Role of androgens in cardiovascular pathology

Dimitry A Chistiakov, Veronika A Myasoedova, Alexandra A Melnichenko, Andrey V Grechko, Alexander N Orekhov, Dimitry A Chistiakov, Veronika A Myasoedova, Alexandra A Melnichenko, Andrey V Grechko, Alexander N Orekhov

Abstract

Cardiovascular effects of android hormones in normal and pathological conditions can lead to either positive or negative effects. The reason for this variation is unknown, but may be influenced by gender-specific effects of androids, heterogeneity of the vascular endothelium, differential expression of the androgen receptor in endothelial cells (ECs) and route of androgen administration. Generally, androgenic hormones are beneficial for ECs because these hormones induce nitric oxide production, proliferation, motility, and growth of ECs and inhibit inflammatory activation and induction of procoagulant, and adhesive properties in ECs. This indeed prevents endothelial dysfunction, an essential initial step in the development of vascular pathologies, including atherosclerosis. However, androgens can also activate endothelial production of some vasoconstrictors, which can have detrimental effects on the vascular endothelium. Androgens also activate proliferation, migration, and recruitment of endothelial progenitor cells (EPCs), thereby contributing to vascular repair and restoration of the endothelial layer. In this paper, we consider effects of androgen hormones on EC and EPC function in physiological and pathological conditions.

Keywords: androgens; atherosclerosis; cardiovascular disorders; risk factors; testosterone therapy.

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

References

    1. Nettleship JE, Jones RD, Channer KS, Jones TH. Testosterone and coronary artery disease. Front Horm Res. 2009;37:91–107.
    1. Kannel WB, Hjortland MC, Mcnamara PM, Gordon T. Menopause and risk of cardiovascular disease: the Framingham study. Ann Intern Med. 1976;85(4):447–452.
    1. Hendrix SL, Wassertheil-Smoller S, Johnson KC. Effects of Conjugated Equine Estrogen on Stroke in the Women’s Health Initiative. Circulation. 2006;113(20):2425–2434.
    1. Smith MR. Androgen deprivation therapy for prostate cancer: new concepts and concerns. Curr Opin Endocrinol Diabetes Obes. 2007;14(3):247–254.
    1. Kintzel PE, Chase SL, Schultz LM, O’Rourke TJ. Increased Risk of Metabolic Syndrome, Diabetes Mellitus, and Cardiovascular Disease in Men Receiving Androgen Deprivation Therapy for Prostate Cancer. Pharmacotherapy. 2008;28(12):1511–1522.
    1. Tivesten A, Vandenput L, Labrie F, et al. Low serum testosterone and estradiol predict mortality in elderly men. J Clin Endocrinol Metab. 2009;94(7):2482–2488.
    1. Dockery F, Bulpitt CJ, Donaldson M, Fernandez S, Rajkumar C. The Relationship Between Androgens and Arterial Stiffness in Older Men. J Am Geriatr Soc. 2003;51(11):1627–1632.
    1. Morgentaler A, Miner MM, Caliber M, Guay AT, Khera M, Traish AM. Testosterone Therapy and Cardiovascular Risk: Advances and Controversies. Mayo Clin Proc. 2015;90(2):224–251.
    1. Malkin C, Pugh PJ, Jones RD, Jones TH, Channer KS. Testosterone as a protective factor against atherosclerosis--immunomodulation and influence upon plaque development and stability. J Endocrinol. 2003;178(3):373–380.
    1. Alexandersen P, Haarbo J, Byrjalsen I, Lawaetz H, Christiansen C. Natural Androgens Inhibit Male Atherosclerosis : A Study in Castrated, Cholesterol-Fed Rabbits. Circ Res. 1999;84(7):813–819.
    1. Chan YX, Knuiman MW, Hung J, et al. Testosterone, dihydrotestosterone and estradiol are differentially associated with carotid intima-media thickness and the presence of carotid plaque in men with and without coronary artery disease. Endocr J. 2015;62(9):777–786.
    1. Rosano GMC, Leonardo F, Pagnotta P, et al. Acute Anti-Ischemic Effect of Testosterone in Men With Coronary Artery Disease. Circulation. 1999;99(13):1666–1670.
    1. Kang S-M, Jang Y, Kim Ji-Y, Ji K, et al. Effect of oral administration of testosterone on brachial arterial vasoreactivity in men with coronary artery disease. Am J Cardiol. 2002;89(7):862–864.
    1. English KM, Steeds RP, Jones TH, Diver MJ, Channer KS. Low-dose transdermal testosterone therapy improves angina threshold in men with chronic stable angina: A randomized, double-blind, placebo-controlled study. Circulation. 2000;102(16):1906–1911.
    1. Malkin CJ, Pugh PJ, Morris PD. Testosterone replacement in hypogonadal men with angina improves ischaemic threshold and quality of life. Heart. 2004;90(8):871–876.
    1. Hak AE, Witteman JC, de Jong FH, Geerlings MI, Hofman A, Pols HA. Low levels of endogenous androgens increase the risk of atherosclerosis in elderly men: the Rotterdam study. J Clin Endocrinol Metab. 2002;87(8):3632–3639.
    1. Svartberg J, von Mühlen D, Mathiesen E, Joakimsen O, Bønaa KH, Stensland-Bugge E. Low testosterone levels are associated with carotid atherosclerosis in men. J Intern Med. 2006;259(6):576–582.
    1. Gyllenborg J, Rasmussen SL, Borch-Johnsen K, Heitmann BL, Skakkebaek NE, Juul A. Cardiovascular risk factors in men: The role of gonadal steroids and sex hormone-binding globulin. Metabolism. 2001;50(8):882–888.
    1. Duran J, Oyarce C, Pavez M, et al. GSK-3β/NFAT Signaling Is Involved in Testosterone-Induced Cardiac Myocyte Hypertrophy. PLoS One. 2016;11(12):e0168255.
    1. Zhu YS, Katz MD, Imperato-Mcginley J. Natural potent androgens: lessons from human genetic models. Baillieres Clin Endocrinol Metab. 1998;12(1):83–113.
    1. Zhu YS. Molecular Basis of Steroid Action in the Prostate. Cellscience. 2005;1(4):27–55.
    1. Sultan C, Lumbroso S, Paris F, et al. Disorders of Androgen Action. Semin Reprod Med. 2002;20(3):217–228.
    1. Yoshida S, Ikeda Y, Aihara K-Ichi, Aihara K. Roles of the Androgen – Androgen Receptor System in Vascular Angiogenesis. J Atheroscler Thromb. 2016;23(3):257–265.
    1. Amory JK, Anawalt BD, Matsumoto AM. The effect of 5alpha-reductase inhibition with dutasteride and finasteride on bone mineral density, serum lipoproteins, hemoglobin, prostate specific antigen and sexual function in healthy young men. J Urol. 2008:α9:2333–α9:2338.
    1. Gonzales RJ, Ansar S, Duckles SP, Krause DN. Androgenic/estrogenic balance in the male rat cerebral circulation: metabolic enzymes and sex steroid receptors. J Cereb Blood Flow Metab. 2007;27(11):1841–1852.
    1. Krause DN, Duckles SP, Gonzales RJ. Local oestrogenic/androgenic balance in the cerebral vasculature. Acta Physiol. 2011;203(1):181–186.
    1. Aranda A, Pascual A. Nuclear Hormone Receptors and Gene Expression. Physiol Rev. 2001;81(3):1269–1304.
    1. Kahn SM, Hryb DJ, Nakhla AM, Romas NA, Rosner W. Sex hormone-binding globulin is synthesized in target cells. Sex hormone-binding globulin is synthesized in target cells. J Endocrinol. 2002;175:113–120.
    1. Bagchi G, Wu J, French J, Kim J, Moniri NH, Daaka Y. Androgens Transduce the G s-Mediated Activation of Protein Kinase A in Prostate Cells. Cancer Res. 2008;68(9):3225–3231.
    1. Christian HC, Rolls NJ, Morris JF. Nongenomic actions of testosterone on a subset of lactotrophs in the male rat pituitary. Endocrinology. 2000;141(9):3111–3119.
    1. Gatson JW, Kaur P, Singh M. Dihydrotestosterone differentially modulates the mitogen-activated protein kinase and the phosphoinositide 3-kinase/Akt pathways through the nuclear and novel membrane androgen receptor in C6 cells. Endocrinology. 2006;147(4):2028–2034.
    1. Kim SB, Kanno A, Ozawa T, Tao H, Umezawa Y. Nongenomic Activity of Ligands in the Association of Androgen Receptor with SRC. ACS Chem Biol. 2007;2(7):484–492.
    1. Gates PE, Strain WD, Shore AC. Human endothelial function and microvascular ageing. Exp Physiol. 2009;94(3):311–316.
    1. Fadini GP, Agostini C, Sartore S, Avogaro A. Endothelial progenitor cells in the natural history of atherosclerosis. Atherosclerosis. 2007;194(1):46–54.
    1. Werner N, Kosiol S, Schiegl T, et al. Circulating Endothelial Progenitor Cells and Cardiovascular Outcomes. N Engl J Med Overseas Ed. 2005;353(10):999–1007.
    1. Torres-Estay V, Carreño DV, San Francisco IF, Sotomayor P, Godoy AS, Smith GJ. Androgen receptor in human endothelial cells. J Endocrinol. 2015;224(3):R131–R137.
    1. Somjen D, Kohen F, Jaffe A, Amir-Zaltsman Y, Knoll E, Stern N. Effects of gonadal steroids and their antagonists on DNA synthesis in human vascular cells. Hypertension. 1998;32(1):39–45.
    1. Somjen D, Kohen F, Gayer B, Kulik T, Knoll E, Stern N. Role of putative membrane receptors in the effect of androgens on human vascular cell growth. Role of putative membrane receptors in the effect of androgens on human vascular cell growth. J Endocrinol. 2004;180:97–106.
    1. Cai J, Hong Y, Weng C, Tan C, Imperato-Mcginley J, Zhu Y-S. Androgen stimulates endothelial cell proliferation via an androgen receptor/VEGF/cyclin A-mediated mechanism. Am J Physiol Heart Circ Physiol. 2011;300(4):H1210–H1221.
    1. Campelo AE, Cutini PH, Massheimer VL, Christian HC, Rolls NJ, Morris JF. Testosterone modulates platelet aggregation and endothelial cell growth through nitric oxide pathway. Nongenomic actions of testosterone on a subset of lactotrophs in the male rat pituitary. Endocrinology. 2000;141:3111–3119.
    1. Aird WC. Endothelial cell heterogeneity. Crit Care Med. 2003;31(Supplement):S221–S230.
    1. Prins GS, Birch L, Greene GL. Androgen Receptor Localization in Different Cell Types of the Adult Rat Prostate*. Endocrinology. 1991;129(6):3187–3199.
    1. Wen J, Zhao Y, Li J, et al. Suppression of DHT-induced paracrine stimulation of endothelial cell growth by estrogens via prostate cancer cells. Prostate. 2013;73(10):1069–1081.
    1. Weng C, Cai J, Wen J, et al. Differential effects of estrogen receptor ligands on regulation of dihydrotestosterone-induced cell proliferation in endothelial and prostate cancer cells. Int J Oncol. 2013;42(1):327–337.
    1. Qiao Y, Zhang Z-K, Cai L-Q, Tan C, Imperato-Mcginley JL, Zhu Y-S. 17α-estradiol inhibits LAPC-4 prostatic tumor cell proliferation in cell cultures and tumor growth in xenograft animals. Prostate. 2007;67(16):1719–1728.
    1. Balakumar P, Kaur T, Singh M. Potential target sites to modulate vascular endothelial dysfunction: Current perspectives and future directions. Toxicology. 2008;245(1–2):49–64.
    1. Hill JM, Zalos G, Halcox JPJ, et al. Circulating Endothelial Progenitor Cells, Vascular Function, and Cardiovascular Risk. N Engl J Med Overseas Ed. 2003;348(7):593–600.
    1. Werner L, Deutsch V, Barshack I, Miller H, Keren G, George J. Transfer of endothelial progenitor cells improves myocardial performance in rats with dilated cardiomyopathy induced following experimental myocarditis. J Mol Cell Cardiol. 2005;39(4):691–697.
    1. Flores-Ramírez R, Uribe-Longoria A, Rangel-Fuentes MM, et al. Intracoronary infusion of CD133+ endothelial progenitor cells improves heart function and quality of life in patients with chronic post-infarct heart insufficiency. Cardiovasc Revasc Med. 2010;11(2):72–78.
    1. Wang XX, Zhang FR, Shang YP, et al. Transplantation of autologous endothelial progenitor cells may be beneficial in patients with idiopathic pulmonary arterial hypertension: a pilot randomized controlled trial. J Am Coll Cardiol. 2007;49(14):1566–1571.
    1. Foresta C, Caretta N, Lana A, et al. Reduced number of circulating endothelial progenitor cells in hypogonadal men. J Clin Endocrinol Metab. 2006;91(11):4599–4602.
    1. Liao CH, Wu YN, Lin FY, Tsai WK, Liu SP, Chiang HS. Testosterone replacement therapy can increase circulating endothelial progenitor cell number in men with late onset hypogonadism. Andrology. 2013;1(4):563–569.
    1. Liu R, Ding L, Yu M-H, Mh Y, et al. Effects of dihydrotestosterone on adhesion and proliferation via PI3-K/Akt signaling in endothelial progenitor cells. Endocrine. 2014;46(3):634–643.
    1. Kelly DM, Jones TH. Testosterone: a vascular hormone in health and disease. J Endocrinol. 2013;217(3):R47–R71.
    1. Williams MR, Dawood T, Ling S, et al. Dehydroepiandrosterone increases endothelial cell proliferation in vitro and improves endothelial function in vivo by mechanisms independent of androgen and estrogen receptors. J Clin Endocrinol Metab. 2004;89(9):4708–4715.
    1. Simoncini T, Mannella P, Fornari L, Varone G, Caruso A, Genazzani AR. Dehydroepiandrosterone Modulates Endothelial Nitric Oxide Synthesis Via Direct Genomic and Nongenomic Mechanisms. Endocrinology. 2003;144(8):3449–3455.
    1. Goglia L, Tosi V, Sanchez AM, et al. Endothelial regulation of eNOS, PAI-1 and t-PA by testosterone and dihydrotestosterone in vitro and in vivo. Mol Hum Reprod. 2010;16(10):761–769.
    1. Yu J, Akishita M, Eto M, et al. Androgen Receptor-Dependent Activation of Endothelial Nitric Oxide Synthase in Vascular Endothelial Cells: Role of Phosphatidylinositol 3-Kinase/Akt Pathway. Endocrinology. 2010;151(4):1822–1828.
    1. Wynne FL, Khalil RA. Testosterone and coronary vascular tone: Implications in coronary artery disease. J Endocrinol Invest. 2003;26(2):181–186.
    1. Wong SL, Leung FP, Lau CW, et al. Cyclooxygenase-2-Derived Pros-taglandin F2 Mediates Endothelium-Dependent Contractions in the Aortae of Hamsters With Increased Impact During Aging. Circ Res. 2009;104(2):228–235.
    1. Marrachelli VG, Miranda FJ, Centeno JM, et al. Role of NO-synthases and cyclooxygenases in the hyperreactivity of male rabbit carotid artery to testosterone under experimental diabetes. Pharmacol Res. 2010;61(1):62–70.
    1. Wu CC, Schwartzman ML. The role of 20-HETE in androgen-mediated hypertension. Prostaglandins Other Lipid Mediat. 2011;96(1–4):45–53.
    1. Caughey GE, Cleland LG, Penglis PS, Gamble JR, James MJ. Roles of cyclooxygenase (COX)-1 and COX-2 in prostanoid production by human endothelial cells: selective up-regulation of prostacyclin synthesis by COX-2. J Immunol. 2001;167(5):2831–2838.
    1. Brancaleone V, Vellecco V, Matassa DS, et al. Crucial role of androgen receptor in vascular H 2 S biosynthesis induced by testosterone. Br J Pharmacol. 2015;172(6):1505–1515.
    1. Wang M, Guo Z, Wang S. The Effect of Certain Conditions in the Regulation of Cystathionine γ-Lyase by Exogenous Hydrogen Sulfide in Mammalian Cells. Biochem Genet. 2013;51(7–8):503–513.
    1. Wang K, Ahmad S, Cai M, et al. Dysregulation of hydrogen sulfide producing enzyme cystathionine γ-lyase contributes to maternal hypertension and placental abnormalities in preeclampsia. Circulation. 2013;127(25):2514–2522.
    1. Maturana MA, Breda V, Lhullier F, Spritzer PM. Relationship between endogenous testosterone and cardiovascular risk in early postmenopausal women. Metabolism. 2008;57(7):961–965.
    1. Polderman KH, Stehouwer CD, van Kamp GJ, Dekker GA, Verheugt FW, Gooren LJ. Influence of sex hormones on plasma endothelin levels. Ann Intern Med. 1993;118(6):429–432.
    1. Kumanov P, Tomova A, Kirilov G, Dakovska L, Schinkov A. Increased plasma endothelin levels in patients with male hypogonadism. Andrologia. 2002;34(1):29–33.
    1. Kumanov P, Tomova A, Kirilov G. Testosterone replacement therapy in male hypogonadism is not associated with increase of endothelin-1 levels. Int J Androl. 2007;30(1):41–47.
    1. Wyce A, Bai Y, Nagpal S, Thompson CC. Research Resource: The androgen receptor modulates expression of genes with critical roles in muscle development and function. Mol Endocrinol. 2010;24(8):1665–1674.
    1. Pirompol P, Teekabut V, Weerachatyanukul W, Bupha-Intr T, Wattana-permpool J. Supra-physiological dose of testosterone induces pathological cardiac hypertrophy. J Endocrinol. 2016;229(1):13–23.
    1. Papamitsou T, Barlagiannis D, Papaliagkas V, Kotanidou E, Dermentzo-poulou-Theodoridou M. Testosterone-induced hypertrophy, fibrosis and apoptosis of cardiac cells--an ultrastructural and immunohistochemical study. Med Sci Monit. 2011;17(9):BR266–BR273.
    1. Zwadlo C, Schmidtmann E, Szaroszyk M, et al. Antiandrogenic therapy with finasteride attenuates cardiac hypertrophy and left ventricular dysfunction. Circulation. 2015;131(12):1071–1081.
    1. Yeap BB. Androgens and cardiovascular disease. Curr Opin Endocrinol Diabetes Obes. 2010;17(3):269–276.
    1. Rosano GM, Cornoldi A, Fini M. Effects of androgens on the cardiovascular system. J Endocrinol Invest. 2005;28(3 Suppl):32–38.
    1. Allan CA, Strauss BJG, Mclachlan RI. Body composition, metabolic syndrome and testosterone in ageing men. Int J Impot Res. 2007;19(5):448–457.
    1. Tsang S, Wu S, Liu J, Wong TM. Testosterone protects rat hearts against ischaemic insults by enhancing the effects of α1 -adrenoceptor stimulation. Br J Pharmacol. 2008;153(4):693–709.
    1. Zhang L, Lei D, Zhu GP, Hong L, Wu SZ. Physiological testosterone retards cardiomyocyte aging in Tfm mice via androgen receptor-independent pathway. Chin Med Sci J. 2013;28(2):88–94.
    1. Liu PY, Death AK, Handelsman DJ. Androgens and cardiovascular disease. Endocr Rev. 2003;24(3):313–340.
    1. Wu FC, von Eckardstein A. Androgens and coronary artery disease. Endocr Rev. 2003;24(2):183–217.
    1. Gonzales RJ, Ansar S, Duckles SP, Krause DN. Androgenic/estrogenic balance in the male rat cerebral circulation: metabolic enzymes and sex steroid receptors. Am J Physiol Heart Circ Physiol. 2005;289:H578–585.
    1. Hatakeyama H, Nishizawa M, Nakagawa A, Nakano S, Kigoshi T, Uchida K. Testosterone inhibits tumor necrosis factor-α-induced vascular cell adhesion molecule-1 expression in human aortic endothelial cells. FEBS Lett. 2002;530(1–3):129–132.
    1. Zhang X, Wang LY, Jiang TY, et al. Effects of testosterone and 17-beta-estradiol on TNF-alpha-induced E-selectin and VCAM-1 expression in endothelial cells. Analysis of the underlying receptor pathways. Life Sci. 2002;71(1):15–29.
    1. Death AK, Mcgrath KC, Sader MA, et al. Dihydrotestosterone promotes vascular cell adhesion molecule-1 expression in male human endothelial cells via a nuclear factor-kappaB-dependent pathway. Endocrinology. 2004;145(4):1889–1897.
    1. Annibalini G, Agostini D, Calcabrini C, et al. Effects of sex hormones on inflammatory response in male and female vascular endothelial cells. J Endocrinol Invest. 2014;37(9):861–869.
    1. Norata GD, Tibolla G, Seccomandi PM, Poletti A, Catapano AL. Dihydrotestosterone decreases tumor necrosis factor-alpha and lipo-polysaccharide-induced inflammatory response in human endothelial cells. J Clin Endocrinol Metab. 2006;91(2):546–554.
    1. Xu ZR, Hu L, Cheng LF, Qian Y, Yang YM. Dihydrotestosterone protects human vascular endothelial cells from H(2)O(2)-induced apoptosis through inhibition of caspase-3, caspase-9 and p38 MAPK. Eur J Pharmacol. 2010;643(2–3):254–259.
    1. Moretti C, Lanzolla G, Moretti M, Gnessi L, Carmina E. Androgens and Hypertension in Men and Women: a Unifying View. Curr Hypertens Rep. 2017;19(5):44.
    1. Agledahl I, Brodin E, Svartberg J, Hansen JB. Plasma free tissue factor pathway inhibitor (TFPI) levels and TF-induced thrombin generation ex vivo in men with low testosterone levels. Thromb Haemost. 2009;101(3):471–477.
    1. Phillips GB, Pinkernell BH, Jing TY. The association of hypotestos-teronemia with coronary artery disease in men. Arterioscler Thromb Vasc Biol. 1994;14(5):701–706.
    1. Pugh PJ, Channer KS, Parry H, Downes T, Jone TH. Bio-available testosterone levels fall acutely following myocardial infarction in men: association with fibrinolytic factors. Endocr Res. 2002;28(3):161–173.
    1. Jin H, Lin J, Fu L, et al. Physiological testosterone stimulates tissue plasminogen activator and tissue factor pathway inhibitor and inhibits plasminogen activator inhibitor type 1 release in endothelial cells. Biochem Cell Biol. 2007;85(2):246–251.
    1. Borst SE, Shuster JJ, Zou B, et al. Cardiovascular risks and elevation of serum DHT vary by route of testosterone administration: a systematic review and meta-analysis. BMC Med. 2014;12(1):211.
    1. Basaria S, Coviello AD, Travison TG, et al. Adverse Events Associated with Testosterone Administration. N Engl J Med Overseas Ed. 2010;363(2):109–122.
    1. Vigen R, O’Donnell CI, Barón AE, et al. Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels. JAMA. 2013;310(17):1829–1836.
    1. Morgentaler A, Lunenfeld B. Testosterone and cardiovascular risk: world’s experts take unprecedented action to correct misinformation. The Aging Male. 2014;17(2):63–65.

Source: PubMed

3
購読する