Prolactin in human systemic lupus erythematosus

Area of Science:

• Immunology
• Endocrinology
• Rheumatology

Background:

• Accumulating evidence suggests a role for elevated serum prolactin (PRL) in the pathogenesis and clinical expression of systemic lupus erythematosus (SLE).
• Hyperprolactinemia (HPRL) is observed in 20-30% of SLE patients, potentially influencing disease activity, particularly during pregnancy.

Purpose of the Study:

• To explore the association between prolactin (PRL) and the clinical activity and pathogenesis of systemic lupus erythematosus (SLE).
• To investigate the potential role of PRL as a promoter of SLE activity and severity, including its involvement in organ-specific manifestations like lupus nephritis and CNS SLE.

Main Methods:

• Review of clinical and experimental studies investigating the relationship between PRL levels and SLE activity.
• Analysis of PRL and cytokine levels in urine and cerebrospinal fluid (CSF) of SLE patients.
• Examination of PRL production by lymphocytes in active SLE patients.

Main Results:

• HPRL is associated with SLE clinical activity, especially during pregnancy, and may contribute to SLE onset in some patients.
• Elevated PRL and IL-6 are found in urine of lupus nephritis patients and CSF of CNS SLE patients, suggesting PRL's role in organ-specific pathology.
• Lymphocytes in active SLE produce increased PRL, indicating extrapituitary PRL involvement in aberrant immune processes.

Conclusions:

• Prolactin (PRL) acts as a bridge between the neuroendocrine and immune systems in SLE, participating in immune and inflammatory processes.
• Understanding the interactions between PRL, cytokines, autoantibodies, and organ involvement is crucial for managing SLE.
• Further research into these neuroendocrine-immune interactions may lead to novel therapeutic strategies for SLE.