Bizzarro A, Valentini G, Di Martino G, DaPonte A, De Bellis A, Iacono G
J Clin Endocrinol Metab. 1987 Jan;64(1):32-6. doi: 10.1210/jcem-64-1-32.
To examine the role of sex steroid hormones in the development of autoimmune diseases, we studied five patients with Klinefelter's syndrome associated with autoimmune disease, three of whom had Sjögren's syndrome (SS) and two of whom had systemic lupus erythematosus (SLE). Serum testosterone (T) and LH levels, antinuclear antibodies (ANA) and rheumatoid factor (RF) titers, erythrocyte sedimentation rate (ESR), hemolytic complement (CH50) levels, and peripheral T lymphocyte subsets (OKT3+, OKT4+, and OKT8+) were measured before treatment, after 60 days of placebo treatment, and after 60 days of oral T undecanoate (TU) treatment. Before treatment and after placebo, with respect to normal men, the patients had lower serum T and higher LH levels, lower percentages and absolute values of OKT3+ (total T lymphocytes) and OKT8+ (suppressor/cytotoxic T lymphocytes) cells, and, consequently, an increased OKT4/OKT8 ratio. Hemolytic complement (CH50) in serum was below normal in the two patients with SLE, while it was normal in the patients with SS. The ESR was above normal in all patients, and all had high titers of ANA and RF. After TU therapy, serum T levels increased and LH levels decreased, but not to normal. OKT3+ and OKT8+ cells and the OKT4/OKT8 ratio became normal, and RF and ANA titers decreased. The CH50 level did not change in the SS patients, while it increased to normal in the two patients with SLE. The ESR decreased in all patients during therapy. Furthermore, after TU therapy, both the SS and SLE patients had a clinical remission of their autoimmune disease. Our results indicate a therapeutic effect of T on autoimmune diseases in patients with hypogonadism and Klinefelter's syndrome.
为研究性甾体激素在自身免疫性疾病发展中的作用，我们对5例患有与自身免疫性疾病相关的克兰费尔特综合征的患者进行了研究，其中3例患有干燥综合征（SS），2例患有系统性红斑狼疮（SLE）。在治疗前、安慰剂治疗60天后以及口服十一酸睾酮（TU）治疗60天后，测定血清睾酮（T）和促黄体生成素（LH）水平、抗核抗体（ANA）和类风湿因子（RF）滴度、红细胞沉降率（ESR）、溶血补体（CH50）水平以及外周血T淋巴细胞亚群（OKT3 +、OKT4 +和OKT8 +）。在治疗前和服用安慰剂后，与正常男性相比，这些患者血清T水平较低，LH水平较高，OKT3 +（总T淋巴细胞）和OKT8 +（抑制/细胞毒性T淋巴细胞）细胞的百分比和绝对值较低，因此OKT4/OKT8比值升高。2例SLE患者血清中的溶血补体（CH50）低于正常水平，而SS患者的则正常。所有患者的ESR均高于正常水平，且ANA和RF滴度均较高。TU治疗后，血清T水平升高，LH水平降低，但未恢复正常。OKT3 +和OKT8 +细胞以及OKT4/OKT8比值恢复正常，RF和ANA滴度降低。SS患者的CH50水平未发生变化，而2例SLE患者的CH50水平升高至正常。治疗期间所有患者的ESR均下降。此外，TU治疗后，SS和SLE患者的自身免疫性疾病均出现临床缓解。我们的结果表明，T对性腺功能减退和克兰费尔特综合征患者的自身免疫性疾病具有治疗作用。
