Raine Charles, Giles Ian
Centre for Rheumatology, Department of Inflammation, Division of Medicine, University College London, London, United Kingdom.
Front Med (Lausanne). 2022 Jul 22;9:909879. doi: 10.3389/fmed.2022.909879. eCollection 2022.
Rheumatoid arthritis (RA) is the most common inflammatory rheumatic disease and has a female predominance of around 3:1. The relationship between sex hormones and RA has been of great interest to researchers ever since Philip Hench's observations in the 1930's regarding spontaneous disease amelioration in pregnancy. Extensive basic scientific work has demonstrated the immunomodulatory actions of sex hormones but this therapeutic potential has not to date resulted in successful clinical trials in RA. Epidemiological data regarding both endogenous and exogenous hormonal factors are inconsistent, but declining estrogen and/or progesterone levels in the menopause and post-partum appear to increase the risk and severity of RA. This review assimilates basic scientific, epidemiological and clinical trial data to provide an overview of the current understanding of the relationship between sex hormones and RA, focusing on estrogen, progesterone and androgens.
类风湿关节炎（RA）是最常见的炎性风湿性疾病，女性患病率约为男性的3倍。自20世纪30年代菲利普·亨奇观察到孕期疾病自然缓解以来，性激素与RA之间的关系一直备受研究人员关注。大量基础科学研究表明了性激素的免疫调节作用，但这种治疗潜力至今尚未在RA临床试验中取得成功。关于内源性和外源性激素因素的流行病学数据并不一致，但绝经和产后雌激素和/或孕激素水平下降似乎会增加RA的风险和严重程度。本综述综合了基础科学、流行病学和临床试验数据，以概述目前对性激素与RA之间关系的理解，重点关注雌激素、孕激素和雄激素。
