The estrogen paradox in pulmonary arterial hypertension

American Journal of Physiology. Lung Cellular and Molecular Physiology
Seiichiro SakaoKoichiro Tatsumi

Abstract

Idiopathic pulmonary arterial hypertension (PAH) is a disabling condition characterized by PA vasoconstriction and remodeling as well as in situ thrombosis and eventual right heart failure. Idiopathic PAH occurs more frequently in females than in males. The female:male ratio is 1.64 ∼ 3.88:1. Although endogenous sex hormones including estrogen have been suggested to account for the observed gender differences in PAH, a precise pathobiology for the gender differences remains uncertain. Recent studies demonstrated that estrogen exerts beneficial effects on the pulmonary vasculature. However, it seems to contradict the female predominance that is observed in idiopathic PAH. Moreover, Sweeney and Voelkel (Sweeney L and Voelkel NF. Eur J Med Res 14: 433-442, 2009) showed that early and long-term estrogen exposure might be correlated with an increased risk of the development of PAH. Here we ask the question: Is estrogen a friend or a foe? According to accumulating evidence, we postulate that the different effects of estrogens on different target cells could account for this paradox, i.e., estrogens may exert beneficial effects only on the increased muscularization of vessel walls, but not on phenotypically altered endothelial cells. ...Continue Reading

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Jan 14, 2012·Endocrine Reviews·Elizabeth A TownsendY S Prakash
Oct 29, 2011·Pulmonary Circulation·Pravin B Sehgal, Jason E Lee
Jan 1, 2014·Clinical Medicine Insights. Cardiology·DeLisa Fairweather
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Jul 4, 2013·Human & Experimental Toxicology·E BalB Sirmagul

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