Vascular Health and Gender-Affirming Hormone Therapy: The Immune System in Motion.

IF 8.8 1区医学 Q1 HEMATOLOGY

Arteriosclerosis, Thrombosis, and Vascular Biology Pub Date : 2026-09-01 Epub Date: 2026-07-09 DOI:10.1161/ATVBAHA.125.322093

Jeimison D Santos, Jefferson Elias-Oliveira, Ualter G Cipriano, Pedro Vargas-Pinilla, Daniela Carlos, Vania L D Bonato, Rita C Tostes

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引用次数: 0

Abstract

Given that fluctuations in sex hormone levels greatly influence cardiovascular homeostasis, this review addresses how gender-affirming hormone therapy impacts vascular function and the immune system, and how these effects may contribute to altered cardiovascular performance in transgender individuals. Gender-affirming hormone therapy alters leukocyte activation and cytokine secretion, that may impact vascular responsiveness, with distinct effects in feminizing and masculinizing regimens. Moreover, gender-affirming hormone therapy-induced changes in the gut microbiome and body composition, together with factors such as sex chromosomes, and environmental stressors may further modulate inflammatory states with potential consequences for cardiovascular health. This review also discusses factors that limit current research, contributing to inconsistent findings and persistent gaps in understanding the cardiovascular and immunologic effects of gender-affirming hormone therapy, along with directions for future studies. Although available data remain limited, understanding these interconnections is essential for optimizing therapeutic strategies, improving cardiovascular health, and fostering more inclusive clinical practices for the transgender community.

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血管健康和性别确认激素治疗：运动中的免疫系统。

鉴于性激素水平的波动极大地影响心血管稳态，本综述探讨了性别肯定激素治疗如何影响血管功能和免疫系统，以及这些影响如何导致变性人心血管功能的改变。性别确认激素治疗改变白细胞活化和细胞因子分泌，这可能影响血管反应性，在女性化和男性化方案中具有明显的效果。此外，性别确认激素治疗引起的肠道微生物组和身体组成的变化，以及性染色体等因素和环境压力源可能进一步调节炎症状态，从而对心血管健康产生潜在影响。本综述还讨论了限制当前研究的因素，这些因素导致研究结果不一致，在理解性别肯定激素治疗的心血管和免疫效应方面存在持续的差距，以及未来研究的方向。尽管可用的数据仍然有限，但了解这些相互关系对于优化治疗策略、改善心血管健康和促进跨性别社区更具包容性的临床实践至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arteriosclerosis, Thrombosis, and Vascular Biology 医学-外周血管病

CiteScore

15.60

自引率

2.30%

发文量

337

审稿时长

2-4 weeks

期刊介绍： The journal "Arteriosclerosis, Thrombosis, and Vascular Biology" (ATVB) is a scientific publication that focuses on the fields of vascular biology, atherosclerosis, and thrombosis. It is a peer-reviewed journal that publishes original research articles, reviews, and other scholarly content related to these areas. The journal is published by the American Heart Association (AHA) and the American Stroke Association (ASA). The journal was published bi-monthly until January 1992, after which it transitioned to a monthly publication schedule. The journal is aimed at a professional audience, including academic cardiologists, vascular biologists, physiologists, pharmacologists and hematologists.