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Editorial

Androgens in rheumatoid arthritis: when are they effectors?

Maurizio Cutolo

Author Affiliations

Research Laboratory and Academic Unit of Clinical Rheumatology, Department of Internal Medicine, University of Genova Italy, Viale Benedetto XV, 6, 16132 Genova Italy

Arthritis Research & Therapy 2009, 11:126  doi:10.1186/ar2804


See related research article by Karlson et al., http://arthritis-research.com/content/11/3/R97

Published: 22 September 2009

Abstract

Neither hormone receptor genes nor plasma androgens seem significantly altered in female subjects before they became affected by rheumatoid arthritis (RA) and, therefore, do not seem to play a role as risk factors for its development. However, serum testosterone levels are inversely correlated with RA activity and dehydro-epiandrosterone sulfate (DHEAS) plasma levels are inversely correlated with both disease duration and clinical severity in patients already affected by active RA. In particular, gonadal and adrenal androgens (that is, testosterone and DHEAS) are significantly decreased in inflamed synovial tissue/fluids during active disease as a consequence of the inflammatory reaction, which supports a pro-inflammatory milieu in RA joints. Recently, male gender has been found to be a major predictor of remission in early RA.