Estrogen and testosterone therapies in multiple sclerosis.
Estrogen and testosterone therapies in multiple sclerosis.
复制标题
DOI：
10.1016/s0079-6123(09)17516-7
复制
发表时间：
2009
影响因子：
--
通讯作者：
Voskuhl, Rhonda R.
中科院分区：
文献类型：
--
作者：
Gold, Stefan M.;Voskuhl, Rhonda R.
关键词：
几十年来，人们已经知道女性更容易患上炎症性自身免疫性疾病，包括多发性硬化症（MS）、类风湿性关节炎和银屑病。此外，患有这些疾病的女性患者在怀孕期间经历临床改善，产后暂时“反弹”恶化。这些临床观察表明，性激素对疾病的影响表明，男性激素睾酮和妊娠激素雌三醇，分别用于治疗MS的潜在用途。越来越多的研究使用MS动物模型实验性自身免疫性脑脊髓炎（EAE）支持这些激素的治疗效果。睾酮和雌三醇都被发现具有抗炎和神经保护作用。最近两项关于男性MS患者经皮睾酮和女性MS患者口服雌三醇的初步研究结果支持这些激素的治疗潜力。在本文中，我们回顾性激素治疗MS的临床前和临床证据，并讨论潜在的作用机制。
It has been known for decades that females are more susceptible to inflammatory autoimmune diseases including multiple sclerosis (MS), rheumatoid arthritis, and psoriasis. In addition, female patients with these diseases experience clinical improvements during pregnancy with a temporary ‘rebound’ exacerbation post partum. These clinical observations suggest an effect of sex hormones on disease suggest potential use of the male hormone testosterone and the pregnancy hormone estriol, respectively, for treatment of MS. A growing number of studies using the MS animal model experimental autoimmune encephalomyelitis (EAE) support a therapeutic effect of these hormones. Both testosterone and estriol have been found to induce anti-inflammatory as well as neuroprotective effects. Findings from two recent pilot studies of transdermal testosterone in male MS patients and oral estriol in female MS patients support the therapeutic potential of these hormones. In this paper, we review the pre-clinical and clinical evidence for sex hormone treatments in MS and discuss potential mechanisms of action.