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Skinner BD, Davies RJ, Weaver SR, Cable NT, Lucas SJE, Lucas RAI. A Systematic Review and Meta-Analysis Examining Whether Changing Ovarian Sex Steroid Hormone Levels Influence Cerebrovascular Function. Front Physiol 2021; 12:687591. [PMID: 34220552 PMCID: PMC8248489 DOI: 10.3389/fphys.2021.687591] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/21/2021] [Indexed: 01/14/2023] Open
Abstract
Sex differences in cerebrovascular disease rates indicate a possible role for ovarian sex steroid hormones in cerebrovascular function. To synthesise and identify knowledge gaps, a systematic review and meta-analysis was conducted to assess how ovarian sex steroid hormone changes across the lifespan affect cerebrovascular function in women. Three databases (EMBASE, MEDLINE and Web of Science) were systematically searched for studies on adult cerebrovascular function and ovarian sex steroid hormones. Forty-five studies met pre-defined inclusion criteria. Studied hormone groups included hormone replacement therapy (HRT; n = 17), pregnancy (n = 12), menstrual cycle (n = 7), menopause (n = 5), oral contraception (n = 2), and ovarian hyperstimulation (n = 2). Outcome measures included pulsatility index (PI), cerebral blood flow/velocity (CBF), resistance index (RI), cerebral autoregulation, and cerebrovascular reactivity. Meta-analysis was carried out on HRT studies. PI significantly decreased [−0.05, 95% CI: (−0.10, −0.01); p = 0.01] in post-menopausal women undergoing HRT compared to post-menopausal women who were not, though there was considerable heterogeneity (I2 = 96.8%). No effects of HRT were seen in CBF (p = 0.24) or RI (p = 0.77). This review indicates that HRT improves PI in post-menopausal women. However, there remains insufficient evidence to determine how changing ovarian sex steroid hormone levels affects cerebrovascular function in women during other hormonal phases (e.g., pregnancy, oral contraception).
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Affiliation(s)
- Bethany D Skinner
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Rebecca J Davies
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Samuel R Weaver
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - N Tim Cable
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Samuel J E Lucas
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Rebekah A I Lucas
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
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Lechuga TJ, Zhang HH, Sheibani L, Karim M, Jia J, Magness RR, Rosenfeld CR, Chen DB. Estrogen Replacement Therapy in Ovariectomized Nonpregnant Ewes Stimulates Uterine Artery Hydrogen Sulfide Biosynthesis by Selectively Up-Regulating Cystathionine β-Synthase Expression. Endocrinology 2015; 156:2288-98. [PMID: 25825818 PMCID: PMC4430606 DOI: 10.1210/en.2015-1086] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Estrogens dramatically dilate numerous vascular beds with the greatest response in the uterus. Endogenous hydrogen sulfide (H2S) is a potent vasodilator and proangiogenic second messenger, which is synthesized from L-cysteine by cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE). We hypothesized that estrogen replacement therapy (ERT) selectively stimulates H2S biosynthesis in uterine artery (UA) and other systemic arteries. Intact and endothelium-denuded UA, mesenteric artery (MA), and carotid artery (CA) were obtained from ovariectomized nonpregnant ewes (n = 5/group) receiving vehicle or estradiol-17β replacement therapy (ERT). Total RNA and protein were extracted for measuring CBS and CSE, and H2S production was determined by the methylene blue assay. Paraffin-embedded UA rings were used to localize CBS and CSE proteins by immunofluorescence microscopy. ERT significantly stimulated CBS mRNA and protein without altering CSE mRNA or protein in intact and denuded UA. Quantitative immunofluorescence microscopic analyses showed CBS and CSE protein localization in endothelium and smooth muscle and confirmed that ERT stimulated CBS but not CSE protein expression in UA endothelium and smooth muscle. ERT also stimulated CBS, but not CSE, mRNA and protein expression in intact and denuded MA but not CA in ovariectomized ewes. Concomitantly, ERT stimulated UA and MA but not CA H2S production. ERT-stimulated UA H2S production was completely blocked by a specific CBS but not CSE inhibitor. Thus, ERT selectively stimulates UA and MA but not CA H2S biosynthesis by specifically up-regulating CBS expression, implicating a role of H2S in estrogen-induced vasodilation and postmenopausal women's health.
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Affiliation(s)
- Thomas J Lechuga
- Departments of Obstetrics and Gynecology (T.J.L., H.H.Z., L.S., M.K., J.J., D.-b.C.) and Pathology (T.J.L., D.-b.C.), University of California Irvine, Irvine, California 92697; Department of Obstetrics and Gynecology, Pediatrics, and Animal Sciences (R.R.M.), University of Wisconsin-Madison, Madison, Wisconsin 53715; and Division of Neonatal-Perinatal Medicine (C.R.R.), Department of Pediatrics and Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas 75390
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Lee GJ, Curiel AR, Miller KJ, Amano S, Gorsuch R, Small GW. Language performance in postmenopausal women with and without hormone therapy and men. ACTA ACUST UNITED AC 2012; 8:625-632. [PMID: 25705244 DOI: 10.2217/ahe.12.66] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
AIMS In the current study, we explored the potential effects of hormone therapy (HT) on language functioning in healthy, postmenopausal women and compared them with men of similar ages. MATERIALS & METHODS Language functioning on tasks of verbal fluency and object naming was examined in 100 participants (mean age: 61.9 years; 33 HT users, 15 HT non-users and 52 men) at baseline and follow-up (mean follow-up time period: 2.6 years). RESULTS At baseline, men had higher composite language scores than HT users. However, HT users demonstrated more improvement over time compared with men, whereas HT non-users performed similarly to men, with no improvement over time. Longer duration of HT use was not associated with improved performance on language tests. CONCLUSION These results suggest an association between HT use and better language ability in postmenopausal women.
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Affiliation(s)
- Grace J Lee
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA 90024, USA
| | | | - Karen J Miller
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA 90024, USA ; Longevity Center Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, CA 90024, USA
| | - Stacy Amano
- Fuller Theological Seminary, Pasadena, CA, USA
| | | | - Gary W Small
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA 90024, USA ; Longevity Center Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, CA 90024, USA
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