The immunomodulatory effects of estrogens: Clinical relevance in immune-mediated rheumatic diseases: Annals of the New York Academy of Sciences

Maurizio Cutolo, Renata Brizzolara, Fabiola Atzeni, Silvia Capellino, Rainer H. Straub, Pier Carlo Sarzi Puttini

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Immunological, epidemiological, and clinical evidence suggest that female sex hormones play an important role in the etiology and pathophysiology of chronic immune/inflammatory diseases. Several significant factors generate confusion and opposite conclusions in evaluating the role of estrogens in these diseases, including relatively superficial translational studies from animals to the human condition, the different effects of estrogens on their different receptors or on different target cells, the different estrogen concentrations employed, and opposite effects (especially on cell proliferation) exerted by different peripheral estrogen metabolites. A preponderance of 16α-hydroxylated estrogens, as observed in rheumatoid arthritis synovial fluids, is an unfavorable sign in synovial inflammation. Since 17β-estradiol administered during hormone replacement therapy will rapidly increase estrone sulfate after conversion in adipose tissue by aromatases, hormone replacement therapy can have proinflammatory effects by providing estrone sulfate to the inflamed synovial tissue. In addition, it appears that the use of combined oral contraceptives is associated with an increased risk of at least systemic lupus erythematosus. In conclusion, estrogens are generally considered as enhancers of cell proliferation and humoral immune response.

Original languageEnglish
Title of host publicationAnnals of the New York Academy of Sciences
Pages36-42
Number of pages7
Volume1193
DOIs
Publication statusPublished - Apr 2010

Publication series

NameAnnals of the New York Academy of Sciences
Volume1193
ISSN (Print)00778923
ISSN (Electronic)17496632

Keywords

  • Aromatase
  • Autoimmune rheumatic diseases
  • Estrogens
  • Rheumatoid arthritis
  • Sex hormones
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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