#44; and sex hormones can induce SOCS2 levels which provides a mechanism for cross-talking where multiple factors &#40;endo- and xenobiotics&#41; can regulate GH activity&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Body growth</span><p id="par0025" class="elsevierStylePara elsevierViewall">GH is predominantly linked with postnatal growth&#46;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">32</span></a> Liver is the principal source of circulating IGF-I&#44; and GH-dependent transcription of IGF-I is directly regulated by STAT5&#46;<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">1&#44;5</span></a> Importantly&#44; the mode of GH administration influences GH actions on liver&#46; Intermittent &#40;male pattern&#41; GH administration to rodents is a more potent stimulus of body growth rate&#44; IGF-I expression&#44; and STAT5b activity in liver than is continuous &#40;female pattern&#41; administration&#46; However&#44; GH is more effective than IGF-I because GH exerts additional growth-promoting actions independent of IGF-I&#46; Global disruption of STAT5b in mice causes loss of sexually dimorphic growth characteristics&#44; so that the affected males reduced their size to female size&#44; while female mice appeared unaffected&#46; In addition&#44; circulating IGF-I is reduced by 30&#8211;50&#37; in affected male&#44; but not in female mice&#46; However&#44; combined disruption of STAT5a&#47;b significantly reduced body weight gain in females and suppressed body growth more than in STAT5b null male mice&#44; approaching that observed in either GH or GHR deficient mice&#46; These studies demonstrated that STAT5b is important for male-specific body growth&#44; whereas STAT5a regulates body growth in both sexes&#46; In addition to STAT5b&#44; other transcription factors are related with body growth&#46; This is exemplified by the glucocorticoid receptor&#44; which is a critical co-activator of STAT5b in liver&#44;<a class="elsevierStyleCrossRef" href="#bib0565"><span class="elsevierStyleSup">41</span></a> or by interactions between E2&#47;ER signaling and STAT5&#46;<a class="elsevierStyleCrossRef" href="#bib0570"><span class="elsevierStyleSup">42</span></a> Experiments in mice with SOCS2 disruption also support that STAT5b is critical for GH regulation of somatic growth&#46;<a class="elsevierStyleCrossRefs" href="#bib0560"><span class="elsevierStyleSup">40&#44;43</span></a> In addition to endocrine actions&#44; paracrine involvement of STAT5a&#47;b in the effects of GH on muscle is also evidenced by the loss of muscle IGF-I transcripts and mass seen in the muscle-specific deletion of STAT5a&#47;b&#46;<a class="elsevierStyleCrossRef" href="#bib0580"><span class="elsevierStyleSup">44</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Lipid metabolism</span><p id="par0030" class="elsevierStylePara elsevierViewall">The main metabolic process affected by GH status is energy&#47;fuel metabolism&#44; particularly lipid&#47;fat metabolism&#46;<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">1&#44;5&#44;45</span></a> A key physiological function of GH is the promotion of protein synthesis and inhibition of protein degradation in muscle&#44; bone and other large organs&#44; inhibiting glucose and aminoacids catabolism by promoting the utilization of lipids as energy source&#46; These systemic effects of GH are achieved through inhibition of insulin actions and the promotion of fatty acid mobilization from adipose tissue and liver&#46;<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">1&#44;4</span></a> In adipose tissue&#44; GH is a lipolytic hormone and reduces fat mass&#46; This is particularly evident in individuals who have accumulated excess fat during periods of GH deficiency&#46;<a class="elsevierStyleCrossRefs" href="#bib0370"><span class="elsevierStyleSup">2&#44;4</span></a> In the liver&#44; GH promotes triglyceride synthesis and secretion&#59; in addition to increasing lipogenesis &#40;e&#46;g&#46;&#44; SREBP1&#41;&#44; GH inhibits PPAR&#945; expression and decreases lipid oxidation&#46;<a class="elsevierStyleCrossRefs" href="#bib0530"><span class="elsevierStyleSup">34&#44;46</span></a> In the skeletal muscle&#44; GH stimulates triglyceride uptake and lipid oxidation&#44; which can be modified by factors such as nutrition&#44; exercise&#44; and sex steroid hormones&#46; Conversely&#44; GH deficiency &#40;GHD&#41; in adulthood causes a metabolic syndrome &#40;i&#46;e&#46;&#44; increased visceral adiposity&#44; fatty liver&#44; decreased muscle mass&#44; metabolic disturbances&#41; that can be ameliorated by GH replacement&#46; An ineffective GHR-JAK2-STAT5 signaling pathway results in fatty liver and adiposity in rodents and human which is due to enhanced lipogenesis and reduced triglyceride secretion as well as reduced lipolysis&#46;<a class="elsevierStyleCrossRefs" href="#bib0390"><span class="elsevierStyleSup">6&#44;27&#44;28</span></a> This is supported by original findings that STAT5b-deleted male mice become obese in later life<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">26</span></a> and that STAT5b deletion in a mature human was associated with obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0595"><span class="elsevierStyleSup">47</span></a> In contrast&#44; ablation of SOCS2 in mice&#44; which increased STAT5 signaling&#44; protected from high-fat diet-induced liver steatosis<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">29</span></a>&#46; These findings highlight two physiological aspects of GHR-STAT5b signaling&#58; &#40;a&#41; STAT5b plays a critical role in regulation of key enzymes or genes otherwise involved in lipid and energy balance&#46; Clinically relevant&#44; anti-obesity actions of GH are enhanced by the male pattern of pituitary GH secretion due to pulsatile STAT5 activation&#46; &#40;b&#41; Despite normal plasma FFA and minimal adiposity&#44; absent GHR signaling leads to fatty liver because of reduced STAT5 activation&#46; Relevant to this review&#44; agonists of Liver X Receptor &#40;LXR&#41;&#44; which cause hepatic steatosis&#44;<a class="elsevierStyleCrossRef" href="#bib0600"><span class="elsevierStyleSup">48</span></a> can inhibit GH-STAT5b signaling&#46;<a class="elsevierStyleCrossRef" href="#bib0605"><span class="elsevierStyleSup">49</span></a> This inhibition is mediated by SREBP1&#44; a LXR target gene&#44; through the downregulation of STAT5b gene transcription and stimulation of STAT5b protein degradation&#46; These findings highlight the molecular interactions of LXR with GH-STAT5b signaling in liver&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Glucose metabolism</span><p id="par0035" class="elsevierStylePara elsevierViewall">GH stimulates the hepatic glucose production&#46; GH increases glycogenolysis&#59; however&#44; it has either a stimulatory or no effect on gluconeogenesis&#46; This may be a result of GH antagonism of insulin action leading to hepatic&#47;systemic insulin resistance&#46; In addition&#44; IGF-I exerts profound effects on carbohydrate metabolism and may enhance insulin sensitivity by suppressing GH release&#46;<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">4</span></a> Therefore&#44; activation of IGF-I signaling adds more complexity for understanding molecular mechanisms involved in GH-induced insulin resistance in vivo&#46; GHD mice and the GHRKO mice have improved insulin sensitivity and up-regulated hepatic insulin signaling&#44; suggesting that GH antagonizes insulin signaling locally in the liver&#46;<a class="elsevierStyleCrossRef" href="#bib0610"><span class="elsevierStyleSup">50</span></a> However&#44; over-expressing the human GH gene in rats increases basal hepatic glucose uptake and glycogen content&#46;<a class="elsevierStyleCrossRef" href="#bib0615"><span class="elsevierStyleSup">51</span></a> GH-induced insulin resistance may be developed by the increased FFA mobilization from peripheral adipose tissue which can then affect liver insulin sensitivity&#44; and lead to insulin resistance and up-regulation of gluconeogenic genes &#91;e&#46;g&#46;&#44; glucose-6-phosphatase&#44; phosphoenolpyruvate carboxykinase&#93; in the liver with an important role in glucose homeostasis&#46; Interestingly&#44; the LID mice shows a 75&#37; reduction in circulating IGF-I levels&#44; 3&#8211;4 fold increase in circulating GH levels and insulin resistance&#44; without significant increase in circulating FFA levels&#44; arguing for the existence of a local cross-talk between GH and insulin signaling systems within the hepatocyte&#46; Moreover&#44; after crossing LID mice with GH transgenic mice&#44; serum FFA levels were significantly increased and there was an improvement in insulin sensitivity due to higher hepatic&#44; adipose tissue and skeletal muscle glucose uptake&#46;<a class="elsevierStyleCrossRef" href="#bib0620"><span class="elsevierStyleSup">52</span></a> It has been suggested that&#44; in addition to FFA&#44; the SOCS family of proteins&#44; whose expression is induced by both GH and insulin in the liver&#44; may contribute to insulin resistance&#46;<a class="elsevierStyleCrossRefs" href="#bib0605"><span class="elsevierStyleSup">49&#44;53</span></a> Recently&#44; we have shown that SOCS2 deletion protected against fatty liver but&#44; paradoxically&#44; worsen insulin resistance in high-fat diet fed mice&#46;<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">29</span></a> In contrast&#44; SOCS2 deletion protected against streptozotocin-induced type I diabetes in adult male mice &#40;in press&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Gender dimorphism</span><p id="par0040" class="elsevierStylePara elsevierViewall">As mentioned above&#44; sex hormones imprint a sex-dependent pattern of pituitary GH hormone secretion which is a major player in establishing and maintaining gender dimorphism in liver physiology&#46;<a class="elsevierStyleCrossRefs" href="#bib0445"><span class="elsevierStyleSup">17&#44;54</span></a> From neonatal period of life&#44; gonadal steroids play a critical role to maintain liver response to GH in adulthood&#46; Neonatal exposure to T is crucial and the full response to androgens in adulthood is dependent on neonatal imprinting by T&#46; The male characteristic metabolism in liver in adulthood is dependent on continuous androgen exposure&#46; In female rats&#44; gonadectomy has little impact on hepatic steroid metabolism&#59; estrogen treatment &#40;or exposition&#41;&#44; however&#44; feminizes hepatic metabolism in male rats&#46; Most of the hepatic gender dimorphism can be explained by the female-specific pattern of pituitary GH secretion&#44; through the induction of female-predominant transcripts and suppression of male-predominant ones&#59; 20&#8211;30&#37; of all hepatic genes have a sex-specific expression pattern in rodents&#46; Genome-wide screens of gene expression have shown that GH- and sex-dependent regulation of hepatic gene expression affects several families of hepatic genes involved in endo- and xenobiotic metabolism and metabolic functions &#40;e&#46;g&#46;&#44; lipid metabolism&#41;&#46; In addition&#44; a number of other hepatic transcripts encoding plasma proteins&#44; enzymes&#44; transcription factors and receptors involved in the metabolism of proteins&#44; carbohydrates&#44; lipids&#44; or signaling regulation have been also found to be up- and&#47;or down-regulated by the different patterns of GH or sex-steroid exposure&#46;<a class="elsevierStyleCrossRefs" href="#bib0530"><span class="elsevierStyleSup">34&#44;38</span></a> There is consensus on the response to sex-different pattern of pituitary GH secretion as the major cause of gender dimorphism in liver&#46; However&#44; it is likely that other factors are behind some hepatic sex differences&#46; Potential mechanisms that could contribute to this &#8220;liver sexuality&#8221; are the pituitary-independent effects of estrogens through interaction with ER&#945; and GH-JAK2-STAT5b signaling pathway in liver&#46; STAT5b is a key player in this scenario and it is responsible for the masculinization of the male liver&#46;<a class="elsevierStyleCrossRefs" href="#bib0490"><span class="elsevierStyleSup">26&#44;38</span></a> Conversely&#44; other transcription factors &#40;e&#46;g&#46;&#44; HNF6 and HNF3b&#41; are more efficiently activated in female liver or by the continuous GH administration&#46;<a class="elsevierStyleCrossRefs" href="#bib0635"><span class="elsevierStyleSup">55&#44;56</span></a> As mentioned above&#44; SREBP1c induction&#44; as well as hepatic triglyceride synthesis and VLDL secretion&#44; and PPAR&#945; inhibition can be observed in the liver after continuous GH administration&#46;<a class="elsevierStyleCrossRefs" href="#bib0530"><span class="elsevierStyleSup">34&#44;46</span></a></p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">The liver&#44; a physiological target for sex steroids</span><p id="par0045" class="elsevierStylePara elsevierViewall">As mentioned above&#44; the liver represents a target tissue for sex hormones where physiologically and therapeutically relevant interactions between E2&#47;T- and GH-dependent signaling can be developed&#46; Estrogens and androgens can signal through multiple receptors &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Estrogen signaling can be mediated by multiple receptors&#46;<a class="elsevierStyleCrossRef" href="#bib0645"><span class="elsevierStyleSup">57</span></a> Most of the known estrogenic effects are mediated via direct interaction of estrogen with the DNA-binding transcription factors&#44; ER&#945; and ER&#946;&#46; This classical estrogen signaling occurs through a direct binding of ER dimers to estrogen responsive elements in the regulatory regions of estrogen target genes&#44; followed by activation of the transcriptional machinery at the transcription start site&#46; In addition&#44; E2 can modulate gene expression by a second mechanism in which ERs interact with other transcription factors &#40;e&#46;g&#46;&#44; STAT5&#41;&#44; through a process referred to as transcription factor cross-talk&#46; E2 may also elicit effects through non-genomic mechanisms&#44; which involve the activation of downstream kinase pathways via membrane-localized ERs&#46; An orphan G protein-coupled receptor &#40;GPR&#41;-30 in the cell membrane has also been reported to mediate non-genomic and rapid estrogen signaling&#46; Finally&#44; E2 has a similar affinity for ER&#945; and ER&#946; and they are activated by a wide range of ligands including Selective Estrogen Receptor Modulators &#40;SERMs&#41; &#40;e&#46;g&#46;&#44; raloxifen&#41; as well as many other xenobiotic compounds&#46; Tissue expression of ERs is also a critical determinant of estrogenic actions&#46; ER&#946; is expressed in the ovary&#44; prostate&#44; lung&#44; gastrointestinal tract&#44; bladder&#44; and hematopoietic and the central nervous systems&#44; while ER&#945; is mainly expressed in reproductive tissues&#44; kidney&#44; bone&#44; white adipose tissue&#44; and liver&#46; This indicates that specific actions of estrogens in liver can be mimicked by using selective ER&#945; agonists such as propyl-pyrazole-triol &#40;PPT&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0650"><span class="elsevierStyleSup">58</span></a> Therefore&#44; the above mentioned data indicate that the mechanisms involved in ER signaling are influenced by tissue ER distribution&#44; the target gene&#44; and the activity or crosstalk with other signaling pathways&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Androgen signaling can also be mediated by genomic and non-genomic mechanisms&#46;<a class="elsevierStyleCrossRefs" href="#bib0430"><span class="elsevierStyleSup">14&#44;59</span></a> The major circulating androgen&#44; T&#44; is synthesized in testicular Leydig cells and released into blood&#44; where it binds to steroid hormone-binding globulin &#40;SHBG&#41; to facilitate the transport&#46; Within target cells&#44; T is converted to DHT&#44; a more active androgen&#44; by 5&#945;-reductase&#46; Similarly to classical E2 signaling&#44; most of the known androgenic effects are mediated via direct interaction of T&#47;DHT with the DNA-binding transcription factor AR which plays an important role in regulating androgen action in men and women&#46; Androgen-activated AR regulates the transcription of a variety of target genes through the interaction with different coregulators which contribute to tissue specificity of androgen actions&#46; There are also evidences that T&#47;AR may also elicit effects through non-genomic mechanisms&#58; &#40;1&#41; the AR is palmitoylated&#44; which regulates its localization to the membrane&#59; &#40;2&#41; the AR can be localized in lipid rafts within the membrane&#59; &#40;3&#41; membrane-localized AR mediates rapid G protein signaling by androgens&#44; and &#40;4&#41; androgen activation of membrane-localized AR leads to rapid transactivation of the EGF receptor which is followed by activation of Akt and MAPK pathways and subsequent nuclear AR-mediated signaling&#46; However&#44; whether altered androgen&#47;AR signaling dysfunctions may play a role in the pathophysiology of different metabolic phenotypes or influence somatotropic-liver axis remains&#44; in comparison with E2&#47;ER signaling&#44; largely unknown&#46;</p><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Body growth and composition</span><p id="par0055" class="elsevierStylePara elsevierViewall">The impact of sex steroids on body growth and composition is complex&#46;<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">16</span></a> The increase in pubertal growth velocity associated with increased GH secretion has been traditionally attributed to T in boys&#44; and to E2 or adrenal androgen secretion in girls&#46; However&#44; during last years&#44; research has indicated that E2 may be the principal hormone stimulating the pubertal growth spurt in both sexes&#46;<a class="elsevierStyleCrossRefs" href="#bib0660"><span class="elsevierStyleSup">60&#44;61</span></a> Interestingly&#44; ER&#945;&#44; but not ER&#946;&#44; mediates important effects of estrogens in the skeleton of male mice during growth and maturation&#46;<a class="elsevierStyleCrossRef" href="#bib0550"><span class="elsevierStyleSup">38</span></a> A phenotype similar to ER&#945;KO mice can be also found in aromatase-deficient &#40;ArKO&#41; male rats&#44; which cannot produce estrogens&#46; Notably&#44; E2 can rescue skeletal growth rates in the absence of GHR &#40;i&#46;e&#46;&#44; in GHRKO mice&#41; associated with an increase in hepatic and serum IGF-I&#44;<a class="elsevierStyleCrossRef" href="#bib0670"><span class="elsevierStyleSup">62</span></a> a novel mechanism of GHR-independent stimulation of hepatic IGF-I production&#46; This is also supported by E2 induction of IGF-I gene expression in hypothyroid male rat liver&#44; a model with low or undetectable levels of circulating GH&#46;<a class="elsevierStyleCrossRef" href="#bib0530"><span class="elsevierStyleSup">34</span></a> In addition&#44; gender-related differences in body composition emerging at the time of pubertal growth are in part mediated by sex steroids modulating the GH-IGF-I axis&#46; In adulthood&#44; oral E2 administration to postmenopausal women can provoke a reduction of circulating IGF-I levels concomitantly with an increase of GH&#44; whereas transdermally delivered E2 has been shown to elevate both GH secretion and IGF-I concentrations&#46;<a class="elsevierStyleCrossRef" href="#bib0675"><span class="elsevierStyleSup">63</span></a> Similarly&#44; oral administration of pharmacological doses of estrogen to hypopituitary patients inhibits GH-regulated endocrine and metabolic effects &#40;i&#46;e&#46;&#44; circulating IGF-I levels&#44; lipid oxidation&#44; and protein synthesis are suppressed&#44; with a reciprocal elevation of carbohydrate oxidation&#41;&#46; E2 modulation of GH signaling is also exemplified by the greater increase in lean mass and decrease in fat mass&#44; or the greater increase in bone turnover and bone mass&#44; induced by GH treatment in GH-deficient male compared to female patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0680"><span class="elsevierStyleSup">64&#44;65</span></a> These effects on metabolism and body composition are attenuated by transdermal administration&#44; suggesting that these route-dependent effects are consequence of first-pass effect of oral estrogen leading to direct inhibition of GH-JAK2-STAT5-IGF-I signaling pathway&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Sex steroids can modulate cell sensitivity to GH through multiple mechanisms &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; Estrogens can modulate GH actions in liver by acting peripherally&#44; modulating GH responsiveness&#44; which include changes in hepatic GHR expression and crosstalk with GH-activated JAK2-STAT5 signaling pathway&#46; Particularly&#44; estrogens can induce SOCS-2 and SOCS-3 expression which in turn negatively regulate GHR-JAK2-STAT5 signaling pathway leading to reduction in transcriptional activity in liver&#46;<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">18</span></a> Recently&#44; we have shown that subcutaneous administration of nearly physiological doses of E2 to hypothyroid male rats dramatically influenced the hepatic transcriptional response to pulsatile &#40;male pattern&#41; GH administration including expression of genes related to GH-regulated endocrine&#44; metabolic&#44; and gender-differentiated functions&#46;<a class="elsevierStyleCrossRef" href="#bib0630"><span class="elsevierStyleSup">54</span></a> Together with induction of a female-pattern of gene expression&#44; E2 inhibited GH-regulated STAT5b targeted genes in liver which was associated with increased mRNA expression of several members of SOCS family&#46; Hypothetically&#44; other members of the negative regulators of STAT family may also contribute to E2 interaction with GH signaling in liver&#46; This is explained by ER&#945; stimulation of PIAS3 expression which inhibits STAT3 DNA-binding&#46; Interestingly&#44; as mentioned above&#44; a direct interaction between ER and STAT5 may also regulate STAT5-dependent transcriptional activity<a class="elsevierStyleCrossRef" href="#bib0570"><span class="elsevierStyleSup">42</span></a> and influence GH physiology&#46; Therefore&#44; besides E2 regulation of pubertal growth and the female-pattern of pituitary GH secretion&#44; induction of negative regulators of JAK2-STAT5 signaling pathway in vivo is a very relevant mechanism that&#44; in part&#44; could explain how E2 modulates hepatic transcriptional response to GH&#46; T can also modulate the GH-IGF-I axis&#46; Androgen-mediated signaling has shown to be a critical determinant of body composition in adult men promoting growth of lean mass and suppressing fat deposition&#46;<a class="elsevierStyleCrossRefs" href="#bib0690"><span class="elsevierStyleSup">66&#8211;70</span></a> Multiple evidences have shown that the growth promoting and metabolic effects of T need positive interplay with GH-IGF-I axis&#46; Notably&#44; linear growth in GH-deficient children receiving GH replacement is further stimulated by androgen treatment&#44; and GH is required for full androgen growth-promoting effect&#46; T enhances the growth of boys with hypogonadism and of those with hypopituitarism during GH treatment&#59; however&#44; the effects of T on somatic growth are poor in boys with hypopituitarism without concomitant GH replacement&#46; The critical role of T-GH interactions on body composition is also exemplified in adult GH-deficient men&#44; in whom lean body mass remains subnormal even after adequate androgen replacement&#46; In hypopituitary adults who are not receiving GH replacement&#44; T exerts no effect on circulating IGF-I and both hormones&#44; however&#44; are necessary to exert an optimal effect on circulating IGF-I&#46; Finally&#44; the observation that the effects of GH replacement are more marked in men than in women provides further evidence that T might enhance the anabolic effects of GH in vivo&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Lipid and glucose metabolism</span><p id="par0065" class="elsevierStylePara elsevierViewall">Sexual dimorphism exists in lipid and glucose metabolism&#46;<a class="elsevierStyleCrossRefs" href="#bib0415"><span class="elsevierStyleSup">11&#44;54</span></a> E2 has a physiological role in the control of lipid and glucose metabolism in both human and rodents&#59; deficiency of E2&#47;ER&#945; signaling can lead to a metabolic syndrome-like phenotype &#40;i&#46;e&#46;&#44; fatty liver&#44; adiposity&#44; insulin resistance&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">7&#8211;9</span></a> This is exemplified in postmenopausal women who have higher tendency to develop metabolic syndrome than premenopausal&#46; ER&#945; deficiency or decreased levels of aromatase activity leads to the development of visceral adiposity&#44; insulin resistance&#44; and hyperinsulinemia both in male humans and mice&#46; This metabolic syndrome-like phenotype is reversible by E2 treatment in ER&#945;KO and ArKO mice&#46; The beneficial influence of E2 in relation to normalizing lipid and glucose homeostasis is also evidenced in ob&#47;ob and high-fat diet fed mice&#44; models of obesity and type 2 diabetes&#46; Importantly&#44; treatment of ob&#47;ob mice with PPT can improve glucose tolerance and insulin sensitivity&#44; which supports the critical role of ER&#945; signaling in the control of glucose homeostasis&#46; Estrogenic signaling via GPR-30 has also been implicated in insulin production and glucose homeostasis&#46; ER&#945; mainly mediates anti-lipogenesis&#44; reduction of adiposity and improvement of insulin sensitivity&#59; ER&#946;-dependent activity&#44; however&#44; may be detrimental for the maintenance of normal glucose and lipid homeostasis&#46; In ER&#945;KO mice&#44; insulin resistance is mainly localized to the liver&#44; including increased lipid content and hepatic glucose production&#46; Surprisingly&#44; when ER&#945; was selectively ablated in liver &#40;LERKO&#41;&#44; LERKO mice did not recapitulate the observed ER&#945;KO mice phenotype &#40;i&#46;e&#46;&#44; adiposity&#44; glucose intolerance&#44; insulin resistance&#41;&#44; even when challenged with a high fat diet&#46; This suggests the presence of unidentified compensatory mechanism&#47;s or that hepatic insulin resistance occurs as a secondary effect upon ablation of E2 signaling in other cell types&#46; Interestingly&#44; selective ablations of ER&#945; in the hypothalamic brain region or in hematopoietic&#47;myeloid cells give rise to an increase in body weight and reduced glucose tolerance&#46; The antilipogenic effects of E2 in liver are in part due to activation of PPAR&#945;- and inhibition of LXR&#945;-dependent signaling pathways which is followed by increased fatty acid oxidation and inhibition of lipogenic genes &#40;e&#46;g&#46;&#44; SREPB1c&#44; Apo E&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0530"><span class="elsevierStyleSup">34</span></a> Activation of LXR&#945;-dependent signaling increases triglyceride accumulation in the liver&#59; E2&#47;ER&#945; signaling&#44; in contrast&#44; reduces lipogenic pathway expression and fatty liver induced by LXR activation in mouse&#46;<a class="elsevierStyleCrossRef" href="#bib0650"><span class="elsevierStyleSup">58</span></a> Similarly to E2&#47;ER&#945; deficiency&#44; a decrease of androgen&#47;AR signaling is also associated with a metabolic syndrome-like phenotype &#40;i&#46;e&#46;&#44; truncal adiposity&#44; fatty liver&#44; increased triglycerides&#47;cholesterol&#44; reduced HDL&#44; insulin resistance-type 2 diabetes&#41; and this is improved after T replacement therapy&#46;<a class="elsevierStyleCrossRefs" href="#bib0425"><span class="elsevierStyleSup">13&#44;70&#44;71</span></a> However&#44; the specific role of the androgen&#47;AR signaling for the regulation of liver metabolism is&#44; in comparison with E2&#47;ER&#945;&#44; still largely unknown&#46; Results derived from various AR knockout mouse models reveal tissue-specific AR signaling that is involved in regulation of lipid metabolism &#40;i&#46;e&#46;&#44; inhibits lipogenesis&#44; prevents liver steatosis&#41; and promotes anabolic growth in peripheral tissues&#46;<a class="elsevierStyleCrossRef" href="#bib0710"><span class="elsevierStyleSup">70</span></a> In male mice&#44; the deletion of AR &#40;ARKO&#41; causes late-onset obesity whereas the liver-specific ARKO &#40;LARKO&#41; male mice have increased insulin resistance and steatosis&#44; with decreased &#946;-oxidation&#44; upon high-fat diet&#46; Clinically relevant&#44; increased insulin resistance and impaired glucose tolerance have also been observed in men with T deficiency&#46;<a class="elsevierStyleCrossRefs" href="#bib0425"><span class="elsevierStyleSup">13&#44;70&#44;71</span></a> In addition&#44; some AR polymorphisms&#44; with reduced AR activity&#44; are associated with an excess of body fat and fat distribution pattern in both sexes&#46;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">14</span></a> Notably&#44; T treatment can reduce visceral-fat in mice and men&#44; and improves non-alcoholic fatty liver disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0415"><span class="elsevierStyleSup">11&#8211;14&#44;70&#8211;72</span></a> However&#44; most E2&#47;ER&#945; actions that control body weight and lipid&#47;glucose metabolism are relevant in both female and male&#44; suggesting that T aromatization in E2&#44; acting on ER&#945;&#44; might also contribute to energy homeostasis in males&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">In summary&#44; a decrease in E2&#47;ER&#945;- or T&#47;AR signaling is associated with metabolic disorders &#40;i&#46;e&#46;&#44; metabolic syndrome-like phenotype with adiposity and hepatic steatosis&#41; which resemble deficiency of GHR-JAK2-STAT5 signaling&#46; Interestingly&#44; these metabolic disorders can be partially prevented&#44; or ameliorated&#44; by E2&#47;T and&#47;or GH replacements which suggest that these hormones regulate overlapping cellular networks related with physiological control of lipid and glucose homeostasis&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conclusions</span><p id="par0075" class="elsevierStylePara elsevierViewall">Estrogen&#47;ER&#945;- and androgen&#47;AR-dependent signaling play a critical role in liver physiology and pathology in both females and males&#46; Physiologically and therapeutically relevant are sex hormones interactions with GH-regulated endocrine &#40;e&#46;g&#46;&#44; IGF-I&#41;&#44; metabolic &#40;e&#46;g&#46;&#44; lipid and glucose metabolism&#41;&#44; and sex-differentiated &#40;e&#46;g&#46;&#44; endo- and xenobiotic metabolism&#41; functions in the liver&#46; The influence of sex hormones is executed at the level of pituitary GH secretion and the regulation of GHR-JAK2-STAT5-SOCS2 signaling pathway&#46; Therefore&#44; the pituitary &#40;GH&#41;-gonadal &#40;E2 and T&#41;-liver axis is relevant due to the physiological roles that these hormones have in mammals&#44; and the widespread use of sex hormones-related compounds in humans&#46; In the general population&#44; the endocrine and metabolic consequences of long-term exposition to sex hormones-related compounds and their influence on the pituitary-liver axis are largely unknown&#46; Thus&#44; understanding this complex interaction in physiological and pathological states could contribute to prevent health damage and improve clinical management of patients with growth&#44; developmental and metabolic disorders&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflict of interest</span><p id="par0080" class="elsevierStylePara elsevierViewall">The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest&#46;</p></span></span>"
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          "titulo" => "Regulation of pituitary GH secretion"
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          "titulo" => "GH-STAT5 signaling in liver physiology"
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              "titulo" => "Gender dimorphism"
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          "titulo" => "The liver&#44; a physiological target for sex steroids"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">GH and sex hormones are critical regulators of body growth and composition&#44; somatic development&#44; intermediate metabolism&#44; and sexual dimorphism&#46; Deficiencies in GH- or sex hormone-dependent signaling and the influence of sex hormones on GH biology may have a dramatic impact on liver physiology during somatic development and in adulthood&#46; Effects of sex hormones on the liver may be direct&#44; through hepatic receptors&#44; or indirect by modulating endocrine&#44; metabolic&#44; and gender-differentiated functions of GH&#46; Sex hormones can modulate GH actions by acting centrally&#44; regulating pituitary GH secretion&#44; and peripherally&#44; by modulating GH signaling pathways&#46; The endocrine and&#47;or metabolic consequences of long-term exposure to sex hormone-related compounds and their influence on the GH-liver axis are largely unknown&#46; A better understanding of these interactions in physiological and pathological states will contribute to preserve health and to improve clinical management of patients with growth&#44; developmental&#44; and metabolic disorders&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La GH y las hormonas sexuales son importantes reguladores del crecimiento y la composici&#243;n corporal&#44; el desarrollo som&#225;tico&#44; el metabolismo intermediario y el dimorfismo sexual&#46; Deficiencias en las actividades fisiol&#243;gicas de estas hormonas&#44; as&#237; como las interacciones de las hormonas sexuales con la GH&#44; repercuten en la fisiolog&#237;a hep&#225;tica tanto durante el desarrollo corporal como en la edad adulta&#46; Las hormonas sexuales pueden actuar sobre el h&#237;gado por mecanismos directos&#44; a trav&#233;s de sus receptores hep&#225;ticos&#44; o indirectos&#44; modulando las funciones de la GH a niveles endocrino y&#47;o metab&#243;lico&#46; Las hormonas sexuales pueden modular las acciones de la GH a nivel central&#44; regulando su patr&#243;n de secreci&#243;n hipofisaria&#44; y perif&#233;ricamente&#44; modulando sus mecanismos de se&#241;alizaci&#243;n intracelular&#46; Las consecuencias endocrinas y&#47;o metab&#243;licas de la exposici&#243;n prolongada a compuestos relacionados con hormonas sexuales&#44; as&#237; como su influencia sobre el eje GH-h&#237;gado son&#44; en gran medida&#44; desconocidas&#46; La comprensi&#243;n de estas interacciones en diferentes estados fisiol&#243;gicos y patol&#243;gicos contribuir&#225; a mantener la salud y mejorar el manejo cl&#237;nico de los pacientes con transtornos del crecimiento&#44; el desarrollo y el metabolismo&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Fern&#225;ndez-P&#233;rez L&#44; de Mirecki-Garrido M&#44; Guerra B&#44; D&#237;az M&#44; D&#237;az-Chico JC&#46; Esteroides sexuales e interacciones con la hormona de crecimiento&#46; Endocrinol Nutr&#46; 2016&#59;63&#58;171&#8211;180&#46;</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Signaling pathways used by GH to regulate growth and metabolism&#46; GH binds to a preformed GHR dimmer which results in activation of JAK2 tyrosine kinase&#46; Simultaneously&#44; Src kinase is also activated&#46; Canonical JAK2 signaling via STAT5 involves phosphorylation of key tyrosine residues in the cytoplasmic domain of GHR&#44; which recruit STATs to the activated JAK2 and thus facilitating their tyrosine phosphorylation and subsequent dimerization and translocation to the nucleus to regulate gene transcription&#46; ERK can be activated either by SRC and&#47;or PLC&#947; and Ras&#44; or by JAK2 via the adaptors proteins&#46; The PtdIns 3-kinase and the serine-threonine-protein kinase mTOR pathway is activated by JAK2 via IRS phosphorylation&#46; These signaling pathways influence transcription of genes involved in growth and metabolism&#46; Abbreviations&#58; ERK&#44; extracellular signal-regulated kinase&#59; FAK&#44; focal adhesion kinase&#59; Grb&#44; growth factor receptor-bound protein&#59; IRS&#44; insulin receptor substrate&#59; JAK2&#44; Janus Kinase 2&#59; JNK&#44; c-Jun N-terminal kinase&#59; MEK&#44; dual specificity mitogen-activated protein kinase kinase 2&#59; mTOR&#44; mammalian target of rapamycin&#59; PI3K&#44; phosphoinositide 3-kinae&#59; PKC&#44; protein kinase C&#59; PLC&#947;&#44; phospholipase C&#947;&#59; SHC&#44; SH2-domain containing transforming protein&#59; SOCS&#44; suppressor of cytokine signaling&#59; SOS&#44; son of sevenless&#59; SRC&#44; proto-oncogene tyrosine-protein kinase Src&#59; STAT&#44; signal transducer and activator of transcription&#46;</p>"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Cell signaling by sex steroids&#46; Estrogens and androgens can signal through multiple receptors&#46; Most of their known effects are mediated via direct interaction of sex steroids with the DNA-binding transcription factors&#44; nuclear steroid receptor&#44; SR &#40;ER&#44; AR&#41; &#40;<span class="elsevierStyleBold">I</span>&#41;&#46; In addition&#44; estrogens and androgens can modulate gene expression by a second mechanism in which SR interact with other transcription factors &#40;e&#46;g&#46;&#44; STAT5&#41; &#40;<span class="elsevierStyleBold">II</span>&#41;&#46; There are also evidences that sex steroids may also elicit effects through non-genomic mechanisms&#44; which involve the activation of downstream kinase pathways via a G protein-coupled receptor &#40;GPCR&#41; &#40;<span class="elsevierStyleBold">III</span>&#41; or SR &#40;<span class="elsevierStyleBold">IV</span>&#41; localized in the cell membrane&#46;</p>"
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          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Sex steroids modulate cell sensitivity to GH&#46; Sex steroids can regulate GH actions in liver by modulating GH responsiveness which includes changes in hepatic GHR expression and crosstalk with GH-activated JAK2-STAT5 signaling pathway&#46;</p>"
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        "texto" => "<p id="par0085" class="elsevierStylePara elsevierViewall">We thank all the authors that have made a contribution to the understanding of the crosstalk between sex hormones and GH signaling in liver&#46; We apologize to those whose work deserves to be cited but unfortunately are not quoted because of space limitations&#46; The research program in the author&#39;s lab was supported by grants-in-aid from the Spanish Ministry of Economy and Competitivity &#40;MINECO&#41; with the funding of <span class="elsevierStyleGrantSponsor" id="gs1">European Regional Development Fund-European Social Fund</span> &#40;<span class="elsevierStyleGrantNumber" refid="gs1">SAF2012-37344</span>&#41;&#44; <span class="elsevierStyleGrantSponsor" id="gs2">Canary Islands Government</span> &#40;<span class="elsevierStyleGrantNumber" refid="gs2">ACIISI PI2010</span>&#41;&#44; and <span class="elsevierStyleGrantSponsor" id="gs3">Alfredo Martin-Reyes Foundation &#40;Arehucas&#41;-FICIC</span>&#46;</p>"
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