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Progesterone enhances adrenergic control of skin blood flow in women with high but not low orthostatic tolerance

机译:黄体酮可增强体位耐受性高但不低的女性对皮肤血流的肾上腺素能控制

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摘要

Women are more susceptible to orthostatic intolerance. Peripheral α-adrenergic responsiveness is important in orthostasis and is lower in women compared to men, and is modulated by female sex hormones. We tested the hypothesis that oestradiol attenuates peripheral cutaneous adrenergic responses in women with low orthostatic tolerance (LT), whereas progesterone enhances adrenergic responses in women with high orthostatic tolerance (HT). After completing a maximal lower body negative pressure test to determine level of orthostatic tolerance (cumulative stress index, CSI), women self administered a gonadotropin releasing hormone (GnRH) antagonist for 16 days to suppress endogenous sex hormone production. Oestradiol (E2, 0.2 mg day−1, patch; days 4–16), and progesterone (P4, 200 mg day−1, oral; days 12–16) were administered. Skin blood flow responses to graded intradermal microdialysis infusions of noradrenaline (NA) were measured during GnRH antagonist, E2, and E2+P4, in eight HT (s.e.m. = 22 ± 1 years, CSI −871 ± 86 mmHg min) and eight LT (21 ± 1 years, CSI −397 ± 65 mmHg min) women. In separate probes, NA was infused alone, and co-infused with the nitric oxide synthase inhibitor NG-monomethyl-l-arginine (l-NMMA, 10 mm), the non-selective cyclooxygenase inhibitor ketorolac tromethamine (Keto, 10 mm), and combined l-NMMA + Keto (10 mm each). Progesterone administration enhanced adrenergic responses in HT women (logEC50 GnRH −4.02 ± 0.39, E2+P4−5.18 ± 0.31, P < 0.05); this response was reversed with Keto (E2+P4 logEC50 NA+Keto −3.82 ± 0.35, P < 0.05). In contrast, no change in adrenergic responsiveness occurred in LT women during any hormone condition. These data indicate differential regulation of cutaneous adrenergic responses by progesterone via the cyclooxygenase pathway in women with high and low orthostatic tolerance.
机译:妇女更容易患立位不耐症。外周α-肾上腺素能反应在矫正中很重要,女性比男性低,并且受女性性激素调节。我们测试了雌二醇降低体位耐受性低的女性(LT)的外周皮肤肾上腺素能反应的假设,而孕酮增强体位耐受性高的女性(HT)的雌激素反应。在完成最大的下半身负压测试以确定体位耐受性水平(累积压力指数,CSI)后,妇女自行服用促性腺激素释放激素(GnRH)拮抗剂16天以抑制内源性激素的产生。雌二醇(E2,0.2 mg day -1 ,贴剂;第4-16天)和孕酮(P4,200 mg day -1 ,口服;第12-16天)被管理。在GnRH拮抗剂,E2和E2 + P4的八个HT(sem = 22±1年,CSI -871±86 mmHg min)和八个LT( 21±1岁,CSI -397±65 mmHg(最小)女性。在单独的探针中,将NA单独输注,并与一氧化氮合酶抑制剂N G -单甲基-1-精氨酸(1-NMMA,10 mm)共输注,这是一种非选择性的环氧合酶抑制剂酮咯酸氨基丁三醇(Keto,10毫米),和1-NMMA +酮基组合(每个10毫米)。孕激素的施用增强了HT妇女的肾上腺素能反应(logEC50 GnRH -4.02±0.39,E2 + P4-5.18±0.31,P <0.05);该反应用Keto逆转(E2 + P4 logEC50 NA + Keto -3.82±0.35,P <0.05)。相反,在任何激素状况下,LT妇女的肾上腺素能反应性均未发生变化。这些数据表明,在体位耐受性高和低的女性中,孕酮通过环氧合酶途径对皮肤肾上腺素能反应的差异调节。

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