Cardiac allograft vasculopathy after cardiac transplantation and hormone therapy: positive effects?
BACKGROUND
There is a great deal of controversy surrounding the issue of hormone replacement therapy after transplantation. The question whether or not this therapy has effects in cardiac allograft vasculopathy (CAV), the Achilles heel of cardiac transplantation or other unique aspects of allograft function is still unknown.


METHODS
We investigated the long-term effect of 17beta-estradiol as well as phytoestrogen Coumestrol, a synthetically produced phytoestrogen, on the development of CAV and the degree of fibrosis in an ovariectomized female heterotopic chronic allograft model (LEW-F344).


RESULTS
We found that, 150 days after transplantation, no significant effect of estrogen application on intimal thickening of coronary arteries was observed. 17beta-estradiol and phytoestrogen Coumestrol did significantly reduce the perivascular immune reaction. However, the immune effect had no consequence on the intensity of CAV. Although neither 17beta-estradiol nor phytoestrogen Coumestrol revealed a positive effect on CAV, the group of animals treated with 17beta-estradiol showed the highest decline in heart function and the most distinct fibrosis.


CONCLUSIONS
17beta-estradiol does not affect CAV positively, but worsens cardiac allograft function and leads to increased fibrosis. This is the first study showing a negative effect of 17-beta-estradiol after heart transplantation in the long term.
Lange
Volkmar
V
Department of Cardiac and Thoracic Surgery, University of Wuerzburg, Germany.
Renner
Andre
A
Sagstetter
Martina
M
Harms
Harry
H
Elert
Olaf
O
D000818:Animals; D001835:Body Weight / Q000187:drug effects; D003375:Coumestrol / Q000627:therapeutic use*; D004195:Disease Models, Animal; D004958:Estradiol / Q000627:therapeutic use*; D005260:Female; D016027:Heart Transplantation / Q000276:immunology / Q000473:pathology*; D048789:Phytoestrogens / Q000627:therapeutic use; D011183:Postoperative Complications / Q000453:epidemiology*; D051381:Rats; D011916:Rats, Inbred F344; D011917:Rats, Inbred Lew; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology; D014184:Transplantation, Homologous; D014185:Transplantation, Isogeneic; D014599:Uterus / Q000033:anatomy & histology / Q000187:drug effects; D015430:Weight Gain
D048789:Phytoestrogens; D004958:Estradiol; D003375:Coumestrol