Oestrogen-mediated upregulation of the Mas receptor contributes to sex differences in acute lung injury and lung vascular barrier regulation
- 6 August 2020
- journal article
- research article
- Published by European Respiratory Society (ERS) in European Respiratory Journal
- Vol. 57 (1), 2000921
- https://doi.org/10.1183/13993003.00921-2020
Abstract
Epidemiological data from the SARS-CoV-2 outbreak suggest sex differences in mortality and vulnerability; yet sex-dependent incidences of acute respiratory distress syndrome (ARDS) remain controversial and sex-dependent mechanisms of endothelial barrier regulation is unknown. In premenopausal women increased signalling of angiotensin (Ang)-(1–7) via the Mas receptor has been linked to lower cardiovascular risk. Since stimulation of the Ang-(1–7)/Mas axis protects the endothelial barrier in acute lung injury (ALI), we hypothesised that increased Ang-(1–7)/Mas signalling may protect females over males in ALI/ARDS. Clinical data were collected from Charité inpatients. Sex differences in ALI were assessed in wild-type (WT) and Mas-deficient (Mas−/−) mice. Endothelial permeability was assessed as weight change in isolated lungs and as trans-endothelial electrical resistance in vitro. In 734 090 Charité inpatients (2005–2016), ARDS had a higher incidence in men as compared to women. In murine ALI, male WT mice had more lung edema, protein leak, and histological evidence of injury than female WT mice. Lung weight change in response to platelet-activating factor (PAF) was more pronounced in male WT and female Mas−/− mice than female WT, whereas Mas receptor expression was higher in female WT lungs. Ovariectomy attenuated protection in female WT mice and reduced Mas receptor expression. In vitro, estrogen increased Mas receptor expression and attenuated endothelial leak in response to thrombin; this effect was alleviated by Mas receptor blockade. Improved lung endothelial barrier function protects female mice from ALI-induced lung edema. This effect is partially mediated via enhanced Ang-(1–7)/Mas signalling as a result of estrogen-dependent Mas expression.Keywords
Funding Information
- Deutsche Forschungsgemeinschaft (KU 1218/7, WA 1441/22)
This publication has 35 references indexed in Scilit:
- COVID-19: the gendered impacts of the outbreakThe Lancet, 2020
- Incidence and Outcomes of Acute Respiratory Distress SyndromeMedicine, 2015
- Sex, Race, and the Development of Acute Lung InjurySocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2013
- Acute Respiratory Distress SyndromeJAMA, 2012
- Impact of Socioethnic Factors on Outcomes Following Traumatic Brain InjuryThe Journal of Trauma and Acute Care Surgery, 2011
- Therapeutic strategies for severe acute lung injuryCritical Care Medicine, 2010
- Low-Tidal-Volume Ventilation in the Acute Respiratory Distress SyndromeThe New England Journal of Medicine, 2007
- The impact of sex and sex hormones on lung physiology and disease: lessons from animal studiesAmerican Journal of Physiology-Lung Cellular and Molecular Physiology, 2007
- Regulatory effects of estrogen on acute lung inflammation in miceAmerican Journal of Physiology-Cell Physiology, 2005
- Race and gender differences in acute respiratory distress syndrome deaths in the United States: An analysis of multiple-cause mortality data (1979–1996)*Critical Care Medicine, 2002