Sex hormones and autoimmunity

“…Various epidemiological and immunological studies suggest that reproductive and sex hormones play a fundamental role in the etiology and progression of various autoimmune diseases [29][30][31].…”

Section: Discussionmentioning

confidence: 99%

Acute immunomodulatory changes during controlled ovarian stimulation: evidence from the first trial investigating the short-term effects of estradiol on biomarkers and B cells involved in autoimmunity

Ghirardello

Gizzo

Noventa

et al. 2015

J Assist Reprod Genet

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Purpose The aim of the present study was to evaluate the in vivo immunomodulatory effects of an acute short-term estradiol (E 2 ) increase on serum levels of B cell-activating factor (BAFF), immunoglobulins (Ig), anti-nuclear antibodies (ANA), and the peripheral B cell phenotype. Methods We conducted, at the Infertility Center of the University of Padua, a prospective case-control study on a cohort of infertile normo-responder women (group-A, 63 patients) undergoing controlled ovarian stimulation (COS) compared with an age-matched cohort of normo-ovulatory healthy women (group-B, 39 patients). Three serial blood sample assays were conducted in both groups, at T0, hypothalamic suppression; T1, ovulation induction; and T2, βhCG test in group A, and at T0, 2nd day; T1, 14th day; and T2, 21st day of cycle in group B, and serum levels of E 2 and BAFF, BAFF/E 2 ratio, circulating IgM, IgG, and IgA, ANA titer, and peripheral B cell phenotype were measured. We compared group-A versus group-B in terms of absolute and E 2 normalized values of BAFF at baseline (T0) to verify for possible differences between healthy and infertile women, at T1 to verify for possible differences occurring after spontaneous ovulation versus COS, and at T2 to evaluate differences in serum BAFF levels between pregnant versus non-pregnant patients (considering only group-A) and between non-pregnant women after spontaneous versus COS cycles (group-B versus group-A). In group-A, we also evaluated IgM, IgG, IgA levels, ANA titer, and peripheral B cell phenotype at T0 versus T1 versus T2. Results With the exception of E 2 levels at T1 (as expected), no significant differences were found between the two groups for all outcome measures. In group-A, BAFF at T0 positively correlated with IgM levels; marginal zone CD19+/CD27+/ IgD+ memory B cell compartment tended to be expanded at T1 when compared with T0. Conclusions Despite several mechanistic and clinical studies supporting a stimulatory role of E 2 on autoimmunity, the acute increase of E 2 during COS for infertility treatment does not seem to have a major impact on the immune system.

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“…It is well-known that estrogen plays a crucial role in immune system modulation and, thus, expression of autoimmune diseases. However, its effects on cell proliferation, cytokine production and differentiation of hematopoietic cells varies in different tissues depending on the type of the estrogen receptor (ER), ER-α or ER-β, present [10,11]. Therefore, there is reason for concern regarding increased risks of complications in women with autoimmune diseases undergoing IVF.…”

Section: Discussionmentioning

confidence: 99%

Ovarian stimulation and embryo banking for fertility preservation in a woman with severe mixed connective tissue disease: is it safe?

Sioulas

Gracia

2011

J Assist Reprod Genet

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Objective To report the first case of using assisted reproductive technologies (ART) for fertility preservation in a patient with mixed connective tissue disease (MCTD), secondary pulmonary hypertension (PH) and antiphospholipid syndrome (APS). Design Case-report and review of the literature. Setting Academic infertility practice and tertiary care center. Patient(s) A 25-year-old woman with MCTD, complicated with PH and APS, who was scheduled for gonadotoxic therapy Intervention(s) Controlled ovarian hyperstimulation, egg retrieval, embryo banking. Main outcome measure(s) Successful ART cycle leading to embryo banking without worsening her underlying disease. Result(s) Following successful embryo cryopreservation, the patient experienced respiratory failure and other severe complications, resulting in a prolonged hospital stay. Conclusion(s) Controlled ovarian hyperstimulation for embryo banking in women with MCTD, PH and APS may pose a risk for potentially catastrophic complications. A multidisciplinary approach to these patients is necessary to optimize the outcomes of such procedures. More data are needed regarding the safety of fertility preservation technologies in patients with complex medical diseases.

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Sex hormones and autoimmunity

Cited by 132 publications

References 138 publications

The role of environmental estrogens and autoimmunity

The role of environmental estrogens and autoimmunity

Acute immunomodulatory changes during controlled ovarian stimulation: evidence from the first trial investigating the short-term effects of estradiol on biomarkers and B cells involved in autoimmunity

Ovarian stimulation and embryo banking for fertility preservation in a woman with severe mixed connective tissue disease: is it safe?

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