多发性硬化症中的荷尔蒙疗法:临床数据的综述
1UCSF Weill Institute for Neuroscience, Division of Neuroimmunology and Glial Biology, Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
Current neurology and neuroscience reports
|December 15, 2023
概括
外源激素对多发性硬化症 (MS) 风险和进展有不同的影响. 虽然一些治疗方法显示出适度的益处,但需要更多的研究,包括大型临床试验,以了解它们对MS的全部影响.
科学领域:
- 神经科学是一个神经科学.
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
背景情况:
- 外源激素可能会影响多发性硬化症 (MS) 的风险和过程.
- 了解这些影响对于在妇女和接受特定治疗的个体中管理MS至关重要.
研究的目的:
- 审查有关外源激素对患有多发性硬化的人类影响的当前知识.
- 总结观察和干预研究的发现.
主要方法:
- 现有观察性和干预性研究的叙述性综述.
- 对联合口服避孕药,雌醇,生育治疗,雄激素,SERM,SARM,性别确认治疗和更年期激素治疗的数据分析.
主要成果:
- 结合口服避孕药和雌醇对MS的炎症活性表现出适度的影响;雌醇可能提供神经保护.
- 在大型队列中,生育治疗没有显示出复发风险的增加.
- 临床前数据表明雄激素,SERM和SARM的神经保护潜力,但临床数据有限.
- 性别肯定治疗中的雌激素可能会增加炎症风险;更年期激素治疗在特定窗口内似乎是安全的,但长期的神经保护作用是未知的.
结论:
- 外源激素对MS风险,炎症和神经保护有多种影响.
- 大型随机试验对于确定外源激素对MS的影响至关重要.
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