Androgens and estrogens modulate the immune and inflammatory responses in rheumatoid arthritis
Androgens and estrogens modulate the immune and inflammatory responses in rheumatoid arthritis
复制标题
DOI：
10.1111/j.1749-6632.2002.tb04210.x
复制
发表时间：
2002-01-01
期刊：
影响因子：
--
通讯作者：
Sulli, A
中科院分区：
文献类型：
--
作者：
Cutolo, M;Seriolo, B;Sulli, A
一般来说，雄激素对不道德免疫反应和细胞免疫反应都有抑制作用，似乎代表着天然的抗炎激素；相反，雌激素具有免疫增强活性，至少对体液免疫反应具有促进作用。在男性和女性类风湿关节炎患者的体液(即血液、滑液、涂片、唾液)中都检测到低水平的性腺雄激素(睾酮/双氢睾酮)和肾上腺雄激素(脱氢表雄酮及其硫酸盐)，以及较低的雄激素/雌激素比率，这支持了免疫抑制雄激素水平下降的致病作用的可能性。一些生理、病理和治疗条件可能会改变性激素环境和/或外周转换，包括月经周期、妊娠、产后、更年期、慢性应激和炎性细胞因子，以及皮质类固醇、口服避孕药和类固醇激素替代品的使用，导致雄激素/雌激素比率改变和相关影响。因此，性激素平衡仍然是调节免疫和炎症反应的关键因素，这种平衡的治疗调节应该是类风湿性关节炎和其他自身免疫性风湿病先进生物治疗的一部分。
Generally, androgens exert suppressive effects on both Immoral and cellular immune responses and seem to represent natural anti-inflammatory hormones; in contrast, estrogens exert immunoenhancing activities, at least on humoral immune response. Low levels of gonadal androgens (testosterone/dihydrotestosterone) and adrenal androgens (dehydroepiandrosterone and its sulfate), as well as lower androgen/estrogen ratios, have been detected in body fluids (that is, blood, synovial fluid, smears, salivary) of both male and female rheumatoid arthritis patients, supporting the possibility of a pathogenic role for the decreased levels of the immune-suppressive androgens. Several physiological, pathological, and therapeutic conditions may change the sex hormone milieu and/or peripheral conversion, including the menstrual cycle, pregnancy, the postpartum period, menopause, chronic stress, and inflammatory cytokines, as well as use of corticosteroids, oral contraceptives, and steroid hormonal replacements, inducing altered androgen/estrogen ratios and related effects. Therefore, sex hormone balance is still a crucial factor in the regulation of immune and inflammatory responses, and the therapeutical modulation of this balance should represent part of advanced biological treatments for rheumatoid arthritis and other autoimmune rheumatic diseases.