The Impact of Sex Hormones on Physiological Alterations and Severity of Asthma

Sex hormones, including estradiol, progesterone and testosterone recently have been recognized as modulators of airway inflammation and immune responses, but currently it remains a poorly defined association between sex hormones and severity of asthma. The objective of this study was to investigate the serum levels of estradiol, progesterone and testosterone in asthmatic patients and their association with disease severity. A cross-sectional case–control study was carried out on 88 asthmatic patients, diagnosed according to the Global Initiative for Asthma (GINA) and 62 healthy controls of similar age and sex. Patients who had endocrine disease or chronic systemic disease were excluded. Serum estradiol, progesterone and testosterone levels were assessed by enzyme-linked immunosorbent assay (ELISA). Serum estradiol levels were higher in asthmatic patients than in controls (72.4 ± 18.6 vs. 58.1 ± 14.3 pg/mL, P < 0.002). Patients also had increased levels of progesterone (1.89 ± 0.54 vs 1.32 ± 0.41 ng/mL, P < 0.003), and decreased testosterone (392.6 ± 110.8 vs 465.3 ± 124.5 ng/dL, P < 0.04). Stratification by disease severity showed significant differences in estradiol (P =0.033) and testosterone (P =0.001), both were highest in severe asthma and the lowest for testosterone was found in severe asthma. There was no difference in progesterone concentrations by severity (P = 0.075). There was a strong negative correlation between testosterone and estradiol (r = −0.41, P