Da Silva J A
Serviço de Medicina III e Reumatologia, Hospitais da Universidade de Coimbra, Portugal.
Ann N Y Acad Sci. 1999 Jun 22;876:102-17; discussion 117-8. doi: 10.1111/j.1749-6632.1999.tb07628.x.
Gender and sex hormones exert powerful effects in the susceptibility and progression of numerous human and experimental autoimmune diseases. This has been attributed to direct immunological effects of sex hormones that impact a clear gender dimorphism on the immune system. Globally, estrogens depress T cell-dependent immune function and diseases, but enhance antibody production and aggravate B cell-dependent diseases. Androgens suppress both T-cell and B-cell immune responses and virtually always result in the suppression of disease expression. Defects in the hypothalamic-pituitary-adrenal (HPA) axis have been proposed to play an important role in the pathogenesis of autoimmune diseases. Glucocorticoid response to stress, including immune challenge, is strongly inhibited by androgens and enhanced by estrogens. Complex three-way interactions between these systems appear to be involved in gender dimorphism of the immune system. This paper reviews the mechanisms involved in interactions between sex steroids and the HPA axis, addresses the possibility of similar interactions on immunocompetent cells, and explores an integrated perspective of the impact of these interplays on the immune system.
性别和性激素在多种人类及实验性自身免疫性疾病的易感性和病情进展中发挥着强大作用。这归因于性激素的直接免疫效应，其对免疫系统产生明显的性别二态性影响。在全球范围内，雌激素会抑制T细胞依赖性免疫功能和疾病，但会增强抗体产生并加重B细胞依赖性疾病。雄激素会抑制T细胞和B细胞免疫反应，几乎总是导致疾病表达受到抑制。下丘脑 - 垂体 - 肾上腺（HPA）轴的缺陷被认为在自身免疫性疾病的发病机制中起重要作用。雄激素会强烈抑制糖皮质激素对应激（包括免疫挑战）的反应，而雌激素则会增强这种反应。这些系统之间复杂的三方相互作用似乎参与了免疫系统的性别二态性。本文综述了性类固醇与HPA轴之间相互作用的机制，探讨了免疫活性细胞上类似相互作用的可能性，并从综合角度探讨了这些相互作用对免疫系统的影响。
