Androgens drive microvascular endothelial dysfunction in women with polycystic ovary syndrome: role of the endothelin B receptor.

Autor: Usselman CW; John B. Pierce Laboratory, Yale School of Medicine, New Haven, CT, USA.; Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.; Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada., Yarovinsky TO; Departments of Internal Medicine (Cardiovascular Medicine) and Immunobiology, Yale School of Medicine, New Haven, CT, USA.; Yale Cardiovascular Research Center, Yale University School of Medicine, New Haven, CT, USA., Steele FE; Departments of Internal Medicine (Cardiovascular Medicine) and Immunobiology, Yale School of Medicine, New Haven, CT, USA.; Yale Cardiovascular Research Center, Yale University School of Medicine, New Haven, CT, USA., Leone CA; John B. Pierce Laboratory, Yale School of Medicine, New Haven, CT, USA., Taylor HS; Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA., Bender JR; Departments of Internal Medicine (Cardiovascular Medicine) and Immunobiology, Yale School of Medicine, New Haven, CT, USA.; Yale Cardiovascular Research Center, Yale University School of Medicine, New Haven, CT, USA., Stachenfeld NS; John B. Pierce Laboratory, Yale School of Medicine, New Haven, CT, USA.; Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
Jazyk: angličtina
Zdroj: The Journal of physiology [J Physiol] 2019 Jun; Vol. 597 (11), pp. 2853-2865. Date of Electronic Publication: 2019 Mar 27.
DOI: 10.1113/JP277756
Abstrakt: Key Points: Polycystic ovary syndrome (PCOS) is a complex syndrome with cardiovascular risk factors, including obesity and insulin resistance. PCOS is also associated with high androgens, increases the risk of cardiovascular dysfunction in women. Due to the complexity of PCOS, had it has been challenging to isolate specific causes of the cardiovascular dysfunction. Our measure of cardiovascular dysfunction (endothelial dysfunction) was most profound in lean women with PCOS. The endothelin-1-induced vasodilation in these PCOS subject, was dependent on the ET B R but was not NO-dependent. We also demonstrated oestrogen administration improved endothelial function in lean and obese women with PCOS likely because oestrogen increased NO availability. Our studies indicate a primary role for androgens in cardiovascular dysfunction in PCOS.
Abstract: Endothelin-1 (ET-1) is an indicator of endothelial injury and dysfunction and is elevated in women with androgen excess polycystic ovary syndrome (AE-PCOS). The endothelin B receptor (ET B R) subtype mediates vasodilatation, but is blunted in women with PCOS. We hypothesized that androgen drives endothelial dysfunction in AE-PCOS women and oestradiol (EE) administration reverses these effects. We assessed microvascular endothelial function in women with (7 lean and 7 obese) and without AE-PCOS (controls, 6 lean, 7 obese). Only obese AE-PCOS women were insulin resistant (IR). We evaluated cutaneous vascular conductance (%CVC max ) with laser Doppler flowmetry during low dose intradermal microdialysis ET-1 perfusions (1, 3, 4, 5 and 7 pmol) with either lactated Ringer solution alone, or with ET B R (BQ-788), or nitric oxide (NO) inhibition (l-NAME). Log[ET-1]-%maxCVC dose-response curves demonstrated reduced vasodilatory responses to ET-1 in lean AE-PCOS (logED 50 , 0.59 ± 0.08) versus lean controls (logED 50 , 0.49 ± 0.09, P < 0.05), but not compared to obese AE-PCOS (logED 50 , 0.65 ± 0.09). ET B R inhibition decreased ET-1-induced vasodilatation in AE-PCOS women (logED 50 , 0.64 ± 0. 22, P < 0.05). This was mechanistically observed at the cellular level, with ET-1-induced, DAF-FM-measurable endothelial cell NO production, which was abrogated by dihydrotestosterone in an androgen receptor-dependent manner. EE augmented the cutaneous vasodilating response to ET-1(logED 50 0.29 ± 0.21, 0.47 ± 0.09, P < 0.05 for lean and obese, respectively). Androgens drive endothelial dysfunction in lean and obese AE-PCOS. We propose that the attenuated ET-1-induced vasodilatation in AE-PCOS is a consequence of androgen receptor-mediated, suppressed ET B R-stimulated NO production, and is reversed with EE.
(© 2019 The Authors. The Journal of Physiology © 2019 The Physiological Society.)
Databáze: MEDLINE
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