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Thromb Haemost 1998; 79(05): 1029-1033
DOI: 10.1055/s-0037-1615115
Review Article
Schattauer GmbH

The Effects of Sex Steroids on Plasma Levels of Marker Proteins of Endothelial Cell Functioning

P. J. M. van Kesteren
1   From the Departments of Andrology, Amsterdam
,
T. Kooistra
4   From the Departments of Gaubius Laboratory, TNO-PG, Leiden, The Netherlands
,
M. Lansink
4   From the Departments of Gaubius Laboratory, TNO-PG, Leiden, The Netherlands
,
G. J. van Kamp
2   From the Departments of Clinical Chemistry, Amsterdam
,
H. Asscheman
1   From the Departments of Andrology, Amsterdam
,
L. J. G. Gooren
1   From the Departments of Andrology, Amsterdam
,
J. J. Emeis
4   From the Departments of Gaubius Laboratory, TNO-PG, Leiden, The Netherlands
,
U. M. Vischer
5   From the Department of Internal Medicine, Hôpital Cantonal et Universitaire de Genève, Geneva, Switzerland
,
C. D. A. Stehouwer
3   From the Departments of Internal Medicine, Academic Hospital Vrije Universiteit, Amsterdam
› Author Affiliations
Further Information

Publication History

Received 29 September 1997

Accepted after resubmission 14 January 1998

Publication Date:
07 December 2017 (online)

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Summary

We studied thirteen male-to-female (M→F) and ten female-to-male (F→M) transsexuals who, for four months, received cross-sex treatment with, respectively, ethinylestradiol and cyproterone acetate, and with testosterone esters. We assessed the effects of treatment on plasma levels of tissue-type plasminogen activator (tPA), von Willebrand factor (vWF), vWF-propeptide (vWF:AgII) and bigendothelin-1 (big-ET-1), four proteins that are markers of endothelial cell functioning. We also measured urokinase-type PA (uPA) and plasminogen activator inhibitor-type 1 (PAI-1), which may not be endothelium-derived but share major clearance pathways with tPA.

In M→F transsexuals, mean plasma levels of tPA (minus 4.4 ng/ml), big-ET-1 (minus 0.8 pg/ml), uPA (minus 0.5 ng/ml) and PAI-1 (minus 26 ng/ml) decreased (all Ps ≤0.02). The level of vWF increased (plus 24%; P = 0.005), while vWF:AgII did not change (P = 0.49).

In F→M transsexuals, levels of big-ET-1 increased (plus 0.4 pg/ml; P = 0.02), while tPA, uPA and PAI-1 did not change (all Ps >0.25). In this group vWF decreased (minus 14%; P = 0.06), but vWF:AgII did not change (P = 0.38).

Estrogens and androgens have clear effects on plasma levels of endothelial marker proteins. The mechanisms behind these effects are complex and appear to involve both altered secretion (big-ET-1) and processing and/or clearance (vWF and possibly tPA). Therefore, effects of hormones on the levels of endothelial marker proteins do not necessarily reflect changes in endothelial cell functioning, at least with regard to changes in vWF level associated with the oral administration of high doses of ethinylestradiol and cyproterone acetate to healthy men and the parenteral administration of testosterone to healthy women.

 

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