Sex steroids in Sjögren's syndrome

Sjögren s syndrome (SS) is a strongly female dominant autoimmune disease. SS targets mainly salivary and lacrimal glands and leads to loss of the secreting acinar cells of these glands. Accordingly, secretion of the affected glands is diminished and the main symptoms of SS, dryness of mouth and eyes, follow. In addition to these sicca symptoms, SS patients suffer from severe fatigue and can have various extraglandular symptoms. To date, the etiology of SS still remains unknown. Female dominance and the late onset of the disease simultaneously with remarkable hormonal changes in the body (menopause, adrenopause) encouraged us to hypothesize that sex steroids, especially androgens, are involved in the onset and progression of SS. We confirmed our hypothesis and showed that patients with SS suffer from androgen depletion both systemically and locally in the target tissue of SS, salivary glands. We especially focused on the local androgen environment in salivary glands and demonstrated that healthy salivary glands contain a complete enzymatic machinery for local synthesis of androgens and estrogens from pro-hormone dehydroepiandrosterone (DHEA). However, in SS salivary glands the enzymes catalyzing the local androgen synthesis are defective and, in a subgroup of patients, practically non-functional. Probably due to this local defect in DHEA processing, therapy with DHEA was found unbeneficial for SS patients in the treatment of fatigue. We also studied the effect of the local androgen depletion on salivary glands. We found that in salivary gland cells and healthy labial salivary glands androgens upregulate integrin subunits α1 and α2, which are important for the communication, differentiation and function of the acinar cells. On the contrary, in SS salivary glands DHEA failed to upregulate these signaling molecules, again probably due to defective processing of DHEA into active androgens. Our finding highlights the importance of the local androgen environment and local DHEA processing for the function and welfare of salivary glands. In conclusion, this study showed that patients with SS are androgen depleted both systemically and locally in salivary glands. SS patients also have a defective local sex steroid synthesizing enzymatic machinery further impairing the local androgen depletion. We also showed that the local androgen defect leads to decreased expression of acinar cell specific integrin molecules, which impairs the signaling between the acinar cells and basement membrane and might thus explain the acinar cell loss seen in SS salivary glands. By showing the importance of the local sex steroid imbalance in SS we have clarified some etiopathogenetic mechanisms of SS, which have thus far remained unknown.

The Organisation of Policy Meets the Commercialisation of Sex - Global Linkages, Policies, Technologies

During recent years the commercialisation of sex has increased and intensified both locally and globally. This thesis explores the commercialisation of bodies, sex and sexualities, particularly the sex trade, and the impact of rapidly evolving information and communication technologies on this globalising trade. The main focus of this work is on the policies, discourses and policy developments in the area especially in the Finnish context. The study is based on multidisciplinary theoretical sources through which the framework of multiple linkages relevant to the commercialisation of sex is conceptualised. The sex trade functions through a web of intersecting linkages of a substantive, economic, organisational, temporal, spatial, cultural, technological, as well as of legislative and policy nature. This framework of linkages forms the basis for the analysis of the main empirical data, namely qualitative interviews with thirty key managers and professionals, who are responsible for the preparation and implementation of policies on commercial sex. In addition, the thesis addresses the policies and policy practices on the sex trade through the analysis of national and international policy instruments. In addition to analysing the processes of the commercialisation of sex and its effects, the study also discusses their further implications for organisational policy-making, research, and society more generally. The thesis thus seeks to contribute to practice, research and theory on gender, management and organisations.

Notions of Nation : A Critical Discursive Psychology perspective on the Isle of Man

At the the heart of this study can be seen the dual concern of how the nation is represented as a categorical entity and how this is put to use in everyday social interactions.This can be seen as a reaction to the general approach to categorisation and identity functions that tend to be reified and essentialized within the social sciences. The empirical focus of this study is the Isle of Man, a crown dependency situated geographically central within the British Isles while remaining political outside the United Kingdom. The choice of this site was chosen explicitly as ‘notions of nation’ expressed on the island can be seen as being contested and ephemerally unstable. To get at these ‘notions of nation’ is was necessary to choose specific theoretical tools that were able to capture the wider cultural and representational domain while being capable of addressing the nuanced and functional aspects of interaction. As such, the main theoretical perspective used within this study was that of critical discursive psychology which incorporates the specific theoretical tools interpretative repertoires, ideological dilemmas and subject positions. To supplement these tools, a discursive approach to place was taken in tandem to address the form and function of place attached to nationhood. Two methods of data collection were utilized, that of computer mediated communication and acquaintance interviews. From the data a number of interpretative repertoires were proposed, namely being, essential rights, economic worth, heritage claims, conflict orientation, people-as-nation and place-as-nation. Attached to such interpretative repertoires were the ideological dilemmas region vs. country, people vs. place and individualism vs. collectivism. The subject positions found are much more difficult to condense, but the most significant ones were gender, age and parentage. The final focus of the study, that of place, was shown to be more than just an unreflected on ‘container’ of people but was significant in terms of the rhetorical construction of such places for how people saw themselves and the discursive function of the particular interaction. As such, certain forms of place construction included size, community, temporal, economic, safety, political and recognition. A number of conclusions were drawn from the above which included, that when looking at nation categories we should take into account the specific meanings that people attach to such concepts and to be aware of the particular uses they are put to in interaction. Also, that it is impossible to separate concepts neatly, but it is necessary to be aware of the intersection where concepts cross, and clash, when looking at nationhood.