Droga do debiutów 2014 - Przemek Górynowicz & IHS

Soybeans are unique among beans because they contain compounds called isoflavones. Because these molecules have structures very similar to the body's natural estrogens (hence the name plant- or phyto-estrogens), major research efforts are directed at understanding what isoflavones do in our bodies when we eat soy.

Estrogens

Estrogens are hormones that our bodies make and require for normal growth and development, and to maintain good adult health not only in women, but also in men. Estrogens are essential for the female reproductive system, but they are also important for the bones, the heart, and possibly the brain.

For women faced with menopause (and loss of estrogens), how to replace estrogens is a major issue. In standard hormone replacement therapy (HRT), the combination of estrogens with a synthetic progesterone prevents osteoporosis - it also largely overcomes the increased risk of uterine cancer from using estrogens alone (1). However, combination HRT is less effective than estrogens alone in protecting against heart disease, and may slightly increase breast cancer risk (2). So, on the one hand, estrogens are good; however, dealing with their replacement is a complex issue.

How do estrogens work? They complex with proteins called estrogen receptors (ERs). These complexes "dock" at sites (response elements) within selected genes in the cell's nucleus, switching those genes on or off. This switching makes cells proliferate (like breast growth during puberty) or causes them to differentiate and make special products (for example, milk following pregnancy). For many years, only a single ER was known, ER alpha. Now another ER, ER beta, has been found (3), and predominates in certain estrogen-responsive tissues, such as bone and the bladder (4). This explains why estrogens can have beneficial effects in bone and can control urinary incontinence, even though for years ER alpha could not be detected in either bone or the bladder.

Soy Isoflavones

How do soy isoflavones fit into estrogen action? Genistein, the most abundant isoflavone in soybeans, binds only weakly with ER alpha, but complexes with ER beta almost as well as estrogen does (5). This probaby explains genistein's ability to prevent bone loss in ovariectomized rats (6). The predominance of ER beta in the cardiovascular system suggests that soy isoflavones may be partly responsible for the lower incidence of heart disease in soy-consuming countries.

And what about cancer? In countries (mostly Southeast Asia) where soy consumption is high, the incidence of breast, prostate and uterine cancer is substantially lower than in the USA (7). Moreover, in a group of caucasian (Australian) women, those whose diets included higher amounts of isoflavones and other phytoestrogens had a lowered incidence of breast cancer (8). Interestingly, the intake of soy in these women (derived from their urinary isoflavonoid output rate) was less than one serving per day. Does this mean that eating soy and its isoflavones protects us from cancer? Conclusive answers cannot be given at this time, since the observed beneficial effects could be the result of associated dietary/lifestyle factors. It should also be noted that using concentrated isoflavone preparations (in pill form, for example) extracted from the soybean leaves behind the rest of the phytochemicals in soy foods that have health benefits. This may have effects that are impossible to predict at this point.

Isoflavones and Growth Factor Signaling

Many chronic human diseases involve defects in growth factor action. Growth factors are molecules that regulate the growth (proliferation) of cells. They can be released from cells in response to estrogen, and affect neighboring cells. When growth factors bind to their receptors (usually located straddling the cell's membrane), the part of the receptor inside the cell issues a signal to the rest of the cell, much like a doorbell at the entrance to a house. You can imagine how disruptive it would be if someone changed the doorbell from a soft sound to a really loud one. On the other hand, if the doorbell broke, you wouldn't know if anyone was at the door.

A significant advance in our understanding of the health benefits of soy comes from its use in treatment of the Osler-Weber-Rendu (OWR) syndrome. OWR is a hereditary disease where patients suffer multiple episodes of nose bleeds (in some as many as 3-6 a day) (9). Although not life-threatening, the loss of blood (which can also occur elsewhere in the body) often requires blood transfusions to maintain normal hematocrit levels. In an initial study at Yale University, certain OWR patients on a soy protein diet containing the isoflavones experienced an almost complete cessation of bleeding (10). This is all the more fascinating because genetic mutations that cause OWR produce defects in proteins involved in a signaling pathway initiated by transforming growth factor beta (TGFb) (11). How the actions of soy isoflavones interface with TGFb signaling remains to be elucidated, but in view of the data, we suggest that abnormalities in TGFb signaling may be at the crux of certain soy responsive diseases, including cancer, heart disease and osteoporosis (12). If so, isoflavones may be better understood by their effects on growth factors than for their apparent similarity to estrogens.