Prolactin and Autoimmunity.
Prolactin and Autoimmunity.
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DOI：
10.3389/fimmu.2018.00073
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发表时间：
2018
影响因子：
7.3
通讯作者：
Shoenfeld Y
中科院分区：
文献类型：
--
作者：
Borba VV;Zandman-Goddard G;Shoenfeld Y
自身免疫性疾病在性别之间存在的巨大差异是自身免疫现象中最令人费解的观察结果之一。性激素被认为在这种两性差异中起着关键作用。育龄女性自身免疫性疾病患病率较高、孕期疾病发作/复发以及产后出现相关情况等都是支持这一假说的论据。当然，生育对免疫系统是最显著的挑战之一，免疫系统不仅要接纳胎儿，还必须应对复杂的内分泌变化。已知激素内稳态对形成一个有能力且健康的免疫系统具有关键影响。催乳素（PRL）具有作为激素和细胞因子的生物活性功能。它干扰免疫系统的调节，主要是抑制自身反应性B淋巴细胞的阴性选择。同样，高催乳素血症与几种自身免疫性疾病的发病机制和活动有关。多巴胺是催乳素分泌的有效抑制剂，这要么是由于对脑垂体的直接影响，要么是由于刺激了下丘脑中的突触后多巴胺受体，从而引起催乳素抑制因子的释放。因此，多巴胺激动剂已被证实在自身免疫性疾病患者中具有临床益处，是一种有待探索的有前景的治疗方法。在这篇综述中，我们试图对催乳素、自身免疫性疾病和生育之间的联系进行批判性综述。
The great asymmetry of autoimmune diseases between genders represents one of the most enigmatic observations among the mosaic of autoimmunity. Sex hormones are believed to play a crucial role on this dimorphism. The higher prevalence of autoimmunity among women at childbearing ages, disease onset/relapses during pregnancy, and post-partum are some of the arguments that support this hypothesis. Certainly, motherhood represents one of the most remarkable challenges for the immune system, which not only has to allow for the conceptus, but also has to deal with complex endocrine alterations. Hormonal homeostasis is known to exert a crucial influence in achieving a competent and healthy immune system. Prolactin (PRL) has a bioactive function acting as a hormone and a cytokine. It interferes with immune system modulation, mainly inhibiting the negative selection of autoreactive B lymphocytes. Likewise, hyperprolactinemia has been described in relation to the pathogenesis and activity of several autoimmune disorders. Dopamine is an effective inhibitor of PRL secretion due to either a direct influence on the hypophysis or stimulation of postsynaptic dopamine receptors in the hypothalamus, arousing the release of the PRL inhibitory factor. Hence, dopamine agonists have proven to offer clinical benefits among autoimmune patients and represent a promising therapy to be explored. In this review, we attempt to provide a critical overview of the link between PRL, autoimmune diseases, and motherhood.