Division of Rheumatology, Temple University School of Medicine, PA, United States.
Division of Rheumatology, Albert Einstein College of Medicine, NY, United States.
Autoimmun Rev. 2015 Jun;14(6):536-42. doi: 10.1016/j.autrev.2015.02.004. Epub 2015 Feb 16.
This article reviews the effects of progestogens on the innate and adaptive immunity and its role in the pathogenesis of autoimmune diseases including systemic lupus erythematosus, rheumatoid arthritis, and multiple sclerosis. The interplay between the sex hormones such as progestogens and the immune system is very complex. Multiple factors affect immunomodulatory effects of the progestogens including fluctuations in the endogenous sex hormone levels, stress, use of exogenous hormones (dose, route and the timing of administration), and alterations in the hormonal metabolism. Although immunomodulatory effects of progesterone, especially progesterone's effect on T cells, T cell subsets and their ratios, dose effects, and the use of synthetic progestins have been studied, there are still wide open areas for further explorations of the progestogens' multifaceted impact on the immune system. Better understanding of the intricate immunomodulatory effects of the progestins may pave the path to developing clinically meaningful therapeutic interventions in certain autoimmune diseases.
这篇文章综述了孕激素对固有免疫和适应性免疫的影响，以及其在自身免疫性疾病发病机制中的作用，这些疾病包括系统性红斑狼疮、类风湿关节炎和多发性硬化症。孕激素等性激素与免疫系统之间的相互作用非常复杂。多种因素影响孕激素的免疫调节作用，包括内源性性激素水平的波动、应激、外源性激素的使用（剂量、途径和给药时间）以及激素代谢的改变。尽管孕激素的免疫调节作用，特别是孕激素对 T 细胞、T 细胞亚群及其比值、剂量效应以及合成孕激素的使用已得到研究，但孕激素对免疫系统的多方面影响仍有很大的探索空间。更好地了解孕激素复杂的免疫调节作用，可能为开发某些自身免疫性疾病的临床有意义的治疗干预措施铺平道路。
