Puglisi Rossella, Mattia Gianfranco, Carè Alessandra, Marano Giuseppe, Malorni Walter, Matarrese Paola
Center for Gender Specific Medicine, Istituto Superiore di Sanità, Rome, Italy.
School of Medicine, University of Rome Tor Vergata, Rome, Italy.
Front Endocrinol (Lausanne). 2019 Oct 25;10:733. doi: 10.3389/fendo.2019.00733. eCollection 2019.
This review takes into consideration the main mechanisms involved in cellular remodeling following an ischemic injury, with special focus on the possible role played by non-genomic estrogen effects. Sex differences have also been considered. In fact, cardiac ischemic events induce damage to different cellular components of the heart, such as cardiomyocytes, vascular cells, endothelial cells, and cardiac fibroblasts. The ability of the cardiovascular system to counteract an ischemic insult is orchestrated by these cell types and is carried out thanks to a number of complex molecular pathways, including genomic (slow) or non-genomic (fast) effects of estrogen. These pathways are probably responsible for differences observed between the two sexes. Literature suggests that male and female hearts, and, more in general, cardiovascular system cells, show significant differences in many parameters under both physiological and pathological conditions. In particular, many experimental studies dealing with sex differences in the cardiovascular system suggest a higher ability of females to respond to environmental insults in comparison with males. For instance, as cells from females are more effective in counteracting the ischemia/reperfusion injury if compared with males, a role for estrogen in this sex disparity has been hypothesized. However, the possible involvement of estrogen-dependent non-genomic effects on the cardiovascular system is still under debate. Further experimental studies, including sex-specific studies, are needed in order to shed further light on this matter.
本综述考虑了缺血性损伤后细胞重塑所涉及的主要机制，特别关注非基因组雌激素效应可能发挥的作用。同时也考虑了性别差异。事实上，心脏缺血事件会对心脏的不同细胞成分造成损伤，如心肌细胞、血管细胞、内皮细胞和心脏成纤维细胞。心血管系统对抗缺血性损伤的能力是由这些细胞类型协调的，并通过许多复杂的分子途径来实现，包括雌激素的基因组（缓慢）或非基因组（快速）效应。这些途径可能是导致两性之间观察到差异的原因。文献表明，男性和女性的心脏，更普遍地说，心血管系统细胞，在生理和病理条件下的许多参数上都存在显著差异。特别是，许多关于心血管系统性别差异的实验研究表明，与男性相比，女性对环境损伤的反应能力更强。例如，与男性相比，女性细胞在对抗缺血/再灌注损伤方面更有效，因此有人推测雌激素在这种性别差异中起作用。然而，雌激素依赖性非基因组效应在心血管系统中的可能作用仍存在争议。需要进一步的实验研究，包括性别特异性研究，以便更清楚地了解这一问题。
