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雷洛昔芬和激素替代疗法对健康绝经后妇女血清Th2和Th3型细胞因子浓度的影响:一项随机对照试验。

Effects of raloxifene and hormone replacement therapy on serum Th2 and Th3 type cytokine concentrations in healthy postmenopausal women: a randomised controlled trial.

作者信息

Kumru Selahattin, Yildiz Fahrettin M, Godekmerdan Ahmet, Kutlu Selim, Yilmaz Bayram, Gurates Bilgin

机构信息

Department of Obstetric and Gynecology, Firat University Medical School, 23 119 Elazig, Turkey.

出版信息

Arch Gynecol Obstet. 2008 Jun;277(6):489-93. doi: 10.1007/s00404-007-0521-3.

DOI:10.1007/s00404-007-0521-3
PMID:18066566
Abstract

BACKGROUND

Since sex hormones are reported to have important roles in the regulation of immune function, this study was designed to investigate the effects hormone replacement therapy (HRT) and raloxifene (RAL) on serum cytokine concentrations in healthy postmenopausal women.

METHODS

Fifty-three healthy postmenopausal women were randomly assigned and treated by RAL (Group I, [RAL 60 mg daily and continuously], n = 16), HRT (Group II, [2 mg estradiol valerat + 2 mg dienogest, continuously] n = 18) or placebo (Group III, n = 19). Two fasting morning blood samples were obtained from each participant before and 3 months after the treatments. Serum concentration of interleukin (IL)-4 (as a Th2 cytokine) and transforming growth factor-beta (TGF-beta)1 (as a Th3 cytokine), were measured by using commercially available enzyme-linked immunosorbent assay kits. Kruskal-Wallis analysis of variance, Mann-Whitney U, and Wilcoxon Signed-Ranks Tests were used as necessary.

RESULTS

At the beginning of the study, the chronological ages, menopausal ages, years of amenorrhea, weights, body mass indexes, and blood pressures were not significantly different between groups (P < 0.05). RAL treatment caused a significant decrease on serum IL-4 concentration (P < 0.001). Although HRT caused a 14% decrease in serum IL-4 concentration, this decrease was not statistically significant (P > 0.05). Serum TGF-beta1 concentrations were significantly decreased by HRT when compared to basal value (P < 0.001), and to control (P < 0.05). RAL treatment has no significant effect on serum TGF-beta1 concentration (P > 0.05).

CONCLUSION

It seems that RAL treatment might cause a decrease in serum IL-4 concentration while valerate plus dienogest treatment as HRT seems to cause a Th3 tendency in healthy postmenopausal women.

摘要

背景

由于据报道性激素在免疫功能调节中起重要作用,本研究旨在调查激素替代疗法(HRT)和雷洛昔芬(RAL)对健康绝经后女性血清细胞因子浓度的影响。

方法

53名健康绝经后女性被随机分组,分别接受RAL治疗(第一组,[每日持续服用60mg RAL],n = 16)、HRT治疗(第二组,[持续服用2mg戊酸雌二醇+2mg地诺孕素],n = 18)或安慰剂治疗(第三组,n = 19)。在治疗前和治疗3个月后,从每位参与者采集两份空腹晨间血样。使用市售酶联免疫吸附测定试剂盒测量血清白细胞介素(IL)-4(作为Th2细胞因子)和转化生长因子-β(TGF-β)1(作为Th3细胞因子)的浓度。必要时使用Kruskal-Wallis方差分析、Mann-Whitney U检验和Wilcoxon符号秩检验。

结果

在研究开始时,各组之间的实际年龄、绝经年龄、闭经年限、体重、体重指数和血压无显著差异(P < 0.05)。RAL治疗导致血清IL-4浓度显著降低(P < 0.001)。虽然HRT使血清IL-4浓度降低了14%,但这种降低无统计学意义(P > 0.05)。与基础值相比,HRT使血清TGF-β1浓度显著降低(P < 0.001),与对照组相比也显著降低(P < 0.05)。RAL治疗对血清TGF-β1浓度无显著影响(P > 0.05)。

结论

似乎RAL治疗可能会导致血清IL-4浓度降低,而戊酸雌二醇加地诺孕素作为HRT治疗似乎会使健康绝经后女性呈现Th3倾向。

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