Department of Neurology, Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, MA, USA.
Mult Scler. 2018 Jan;24(1):36-41. doi: 10.1177/1352458517737395.
There is significant animal model data demonstrating a benefit of testosterone on both inflammatory and neuroprotective mechanisms relevant to multiple sclerosis (MS). Several studies have demonstrated lowered testosterone levels in up to 40% of men with MS. Lower testosterone levels were correlated with worsened scores of physical and cognitive disability. There is increasing data suggesting a role of testosterone in MS risk. A pilot study has demonstrated significant benefits of testosterone replacement therapy on cognitive, radiological, and immunological outcome measures in men with MS. Larger studies in other conditions have demonstrated concerns in terms of cardiovascular risk, which indicate the need for careful monitoring upon administration to MS patients. Further studies are needed to develop safer testosterone preparations, which preserve its multiple beneficial effects, as well as multicenter clinical trials to evaluate safety, dosing, and efficacy in larger populations of men with MS. Additionally, studies are needed to further explore the role of androgens as a risk factor for MS, particularly at key life transitions.
有大量的动物模型数据表明，睾丸酮对多发性硬化症（MS）相关的炎症和神经保护机制都有好处。多项研究表明，高达 40%的 MS 男性的睾丸酮水平降低。较低的睾丸酮水平与身体和认知残疾评分的恶化相关。越来越多的数据表明睾丸酮在 MS 风险中的作用。一项初步研究表明，睾丸酮替代疗法对 MS 男性的认知、影像学和免疫学结果指标有显著益处。在其他情况下进行的更大规模的研究表明，在心血管风险方面存在问题，这表明需要对 MS 患者进行谨慎监测。需要进一步研究开发更安全的睾丸酮制剂，以保留其多种有益作用，以及进行多中心临床试验，以评估更大规模 MS 男性群体的安全性、剂量和疗效。此外，还需要进一步研究雄激素作为 MS 风险因素的作用，特别是在关键的生命转折点。
