Abdi F, Mobedi H, Mosaffa N, Dolatian M, Ramezani Tehrani F
a Students' Research Office, Nursing and Midwifery Faculty , Shahid Beheshti University of Medical Sciences , Tehran , Iran ;
b Biomaterials Department , Iran Polymer and Petrochemical Institute , Tehran , Iran ;
Climacteric. 2016 Jun;19(3):234-9. doi: 10.3109/13697137.2016.1164136. Epub 2016 Apr 18.
Despite valuable evidence documented on immunological changes in postmenopausal women, particularly following hormone replacement therapy (HRT), it is difficult to explain whether immunological changes during menopause are caused by HRT. This systematic review aimed to summarize the results of studies available on postmenopausal immunological changes and to determine any potential effects of HRT on the immunological profile of postmenopausal women.
For this systematic review, we primarily explored 751 papers about the immune system status of postmenopausal women published during 1955-2015. Scientific databases including Web of Science, MEDLINE, Scopus, Embase, Google Scholar, and the Cochrane database were searched for a number of relevant key terms. Of 209 papers that met the initial search criteria, 13 papers were potentially retrievable and included descriptions of changes in immunological factors during the postmenopausal period and the effects of HRT on such changes.
HRT resulted in a range of immunological changes in postmenopausal women. These changes included reductions in interleukin-2 (IL-2), IL-6, and insulin-like growth factor-1 levels and increments in IL-1 and IL-4 levels. Elevations in B-cell production and estrogen receptor alpha, CD19+ cells, and C3 and C4 complement levels were also documented. Decreased CD8+ counts were also a constant finding in most reviewed papers. However, data on the changes in other factors such as tumor necrosis factor-alpha, interferon-gamma, CD4+, and CD25+ were contradictory. Levels of some immunological factors, e.g. immunoglobulin G (IgG), IgM, and IL-10, remained unchanged following HRT.
Postmenopausal women are prone to impaired immune responses. HRT during the menopausal period can mediate immunological responses by inducing significant changes in immunological mediators.
尽管已有关于绝经后女性免疫变化的宝贵证据，尤其是激素替代疗法（HRT）后的免疫变化，但很难解释绝经期间的免疫变化是否由HRT引起。本系统评价旨在总结绝经后免疫变化的现有研究结果，并确定HRT对绝经后女性免疫特征的任何潜在影响。
对于本系统评价，我们主要检索了1955年至2015年间发表的751篇关于绝经后女性免疫系统状况的论文。在科学数据库，包括科学网、医学期刊数据库、Scopus数据库、Embase数据库、谷歌学术和考克兰数据库中搜索了一些相关关键词。在符合初始检索标准的209篇论文中，13篇可能被检索到，其中包括绝经后期免疫因子变化的描述以及HRT对此类变化的影响。
HRT导致绝经后女性出现一系列免疫变化。这些变化包括白细胞介素-2（IL-2）、IL-6和胰岛素样生长因子-1水平降低，以及IL-1和IL-4水平升高。还记录到B细胞产生增加以及雌激素受体α、CD19+细胞、C3和C4补体水平升高。CD8+计数减少也是大多数综述论文中的常见发现。然而，关于其他因子如肿瘤坏死因子-α、干扰素-γ、CD4+和CD25+变化的数据相互矛盾。一些免疫因子水平，如免疫球蛋白G（IgG）、IgM和IL-10，在HRT后保持不变。
绝经后女性容易出现免疫反应受损。绝经期间的HRT可通过诱导免疫介质的显著变化来调节免疫反应。
