Rola androgenów w patogenezie i przebiegu klinicznym stwardnienia rozsianego. Nowe możliwości terapii

• Authors: Małgorzata Turniak , Andrzej Głąbiński

Title variants

EN

Role of androgens in the pathogenesis and clinical course of multiple sclerosis. New therapeutic possibilities

• Languages of publication: EN PL

Abstracts

EN

Multiple sclerosis is an autoimmune disease that affects the central nervous system. An autoimmune reaction directed against myelin components leads to the degradation of sheaths surrounding axons of nerve cells, thus affecting the ability of the nerves to conduct electrical impulses to and from the brain. Despite extensive studies, the aetiology and pathogenesis of this disease is still not clear. It has been shown that the interplay between genetic and environmental factors is responsible for multiple sclerosis development. The average female-to-male ratio at a typical age of disease onset is around 2.0. It means that women suffer from multiple sclerosis twice as often as men. It has also been reported that the clinical course of the disease is different in women and men. Studies showing that the female-to-male ratio is not observed in paediatric patients, suggest that sex hormones play a role in the pathogenesis of multiple sclerosis and susceptibility to this disease. Numerous studies have reported that androgens affect neural and glial cell survival in vitro. In addition, the positive effect of both endogenous and exogenous testosterone on the clinical course of multiple sclerosis in animal models has been proven. Pilot studies concerning the treatment with testosterone and selective androgen receptor modulators have shown promising tolerance and no severe side effects, suggesting that they may be good candidates for a new therapy for multiple sclerosis patients.

PL

Stwardnienie rozsiane to choroba autoimmunologiczna, która atakuje ośrodkowy układ nerwowy. Reakcja autoimmunologiczna skierowana przeciwko komponentom mieliny prowadzi do degradacji osłonki otaczającej aksony komórek nerwowych, co upośledza ich zdolność do przewodzenia impulsów – zarówno z mózgu, jak i do niego. Mimo intensywnych badań etiologia i patogeneza choroby nadal nie są dokładnie poznane. Zostało ustalone, że w rozwoju stwardnienia rozsianego biorą udział czynniki genetyczne i środowiskowe. Średni stosunek częstości występowania choroby u kobiet do częstości jej występowania u mężczyzn w przypadku typowego wieku zachorowania (między 35. a 49. rokiem życia) wynosi około 2,0, czyli kobiety zapadają na stwardnienie rozsiane dwukrotnie częściej. Także przebieg choroby i rokowanie są różne u kobiet i mężczyzn. Zależności tej nie obserwuje się wśród pacjentów pediatrycznych, co może sugerować, że hormony płciowe odgrywają istotną rolę w podatności na schorzenie i jego przebiegu. Liczne badania dowiodły istnienia wpływu androgenów na komórki nerwowe i glej in vitro. Co więcej, pozytywny wpływ zarówno testosteronu, jak i dihydrotestosteronu został udowodniony w modelach zwierzęcych stwardnienia rozsianego. Pilotażowe badania dotyczące zastosowania testosteronu i selektywnych modulatorów receptora androgenowego wykazały obiecującą tolerancję i brak poważnych efektów ubocznych, co daje nadzieję na wykorzystanie tej terapii. Krótko- i długoterminowa efektywność jej działania oraz skutki uboczne wymagają jednak dalszych badań.

Keywords

EN

androgens; androgeny; gender; leczenie; multiple sclerosis; płeć; stwardnienie rozsiane; testosteron; testosterone; therapy

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Aktualności Neurologiczne
• Year: 2015
• Volume: 15
• Issue: 1
• Pages: 28-34

Contributors

author

Małgorzata Turniak

• Klinika Neurologii i Udarów Mózgu, Uniwersytet Medyczny w Łodzi, Uniwersytecki Szpital Kliniczny im. Wojskowej Akademii Medycznej – Centralny Szpital Weteranów, Łódź, Polska

author

Andrzej Głąbiński

• Klinika Neurologii i Udarów Mózgu, Uniwersytet Medyczny w Łodzi, Uniwersytecki Szpital Kliniczny im. Wojskowej Akademii Medycznej – Centralny Szpital Weteranów, Łódź, Polska

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• Document Type: review