Geschlechtsspezifische Reaktionen des Immunsystems

Zusammenfassung

Die durch Östrogene und Progesteron begünstigte Suppression T-Zell-mediierter relativ zu B-Zell-mediierten Immunantworten kann die prädominante B-Zell-Immunantwort bei Frauen und das gehäufte Auftreten von Autoimmunerkrankungen wie SLE oder RA bei Frauen erklären. Da die relativen Konzentrationen von Sexual-hormonen in der Schwangerschaft ansteigen, kann eine hormoninduzierte Proliferation oder Apoptose spezifischer Lymphozyten während der Schwangerschaft bei Patientinnen mit rheumatoider Arthritis, SLE oder multipler Sklerose eine Remission bzw. Exazerbation der Erkrankung während oder nach der Schwangerschaft induzieren.

Weitergehende Untersuchungen der Pathomechanismen, die den hormonellen Beeinflussungen der Immunfunktionen zugrunde liegen, werden dazu beitragen, unser Verständnis für geschlechtsspezifische Unterschiede von Krankheitsmanifestationen und -verläufen zu erweitern und eine Modulation hormoneller Faktoren in unser therapeutisches Repertoire einzubeziehen.

Summary

Sex-related differences in the prevalence of autoimmune disorders and during the course of rheumatic diseases are not unusal. SLE represents a prototypic example of a disease that occurs predominantly in female patients during the reproductive age. Its initial presentation may coincide with pregnancy or upon intake of exogenous estrogens and suggests an immune stimulatory effect of estrogens.

Even though epidemiological evidence suggests a hormonal dependence for various autoimmune diseases, the underlying immunopathogenetic mechanisms are less well understood. The regulation of proliferation, activation and programmed cell death (“apoptosis“) of lymphocytes is crucial for the maintenance of a broad immunological repertoire but also important for limitation of uncontrolled lymphocytic clonal proliferation of autoreactive lymphocytes. This review summarizes the current understanding of how T and B cell function is modulated by estrogens and progesterone and may help to understand and incorporate modulation of hormonal factors in therapeutic concepts.

Schlüsselwörter

T-Zelle - B-Zelle - SLE - Östrogen

Keywords

T cell - B cell - SLE - estrogens

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