Division of Molecular Medicine, Department of Anesthesiology, David Geffen School of Medicine at University of California, Los Angeles, USA.
Am J Respir Crit Care Med. 2012 Jul 15;186(2):125-31. doi: 10.1164/rccm.201201-0058PP. Epub 2012 May 3.
Although the incidence of pulmonary hypertension is higher in female patients, numerous experimental studies have demonstrated better outcome in female animals, exacerbation of the disease after ovariectomy, and a strong protective effect of estrogen: a phenomenon known as the "estrogen paradox" of pulmonary hypertension. On the other hand, some clinical studies have indirectly linked estrogen to increased risk of portopulmonary hypertension, whereas others implicate increased estrogen metabolism and high levels of certain estrogen metabolites in promoting pulmonary vascular remodeling in familial pulmonary arterial hypertension. In this review we investigate the estrogen paradox through highlighting the differential receptor-mediated effects of estrogen. Although estrogen and estrogen receptor-based therapies have shown promise in rescuing preexisting pulmonary hypertension in animals, their role is yet to be defined in humans.
虽然肺动脉高压在女性患者中的发病率较高，但许多实验研究表明，雌性动物的预后更好，卵巢切除术后疾病加重，雌激素具有很强的保护作用：这一现象被称为肺动脉高压的“雌激素悖论”。另一方面，一些临床研究间接将雌激素与增加的门静脉高血压风险联系起来，而其他研究则表明，在家族性肺动脉高压中，雌激素代谢增加和某些雌激素代谢物水平升高促进肺血管重塑。在这篇综述中，我们通过强调雌激素的差异受体介导作用来探讨雌激素悖论。虽然基于雌激素和雌激素受体的治疗方法已显示出在动物中挽救已存在的肺动脉高压方面有希望，但它们在人类中的作用仍有待确定。
