Intranuclear Expression of Progesterone Receptors in Smooth Muscle Cells of Renovascular Fibromuscular Dysplasia: A Pilot Study

A Challenging Case of Fibromuscular Dysplasia in a Transgender Patient: Is There a Hormonal Link?

“… 8 Although of unknown aetiology, smoking and genetic factors have been linked with the disease, as well as an association with oestrogen exposure and increased numbers of progesterone receptors. 2 , 8 , 9 In this case report, although the patient was XY, it is suggested that there may be a link between gender re-assignment hormone therapy and the development of FMD. A literature search revealed no similar reported cases, but the number of gender reassignments is increasing and the levels of oestrogens in this population are typically many times the physiological normal in the XX population.…”

Progesterone receptor expression in fibromuscular dysplasia: A report of two unusual cases

“…[1,3,7] Therefore, ancillary studies may be useful to elucidate accurate diagnosis. In a recent study of Silhol et al, [10] nuclear PR positivity was observed in medial smooth muscle cells in all five cases. In accordance with this finding, herein, we present two unusual FMD cases in whom we performed immunohistochemical progesterone receptor (PR) staining and confirmed nuclear positivity in myofibroblasts and smooth muscle cells of the arterial wall.…”

“…Although genetic, hormonal, environmental, mechanical, and ischemic factors have been hypothesized in the etiopathogenesis, none of them has been clearly proven, yet. [6,8,10,[12][13][14] It has long been known that estrogen alpha-beta, progesterone and androgen receptors are expressed by vascular smooth muscle cells and intimal myofibroblasts. [6,8,10,15] Furthermore, it has been well-documented that abdominal aortic aneurysms and atherosclerosis affect males much more frequently than females, as estrogen alpha and beta receptors, and their messenger ribonucleic acid (mRNA) are upregulated in female arterial myocytes and myofibroblasts in contrary to male arterial myocytes and myofibroblasts in which androgen receptors and mRNA are upregulated.…”

“…[6,8,10,[12][13][14] It has long been known that estrogen alpha-beta, progesterone and androgen receptors are expressed by vascular smooth muscle cells and intimal myofibroblasts. [6,8,10,15] Furthermore, it has been well-documented that abdominal aortic aneurysms and atherosclerosis affect males much more frequently than females, as estrogen alpha and beta receptors, and their messenger ribonucleic acid (mRNA) are upregulated in female arterial myocytes and myofibroblasts in contrary to male arterial myocytes and myofibroblasts in which androgen receptors and mRNA are upregulated. [15][16][17][18][19] Apart from the investigations related to the etiopathogenesis of atherosclerosis and aortic aneurysms, concerning the role of sex hormone receptors in vascular diseases, recently nuclear PR positivity, has been shown in smooth muscle cells of media layer in five patients with renal FMD.…”

Epidemiology of fibromuscular dysplasia: A review of the literature

“…29 A recent 2015 case-control series published by Silhol and colleagues compared histologic findings from surgically removed renal arteries from six FMD patients (who underwent surgery for stenosis or aneurysm caused by FMD) and three controls (who underwent nephrectomy for non-vascular causes). 30 Immunohistochemical staining detected intense progesterone receptor expression in the nuclei of smooth muscle cells in the FMD patients, whereas no progesterone receptor expression was found in the control patients. There was no difference in estrogen receptor expression between the groups.…”