Styrt B, Sugarman B
Department of Medicine, Michigan State University, East Lansing 48824.
Rev Infect Dis. 1991 Nov-Dec;13(6):1139-50. doi: 10.1093/clinids/13.6.1139.
The multiple effects of estrogens on infectious processes are only beginning to be understood. The existence of such effects is suggested by gender-related differences in the incidence and severity of some infections and by the association of certain infections with predictable hormonal changes. Current information indicates that estrogens may depress cell-mediated immunity, impair the activity of natural killer cells, and suppress some aspects of neutrophil function. Estrogens potentiate the production of systemic antibody, but local antibody responses may be impaired. Direct effects of estrogens on microorganisms have thus far been best studied in fungi; these hormones may either stimulate or suppress fungal virulence, depending on the species involved. Recent research also suggests responsiveness to estrogens in a wider variety of microorganisms. Studies in cell culture, animals, and humans indicate that pregnancy, estrogen supplementation, and menstrual stage can affect the acquisition and severity of certain bacterial, parasitic, and viral infections. This interaction depends on multiple attributes of both the microbe and the host in a given setting and thus may lead to disparate outcomes; however, there appears to be a predisposition to increased infectious morbidity in certain high-estrogen states. In view of the widespread use of estrogen supplementation, the clinical impact of estrogens on the incidence and outcome of infection needs to be better defined.
雌激素对感染过程的多种影响才刚刚开始被了解。某些感染的发病率和严重程度存在与性别相关的差异，以及某些感染与可预测的激素变化之间的关联，提示了这种影响的存在。目前的信息表明，雌激素可能会抑制细胞介导的免疫、损害自然杀伤细胞的活性，并抑制中性粒细胞功能的某些方面。雌激素会增强全身抗体的产生，但局部抗体反应可能会受到损害。迄今为止，雌激素对微生物的直接影响在真菌中研究得最为充分；这些激素可能会刺激或抑制真菌的毒力，具体取决于所涉及的真菌种类。最近的研究还表明，多种微生物对雌激素有反应。细胞培养、动物和人体研究表明，怀孕、补充雌激素和月经周期会影响某些细菌、寄生虫和病毒感染的获得和严重程度。这种相互作用取决于特定环境中微生物和宿主的多种特性，因此可能导致不同的结果；然而，在某些高雌激素状态下，似乎更容易出现感染发病率增加的情况。鉴于雌激素补充剂的广泛使用，雌激素对感染发病率和结局的临床影响需要得到更明确的界定。
