Hormonal Effects on Prevention or Regression of Atheroma
Fertile non-smoking women have been shown to be protected from occlusive events of the medium-sized muscular arteries (Heller and Jacobs, 1976). Many investigators believe that this protection has now been explained (Miller et al.,1977, Gordon et al.,1977) by the fact that the comparatively lower serum cholesterol and higher high density lipoprotein levels of the female can exist in the presence of a higher fat turnover (Nestel, 1970, 1973; Nestel and Goldrick, 1976). However it remains to be shown why the coronary arteries should be relatively immune to the higher lipid turnover during the fertile period and whether this protection is confined to the medium-sized muscular arterifes; and why oestrogen, given to men and women with coronary artery disease, causes an increased mortality (Bailar and Byar, 1970; Gow and MacGillivray, 1970). Perhaps the female sex hormones, in particular oestrogen, are responsible for inducing the removal of lipid by increased hepatic enzyme activity (Mitchell et al. 1979) or by increased macrophage activity (Nicol et al.,1965) including the formation of multinucleate giant cells in the presence of an increased lipid turnover (Nicol, 1935, and Vernon-Roberts, 1969); or perhaps oestrogen or progesterone brings about an increase in acid esterase activity (Wolman, 1974) which lowers the liquid content of the arterial wall.
KeywordsMultinucleate Giant Cell Internal Elastic Lamina Ascend Aorta Cholesterol Feeding Normal Endothelial Cell
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