Review article

Sex hormones, immune disorders, and inflammatory rheumatic diseases

Dušanka Martinović Kaliterna ; Clinical Department for Rheumatology and Immunology, Clinic for Internal Medicine, Clinical Hospital Centre Split, Split, Croatia
Dijana Perković ; Clinical Department for Rheumatology and Immunology, Clinic for Internal Medicine, Clinical Hospital Centre Split, Split, Croatia
Mislav Radić ; Clinical Department for Rheumatology and Immunology, Clinic for Internal Medicine, Clinical Hospital Centre Split, Split, Croatia
Daniela Marasović Krstulović ; Clinical Department for Rheumatology and Immunology, Clinic for Internal Medicine, Clinical Hospital Centre Split, Split, Croatia
Katarina Borić ; Clinical Department for Rheumatology and Immunology, Clinic for Internal Medicine, Clinical Hospital Centre Split, Split, Croatia
Ivanka Marinović ; Department for Physical Medicine and Rehabilitation with Rheumatology, Clinical Hospital Centre Split, Split, Croatia

Abstract

It is a well-documented fact that sex hormones are implicated in the immune response and that androgens and estrogens modulate susceptibility and progression of autoimmune rheumatic diseases. Estrogens are considered to stimulate cell proliferation and humoral immune responses while androgens exert suppressive effects on both humoral and cellular immune responses. Autoimmune diseases are common in females, especially during the generative period, the most representative of estrogen-related autoimmune diseases being systemic lupus erythematosus. Estrogens and androgens are involved in the pathogenesis of the disease; both exogenous and endogenous estrogens are strong stimulators of cytokine production and disease activity. Some physiological conditions, as well as some drugs and chronic stress, can modulate hormone levels. Low levels of gonadal androgens have been detected in body fluids of both male and female rheumatoid arthritis patients, supporting the possibility of the pathogenic role for decreased androgen levels. Views on hormone replacement therapy or hormonal contraception in rheumatic diseases have been modified and in most rheumatic diseases, including rheumatoid arthritis, hormones are not prohibited. There are still controversies regarding systemic lupus; the new standpoint being that hormonal contraception is not contraindicated in women with inactive or stable active SLE, except for those with positive antiphospholipid antibodies.

Keywords

estrogens; androgens; immune response; autoimmune diseases; hormonal therapy

Hrčak ID:

137773

URI

https://hrcak.srce.hr/137773

Publication date:

30.9.2014.

Article data in other languages: croatian

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