Division of Pediatric Endocrinology, Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Ann N Y Acad Sci. 2014 May;1317:24-31. doi: 10.1111/nyas.12398. Epub 2014 Mar 28.
Sex hormones play an active role in inflammatory responses, with androgens being anti-inflammatory, whereas estrogens have both pro- and anti-inflammatory effects. In rheumatoid arthritis (RA) patients, low levels of androgens and high levels of estrone are found in the synovial fluid. Aromatase is the key enzyme for the conversion of androgens into estrogens. Proinflammatory cytokines stimulate aromatase activity so that the inflammatory milieu can induce conversion of androgens to estrogens. Moreover, testosterone inhibits aromatase activity. As local androgen levels are low in RA, this can contribute to high aromatase activity in the synovium. Importantly, aromatase-converted estrogens are converted into proproliferative and proinflammatory 16-hydroxylated estrogens. A hormone involved in aromatase activity is vitamin D, which downregulates aromatase in human RA macrophages. Collectively, evidence suggests a key role of aromatase in sex hormone balance during chronic inflammation and points to the importance of vitamin D as a possible new tool for aromatase modulation.
性激素在炎症反应中发挥着积极的作用，其中雄激素具有抗炎作用，而雌激素则具有促炎和抗炎双重作用。在类风湿关节炎（RA）患者的滑膜液中，雄激素水平降低，雌酮水平升高。芳香酶是将雄激素转化为雌激素的关键酶。促炎细胞因子刺激芳香酶活性，使炎症环境能够诱导雄激素向雌激素转化。此外，睾酮抑制芳香酶活性。由于 RA 患者局部雄激素水平较低，这可能导致滑膜中芳香酶活性升高。重要的是，芳香酶转化的雌激素会转化为促增殖和促炎的 16-羟化雌激素。参与芳香酶活性的一种激素是维生素 D，它可下调人 RA 巨噬细胞中的芳香酶。综上所述，有证据表明，芳香酶在慢性炎症期间性激素平衡中起着关键作用，并指出维生素 D 作为芳香酶调节的一种可能的新工具的重要性。
