{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:24:18Z","timestamp":1789046658063,"version":"build-2803163510"},"reference-count":65,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:00:00Z","timestamp":1699315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy Carol Davila"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Hepatocellular adenomas are benign endothelial tumors of the liver, mostly associated with female individual users of estrogen-containing medications. However, the precise factors underlying the selective development of hepatic adenomas in certain females remain elusive. Additionally, the conventional profile of individuals prone to hepatic adenoma is changing. Notably, male patients exhibit a higher risk of malignant progression of hepatocellular adenomas, and there are instances where hepatic adenomas have no identifiable cause. In this paper, we theorize the role of the human gastrointestinal microbiota, specifically, of bacterial species producing \u03b2-glucuronidase enzymes, in the development of hepatic adenomas through the estrogen recycling pathway. Furthermore, we aim to address some of the existing gaps in our knowledge of pathophysiological pathways which are not yet subject to research or need to be studied further. As microbial \u03b2-glucuronidases proteins recycle estrogen and facilitate the conversion of inactive estrogen into its active form, this process results in elevated levels of unbound plasmatic estrogen, leading to extended exposure to estrogen. We suggest that an imbalance in the estrobolome could contribute to sex hormone disease evolution and, consequently, to the advancement of hepatocellular adenomas, which are estrogen related.<\/jats:p>","DOI":"10.3390\/ijms242216034","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T11:23:39Z","timestamp":1699356219000},"page":"16034","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Estrobolome and Hepatocellular Adenomas\u2014Connecting the Dots of the Gut Microbial \u03b2-Glucuronidase Pathway as a Metabolic Link"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8787-3829","authenticated-orcid":false,"given":"Sandica","family":"Bucurica","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, \u201cCarol Davila\u201d University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania"},{"name":"Department of Gastroenterology, \u201cDr. Carol Davila\u201d Central Military Emergency University Hospital, 010242 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Lupanciuc","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cDr. Carol Davila\u201d Central Military Emergency University Hospital, 010242 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9829-5035","authenticated-orcid":false,"given":"Florentina","family":"Ionita-Radu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cCarol Davila\u201d University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania"},{"name":"Department of Gastroenterology, \u201cDr. Carol Davila\u201d Central Military Emergency University Hospital, 010242 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ion","family":"Stefan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cDr. Carol Davila\u201d Central Military Emergency University Hospital, 010242 Bucharest, Romania"},{"name":"Department of Medico-Surgical and Prophylactic Disciplines, Titu Maiorescu University, 031593 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice Elena","family":"Munteanu","sequence":"additional","affiliation":[{"name":"Department of Medico-Surgical and Prophylactic Disciplines, Titu Maiorescu University, 031593 Bucharest, Romania"},{"name":"Department of Cardiology, \u201cDr. Carol Davila\u201d Central Military Emergency University Hospital, 010242 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Anghel","sequence":"additional","affiliation":[{"name":"Department of Medico-Surgical and Prophylactic Disciplines, Titu Maiorescu University, 031593 Bucharest, Romania"},{"name":"Department of Internal Medicine, \u201cDr. Carol Davila\u201d Central Military Emergency University Hospital, 010242 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5826-0815","authenticated-orcid":false,"given":"Mariana","family":"Jinga","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cCarol Davila\u201d University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania"},{"name":"Department of Gastroenterology, \u201cDr. Carol Davila\u201d Central Military Emergency University Hospital, 010242 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena Laura","family":"Gaman","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, \u201cCarol Davila\u201d University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.biopha.2018.03.078","article-title":"Estrogen: The Necessary Evil for Human Health, and Ways to Tame It","volume":"102","author":"Patel","year":"2018","journal-title":"Biomed. 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