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The Role of Estradiol in Oxidative Stress in Health and Cystathionine ß-Synthase Deficiency: A Mechanistic Model.

Publication ,  Journal Article
Cruikshank, A; Nijhout, HF; Reed, MC
Published in: CPT: pharmacometrics & systems pharmacology
April 2026

Oxidative stress occurs when there is an imbalance between oxidants and antioxidants, leading to the accumulation of reactive oxygen species (ROS). Excessive ROS can damage lipids, proteins, and DNA, contributing to cellular dysfunction and disease. Interestingly, premenopausal females tend to have lower levels of oxidative stress and higher concentrations of certain antioxidants, such as glutathione (GSH), compared to males and postmenopausal females. These differences point to the important role of sex hormones in regulating oxidative stress and its effects on the body. Yet, clinical and experimental studies report conflicting effects of estradiol, particularly across the menstrual cycle in premenopausal females and in estradiol supplementation in postmenopausal females. Here, we present a mechanistic mathematical model of hydrogen peroxide (H2O2), a key ROS, that explicitly incorporates estradiol and progesterone regulation of key enzymes. Using this model, we elucidate the mechanisms underlying females' lower oxidative stress and provide an explanation for the seemingly contradictory clinical observations at both steady state and during the menstrual cycle. We further apply the model to examine sex differences in cystathionine β-synthase deficiency, explaining the attenuation of sex differences in key metabolites in the pathway. By connecting clinical observations with mathematical modeling, this work provides insights into the underlying mechanisms and paves the way for sex- and menopausal status-specific approaches in medicine and drug development.

Duke Scholars

Published In

CPT: pharmacometrics & systems pharmacology

DOI

EISSN

2163-8306

ISSN

2163-8306

Publication Date

April 2026

Volume

15

Issue

4

Start / End Page

e70243

Related Subject Headings

  • Sex Factors
  • Reactive Oxygen Species
  • Progesterone
  • Oxidative Stress
  • Models, Theoretical
  • Models, Biological
  • Menstrual Cycle
  • Male
  • Hydrogen Peroxide
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Cruikshank, A., Nijhout, H. F., & Reed, M. C. (2026). The Role of Estradiol in Oxidative Stress in Health and Cystathionine ß-Synthase Deficiency: A Mechanistic Model. CPT: Pharmacometrics & Systems Pharmacology, 15(4), e70243. https://doi.org/10.1002/psp4.70243
Cruikshank, Allison, H Frederik Nijhout, and Michael C. Reed. “The Role of Estradiol in Oxidative Stress in Health and Cystathionine ß-Synthase Deficiency: A Mechanistic Model.CPT: Pharmacometrics & Systems Pharmacology 15, no. 4 (April 2026): e70243. https://doi.org/10.1002/psp4.70243.
Cruikshank A, Nijhout HF, Reed MC. The Role of Estradiol in Oxidative Stress in Health and Cystathionine ß-Synthase Deficiency: A Mechanistic Model. CPT: pharmacometrics & systems pharmacology. 2026 Apr;15(4):e70243.
Cruikshank, Allison, et al. “The Role of Estradiol in Oxidative Stress in Health and Cystathionine ß-Synthase Deficiency: A Mechanistic Model.CPT: Pharmacometrics & Systems Pharmacology, vol. 15, no. 4, Apr. 2026, p. e70243. Epmc, doi:10.1002/psp4.70243.
Cruikshank A, Nijhout HF, Reed MC. The Role of Estradiol in Oxidative Stress in Health and Cystathionine ß-Synthase Deficiency: A Mechanistic Model. CPT: pharmacometrics & systems pharmacology. 2026 Apr;15(4):e70243.
Journal cover image

Published In

CPT: pharmacometrics & systems pharmacology

DOI

EISSN

2163-8306

ISSN

2163-8306

Publication Date

April 2026

Volume

15

Issue

4

Start / End Page

e70243

Related Subject Headings

  • Sex Factors
  • Reactive Oxygen Species
  • Progesterone
  • Oxidative Stress
  • Models, Theoretical
  • Models, Biological
  • Menstrual Cycle
  • Male
  • Hydrogen Peroxide
  • Humans