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Effect of Estrogen on Nitric Oxide and Endothelin-1
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TO THE EDITOR:
I read with considerable interest the recent article by Best and colleagues [1]. The observation that estrogen replacement increases nitric oxide levels and, at the same time, reduces concentrations of endothelin-1 is in accord with studies we have done [2] that have used immunocytochemistry to show increased levels of in situ endothelin-1 in diseased coronary artery bypass grafts and coronary arteries. Concurrently, again according to immunocytochemistry, the availability of nitric oxide is reduced in diseased coronary arteries and failed bypass grafts. We have indicated a direct relation between locally increased concentrations of endothelin-1, the consummate vasoconstrictor, and lack of nitric oxide, the potent vasodilator, because of the absence of nitric oxide synthase [3].
The increased severity of coronary artery disease in postmenopausal women may well be related to the abnormalities demonstrated immunocytochemically, which appear to be alleviated by the administration of exogenous estrogen. Estrogen replacement may improve endothelial cell function.
Jerome I. Brody, MD
Allegheny University Hospitals; Philadelphia, PA 19129
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
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