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解析类风湿关节炎治疗的激素疗法及其辅助干预措施。

Unraveling the hormonal approaches for the treatment of rheumatoid arthritis and its complementary interventions.

作者信息

Waghmare Priya Sharad, Kaushik Deepika, Oz Emel, Proestos Charalampos, Oz Fatih, Kumar Mukul

机构信息

Department of Food Technology and Nutrition, Lovely Professional University, Phagwara, Punjab, 144411, India.

Department of Biotechnology, Faculty of Applied Sciences and Biotechnology, Shoolini University, Solan, HP, 173229, India.

出版信息

Inflammopharmacology. 2025 Feb;33(2):443-460. doi: 10.1007/s10787-024-01633-6. Epub 2025 Jan 3.

Abstract

Rheumatoid Arthritis (RA) is an autoimmune, chronic, systemic inflammatory disease that causes redness, swelling, stiffness, and joint pain. It is a long-lasting disease that can have a widespread impact on the body, often affecting the hands, feet, and wrists. The immune cells, such as dendritic cells, T cells, B cells, macrophages, and neutrophils, play a significant role in bone degradation and inflammation. Several cytokines, including TNF-α and IL-17A, play a significant role in causing bone erosion, cartilage deterioration, and joint inflammation. Progesterone and estrogen have a crucial impact on the pathophysiology of RA, influencing the immune system. Research has demonstrated that hormone replacement therapy (HRT) can effectively reduce inflammation, improve disease activity, enhance joint health, alleviate pain, and promote bone strength. Treatments such as tamoxifen and raloxifene, known as selective estrogen receptor modulators (SERMs), are effective against chronic inflammatory illnesses like RA. The treatment with Gonadotropin-releasing hormone (GnRH) has an impact on the hypothalamic-pituitary-gonadal axis, which in turn affects the activity of RA illness. These alternative treatments hold promise in enhancing well-being and alleviating joint pain for individuals with RA.

摘要

类风湿关节炎(RA)是一种自身免疫性、慢性、全身性炎症性疾病,会导致发红、肿胀、僵硬和关节疼痛。它是一种持久性疾病,可对身体产生广泛影响,常累及手、脚和手腕。免疫细胞,如树突状细胞、T细胞、B细胞、巨噬细胞和中性粒细胞,在骨质破坏和炎症中起重要作用。几种细胞因子,包括肿瘤坏死因子-α(TNF-α)和白细胞介素-17A(IL-17A),在导致骨质侵蚀、软骨退化和关节炎症中起重要作用。孕酮和雌激素对RA的病理生理有至关重要的影响,会影响免疫系统。研究表明,激素替代疗法(HRT)可有效减轻炎症、改善疾病活动度、增强关节健康、缓解疼痛并促进骨骼强度。他莫昔芬和雷洛昔芬等治疗方法,即选择性雌激素受体调节剂(SERM),对RA等慢性炎症性疾病有效。促性腺激素释放激素(GnRH)治疗会影响下丘脑-垂体-性腺轴,进而影响RA疾病的活动。这些替代疗法有望改善RA患者的健康状况并减轻关节疼痛。

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