Einthoven Laboratory for Experimental Vascular Medicine, Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, the Netherlands.
J Thromb Haemost. 2010 Aug;8(8):1838-46. doi: 10.1111/j.1538-7836.2010.03930.x. Epub 2010 May 27.
Oral estrogen use is associated with changes in plasma levels of many coagulation proteins.
To gain more insight into the underlying mechanism of estrogen-induced changes in coagulation.
Ovariectomized female mice were used to study the impact of oral 17α-ethinylestradiol (EE) on plasma coagulation, hepatic coagulation gene transcript levels, and dependence on estrogen receptor (ER) α and ERβ.
Ten days of oral EE treatment resulted in significantly reduced plasma activity levels of factor (F)VIII, FXII, combined FII/FVII/FX and antithrombin, whereas FIX activity significantly increased. Regarding hepatic transcript levels, oral EE caused significant decreases in fibrinogen-γ, FII, FV, FVII, FX, FXII, antithrombin, protein C, protein Z, protein Z inhibitor and heparin cofactor II mRNA levels, whereas FXI levels significantly increased and transcript levels of FVIII, FIX, protein S and α(2) -antiplasmin remained unaffected. All EE-induced coagulation-related changes were neutralized by coadministration of the non-specific ER antagonist ICI182780. In addition, ERα-deficient mice lacked the EE-induced changes in plasma coagulation and hepatic transcript profile, whereas ERβ-deficient mice responded similarly to non-deficient littermate controls. A crucial role for the ER was further demonstrated by its rapid effects on transcription, within 2.5-5 h after EE administration, suggesting a short chain of events leading to its final effects.
Oral EE administration has a broad impact on the mouse coagulation profile at the level of both plasma and hepatic mRNA levels. The effects on transcription are rapidly induced, mostly downregulatory, and principally mediated by ERα.
口服雌激素的使用与许多凝血蛋白的血浆水平变化有关。
深入了解雌激素诱导凝血变化的潜在机制。
使用去卵巢雌性小鼠研究口服 17α-乙炔基雌二醇(EE)对血浆凝血、肝凝血基因转录水平以及对雌激素受体(ER)α和 ERβ的影响。
口服 EE 治疗 10 天导致 FVIII、FXII、FII/FVII/FX 与抗凝血酶的血浆活性水平显著降低,而 FIX 活性显著增加。关于肝转录水平,口服 EE 导致纤维蛋白原-γ、FII、FV、FVII、FX、FXII、抗凝血酶、蛋白 C、蛋白 Z、蛋白 Z 抑制剂和肝素辅因子 II mRNA 水平显著降低,而 FXI 水平显著增加,FVIII、FIX、蛋白 S 和 α(2)-抗纤溶酶的转录水平不受影响。所有 EE 诱导的凝血相关变化均被非特异性 ER 拮抗剂 ICI182780 中和。此外,ERα 缺失的小鼠缺乏 EE 诱导的血浆凝血和肝转录谱变化,而 ERβ 缺失的小鼠对非缺失同窝对照的反应相似。ER 的快速作用进一步证明了其在转录水平上的重要作用,即在 EE 给药后 2.5-5 小时内,表明存在导致其最终效应的短链事件。
口服 EE 给药对小鼠血浆和肝 mRNA 水平的凝血谱具有广泛影响。转录的影响是快速诱导的,主要是下调的,主要由 ERα 介导。