Abstract

Clinical and epidemiological data show that biological sex is one of the major determinants for the development and progression of cardiovascular disease (CVD). Impaired endothelial function, characterized by an imbalance in endothelial Nitric Oxide Synthase (eNOS) activity, precedes and accelerates the development of CVD. However, whether there is any sexual dimorphism in eNOS activity and function in endothelial cells (ECs) is still unknown. Here, by independently studying human male and female ECs, we found that female ECs expressed higher eNOS mRNA and protein levels both in vitro and ex vivo. The increased eNOS expression was associated to higher enzymatic activity and nitric oxide production. Pharmacological and genetic inhibition of eNOS affected migratory properties only in female ECs. In vitro angiogenesis experiments confirmed that sprouting mostly relied on eNOS-dependent migration in female ECs. At variance, capillary outgrowth from male ECs was independent of eNOS activity but required cell proliferation. In this study, we found sex-specific differences in the EC expression, activity, and function of eNOS. This intrinsic sexual dimorphism of ECs should be further evaluated to achieve more effective and precise strategies for the prevention and therapy of diseases associated to an impaired endothelial function such as CVD and pathological angiogenesis.

Highlights

  • There are substantial differences between men and women in cardiovascular disease (CVD) epidemiology, patho-physiology, clinical manifestations, effects of therapies, and outcomes[1,2,3]

  • 4 independent male and female lysates, 10 μg/lane) and the densitometric analysis of endothelial Nitric Oxide Synthase (eNOS) protein expression normalized to β-actin are shown. **p < 0.01; n = 14. (C) Upper panel, eNOS protein evaluated on lysates from twin male and female endothelial cells (ECs) at P1 passage or collected immediately after the flushing from cords

  • All cardiovascular risk factors are associated with a loss in endothelial functions that is triggered by a decrease in nitric oxide (NO) production as consequence of a reduced eNOS activity[6, 7]

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Summary

Introduction

There are substantial differences between men and women in cardiovascular disease (CVD) epidemiology, patho-physiology, clinical manifestations, effects of therapies, and outcomes[1,2,3]. Long term exposure to estrogens up regulates eNOS expression in ECs11, 12 whereas the activation of the enzyme and NO formation occur via rapid signaling pathways[13, 14] Both the mechanisms participate in the improvement of EC function. Knowledge of sex-specific expression patterns and of sexual dimorphisms in ECs may contribute to better understand the well-known physio-pathological differences in male and female endothelial function. 4 independent male and female lysates, 10 μg/lane) and the densitometric analysis of eNOS protein expression normalized to β-actin are shown.

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