From: Interaction of the endocrine system with inflammation: a function of energy and volume regulation
 | Effect on immune system/inflammation | Observed changes in chronic inflammatory rheumatic diseases | Long-term consequences |
---|---|---|---|
Energy storage hormones | Â | Â | Â |
Insulin | Direct support of immune cells | Hyperinsulinemia, insulin resistance | Insulin resistance, cachexia, |
Pro-inflammatory in a state of systemic insulin resistance | Stimulation of sympathetic nervous systema | ||
Leukocytes do not become insulin-resistant | Immune activation | ||
Insulin-like growth factor-1 | Low IGF-1, IGF-1 resistance | Cachexia, osteoporosis, immune activation | |
Androgens | Inhibition of immune system and inflammation [148] | Hypoandrogenemia | Cachexia, loss of fertility, osteoporosis |
Insulin resistance, immune activation | |||
Estrogens | Bi-modal role: support of B lymphocytes and T helper type 2; inhibition of macrophages, natural killer cells, and T helper type 1 (see [27]) | Normal peripheral and high local estrogen levels, high 16α-hydroxylated estrogensb | Local juxtainflammatory fat deposition |
Low 2-hydroxylated estrogensc | Immune activation (16α-hydroxylated forms) | ||
Vitamin D | Bi-modal role: support of innate immunity and inhibition of adaptive immunity [149] | Hypovitaminosis D is common | Osteoporosis, cachexia |
Immune activation toward Th1 and Th17 | |||
Osteocalcin | Not known | Little and ambiguous results | Unclear |
Vagus nerve | Immunosuppressive in acute inflammation (TNF) | Low activity | Loss of appetite, gastrointestinal disturbances, immune activation |
Energy expenditure hormones | Â | Â | Â |
Cortisol | Immunosuppressive | Normal to slightly increased in GC-free patients, low levels in GC-pretreated patients | Cachexia, osteoporosis |
Volume overload | |||
Not much influence on immune system | |||
Sympathetic nervous system (noradrenaline/adrenaline) | β-Adrenergic: suppressive for innate immunity and T helper type 1 lymphocytes, support of B lymphocytes | High activity | Cachexia, osteoporosis |
α-Adrenergic: support of inflammation | Hypertension, volume overload | ||
Immune activation due to nerve fiber lossd | |||
Growth hormone | Immunostimulatory | Little and ambiguous results | Cachexia, osteoporosis |
Thyroid hormones (T3) | Directly immunostimulatory | Low T3 levels, diminished activity of the hypothalamic-pituitary-thyroid gland axis but possibly normal T3 levels in muscle | Cachexia |
Indirectly via provision of inorganic iodide | Immune activation in granulocytes | ||
RAAS (angiotensin II) | Directly immunostimulatory | Elevated activity | Volume overload, hypertension |
Cachexia, insulin resistance, osteoporosis | |||
Immune activation |