INFLUENCE OF TESTOSTERONE THERAPY ON CLINICAL AND IMMUNOLOGICAL FEATURES OF AUTOIMMUNE-DISEASES ASSOCIATED WITH KLINEFELTERS-SYNDROME
INFLUENCE OF TESTOSTERONE THERAPY ON CLINICAL AND IMMUNOLOGICAL FEATURES OF AUTOIMMUNE-DISEASES ASSOCIATED WITH KLINEFELTERS-SYNDROME
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DOI：
10.1210/jcem-64-1-32
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发表时间：
1987-01-01
影响因子：
5.8
通讯作者：
IACONO, G
中科院分区：
文献类型：
--
作者：
BIZZARRO, A;VALENTINI, G;IACONO, G
为了探讨性类固醇激素在自身免疫性疾病发展中的作用，我们研究了5例与自身免疫性疾病相关的Klinefelter综合征患者，其中3例患有干燥综合征（SS）， 2例患有系统性红斑狼疮（SLE）。在治疗前、安慰剂治疗60天后、口服十烷酸T （TU）治疗60天后，分别测定血清睾酮(T)和LH水平、抗核抗体（ANA）和类风湿因子（RF）滴度、红细胞沉降率（ESR）、溶血性补体（CH50）水平和外周血T淋巴细胞亚群（OKT3+、OKT4+和OKT8+）。在治疗前和安慰剂治疗后，与正常男性相比，患者血清T水平较低，LH水平较高，OKT3+（总T淋巴细胞）和OKT8+（抑制/细胞毒性T淋巴细胞）细胞的百分比和绝对值较低，因此OKT4/OKT8比值升高。2例SLE患者血清溶血补体（CH50）低于正常，SS患者血清溶血补体（CH50）正常，ESR均高于正常，且ANA和RF均高滴度。经TU治疗后，血清T水平升高，LH水平下降，但未达到正常水平。OKT3+、OKT8+细胞及OKT4/OKT8+比值恢复正常，RF、ANA滴度下降。SS患者CH50水平无变化，而2例SLE患者CH50水平升高至正常。所有患者在治疗期间ESR均下降。此外，在TU治疗后，SS和SLE患者的自身免疫性疾病均有临床缓解。我们的研究结果表明T对性腺功能减退和Klinefelter综合征患者的自身免疫性疾病有治疗作用。
To examine the role of sex steroid hormones in the development of autoimmune diseases, we studied five patients with Klinefelter''s syndrome associated with autoimmune disease, three of whom had Sjogren''s syndrome (SS) and two of whom had systemic lupus erythematosus (SLE). Serum testosterone (T) and LH levels, antinuclear antibodies (ANA) and rheumatoid factor (RF) titers, erythrocyte sedimentation rate (ESR), hemolytic complement (CH50) levels, and peripheral T lymphocyte subsets (OKT3+, OKT4+, and OKT8+) were measured before treatment, after 60 days of placebo treatment, and after 60 days or oral T undecanoate (TU) treatment. Before treatment and after placebo, with respect to normal men, the patients had lower serum T and higher LH levels, lower percentages and absolute values of OKT3+ (total T lymphocytes) and OKT8+ (suppressor/cytotoxic T lymphocytes) cells, and, consequently, an increased OKT4/OKT8 ratio. Hemolytic complement (CH50) in serum was below normal in the two patients with SLE, while it was normal in the patients with SS. The ESR was above normal in all patients, and all had high titers of ANA and RF. After TU therapy, serum T levels increased and LH levels decreased, but not to normal. OKT3+ and OKT8+ cells and the OKT4/OKT8+ ratio became normal, and RF and ANA titers decreased. The CH50 level did not change in the SS patients, while it increased to normal in the two patients with SLE. The ESR decreased in all patients during therapy. Furthermore, after TU therapy, both the SS and SLE patients had a clinical remission of their autoimmune disease. Our results indicate a therapeutic effect of T on autoimmune diseases in patients with hypogonadism and Klinefelter''s syndrome.