Sex hormone adjuvant therapy in rheumatoid arthritis

Sex hormones might exert their immune-modulatory effects at least in the rheumatoid arthritis (RA) synovitis since synovial macrophages, monocytes and lymphocytes possess functional androgen and estrogen receptors and may metabolize gonadal hormones. Low gonadal and adrenal androgens, as well as reduced androgens/estrogens ratios, have been detected in body fluids (blood, synovial fluid, smears, salivary) of male and female patients. These observations support the possible pathogenic role for the decreased levels of the androgens. By considering the well-demonstrated immune-suppressive activities exerted by androgens, male hormones and their derivatives seem to be the most promising therapeutic approach, at least in RA patients.