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

• Published in: Annals of vascular surgery Vol. 29; no. 4; pp. 830 - 835
• Main Authors: Silhol, François, Sarlon-Bartoli, Gabrielle, Daniel, Laurent, Bartoli, Jean Michel, Cohen, Serge, Lepidi, Hubert, Piquet, Philippe, Bartoli, Michel Alain, Vaïsse, Bernard
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01-05-2015; Elsevier Masson
• Subjects: Adult; Bioengineering; Case-Control Studies; Cell Nucleus - chemistry; Cell Nucleus - pathology; Female; Fibromuscular Dysplasia - metabolism; Fibromuscular Dysplasia - pathology; Fibromuscular Dysplasia - surgery; Humans; Immunohistochemistry; Life Sciences; Male; Middle Aged; Muscle, Smooth, Vascular - chemistry; Muscle, Smooth, Vascular - pathology; Muscle, Smooth, Vascular - surgery; Myocytes, Smooth Muscle - chemistry; Myocytes, Smooth Muscle - pathology; Pilot Projects; Receptors, Progesterone - analysis; Renal Artery - chemistry; Renal Artery - pathology; Surgery; Immunohistochemistry; Humans; Middle Aged; Fibromuscular Dysplasia; Male; Vascular; Myocytes; Smooth Muscle; Case-Control Studies; Renal Artery; Pilot Projects; Receptors; Smooth; Adult; Female; Muscle; Progesterone; Cell Nucleus
• ISSN: 0890-5096; 1615-5947
• DOI: 10.1016/j.avsg.2014.10.025

Background The pathogenesis of fibromuscular dysplasia (FMD) remains poorly understood. Yet, understanding this mechanism has taken on new urgency after recent evidence indicating that FMD is not as rare as previously thought. We speculated that hormonal receptors in the walls of dysplastic renal arteries were implicated in the pathogenesis of FMD. Methods We undertook a pilot prospective case–control study comparing histologic findings from renal arteries that were surgically removed in 2 patient groups. The case group included 6 samples from FMD patients who underwent surgery for stenosis or aneurysm caused by FMD. The control group included 3 FMD-free patients who underwent nephrectomy for nonvascular causes. Surgical specimens were sent to the histology laboratory. FMD was defined preoperatively using conventional radiologic criteria and was confirmed by histologic examination. Results Immunohistochemical staining detected intense progesterone receptor expression in the nuclei of smooth muscle cells in FMD patients. No progesterone receptor expression was found in the FMD-free patients. Estrogen receptor expression was not noted in the 2 groups. Conclusions This preliminary finding may suggest that progesterone plays a key role in the pathogenesis of FMD and opens the fields of genetic and therapeutic approaches.