Massa Megan G, David Christina, Jörg Stefanie, Berg Johannes, Gisevius Barbara, Hirschberg Sarah, Linker Ralf A, Gold Ralf, Haghikia Aiden
Department of Neurology, Ruhr University-Bochum, Bochum, Germany.
Department of Neurology, Friedrich-Alexander University-Erlangen-Nuremberg, Erlangen, Germany.
Am J Pathol. 2017 Jul;187(7):1613-1622. doi: 10.1016/j.ajpath.2017.03.006.
The high female-to-male sex ratio of multiple sclerosis (MS) prevalence has continuously confounded researchers, especially in light of male patients' accelerated disease course at later stages of MS. Although multiple studies have concentrated on estrogenic mechanisms of disease modulation, fairly little attention has been paid to androgenic effects in a female system, and even fewer studies have attempted to dissociate hormonal effects on the neurodegenerative and neuroinflammatory processes of MS. Herein, we demonstrate the differential effects of hormone treatment on the acute inflammatory and chronic neurodegenerative phases of murine experimental autoimmune encephalomyelitis. Although s.c. treatment with testosterone and aromatase inhibitor applied beginning on the day of immunization ameliorated initial course of disease, similar treatment administered therapeutically exacerbated chronic disease course. Spinal cord analyses of axonal densities reflected the clinical scores of the chronic phase. In vitro, testosterone treatment not only decreased Th1 and Th17 differentiation in an aromatase-independent fashion, but also exacerbated cell death in induced pluripotent stem cell-derived primary human neurons under oxidative stress conditions in an aromatase inhibitor-dependent manner. Thus, through the alleviation of inflammatory processes and the exacerbation of neurodegenerative processes, androgens may contribute to the epidemiologic sex differentials observed in MS prevalence and course.
多发性硬化症(MS)患病率的女性与男性高性别比一直困扰着研究人员,尤其是考虑到男性患者在MS后期疾病进程加速的情况。尽管多项研究集中在疾病调节的雌激素机制上,但对女性系统中的雄激素作用关注较少,甚至更少的研究试图区分激素对MS神经退行性变和神经炎症过程的影响。在此,我们展示了激素治疗对小鼠实验性自身免疫性脑脊髓炎急性炎症和慢性神经退行性变阶段的不同影响。尽管从免疫当天开始皮下注射睾酮和芳香化酶抑制剂可改善疾病的初始进程,但治疗性给予类似治疗会加剧慢性疾病进程。脊髓轴突密度分析反映了慢性期的临床评分。在体外,睾酮治疗不仅以芳香化酶非依赖的方式减少Th1和Th17分化,还以芳香化酶抑制剂依赖的方式在氧化应激条件下加剧诱导多能干细胞衍生的原代人神经元的细胞死亡。因此,通过减轻炎症过程和加剧神经退行性变过程,雄激素可能导致MS患病率和病程中观察到的流行病学性别差异。