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The Journal of Clinical Endocrinology & Metabolism Vol. 85, No. 4 1648-1657
Copyright © 2000 by The Endocrine Society

Original Studies

In Vivo Effects of Sex Steroids on Lymphocyte Responsiveness and Immunoglobulin Levels in Humans

E. J. Giltay, J. C. M. Fonk, B. M. E. von Blomberg, H. A. Drexhage, C. Schalkwijk and L. J. G. Gooren

Research Institute for Endocrinology, Reproduction, and Metabolism (E.J.G., L.J.G.G.), Departments of Pathology (J.C.M.F., B.M.E.B.) and Clinical Chemistry (C.S.), University Hospital Vrije Universiteit, 1007 MB Amsterdam; and Department of Immunology, Erasmus University (H.A.D.), Rotterdam, The Netherlands

Address all correspondence and requests for reprints to: Erik J. Giltay, M.D., Department of Endocrinology, Division of Andrology, University Hospital Vrije Universiteit, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. E-mail: giltay{at}dds.nl

The female predominance in several autoimmune diseases suggests a role for sex steroid hormones in disease susceptibility. We therefore investigated to what extent sex hormones would influence immune responsiveness. We analyzed T helper type 1 (TH1) and type 2 cytokine patterns, chemokine receptor expression (n = 2 x 10), and Ig levels (n = 2 x 25) in transsexual men and women before and after 4 months of cross-sex hormone administration. Antithyroperoxidase levels were compared between 186 transsexual males (treated >5 yr with estrogens) and 186 male controls.

In men, estrogens plus antiandrogens increased free cortisol levels in 24-h urine samples, decreased natural killer cell numbers, and slightly inhibited the mitogen-induced interferon-{gamma}/interleukin-4 ratio, but up-regulated the expression of TH1-associated chemokine receptors, CCR1, CXCR3, and CCR5. Conversely, in women, androgens slightly decreased free cortisol levels in 24-h urine samples and enhanced the mitogen-induced interferon-{gamma}/interleukin-4 ratio and tumor necrosis factor-{alpha} production. At the single cell level no TH1/TH2 shifts were found. Remarkably, up-regulation of TH1 cytokines was accompanied by down-regulation of CCR1, CXCR3, and CCR5 expression. Neither CD4+ lymphocyte numbers nor IgG, IgM, and antithyroperoxidase levels, although higher in women then in men, were affected by cross-sex hormonal treatment.

These results demonstrate that the capacity to develop a TH1 phenotype of peripheral blood lymphocytes is stimulated by androgens and is slightly inhibited by estrogens. These changes may be direct or indirect through the effects on other hormones.




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