{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T09:02:14Z","timestamp":1792227734516,"version":"4.4.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100004410","name":"Scientific and Technological Research Council of Turkey","doi-asserted-by":"publisher","award":["324S091"],"award-info":[{"award-number":["324S091"]}],"id":[{"id":"10.13039\/501100004410","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n Cytochrome P450 oxidoreductase deficiency (PORD) is a rare form of congenital adrenal hyperplasia caused by impaired electron transfer to multiple microsomal enzymes. Hypertension in PORD has been attributed to mineralocorticoid excess; however, experimental evidence suggests that POR may also regulate endothelial vasodilatory pathways. The vascular effects of PORD in humans remain poorly defined. We evaluated blood pressure regulation, microvascular structure, and serum vasoactive mediators in patients with PORD.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Observational, cross-sectional study.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Ten patients with genetically confirmed PORD (4 females, 6 males; age range 8-27 years) and 41 age- and sex-matched healthy controls were evaluated. Office and 24-hour ambulatory blood pressure monitoring (ABPM) were performed. Microvascular structure was assessed using nailfold capillaroscopy (NFC). Serum levels of thromboxane B\u2082 (TXB\u2082), prostaglandin E\u2082 (PGE\u2082), and nitric oxide (NO) were measured.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Hypertension was present in 80% of patients with PORD compared with 7.3% of controls (P &lt; .001). Office and ambulatory systolic and diastolic pressures were significantly higher in PORD. NFC revealed shorter capillary length (P = .001), more frequent crossed capillaries (P &lt; .001), and avascular areas (P = .039). Serum TXB\u2082 levels were higher in PORD (P = .007), whereas PGE\u2082 and NO did not differ between groups.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n PORD is associated with an increased prevalence of hypertension, microvascular capillary abnormalities, and elevated TXB\u2082, consistent with enhanced cyclooxygenase-mediated vasoconstrictor tone and endothelial dysfunction. These findings suggest that cyclooxygenase-dependent mechanisms may contribute to the vascular alterations observed in PORD.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ejendo\/lvag030","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T12:46:30Z","timestamp":1770986790000},"page":"264-274","source":"Crossref","is-referenced-by-count":1,"title":["Hemodynamic and microvascular abnormalities in P450 oxidoreductase deficiency: evidence for COX-dependent dysfunction"],"prefix":"10.1093","volume":"194","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7780-0231","authenticated-orcid":false,"given":"Ozge","family":"Bayrak Demirel","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul Faculty of Medicine, Istanbul University , Istanbul, 34093 ,","place":["T\u00fcrkiye"]},{"name":"Adolescent Health PhD Program, Institute of Graduate Studies in Health Sciences, Istanbul University , Istanbul, 34093 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