# Pro-Homeostatic Effects of Estrogen on Intraocular Pressure and the Trabecular Meshwork

**Authors:** Hannah A. Youngblood, Jingwen Cai, Jason Sun, Ola A. Elsayed, Hongfang Yu, Sylvia B. Smith, Hongyan Xu, Louis R. Pasquale, W. Daniel Stamer, Yutao Liu

PMC · DOI: 10.1167/iovs.67.3.16 · Investigative Ophthalmology & Visual Science · 2026-03-09

## TL;DR

Estrogen helps regulate eye pressure by supporting the trabecular meshwork, and its absence may increase glaucoma risk.

## Contribution

This study reveals that estrogen signaling ameliorates TGFβ2 effects on genes regulating intraocular pressure.

## Key findings

- Esr1−/− female mice had higher IOP compared to wild-type females.
- Estrogen reduced TGFβ2 effects on genes like NFATC1 and SMAD2.
- Mechanical stretch worsened TGFβ2 effects, but estrogen partially counteracted this.

## Abstract

Elevated intraocular pressure (IOP) results from the dysregulation of aqueous humor outflow through the mechanoresponsive trabecular meshwork (TM). Evidence suggests that low estrogen (E2) and high TGFβ2 levels are risk factors for elevated IOP and primary open-angle glaucoma. We sought to examine whether E2 signaling is involved in TM regulation of IOP homeostasis.

IOP and central cornea thickness were measured in male and female Esr1−/− mice and wild-type littermate controls from 3 to 12 months of age. Primary human TM cells (n = 10, 6 females and 4 males) were treated with TGFβ2 and/or E2 in the presence/absence of cyclic mechanical stretch (CMS) for 24 hours. Expression differences of 17 TGFβ2-responsive genes were assayed by quantitative RT-PCR.

Higher IOP was observed in Esr1−/− females compared to wild-type females (P < 0.05). Treatment with TGFβ2 and/or E2 significantly affected the expression of 10 genes (BMP1, CCN2, FST, GREM1, LAMC1, NFATC1, SERPINE1, SMAD2, SMAD3, and VCAN), with CMS exacerbating the effects of TGFβ2. The addition of E2 ameliorated the effects of TGFβ2 on two genes (NFATC1 and SMAD2) under static conditions and five genes (BMP1, FST, LAMC1, NFATC1, and SMAD2) under CMS.

These findings suggest that estrogen signaling promotes homeostatic TM regulation of IOP.

## Linked entities

- **Genes:** ESR1 (estrogen receptor 1) [NCBI Gene 2099], BMP1 (bone morphogenetic protein 1) [NCBI Gene 649], CCN2 (cellular communication network factor 2) [NCBI Gene 1490], FST (follistatin) [NCBI Gene 10468], GREM1 (gremlin 1, DAN family BMP antagonist) [NCBI Gene 26585], LAMC1 (laminin subunit gamma 1) [NCBI Gene 3915], NFATC1 (nuclear factor of activated T cells 1) [NCBI Gene 4772], SERPINE1 (serpin family E member 1) [NCBI Gene 5054], SMAD2 (SMAD family member 2) [NCBI Gene 4087], SMAD3 (SMAD family member 3) [NCBI Gene 4088], VCAN (versican) [NCBI Gene 1462]
- **Chemicals:** E2 (PubChem CID 5757)
- **Diseases:** primary open-angle glaucoma (MONDO:0005338)
- **Species:** Mus musculus (taxon 10090), Homo sapiens (taxon 9606)

## Full-text entities

- **Genes:** VCAN (versican) [NCBI Gene 1462] {aka CSPG2, ERVR, GHAP, PG-M, WGN, WGN1}, LAMC1 (laminin subunit gamma 1) [NCBI Gene 3915] {aka LAMB2}, CCN2 (cellular communication network factor 2) [NCBI Gene 1490] {aka CTGF, HCS24, IBP-8, IGFBP8, KMD, NOV2}, SMAD2 (SMAD family member 2) [NCBI Gene 4087] {aka CHTD8, JV18, JV18-1, LDS6, MADH2, MADR2}, TGFB2 (transforming growth factor beta 2) [NCBI Gene 7042] {aka CAEND2, G-TSF, LDS4, TGF-beta2}, GREM1 (gremlin 1, DAN family BMP antagonist) [NCBI Gene 26585] {aka C15DUPq, CKTSF1B1, CRAC1, CRCS4, DAND2, DRM}, BMP1 (bone morphogenetic protein 1) [NCBI Gene 649] {aka OI13, PCOLC, PCP, TLD}, NFATC1 (nuclear factor of activated T cells 1) [NCBI Gene 4772] {aka NF-ATC, NF-ATc1.2, NFAT2, NFATc}, ESR1 (estrogen receptor 1) [NCBI Gene 2099] {aka ER, ESR, ESRA, ESTRR, Era, NR3A1}, SERPINE1 (serpin family E member 1) [NCBI Gene 5054] {aka PAI, PAI-1, PAI1, PLANH1}, SMAD3 (SMAD family member 3) [NCBI Gene 4088] {aka HSPC193, HsT17436, JV15-2, LDS1C, LDS3, MADH3}
- **Diseases:** primary open-angle glaucoma (MESH:D005902)
- **Chemicals:** E2 (MESH:D004958)
- **Species:** Mus musculus (house mouse, species) [taxon 10090], Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12988677/full.md

## References

148 references — full list in the complete paper: https://tomesphere.com/paper/PMC12988677/full.md

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Source: https://tomesphere.com/paper/PMC12988677