Neuroendocrine immune pathways in chronic arthritis

被引:17
作者
Capellino, Silvia [1 ]
Straub, Rainer H. [1 ]
机构
[1] Univ Hosp Regensburg, Dept Internal Med 1, Lab Expt Rheumatol & Neuroendocrinoimmunol, D-93042 Regensburg, Germany
来源
BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY | 2008年 / 22卷 / 02期
关键词
androgens; cortisol; estrogen receptors; estrogens; fatigue; hypothalamic - pituitary - adrenal axis; stress; sympathetic nervous system;
D O I
10.1016/j.berh.2008.01.010
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The analysis and understanding of the complex effects of endocrine and nervous system alterations on the inflammatory process in human arthritis is far from complete. Such alterations are observed as decreased responsiveness of the hypothalamic - pituitary - adrenal axis, an inadequate production of cortisol in relation to inflammation, and - consequently - elevated sympathetic activity, alterations of sex hormone metabolism (loss of androgens), psychological alterations (with chronic fatigue and symptoms of depression due to elevated circulating cytokines), local reduction of synovial sympathetic innervation, altered metabolism of estrogens in the synovium, and high expression of estrogen receptors in synovial cells. An understanding of these alterations will help to identify the different neuroendocrine immune mechanisms involved in the pathophysiology of rheumatoid arthritis and could trigger research into novel therapeutic targets for the treatment of patients with rheumatoid arthritis.
引用
收藏
页码:285 / 297
页数:13
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