HORMONE THERAPY AND INFLAMMATORY CELL ADHESION MOLECULES

动脉粥样硬化很可能是一种慢性炎症 与脂蛋白氧化有关的疾病。为了 研究具有抗氧化潜力的雌激素对 慢性血管炎症的可溶性标志物，我们给予 绝经后妇女的17 β-雌二醇， 细胞粘附分子， 炎症细胞进入血管壁。20名妇女被 随机分配至开始一个月的治疗， 17 β-雌二醇0.1 mg每日一次（9例女性）或17 β-雌二醇0.1 mg 醋酸甲羟孕酮2.5mg/d（11例）。我们 测定可溶性E-选择素、细胞间粘附分子 血管细胞粘附分子（VCAM-1） 血清中的浓度，以及低浓度的氧化性 血浆分离脂蛋白（分光光度法二烯 形成测定）在基线和治疗一个月后， 所有试验均设盲。激素治疗 显著延长了低密度脂蛋白的发病时间 与预处理值（77+/-13至88+/-16）相比， min，p=.003），并略微降低了 氧化（p= 0.077）。激素治疗显著降低 ICAM-1水平降低8%（p= 0.009），并倾向于降低E-选择素 VCAM-1水平降低6%（p=.096），VCAM-1水平降低6%（p=.084）。 醋酸甲羟孕酮联合给药未显示 E-选择素相对变化的任何显著差异， ICAM-1和VCAM-1水平，与单独的17 β-雌二醇相比 (all p<.10）。我们得出结论，激素治疗有一个有利的 对血管炎症标志物的影响， 降低绝经后妇女患冠状动脉疾病的风险。

Atherosclerosis is likely a chronic inflammatory disease associated with oxidation of lipoproteins. In order to investigate the effect of an estrogen with antioxidant potential on soluble markers of chronic vascular inflammation, we administered 17beta-estradiol to postmenopausal women, with measurement of cell adhesion molecules that tether and incorporate circulating inflammatory cells into the vessel wall. Twenty women were randomized to begin one-month treatment with either transdermal 17beta-estradiol 0.1 mg daily (9 women) or 17beta-estradiol 0.1 mg and medroxy-progesterone acetate 2.5 mg daily (11 women). We measured soluble E-selectin, intercellular adhesion molecule (ICAM-1) and vascular cell adhesion molecule (VCAM-1) concentrations in serum, and the oxidizability of low density lipoprotein isolated from plasma (spectrophotometric diene formation assay) at baseline and following one month of treatment, with blinded performance of all assays. Hormone therapy significantly prolonged the time to onset of low density lipoprotein oxidation compared with pretreatment values (77+/-13 to 88+/-16 min, p=.003) and marginally reduced the maximum rate of oxidation (p=.077). Hormone therapy significantly lowered ICAM-1 levels by 8% (p=.009) and tended to lower E-selectin levels by 6% (p=.096) and VCAM-1 levels by 6% (p=.084). Co-administration of medroxyprogesterone acetate did not show any significant differences in the relative changes in E-selectin, ICAM-1 and VCAM-1 levels, compared to 17beta-estradiol alone (all p<.10). We conclude that hormone therapy has a favorable effect on markers of vascular inflammation, changes that may reduce the coronary artery disease risk of postmenopausal women.