The effect of estrogen replacement therapy (ERT) on the level of circulating cellular adhesion molecules (cCAMs) in earned out this study on 15 apparently healthy premenopausal women with no clinical evidence of CAD, 15 premenopausal patients with CAD, 15 postmenopausal women not receiving ERT with no clinical evidence of CAD,15 postmenopausal patients not receiving ERT and suffering from CAD, 15 postmenopausal women under ERT in the form of a conjugated equine E2 with no clinical evidence of CAD and finally 15 postmenopausal patients under ERT with CAD. Every individual was subject to clinical evolution including history taking and clinical examination with special stress on the presence of risk factors. All the subjects were not risky i.e. non-smokers, not diabetics, not hypertensive, not hyperlipidemic and with no family history of angina or myocardial infraction. Serum levels of cCAMs, circulating intercellular adhesion molecule-1 (cCAM-1), circulating vascular adhesion molecule-1 (cCAM-1) and circulating E-selectin were measured by ELISA. Serum E2 levels were measured by chemiluminesent enzyme immunmetric assay. Fasting serum glucose ,liver and kidney function tests and lipid profile were also performed. We observed a statistically significant increase in serum levels of cCAMs in postmenopausal women. The most striking elevation in the level of these molecules was detected in postmenopausal women with CAD and not receiving ERT. cCAMs also showed a statistically increase in premenopausal women with CAD and control postmenopausal women with CAD receiving ERT when compared with premenopausal control group. Serum E2 levels showed statistically significant decrease in postmenopausal women than in the premenopausal control group.ERT was associated with a significant decrease in serum levels of cCAMs. Serum E2 levels also showed significant negative correlations with cICAM-1, cVCAM-1 and cE-selectin. In conclusion, the results of the present study revealed that E2 has a cardio protective effect that is mediated in part by limiting the inflammatory response to injury by modulating the expression of CAMs from the endothelium and this and this means that ERT may reduce the risk of CAD in postmenopausal women.
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