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TESTOSTERONE REPLACEMENT THERAPY, INFLAMMATORY CYTOKINES AND LIPID
PROFILES.
Dr Chris Malkin
Department of Cardiology, Royal Hallamshire Hospital, Sheffield S10
2JF
Testosterone has immune-modulating properties and current in-vitro
evidence suggests that testosterone may suppress the
expression of the pro-inflammatory cytokines TNFa,
IL-1ß and IL-6 and potentiate the expression of the
anti-inflammatory cytokine IL-10. We report a randomized
single-blind placebo-controlled crossover study of
testosterone replacement (Sustanon 100) versus placebo
in 27 men (age 62 ± 9years) with symptomatic androgen
deficiency, total testosterone (4.4 ± 1.2 nmol/L)
bioavailable testosterone (2.4 ± 1.1nmol/L). Compared
to placebo testosterone induced reductions of TNFa
(-3.1 ± 8.3 vs 1.3±5.2 pg/ml, p=0.01), IL-1ß (-0.14
± 032 vs 0.18 ± 0.55 pg/ml, p=0.08) and an increase
in IL-10 (0.33 ± 1.8 vs -1.1 ± 3 pg/ml, p=0.01); the
reductions of TNFa and IL-1ß were positively correlated
(rs = 0.588, p =0.003). In addition, a significant
reduction in total cholesterol was recorded with testosterone
therapy (-0.25 ± 0.4 vs -0.004 ±0.4mmol/L, p=0.04).
In conclusion, testosterone replacement shifts the
cytokine balance to a state of reduced inflammation
and lowers total cholesterol. Twenty of these men
had established coronary disease, and because total
cholesterol is a cardiovascular risk factor, and proinflammatory
cytokines mediate the development and complications
associated with atheromatous plaque, these properties
may have particular relevance in men with overt vascular
disease,
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