Diethylstilbestrol monobenzyl ether
Diethylstilbestrol monobenzyl ether (DESMBE), also known as benzestrol, is a synthetic, nonsteroidal estrogen that was studied for medical use but was never marketed. It is a derivative of diethylstilbestrol (DES), a well-known synthetic estrogen that has been widely used in the past for various medical conditions, including hormonal replacement therapy and in efforts to prevent miscarriages. DESMBE, like its parent compound DES, acts as an estrogen receptor agonist, binding to estrogen receptors and mimicking the action of the natural hormone estrogen in the body.
History
The development of DESMBE traces back to the early 20th century when researchers were actively seeking synthetic estrogens that could be used for therapeutic purposes. Diethylstilbestrol itself was first synthesized in 1938 and quickly found a variety of medical applications. Following the discovery of DES, scientists experimented with various derivatives, including DESMBE, in search of compounds with improved efficacy, safety, or pharmacokinetic properties.
Pharmacology
DESMBE, like other estrogens, exerts its effects by binding to estrogen receptors in target tissues, which include the reproductive organs, breast, bone, and cardiovascular system. Upon binding to these receptors, DESMBE initiates a series of cellular events leading to the transcription of specific genes and the subsequent production of proteins that are responsible for the development and maintenance of female secondary sexual characteristics, as well as other physiological effects associated with estrogen.
Clinical Uses
Although DESMBE was studied for potential medical applications, it was never approved for use in any country. Research into its efficacy and safety was likely overshadowed by the widespread adoption of DES and later concerns about the adverse effects associated with DES use, such as an increased risk of certain cancers in both the mothers who took DES and their offspring.
Adverse Effects
Given that DESMBE is a derivative of DES, it is plausible that its use could have led to similar adverse effects as those observed with DES, including an increased risk of cancers such as clear cell adenocarcinoma of the vagina and cervix in daughters exposed in utero, as well as potential cardiovascular and reproductive issues. However, without widespread use, specific adverse effects of DESMBE remain speculative.
Current Status
Today, DESMBE is of interest primarily for its historical significance in the development of synthetic estrogens. The lessons learned from the use and study of DES and its derivatives have informed the development of safer and more effective estrogenic compounds for medical use.
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Contributors: Prab R. Tumpati, MD