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Cross sectional observational study with muscle biopsies Publication date verified at source

Aging is associated with altered estrogen receptor expression and alters redox protein balance in human female skeletal muscle

AI narration, generated on first listen
Journal
GeroScience
Authors
Tamariz-Ellemann A
Institution
University of Copenhagen
Published
7 August 2026
Source
PMID 42566157 · DOI 10.1007/s11357-026-02432-3
Design
Cross sectional observational study with skeletal muscle biopsies and Western blot quantification of estrogen receptor and redox related protein expression, compared across age, menopausal status and lifelong training.
Sample
Healthy women aged 19 to 70, including 26 lifelong trained postmenopausal women

What eNOS and NOX2 is

Estrogen receptors are docking proteins that let estrogen act inside muscle and blood vessel cells. eNOS is the enzyme that makes nitric oxide, which relaxes and widens vessels, while NOX2 generates reactive oxygen species that push the other way. Measuring them together shows which side of that balance the muscle is sitting on.

Drawn from the paper's introduction.

Why they ran it

The authors note it has been hypothesised that age related declines in skeletal muscle and vascular function in women may be partly estrogen dependent, but that human studies of estrogen receptor expression in muscle are very limited.

So they set out to map receptor expression against age, menopausal status and lifelong physical activity, and to see how it relates to proteins involved in redox regulation and vascular function.

Hypothesis They hypothesised that estrogen receptor alpha and GPER1 expression would decline with aging while estrogen receptor beta would increase, with these changes associated with impaired redox balance in older females.

Drawn from the paper's introduction.

Skeletal muscle biopsies were taken from 107 healthy women aged 19 to 70, including a subgroup of 26 postmenopausal women who had trained throughout their lives. The team quantified protein expression of estrogen receptor alpha, estrogen receptor beta and the G protein coupled estrogen receptor GPER1, alongside downstream proteins involved in redox regulation and vascular function.

Estrogen receptor alpha was 48 percent lower in women aged 55 and over than in those under 30. GPER1 was 22 percent lower across all older age groups. Estrogen receptor beta was reduced in mid life, between 45 and 59, but not in the oldest group. Both estrogen receptor alpha and beta correlated positively with endothelial nitric oxide synthase, the enzyme that makes the nitric oxide which relaxes blood vessels. GPER1 showed no such association.

Estrogen receptor beta was associated with NOX2, a pro-oxidant enzyme, which is the observation the authors build their interpretation on. The hypothesis going in had been that receptor alpha and GPER1 would fall with age while receptor beta would rise. The first part held and the second did not, since receptor beta fell in mid life and recovered in the oldest group.

The numbers

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Why this might happen

Proposed by the authors This is the explanation the authors offer in their discussion. This study did not test it.

The authors propose that aging shifts the balance between the two main estrogen receptors toward a more pro-oxidative muscle environment.

Their evidence for that is associational and within this dataset: receptor alpha tracked with antioxidant enzymes and with the nitric oxide producing enzyme, while receptor beta tracked with the pro-oxidant NOX2, which suggests the two receptors sit on different sides of redox regulation.

Drawn from the paper's discussion.

What this does not show

  • No oxidative stress was measured. The study quantifies the abundance of proteins involved in redox regulation. It does not measure reactive oxygen species, oxidative damage, or any functional redox outcome, so a shift in redox balance is inferred from protein levels rather than observed.
  • No muscle function was measured either. There is no strength, power or fatigue outcome. The link from these proteins to the age related decline in muscle and vascular function that motivated the study is assumed, not tested.
  • Being cross sectional, it cannot show that aging causes the change. Everyone was measured once. Younger and older women differ in far more than age, and no one was followed as they aged.
  • Protein abundance is not activity. The authors note they did not assess receptor sensitivity, cellular location or downstream signalling. A receptor can be present and quiet, or scarce and busy.
  • The oldest group was unusual. Twenty six of the participants were lifelong trained postmenopausal women, which is not a typical older population and blurs any clean read of age on its own.

Where this leaves us

It supports, with human data, an idea that had rested largely on animal work: that estrogen signalling in skeletal muscle declines with age in women and moves together with the proteins governing nitric oxide and oxidative balance.

Healthy women aged 19 to 70, with an older subgroup who had trained throughout their lives.

A study that adds functional oxidative stress and muscle function outcomes, and measures receptor activity rather than receptor abundance, which the authors themselves flag as the gap.

Caveats worth holding

  • Cross sectional snapshot rather than follow up over time.
  • Protein abundance only, with no functional oxidative or performance measure.
  • The oldest subgroup was lifelong trained, which is not representative of older women generally.
  • Correlational analysis across several protein targets, with the attendant multiple comparison risk.

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