Tostes R C, Nigro D, Fortes Z B, Carvalho M H C
Grupo de Pesquisa sobre Hipertensão Arterial, Departamento de Farmacologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP, Brasil.
Braz J Med Biol Res. 2003 Sep;36(9):1143-58. doi: 10.1590/s0100-879x2003000900002. Epub 2003 Aug 19.
The cardiovascular protective actions of estrogen are partially mediated by a direct effect on the vessel wall. Estrogen is active both on vascular smooth muscle and endothelial cells where functionally competent estrogen receptors have been identified. Estrogen administration promotes vasodilation in humans and in experimental animals, in part by stimulating prostacyclin and nitric oxide synthesis, as well as by decreasing the production of vasoconstrictor agents such as cyclooxygenase-derived products, reactive oxygen species, angiotensin II, and endothelin-1. In vitro, estrogen exerts a direct inhibitory effect on smooth muscle by activating potassium efflux and by inhibiting calcium influx. In addition, estrogen inhibits vascular smooth muscle cell proliferation. In vivo, 17beta-estradiol prevents neointimal thickening after balloon injury and also ameliorates the lesions occurring in atherosclerotic conditions. As is the case for other steroids, the effect of estrogen on the vessel wall has a rapid non-genomic component involving membrane phenomena, such as alteration of membrane ionic permeability and activation of membrane-bound enzymes, as well as the classical genomic effect involving estrogen receptor activation and gene expression.
雌激素的心血管保护作用部分是通过对血管壁的直接作用介导的。雌激素对血管平滑肌和内皮细胞均有活性，在这些细胞中已鉴定出具有功能活性的雌激素受体。给予雌激素可促进人和实验动物的血管舒张，部分原因是刺激前列环素和一氧化氮的合成，以及减少血管收缩剂的产生，如环氧化酶衍生产物、活性氧、血管紧张素II和内皮素-1。在体外，雌激素通过激活钾外流和抑制钙内流对平滑肌产生直接抑制作用。此外，雌激素抑制血管平滑肌细胞增殖。在体内，17β-雌二醇可防止球囊损伤后新生内膜增厚，并改善动脉粥样硬化病变。与其他类固醇一样，雌激素对血管壁的作用具有快速的非基因组成分，涉及膜现象，如膜离子通透性的改变和膜结合酶的激活，以及涉及雌激素受体激活和基因表达的经典基因组效应。
