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Hormone replacement therapy reverses the decrease in natural killer cytotoxicity but does not reverse the decreases
1Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
Objective:
To investigate the immunologic deviations of postmenopausal women before and after hormone replacement therapy (HRT).
Design:
Prospective study.
Setting:
University teaching hospital.
Patient(S):
Seventeen postmenopausal women (study group) and 17 women of reproductive age (control group).
Intervention(S):
Continuous usage of E(2) valerate 2 mg/d and medroxyprogesterone acetate 5 mg/d in postmenopausal women in the study group.
Main Outcome Measure(S):
Immunophenotyping with flow cytometry, cytokine production with and without mitogen stimulation of the peripheral mononuclear cells, and a natural killer (NK) cell cytotoxicity test against K562 target cells by the (51)Cr-release assay were performed in the control group and in the study group before, 1 month after, and 6 months after HRT.
Result(S):
NK cytotoxicity, interferon-gamma production, and the T-cell subpopulation were significantly decreased, and the subpopulations of CD3(+)CD25(+) and CD3(+)HLA-DR(+) were increased in the study group before HRT when compared with those in the control group. After HRT was given for 6 months, however, the NK cytotoxicity increased significantly in the postmenopausal women to a value similar to that of the control group.
Conclusion(S):
Women after menopause are prone to impaired immune responses. Nevertheless, some of the impairment can be restored after HRT.