Christgau S, Cloos P A C
Osteologix A/S, Symbion Science Park, Fruebjergvei 3, DK-2100 Copenhagen, Denmark.
Minerva Ginecol. 2005 Dec;57(6):611-7.
The effects of estrogen on tissues such as bone, endometrium and breast have been extensively studied, and the pleitropic effects of the female sex hormone are well established. Cartilage is not generally viewed as an estrogen responsive tissue. However, several epidemiological studies, and a few recent intervention studies supports that estrogen may have a role in osteoarthritis (OA), and recent animal studies further suggests that estrogen may be involved in regulation of cartilage turnover. Accordingly the issue of chondroprotrective properties of estrogen has received increased attention in recent scientific publications. In this review, we summarize current studies indicating a role for estrogen in the regulation of cartilage turnover and development of joint diseases. We report results from in vitro and animal studies where the effects of ovariectomy and treatment with estrogen and selective estrogen receptor modulators (SERM) on cartilage erosion have been evaluated. Furthermore, we report results from assessment of the effects of estrogen and SERM in postmenopausal women which shed new light on the interactions between estrogen and joint tissues. It still remains to be established whether estrogen or SERM could find a role in prophylaxis and/or treatment of OA, and much work lies ahead. Current data reviewed in this manuscript can be considered encouraging and they raise the hope that new treatment options for OA may become available based on estrogen and, in particular, compounds acting through the estrogen receptor. However, at present hormone replacement therapy and SERMs available in clinical practice, cannot be recommended as a therapy for arthritic disease.
雌激素对骨骼、子宫内膜和乳腺等组织的影响已得到广泛研究，这种女性性激素的多效性作用也已得到充分证实。软骨通常不被视为对雌激素有反应的组织。然而，多项流行病学研究以及最近的一些干预性研究表明，雌激素可能在骨关节炎（OA）中发挥作用，并且最近的动物研究进一步表明，雌激素可能参与软骨更新的调节。因此，雌激素的软骨保护特性问题在最近的科学出版物中受到了越来越多的关注。在这篇综述中，我们总结了当前表明雌激素在软骨更新调节和关节疾病发展中发挥作用的研究。我们报告了体外和动物研究的结果，其中评估了卵巢切除术以及雌激素和选择性雌激素受体调节剂（SERM）治疗对软骨侵蚀的影响。此外，我们报告了对绝经后女性中雌激素和SERM作用评估的结果，这些结果为雌激素与关节组织之间的相互作用提供了新的线索。雌激素或SERM是否能在OA的预防和/或治疗中发挥作用仍有待确定，还有很多工作要做。本手稿中综述的当前数据可被视为令人鼓舞的，它们带来了希望，即基于雌激素，特别是通过雌激素受体起作用的化合物，可能会有针对OA的新治疗选择。然而，目前临床实践中可用的激素替代疗法和SERM不能被推荐用于治疗关节炎疾病。
