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Hormônios Sexuais e Autoimunidade
| Article Title: |
The connective tissue diseases and the
overall influenceof gender. |
| Article Source: |
Int J Fertil Menopausal Stud 1996
Mar-Apr;41(2):156-65 |
| Author(s): |
Lahita RG |
| Abstract: |
The autoimmune diseases are more common in
women than men.The actual prevalence ranges from the high of 10 to 15
females for eachmale for systemic lupus erythematosus to four females
for every male with rheumatoid arthritis.
Though these diseases are found in the veryyoung and the aged, the high
prevalence is observed after puberty in mostpatients. These diseases
vary with regard to severity, and most investigators suspect that the
signs and symptoms of these diseases vary with menstrual cycle and
change severity during pregnancy. The collagen diseases are
devastatingto the health of young women. Rheumatoid arthritis occurring ata mean age of
40 years results in debilitating erosive changes in bonewith morning
stiffness and eventual crippling. Systemic lupus erythematosus,
Sjogren's syndrome and others, common to women of the childbearing
years,act in several ways to destroy organ systems of the body.
Virtually anyorgan system of the female anatomy can be affected by
these illnesses.In the case of lupus, the disease has protean
manifestations, such as procoagulation, renal destruction, skin
disease, unrelenting arthropathy and arthritis,and
encephalopathy (to name only a few). The underlying mechanisms arenot
known; however, the immune system acts to destroy tissue via
immunecomplex deposition and through the action of cytotoxic lymphocyte
activity.There is an association of both clinical signs and
autoantibody subpopulationswith markers of the HLA-D or MHC II locus on
chromosome 6. No constitutivegene for any of the collagen vascular
diseases has been identified in the human. Evidence exists to support
an altered metabolism of estrogens andandrogens in patients with these
diseases. Recent data also indicate that increased estrogen levels
might initiate autoimmune diseases in many womenand men. Estrogen
hydroxylation is increased in both men and women with autoimmune
diseases like lupus. The mechanisms are unknown, although
estrogenicmetabolites have been shown to increase B cell
differentiation and activateT cells. Moreover, isolated cases of
hyperprolactinemia have been observedin association with these
hyperestrogenic states, and treatment of hyperprolactinemiahas been
shown to ameliorate diseases like lupus. Androgen oxidation isalso
increased in patients with autoimmune disease, but this abnormalityhas
been observed only in patients with lupus, and only women at that.The
result is that women with autoimmune diseases like lupus and rheumatoid arthritis have lower plasma androgens
than control cases. These data have supported the use of weak
androgens, e.g., DHEA,
for thetreatment of lupus. |
| Author's Address: |
Division of Rheumatology and Connective
Tissue Diseases,Roosevelt/St. Lukes Medical Center, New York, New York,
USA. |
Copyright © 1996 AriesSystems Corporation, 200
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Reserved
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