Estradiol 17β inhibition of LDL oxidation and endothelial cell cytotoxicity is opposed by progestins to different degrees

Progestins oppose the effects of estrogens in many biological systems, but it is not known if progestins oppose the antioxidant effects of estrogen and to differing degrees. To test these questions, the effects of various sex steroids on LDL oxidation and cytotoxicity were studied in the absence or presence of endothelial cells. Freshly isolated LDL was incubated in the presence of Cuff in the absence or presence of cultured bovine aortic endothelial cells in phenol rid-free medium and without or with hormones in 0.5% ethanol. The hormones included 17 beta-estradiol (E-2), progesterone (Pg), norgestimate (NGM), levonorgestrel (LNG), and medroxyprogesterone acetate (MPA). LDL oxidation was measured as formation of conjugated dienes, lipid peroxides, and TEARS, and cyotoxicity by tetrazolium salt reduction (MTT reduction). Progestins diminished conjugated diene lag phase, accelerated lipid peroxide and TEARS production in the absence and presence of cells and accelerated cytotoxicity. When E-2 and progestin were incubated with cells at a molar ratio of 1:5, lipid peroxides were reduced from baseline by E-2 alone 31%, E-2/Pg 29%, E-2/NGM 16%, E-2/LNG 9% (all P < 0.05 or more) and E-2/MPA 8% (ns) (E-2 or E-2/Pg > E-2/NGM, E-2/LNG and E-2/MPA [P < 0.001]; E-2/NGM > E-2/LNG or E-2/MPA [P < 0.05]). MTT reduction followed a similar gradient, greatest with E-2 alone, least with E-2/MPA. Conclusions: Progestins promote LDL oxidation and, conjointly, endothelial cell cytotoxicity. Progestins oppose the antioxidant and cytoprotective effects of estrogen when given in combination. MPA and LNG have the strongest prooxidant and cytotoxic effects, which may limit the cardiovascular benefit of estrogen during combined administration in vivo. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.