Use of exogenous estrogens in systemic lupus erythematosus*
Section snippets
Methods
A MEDLINE search for articles published between 1970 and 2000 using the keywords “estrogen,” “lupus,” “menopause,” “flare,” and “thromboembolism” was performed. Both human and animal studies, as well as epidemiologic surveys, were reviewed and presented under the following headings: 1) Effects of estrogens on the immune system and SLE; 2) Endogenous estrogen, disease activity, and prognosis of SLE; 3) Exogenous estrogens and the risk of SLE development; 4) Indications of estrogen therapy in
Effects of estrogens on the immune system and SLE
Estrogens exhibit a number of stimulatory actions on the immune system. Administration of physiologic concentrations of 17β-estradiol enhanced differentiation of B cells and in vitro immunoglobulin production by peripheral blood mononuclear cells (PBMC) in response to pokeweed mitogen stimulation in normal subjects (32). Moreover, 17β-estradiol (at concentrations of 10−10 to 10−8 mol/L) also increased spontaneous in vitro production of immunoglobulins (IgG and IgM) by normal PBMC in a
Conclusions
Whether the benefits of estrogen treatment outweigh its possible deleterious effect on disease activity remains an unanswered question. Based on the currently available information, combination low-dose estrogen OCs may be considered for SLE patients without definite contraindications. Table 4 shows the absolute and relative contraindications to OC use in women (71).Absolute contraindications Pregnancy Past of current
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2021, ChemosphereCitation Excerpt :These pathways are also critical for maintaining fish health and the ability to resist foreign pathogens. It is suggested that exogenous estrogen increases the risk of systemic lupus erythematosus in females by reviewing existing studies (Mok et al., 2001), and our results seem to support this conclusion since the systemic lupus erythematosus pathway was enriched in females after DEHP exposure. Overall, our results suggest that DEHP has an immune interfering effect on marine medaka, and females seem to be more sensitive to immune toxicity.
Pathogenesis of Keratoconus: The intriguing therapeutic potential of Prolactin-inducible protein
2018, Progress in Retinal and Eye ResearchCitation Excerpt :For example, Lupus flares in patients with Systemic Lupus Erythematosus (SLE), caused by use of oral contraceptives and administration of estrogen have been reported (Rojas-Villarraga et al., 2014). Furthermore, the association of SLE with Klinefelter's syndrome, and its improvement following testosterone administration, also imply that sex hormones modulate the incidence or severity of SLE (Mok et al., 2001). In terms of the ocular system, sex hormones are recognized for their critical role in regulating important body functions that affect the eyes, and when they change, so can visual acuity.
Concepts of Contraception for Adolescent and Young Adult Women with Chronic Illness and Disability
2012, Disease-a-MonthCitation Excerpt :Clinicians should remember that the use of the copper IUD does increase the risk for blood loss.45 As noted, OCs are generally safe and effective in women with stable SLE; however, OCs should not be prescribed to those with the aPL syndrome.80,254,268,271 Thus, those with SLE should be screened for the aPL syndrome and estrogen-containing contraceptive methods (such as the pill, patch, or ring) should be avoided if evaluation notes the presence of the aPL syndrome, vasculitis, or nephritis.271-273
Utilization of hyperestrogenic therapies in systemic lupus erythematosus
2010, Reumatologia ClinicaOrofacial pain in the medically complex patient
2008, Orofacial Pain and HeadacheSystemic lupus erythematosus
2007, LancetCitation Excerpt :Hormone replacement therapy (HRT) has been associated with an increased risk of systemic lupus erythematosus,19,20 although another study failed to show any increased risk.21 Several studies have suggested that HRT is unlikely to increase the risk of flares, although these studies in general have been small retrospective case series.22 The SELENA trial23 randomly assigned women with the disorder to receive either HRT or a placebo.
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Address reprint requests to Dr Chi Chiu Mok, MBBS, MRCP, Senior Registrar, Department of Medicine & Geriatrics, Tuen Mun Hospital, Tsing Choon Koon Road, New Territories, Hong Kong. E-mail: [email protected]