Gender, sex hormones and pulmonary hypertension

Austin, E. D., Johansen, A. K., Alzoubi, A., Lahm, T., West, J., Tofovic, S. P., MacLean, M. R. and Oka, M. (2013) Gender, sex hormones and pulmonary hypertension. Pulmonary Circulation, 3(2), pp. 294-314. (doi:10.4103/2045-8932.114756) (PMID:24015330) (PMCID:PMC3757824)

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Publisher's URL: http://www.jstor.org/stable/10.4103/2045-8932.114756

Abstract

Most subtypes of pulmonary arterial hypertension (PAH) are characterized by a greater susceptibility to disease among females, although females with PAH appear to live longer after diagnosis. While this “estrogen paradoxȍ of enhanced female survival despite increased female susceptibility remains a mystery, recent progress has begun to shed light upon the interplay of sex hormones, the pathogenesis of pulmonary hypertension, and the right ventricular response to stress. For example, emerging data in humans and experimental models suggest that estrogens or differential sex hormone metabolism may modify disease risk among susceptible subjects, and that estrogens may interact with additional local factors such as serotonin to enhance the potentially damaging chronic effects of estrogens on the pulmonary vasculature. Regardless, it remains unclear why not all estrogenic compounds behave equally, nor why estrogens appear to be protective in certain settings but detrimental in others. The contribution of androgens and other compounds, such as dehydroepiandrosterone, to pathogenesis and possibly treatment must be considered as well. In this review, we will discuss the recent understandings on how estrogens, estrogen metabolism, dehydroepiandrosterone, and additional susceptibility factors may all contribute to the pathogenesis or potentially to the treatment of pulmonary hypertension, by evaluating current human, cell-based, and experimental model data.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Johansen, Miss Anne Katrine and MacLean, Professor Margaret
Authors: Austin, E. D., Johansen, A. K., Alzoubi, A., Lahm, T., West, J., Tofovic, S. P., MacLean, M. R., and Oka, M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Pulmonary Circulation
Publisher:Medknow Publications
ISSN:2045-8932
ISSN (Online):2045-8940
Copyright Holders:Copyright © 2013 The Authors
First Published:First published in Pulmonary Circulation 3(2):294-314
Publisher Policy:Reproduced under a Creative Commons License
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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
536791Effect of oestrogens and oestrogen metabolites on the serotonin system: role in the development of pulmonary hypertensionMargaret MacleanBritish Heart Foundation (BHF)FS/10/019/28205RI CARDIOVASCULAR & MEDICAL SCIENCES
573731Gender and the development of pulmonary arterial hypertension: regulation of genes from mouse to manMargaret MacleanBritish Heart Foundation (BHF)RG/11/7/28916RI CARDIOVASCULAR & MEDICAL SCIENCES
573733Gender and the development of pulmonary arterial hypertension: regulation of genes from mouse to manMargaret MacleanBritish Heart Foundation (BHF)RG/11/7/28916RI CARDIOVASCULAR & MEDICAL SCIENCES