Plasma sex hormones and aromatase activity in tissues of patients with systemic lupus erythematosus.

Clinical observations and experimental data suggest that sex hormones influence the development of systemic lupus erythematosus (SLE). An imbalance between androgen and estrogen plasma levels may suggest an abnormality in the aromatase activity involved in estradiol synthesis. Aromatase activity in skin and subcutaneous tissue and plasma sex-hormone levels (testosterone, androstenedione, estrone, estradiol, dehydrosterone sulfate, cortisol) were measured in 15 SLE patients (nine female, six male) who had never received corticosteroid treatment and in eight (four female, four male) healthy control subjects. There was a tendency toward an increase in aromatase activity in SLE patients when compared to control subjects. Among SLE patients the aromatase activity varied inversely with disease activity. Patients with SLE had decreased androgen and increased estrogen levels. Aromatase activity in SLE patients had significant direct correlation with estrogen levels. These data suggest that abnormal regulation of aromatase activity may partially explain the abnormalities of estrogen synthesis in SLE.

[Clinical characteristics of disorders of sexual functions in patients with rheumatoid arthritis]. / Klinicheskaia kharakteristika narushenii seksual'noi funktsii u bol'nykh revmatoidnym artritom.

The method of structural analysis was used to study the presence of sexual disorders in 26 male patients with rheumatoid arthritis (RA). The incidence of sexual disorders was 42.3 per cent (11 patients). In this case the ejaculatory and neurohumoral components of the copulative cycle were mostly disturbed. Sexual dysfunction developed during the disease and was often associated with exacerbation of RA. Disorders in pubertal development were revealed in none of the patients. But patients with a disturbed sexual function exhibited a significant decrease in the total cumulative index in the male sexual formula, in the level of total and free testosterone, a rise in the content of prolactin. Possible causes and mechanisms of sexual disorders in male patients with RA are discussed.

[An analysis of the survival of 120 male patients with systemic lupus erythematosus]. / Analiz vyzhivaemosti 120 muzhin, bol'nykh sistemnoi krasnoi volchankoi.

The aim of the study was to evaluate survival rates and causes of death of a large group of male patients with systemic lupus erythematosus (SLE). The group consisted of 120 patients with evident SLE that were observed at the Institute of Reanimatology from 1976 to 1989; the mean age was 31.3 years; the mean age for the disease onset was 29.6 years; the mean follow-up duration was 9.1 years. The survival pattern was obtained with the method of the life table analysis. Maximum lethality was observed during the first years of the disease: in 1-4 years 11 patients died, in 5-6 years--6 patients, and in 8-12 years--7 patients; 27 patients died during the follow-up period, 17--died of lupus nephritis, 4--of neurological involvement, one patient--of heart insufficiency, one--of lung tuberculosis, one--of ischemic heart disease, one--of amyloidosis, one--of sepsis and one patient died of chronic lung insufficiency.

[Aortal defects in systemic lupus erythematosus]. / Aortal'nye porroki pri sistemnoi krasnoi volchanke.

Five patients with significant lupus erythematosus (SLE) are described. The use of ECG, PCG and ultracardiosonography made it possible to verify the diagnosis of aortal valvular disease. On recognition of the damage to the aortal valves the question arises as to the genesis of its occurrence: does it occur because of the lupoid process proper or superaddition of bacterial endocarditis? The similar signs of SLE and bacterial endocarditis are described as are differential and diagnostic criteria. The main mechanisms by which the aortal valvular disease develops in SLE are depicted. Four out of the 5 patients described had bilateral sacroileitis and were not HIA-B27 carriers.

[Genetic aspects of humoral immunity reactions to collagen in man and animals. III. An analysis of the sexual dimorphism of the levels of autoantibodies to collagen type I in systemic lupus erythematosus patients and their modifications in ontogeny]. / Geneticheskie aspekty reaktsii gumoral'nogo immuniteta k kollagenu u cheloveka i zhivotnykh. Soobshchenie III. Analiz polovogo dimorfizma urovnei autoantitel k kollagenu I tipa u bol'nykh sistemnoi krasnoi volchankoi i ikh modifikatsii v ontogeneze.

The study of polymorphism levels of the autoantibodies to collagen type I in patients with systemic lupus erythematosus revealed the sex dimorphism of the character studied. Negative correlation of the levels of autoantibodies to collagen type I and those of sex hormones as well as modulation of the character under the action of xenobiotics were observed.

[Use of androgens in the complex treatment of men with systemic lupus erythematosus]. / Primenenie androgenov v kompleksnom lechenii muzhchin s sistemnoi krasnoi volchankoi.

A controlled trial of the androgenic drug Sustanon-250 was conducted in 9 male patients with exacerbation of systemic lupus erythematosus (SLE). The drug was administered intramuscularly once a week for 4 weeks. The therapy resulted in changes of the initially disturbed levels of sex hormones: the initially lowered levels of testosterone increased significantly by the end of the study (p less than 0.01), the level of serum estradiol and the estrogenic/androgenic ratio returned to normal. A decrease in the values of ESR,L2 and gamma globulins, G and A immunoglobulins, a-DNA, ANF and CRP titers was noted. The amount of T-lymphocytes increased. Two patients were not given corticosteroid and cytotoxic drugs, a dose of drugs for 1 patient was not raised and for 3 patients it was lowered. Over the period of the study skin symptoms, the degree of expression of lymphadenopathy, polyarthritis and Raynaud's syndrome decreased. The drug produced an insignificant effect on the serous membranes, heart and kidneys. The first experience in the use of androgens in men indicated pathogenetic influence of such drugs on SLE.