title: Estrogen paradox in pulmonary hypertension: current controversies and future perspectives.
abstract: 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.
authors.affiliation: Division of Molecular Medicine, Department of Anesthesiology, David Geffen School of Medicine at University of California, Los Angeles, USA.
authors.forename: Soban
authors.initials: S
authors.lastname: Umar
authors.forename: Marlene
authors.initials: M
authors.lastname: Rabinovitch
authors.forename: Mansoureh
authors.initials: M
authors.lastname: Eghbali
mesh_terms: D000818:Animals; D004967:Estrogens / Q000378:metabolism / Q000502:physiology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D051381:Rats; D011960:Receptors, Estrogen / Q000502:physiology; D012737:Sex Factors; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology
chemical_list: D004967:Estrogens; D011960:Receptors, Estrogen