RESEARCH - Androgens and estrogens modulate the immune and inflammatory responses in RA

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Ann N Y Acad Sci. 2002 Jun;966:131-42.

Androgens and estrogens modulate the immune and inflammatory responses in

rheumatoid arthritis.

Laboratory and Division of Rheumatology, Department of Internal Medicine and

Medical Specialities, University of Genova, Genova, Italy. mcutolo@...

Generally, androgens exert suppressive effects on both humoral 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.

PMID: 12114267

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=12114267

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