Estrogens in rheumatoid arthritis; the immune system and bone

Regulation of 11<i>β</i>-Hydroxysteroid Dehydrogenase Type 1 and 2 in Rheumatoid Arthritis

“…It would be of interest to repeat this study in a group of rheumatoid patients brought under control not only with TNF-α blockers but also with particular attention to any sub-group requiring the use of interleukin-6 blockade to relieve symptoms. Surprisingly, and somehow at variance with the literature, amongst the large panel of steroids studied, androgen [14,31,32], oestrogen [16,33] and progesterone [32] metabolites did not display a change in their level as a function of treatment. In part this may be because the group was selected for need of immediate disease control, not because coming from age or gender groups in which hormones might have displayed greater influence.…”

“…Patients with RA (ARA criteria) [15] and disease activity sufficient to justify the use of DMARDs were recruited (PV > 1.72 mPa or Ritchie articular index (AI) > 16 or early morning stiffness [16] > 1 h) [17]. Patients with a history of or with laboratory evidence of hepatitis (excessive alcohol intake, infectious, autoimmune or storage diseases) were excluded.…”

“…PV was considered as the primary reference parameter of disease activity. The power to detect difference between week 0 and week 24 was calculated to be 1.000 (albumin), 0.9306 (platelets), 0.8286 (PV), 0.5949 [8] 0.5444, (THF + 5αTHF/THE), 0.3062 (CRP), 0.2602 [16] and 0.0606 (γGT), respectively) [20].…”

Changes in hand bone mineral density and the association with the level of disease activity in patients with rheumatoid arthritis: Bone mineral density measurements in a multicenter randomized clinical trial

“…Older patients were unlikely to show mBMD gain, which may be due to hormonal changes in this predominantly female population. HRT possibly may have a positive effect on bone metabolism directly through actions on osteoclasts and osteoblasts as well as indirectly through effects on inflammatory cells and processes (38). Previously, HRT was found to stabilize mBMD (39).…”

Tumor Necrosis Factor-Induced Cerebral Insulin Resistance in Alzheimer's Disease Links Numerous Treatment Rationales

“…Although on a small scale, this study is intriguing, because conventional wisdom, predicated on the idea that such anti-TNF treatment has the potential to suppress immunity against certain pathogens that could infect wounds, would have us expect the opposite outcome. As might be expected, elevated levels of sex steroids, such as during pregnancy or after hormonal replacement therapy, and known to suppress TNF, leads to diminished disease activity in rheumatoid arthritis (Ostensen et al, 1983;Kanik and Wilder, 2000;Islander et al, 2011). In contrast, the disease is often aggravated after parturition (Ostensen et al, 1983).…”