Autoimmune diseases: Role of steroid hormones

Publication date: Available online 16 March 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Marisa Benagiano, Paola Bianchi, Mario Milco D’Elios, Ivo Brosens, Giuseppe BenagianoAbstractAutoimmune disorders (AIDs) are a heterogeneous group of diseases in terms of clinical manifestations, pathogenesis, and prevalence and there is yet no agreement to date on a common classification.Adaptive immune responses are responsible for the existence of AIDs, although innate immunity is also involved in misguiding the immune response against self-antigens.Hormones in general, and specifically steroid hormones, play a critical role in the physiology and pathology of the immune system and in particular in adaptive immunity. Hormonal factors, alone or in relation to age, sex, and reproductive status, are involved in conditioning the onset of a number of AIDs. There is a well-defined sexual dimorphism for human auto-immune diseases.At the same time, the classic view has been that steroid hormones have well-defined effects, with one type, oestrogens, being “pro-inflammatory” and the other two progestogens (progesterone and its synthetic analogues) and androgens, being “anti-inflammatory”.Although, this view has been considered too simplistic and seems contradicted by numerous observations, it is still basically valid: progestogens and androgens are immunosuppressive and therefore protective against AIDs, whereas oestrogens are immune-stimulatory and t...

Source: Best Practice and Research Clinical Obstetrics and Gynaecology - March 16, 2019 Category: OBGYN Source Type: research