HORMONAL PATTERN IN WOMEN AFFECTED BY RHEUMATOID-ARTHRITIS

Gonadal sex hormones may account for the sexual dimorphism in the immu ne response and for the greater incidence of autoimmune disease in fem ales. We have previously reported the presence of progesterone (P) def iciency in female patients with thyroid and ovarian autoimmune disease . In this context, the hormonal profile in 9 women with rheumatoid art hritis (RA) and in 9 age-matched ealthy women, were evaluated to verif y the presence of a steroid hormone secretion impairment in a systemic autoimmune disease, further supporting our hypothesis of P deficiency involvement. P and androgen plasma levels, in the luteal phase, were significantly lower (p<0.05 and 0.005, respectively) in RA patients th an in the control group, with a consequent decrease of the free androg en index. Moreover, despite normal cortisol values, corticosterone (B) plasma levels were significantly higher in the RA patients (p<0.01 an d 0.05 in follicular and luteal phase, respectively). Therefore, our p resent data confirm the androgen deficiency in patients with a systemi c autoimmune disease, such as RA and support the immunomodulator effec t of P. Finally, the higher B plasma levels in RA patients may suggest the presence of a slight impairment of the immune hypothalamic-pituit ary-adrenal axis (HPAA), supporting its role in certain phases of RA p athogenesis. In conclusion, in addition to androgens, the immunomodula tor role of P should also be taken into account in the pathogenesis of the systemic autoimmune disease.