Padrões imunoendócrinos distintamente associados em homens e mulheres após fratura decorrente de osteoporose

Abstract

Introduction: Osteoporosis is the result of an imbalance in the bone matrix remodeling process, where bone resorption and formation are performed by osteoclasts and osteoblasts, respectively. This delicate balance is affected by several hormones of cells of the immune system. For a better understanding of bone remodeling, serum levels of chemokines CXCL10 / IP-10, CXCL9 / MIG, CXCL8 / IL-8, CCL2 / MCP-1 and CCL5 / RANTES, of cytokines IL-6, IL-22 were evaluated , IL-23, IL-17A, IL-17R, IFN-γ, TNF-α, IL-10, IL-4, IL-2, metalloproteinase-3 (MMP-3), and of the hormones testosterone, estradiol, parathormone (PTH), leptin, in addition to calcitonin and vitamin D in patients with fractures due to osteoporosis. Patients and methods: Serum levels of hormones, calcitonin and vitamin D were measured by the chemiluminescence method in patients with and without osteoporosis. As cytokines, chemokines and MMP-3 have no pain, 30 patients with osteoporosis were measured using the ELISA and CBA method and compared as differences between men and women. Results: When compared as hormonal differences, as women with osteoporosis lower secondary levels of estradiol and vitamin D (p = 0.047 and p = 0.0275), respectively. Men with osteoporosis demonstrated advanced levels of parathormone (p = 0.0065). Regarding immunological factors, the male gender had high levels of MMP-3 and low levels of CCL-5, while the female had high levels of IL-33. Conclusion: There are hormonal differences between genders in osteoporosis. In women, lower levels of estradiol and vitamin D, and in men, higher levels of parathyroid hormone seem to evade in the disease. Differences in immunological factors also appear to act differently in men and women. The increase in MMP-3 and decrease in CCL5 may be an important factor in osteoporosis in men, while a disease appears to be associated with an increase in IL-33 in women.