medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-334medsovet-9418Research ArticleЗАБОЛЕВАНИЯ КОЖИDERMAL DISEASESРоль половых гормонов в развитии атопического дерматита у женщинThe role of sex hormones in the development of atopic dermatitis in womenhttps://orcid.org/0000-0002-5537-5729КандрашкинаЮ. А.KandrashkinaYu. A.

Кандрашкина Юлия Андреевна - к.м.н., старший преподаватель.

440026, Пенза, ул. Красная, д. 40

Yulia A. Kandrashkina - Cand. Sci. (Med.), Senior Lecturer, Department of Obstetrics and Gynecology.

40, Krasnaya St., 440026, Penza

novikova10l@mail.ruhttps://orcid.org/0000-0002-3902-2018ОрловаЕ. А.OrlovaE. A.

Орлова Екатерина Александровна - д.м.н., доцент, заведующая кафедрой аллергологии и иммунологии с курсом дерматовенерологии и косметологии.

440060, Пенза, ул. Стасова, д. 8а

Ekaterina A. Orlova - Dr. Sci. (Med.), Associate Professor, Head of Department of Allergology and Immunology with a Course of Dermatovenereology and Cosmetology.

8a, Stasov St., 440060, Penza

lisaorl@yandex.ruПензенский государственный университетРоссияPenza State UniversityRussian FederationПензенский институт усовершенствования врачей – филиал Российской медицинской академии непрерывного медицинского образованияРоссияPenza Institute for Advanced Medical Education – a branch of the Russian Medical Academy of Continuing Medical EducationRussian Federation202530092025014146151Copyright © Кандрашкина Ю.А., Орлова Е.А., 20252025Кандрашкина Ю.А., Орлова Е.А.Kandrashkina Y.A., Orlova E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9418

Атопический дерматит (АтД) представляет собой хроническое воспалительное заболевание кожи, широко распространенное во всем мире. У женщин заболевание встречается чаще, чем у мужчин. Данное различие можно объяснить с позиции влияния половых гормонов на функционирование кожного барьера и иммунной системы. Колебания концентрации половых гормонов коррелируют с частотой возникновения АтД. Во время лютеиновой фазы менструального цикла чаще отмечается развитие обострения АтД или ухудшение течения данного заболевания, что связано с выработкой прогестерона и эстрогенов, а в фолликулярную фазу – улучшение течения АтД, что обусловлено преимущественным действием эстрогенов. В течение менструального цикла у женщин происходит изменение барьерной функции кожи, характеризующееся сухостью, нарушением чувствительности и повышением трансэпидермальной потери воды, что свидетельствует о выраженном влиянии половых гормонов на кожу. Половые гормоны могут стимулировать выработку ряда цитокинов, принимающих участие в формировании кожного воспалительного процесса, а также кожного зуда. В период беременности иммунная система модифицируется до достижения иммунной толерантности, эти изменения происходят как на уровне «мать – плод», так и в системном кровотоке, что обусловлено в первую очередь увеличением концентрации прогестерона во время беременности. Изменение гормонального фона при беременности смещает баланс в иммунной системе, что может быть пусковым моментом для развития АтД. Изучение гормонального статуса при обострении АтД, в т. ч. и при беременности, является перспективным и может способствовать разработке профилактических и лечебных мероприятий.

Atopic dermatitis (AD) is a chronic inflammatory skin disease that is widespread throughout the world. The disease is more common in women than in men. This difference can be explained by the influence of sex hormones on the functioning of the skin barrier and the immune system. Fluctuations in the concentration of sex hormones correlate with the incidence of AD. During the luteal phase of the menstrual cycle, AD exacerbation or worsening of the disease is more common, which is associated with the production of progesterone and estrogens, and during the follicular phase, AD improves due to the predominant effect of estrogens. During the menstrual cycle, women experience a change in the barrier function of the skin, characterized by dryness, impaired sensitivity, and increased transepidermal water loss, which indicates a pronounced effect of sex hormones on the skin. Sex hormones can stimulate the production of a number of cytokines involved in the formation of skin inflammation and itching. During pregnancy, the immune system is modified to achieve immune tolerance; these changes occur both at the mother-fetus level and in the systemic bloodstream, primarily due to an increase in progesterone concentration during pregnancy. Changes in hormonal levels during pregnancy shift the balance in the immune system, which can be a trigger for the development of AD. Studying hormonal status during AD exacerbation, including during pregnancy, is promising and can contribute to the development of preventive and therapeutic measures.

атопический дерматитэстрогеныандрогеныпрогестеронкожный барьерцитокиныбеременностьatopic dermatitisestrogensandrogensprogesteroneskin barriercytokinespregnancyReferencesFurue M, Chiba T, Tsuji G, Ulzii D, Kido-Nakahara M, Nakahara T, Kadono T. Atopic dermatitis: Immune deviation, barrier dysfunction, IgE autoreactivity and new therapies. Allergol Int. 2017;66(3):398–403. https://doi.org/10.1016/j.alit.2016.12.002.Furue M, Chiba T, Tsuji G, Ulzii D, Kido-Nakahara M, Nakahara T, Kadono T. Atopic dermatitis: Immune deviation, barrier dysfunction, IgE autoreactivity and new therapies. Allergol Int. 2017;66(3):398–403. https://doi.org/10.1016/j.alit.2016.12.002.Egawa G, Kabashima K. Barrier dysfunction in the skin allergy. Allergol Int. 2018;67(1):3–11. https://doi.org/10.1016/j.alit.2017.10.002.Egawa G, Kabashima K. Barrier dysfunction in the skin allergy. Allergol Int. 2018;67(1):3–11. https://doi.org/10.1016/j.alit.2017.10.002.Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66(1):8–16. https://doi.org/10.1159/000370220.Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66(1):8–16. https://doi.org/10.1159/000370220.Eichenfield LF, Stripling S, Fung S, Cha A, O’Brien A, Schachner LA. Recent Developments and Advances in Atopic Dermatitis: A Focus on Epidemiology, Pathophysiology, and Treatment in the Pediatric Setting. Paediatr Drugs. 2022;24(4):293–305. https://doi.org/10.1007/s40272-022-00499-x.Eichenfield LF, Stripling S, Fung S, Cha A, O’Brien A, Schachner LA. Recent Developments and Advances in Atopic Dermatitis: A Focus on Epidemiology, Pathophysiology, and Treatment in the Pediatric Setting. Paediatr Drugs. 2022;24(4):293–305. https://doi.org/10.1007/s40272-022-00499-x.Ненашева НМ. Современная терапия атопического дерматита: роль эмолентов и антигистаминных препаратов. Эффективная фармакотерапия. Аллергология и иммунология. 2016;1(6):6–14. Режим доступа: https://umedp.ru/upload/iblock/e5c/zodak.pdf.Nenasheva NM. Modern therapy of atopic dermatitis: the role of emollients and antihistamines. Effective Pharmacotherapy. Allergology and Immunology. 2016;1(6):6–14. (In Russ.) Available at: https://umedp.ru/upload/iblock/e5c/zodak.pdf.Flohr C, England K, Radulovic S, McLean WH, Campbel LE, Barker J et al. Filaggrin loss-of-function mutations are associated with early-onset eczema, eczema severity and transepidermal water loss at 3 months of age. Br J Dermatol. 2010;163(6):1333–1336. https://doi.org/10.1111/j.13652133.2010.10068.x.Flohr C, England K, Radulovic S, McLean WH, Campbel LE, Barker J et al. Filaggrin loss-of-function mutations are associated with early-onset eczema, eczema severity and transepidermal water loss at 3 months of age. Br J Dermatol. 2010;163(6):1333–1336. https://doi.org/10.1111/j.13652133.2010.10068.x.Kobiela A, Hovhannisyan L, Jurkowska P, de la Serna JB, Bogucka A, Deptuła M et al. Excess filaggrin in keratinocytes is removed by extracellular vesicles to prevent premature death and this mechanism can be hijacked by Staphylococcus aureus in a TLR2-dependent fashion. J Extracell Vesicles. 2023;12(6):e12335. https://doi.org/10.1002/jev2.12335.Kobiela A, Hovhannisyan L, Jurkowska P, de la Serna JB, Bogucka A, Deptuła M et al. Excess filaggrin in keratinocytes is removed by extracellular vesicles to prevent premature death and this mechanism can be hijacked by Staphylococcus aureus in a TLR2-dependent fashion. J Extracell Vesicles. 2023;12(6):e12335. https://doi.org/10.1002/jev2.12335.Presland RB, Kuechle MK, Lewis SP, Fleckman P, Dale BA. Regulated expression of human filaggrin in keratinocytes results in cytoskeletal disruption, loss of cell-cell adhesion, and cell cycle arrest. Exp Cell Res. 2001;270(2):199–213. https://doi.org/10.1006/excr.2001.5348.Presland RB, Kuechle MK, Lewis SP, Fleckman P, Dale BA. Regulated expression of human filaggrin in keratinocytes results in cytoskeletal disruption, loss of cell-cell adhesion, and cell cycle arrest. Exp Cell Res. 2001;270(2):199–213. https://doi.org/10.1006/excr.2001.5348.Yuki T, Tobiishi M, Kusaka-Kikushima A, Ota Y, Tokura Y. Impaired tight junctions in atopic dermatitis skin and in a skin-equivalent model treated with interleukin-17. PLoS ONE. 2016;11:e0161759. https://doi.org/10.1371/journal.pone.0161759.Yuki T, Tobiishi M, Kusaka-Kikushima A, Ota Y, Tokura Y. Impaired tight junctions in atopic dermatitis skin and in a skin-equivalent model treated with interleukin-17. PLoS ONE. 2016;11:e0161759. https://doi.org/10.1371/journal.pone.0161759.Nomura T, Honda T, Kabashima K. Multipolarity of cytokine axes in the pathogenesis of atopic dermatitis in terms of age, race, species, disease stage and biomarkers. Int Immunol. 2018;30:419–428. https://doi.org/10.1093/intimm/dxy015.Nomura T, Honda T, Kabashima K. Multipolarity of cytokine axes in the pathogenesis of atopic dermatitis in terms of age, race, species, disease stage and biomarkers. Int Immunol. 2018;30:419–428. https://doi.org/10.1093/intimm/dxy015.Kanda N, Hoashi T, Saeki H. The Roles of Sex Hormones in the Course of Atopic Dermatitis. Int J Mol Sci. 2019;20(19):4660. https://doi.org/10.3390/ijms20194660.Kanda N, Hoashi T, Saeki H. The Roles of Sex Hormones in the Course of Atopic Dermatitis. Int J Mol Sci. 2019;20(19):4660. https://doi.org/10.3390/ijms20194660.Farage MA, Neill S, MacLean AB. Physiological changes associated with the menstrual cycle: A review. Obstet Gynecol Surv. 2009;64(1):58–72. https://doi.org/10.1097/OGX.0b013e3181932a37.Farage MA, Neill S, MacLean AB. Physiological changes associated with the menstrual cycle: A review. Obstet Gynecol Surv. 2009;64(1):58–72. https://doi.org/10.1097/OGX.0b013e3181932a37.Raghunath RS, Venables ZC, Millington GW. The menstrual cycle and the skin. Clin Exp Dermatol. 2015;40(2):111–115. https://doi.org/10.1111/ced.12588.Raghunath RS, Venables ZC, Millington GW. The menstrual cycle and the skin. Clin Exp Dermatol. 2015;40(2):111–115. https://doi.org/10.1111/ced.12588.Kiriyama K, Sugiura H, ·Uehara M. Premenstrual deterioration of skin symptoms in female patients with atopic dermatitis. Dermatology. 2003;206(2):110–112. https://doi.org/10.1159/000068463.Kiriyama K, Sugiura H, ·Uehara M. Premenstrual deterioration of skin symptoms in female patients with atopic dermatitis. Dermatology. 2003;206(2):110–112. https://doi.org/10.1159/000068463.Farage MA, Berardesca E, Maibach H. The possible relevance of sex hormones on irritant and allergic responses: their importance for skin testing. Contact Dermatitis. 2010;62(2):67–74. https://doi.org/10.1111/j.16000536.2009.01621.x.Farage MA, Berardesca E, Maibach H. The possible relevance of sex hormones on irritant and allergic responses: their importance for skin testing. Contact Dermatitis. 2010;62(2):67–74. https://doi.org/10.1111/j.16000536.2009.01621.x.Bonamonte D, Foti C, Antelmi AR, Biscozzi AM, Naro ED, Fanelli M et al. Nickel contact allergy and menstrual cycle. Contact Dermatitis. 2005;52(6):309–313. https://doi.org/10.1111/j.0105-1873.2005.00588.x.Bonamonte D, Foti C, Antelmi AR, Biscozzi AM, Naro ED, Fanelli M et al. Nickel contact allergy and menstrual cycle. Contact Dermatitis. 2005;52(6):309–313. https://doi.org/10.1111/j.0105-1873.2005.00588.x.Balakirski G, Novak N. Atopic dermatitis and pregnancy. J Allergy Clin Immunol. 2022;149(4):1185–1194. https://doi.org/10.1016/j.jaci.2022.01.010.Balakirski G, Novak N. Atopic dermatitis and pregnancy. J Allergy Clin Immunol. 2022;149(4):1185–1194. https://doi.org/10.1016/j.jaci.2022.01.010.Tai P, Wang J, Jin H, Song X, Yan J, Kang Y et al. Induction of regulatory T cells by physiological level estrogen. J Cell Physiol. 2008;214(2):456–464. https://doi.org/10.1002/jcp.21221.Tai P, Wang J, Jin H, Song X, Yan J, Kang Y et al. Induction of regulatory T cells by physiological level estrogen. J Cell Physiol. 2008;214(2):456–464. https://doi.org/10.1002/jcp.21221.Miyaura H, Iwata M. Direct and indirect inhibition of Th1 development by progesterone and glucocorticoids. J Immunol. 2002;168(3):1087–1094. https://doi.org/10.4049/jimmunol.168.3.1087.Miyaura H, Iwata M. Direct and indirect inhibition of Th1 development by progesterone and glucocorticoids. J Immunol. 2002;168(3):1087–1094. https://doi.org/10.4049/jimmunol.168.3.1087.Kissick HT, Sanda MG, Dunn LK, Pellegrini KL, On ST, Noel JK, Arredouani MS. Androgens alter T-cell immunity by inhibiting T-helper 1 differentiation. Proc Natl Acad Sci U S A. 2014;111(27):9887–9892. https://doi.org/10.1073/pnas.1402468111.Kissick HT, Sanda MG, Dunn LK, Pellegrini KL, On ST, Noel JK, Arredouani MS. Androgens alter T-cell immunity by inhibiting T-helper 1 differentiation. Proc Natl Acad Sci U S A. 2014;111(27):9887–9892. https://doi.org/10.1073/pnas.1402468111.Hepworth MR, Hardman MJ, Grencis RK. The role of sex hormones in the development of Th2 immunity in a gender-biased model of Trichuris muris infection. Eur J Immunol. 2010;40(2):406–416. https://doi.org/10.1002/eji.200939589.Hepworth MR, Hardman MJ, Grencis RK. The role of sex hormones in the development of Th2 immunity in a gender-biased model of Trichuris muris infection. Eur J Immunol. 2010;40(2):406–416. https://doi.org/10.1002/eji.200939589.Trigunaite A, Dimo J, Jørgensen TN. Suppressive effects of androgens on the immune system. Cell Immunol. 2015;294(2):87–94. https://doi.org/10.1016/j.cellimm.2015.02.004.Trigunaite A, Dimo J, Jørgensen TN. Suppressive effects of androgens on the immune system. Cell Immunol. 2015;294(2):87–94. https://doi.org/10.1016/j.cellimm.2015.02.004.Fuseini H, Yung JA, Cephus JY, Zhang J, Goleniewska K, Polosukhin VV et al. Testosterone Decreases House Dust Mite-Induced Type 2 and IL-17AMediated Airway Inflammation. J Immunol. 2018;201(7):1843–1854. https://doi.org/10.4049/jimmunol.1800293.Fuseini H, Yung JA, Cephus JY, Zhang J, Goleniewska K, Polosukhin VV et al. Testosterone Decreases House Dust Mite-Induced Type 2 and IL-17AMediated Airway Inflammation. J Immunol. 2018;201(7):1843–1854. https://doi.org/10.4049/jimmunol.1800293.Massa MG, David C, Jörg S, Berg J, Gisevius B, Hirschberg S et al. Testosterone Differentially Affects T Cells and Neurons in Murine and Human Models of Neuroinflammation and Neurodegeneration. Am J Pathol. 2017;187(7):1613–1622. https://doi.org/10.1016/j.ajpath.2017.03.006.Massa MG, David C, Jörg S, Berg J, Gisevius B, Hirschberg S et al. Testosterone Differentially Affects T Cells and Neurons in Murine and Human Models of Neuroinflammation and Neurodegeneration. Am J Pathol. 2017;187(7):1613–1622. https://doi.org/10.1016/j.ajpath.2017.03.006.Walecki M, Eisel F, Klug J, Baal N, Paradowska-Dogan A, Wahle E et al. Androgen receptor modulates Foxp3 expression in CD4+CD25+Foxp3+ regulatory T-cells. Mol Biol Cell. 2015;26(15):2845–2857. https://doi.org/10.1091/mbc.E14-08-1323.Walecki M, Eisel F, Klug J, Baal N, Paradowska-Dogan A, Wahle E et al. Androgen receptor modulates Foxp3 expression in CD4+CD25+Foxp3+ regulatory T-cells. Mol Biol Cell. 2015;26(15):2845–2857. https://doi.org/10.1091/mbc.E14-08-1323.Dayoub O, Le Lay S, Soleti R, Clere N, Hilairet G, Dubois S et al. Estrogen receptor α/HDAC/NFAT axis for delphinidin effects on proliferation and differentiation of T lymphocytes from patients with cardiovascular risks. Sci Rep. 2017;7(1):9378. https://doi.org/10.1038/s41598-017-09933-4.Dayoub O, Le Lay S, Soleti R, Clere N, Hilairet G, Dubois S et al. Estrogen receptor α/HDAC/NFAT axis for delphinidin effects on proliferation and differentiation of T lymphocytes from patients with cardiovascular risks. Sci Rep. 2017;7(1):9378. https://doi.org/10.1038/s41598-017-09933-4.Matalka KZ. The effect of estradiol, but not progesterone, on the production of cytokines in stimulated whole blood, is concentration-dependent. Neuro Endocrinol Lett. 2003;24(3-4):185–191. Available at: https://pubmed.ncbi.nlm.nih.gov/14523355.Matalka KZ. The effect of estradiol, but not progesterone, on the production of cytokines in stimulated whole blood, is concentration-dependent. Neuro Endocrinol Lett. 2003;24(3-4):185–191. Available at: https://pubmed.ncbi.nlm.nih.gov/14523355.Watanabe Y, Tajiki-Nishino R, Tajima H, Fukuyama T. Role of estrogen receptors α and β in the development of allergic airway inflammation in mice: A possible involvement of interleukin 33 and eosinophils. Toxicology. 2019;411:93–100. https://doi.org/10.1016/j.tox.2018.11.002.Watanabe Y, Tajiki-Nishino R, Tajima H, Fukuyama T. Role of estrogen receptors α and β in the development of allergic airway inflammation in mice: A possible involvement of interleukin 33 and eosinophils. Toxicology. 2019;411:93–100. https://doi.org/10.1016/j.tox.2018.11.002.Lorenz TK, Heiman JR, Demas GE. Sexual activity modulates shifts in TH1/TH2 cytokine profile across the menstrual cycle: an observational study. Fertil Steril. 2015;104(6):1513–21.e214. https://doi.org/10.1016/j.fertnstert.2015.09.001.Lorenz TK, Heiman JR, Demas GE. Sexual activity modulates shifts in TH1/TH2 cytokine profile across the menstrual cycle: an observational study. Fertil Steril. 2015;104(6):1513–21.e214. https://doi.org/10.1016/j.fertnstert.2015.09.001.Hall OJ, Limjunyawong N, Vermillion MS, Robinson DP, Wohlgemuth N, Pekosz A. Progesterone-Based Therapy Protects Against Influenza by Promoting Lung Repair and Recovery in Females. PLoS Pathogens. 2016;12(9):e1005840. https://doi.org/10.1371/journal.ppat.1005840.Hall OJ, Limjunyawong N, Vermillion MS, Robinson DP, Wohlgemuth N, Pekosz A. Progesterone-Based Therapy Protects Against Influenza by Promoting Lung Repair and Recovery in Females. PLoS Pathogens. 2016;12(9):e1005840. https://doi.org/10.1371/journal.ppat.1005840.Sulcová J, Hill M, Hampl R, Stárka L. Age and sex related differences in serum levels of unconjugated dehydroepiandrosterone and its sulphate in normal subjects. J Endocrinol. 1997;154(1):57–62. https://doi.org/10.1677/joe.0.1540057.Sulcová J, Hill M, Hampl R, Stárka L. Age and sex related differences in serum levels of unconjugated dehydroepiandrosterone and its sulphate in normal subjects. J Endocrinol. 1997;154(1):57–62. https://doi.org/10.1677/joe.0.1540057.Firooz A, Sadr B, Babakoohi S, Sarraf-Yazdy M, Fanian F, Kazerouni-Timsar A, Nassiri-Kashani M et al. Variation of biophysical parameters of the skin with age, gender, and body region. Sci World J. 2012;2012:386936. https://doi.org/10.1100/2012/386936.Firooz A, Sadr B, Babakoohi S, Sarraf-Yazdy M, Fanian F, Kazerouni-Timsar A, Nassiri-Kashani M et al. Variation of biophysical parameters of the skin with age, gender, and body region. Sci World J. 2012;2012:386936. https://doi.org/10.1100/2012/386936.Chen Y, Yokozeki H, Katagiri K. Physiological and functional changes in the stratum corneum restored by oestrogen in an ovariectomized mice model of climacterium. Exp Dermatol. 2017;26(5):394–401. https://doi.org/10.1111/exd.13214.Chen Y, Yokozeki H, Katagiri K. Physiological and functional changes in the stratum corneum restored by oestrogen in an ovariectomized mice model of climacterium. Exp Dermatol. 2017;26(5):394–401. https://doi.org/10.1111/exd.13214.Kao JS, Garg A, Mao-Qiang M, Crumrine D, Ghadially R, Feingold KR, Elias PM. Testosterone perturbs epidermal permeability barrier homeostasis. J Invest Dermatol. 2001;116(3):443–451. https://doi.org/10.1046/j.15231747.2001.01281.x.Kao JS, Garg A, Mao-Qiang M, Crumrine D, Ghadially R, Feingold KR, Elias PM. Testosterone perturbs epidermal permeability barrier homeostasis. J Invest Dermatol. 2001;116(3):443–451. https://doi.org/10.1046/j.15231747.2001.01281.x.Tsutsumi M, Denda M. Paradoxical effects of beta-estradiol on epidermal permeability barrier homeostasis. Br J Dermatol. 2007;157(4):776–779. https://doi.org/10.1111/j.1365-2133.2007.08115.x.Tsutsumi M, Denda M. Paradoxical effects of beta-estradiol on epidermal permeability barrier homeostasis. Br J Dermatol. 2007;157(4):776–779. https://doi.org/10.1111/j.1365-2133.2007.08115.x.Yosipovitch G, Rosen JD, Hashimoto T. Itch: From mechanism to (novel) therapeutic approaches. J Allergy Clin Immunol. 2018;142(5):1375–1390. https://doi.org/10.1016/j.jaci.2018.09.005.Yosipovitch G, Rosen JD, Hashimoto T. Itch: From mechanism to (novel) therapeutic approaches. J Allergy Clin Immunol. 2018;142(5):1375–1390. https://doi.org/10.1016/j.jaci.2018.09.005.Ambros-Rudolph CM, Müllegger RR, Vaughan-Jones SA, Kerl H, Black MM. The specific dermatoses of pregnancy revisited and reclassified: results of a retrospective two-center study on 505 pregnant patients. J Am Acad Dermatol. 2006;54(3):395–404. https://doi.org/10.1016/j.jaad.2005.12.012.Ambros-Rudolph CM, Müllegger RR, Vaughan-Jones SA, Kerl H, Black MM. The specific dermatoses of pregnancy revisited and reclassified: results of a retrospective two-center study on 505 pregnant patients. J Am Acad Dermatol. 2006;54(3):395–404. https://doi.org/10.1016/j.jaad.2005.12.012.Zen M, Ghirardello A, Iaccarino L, Tonon M, Campana C, Arienti S et al. Hormones, immune response, and pregnancy in healthy women and SLE patients. Swiss Med Wkly. 2010;140(13-14):187–201. https://doi.org/10.4414/smw.2010.12597.Zen M, Ghirardello A, Iaccarino L, Tonon M, Campana C, Arienti S et al. Hormones, immune response, and pregnancy in healthy women and SLE patients. Swiss Med Wkly. 2010;140(13-14):187–201. https://doi.org/10.4414/smw.2010.12597.Хамдамов БЗ, Турдыева ДО, Рустамова НБ. Синтез цитокинов при физиологически протекающей беременности. Российский иммунологический журнал. 2024;27(4):853–858. https://doi.org/10.46235/1028-7221-16954-SOC.Khamdamov BZ, Turdyeva DO, Rustamova NB. Synthesis of cytokines during physiological pregnancy. Russian Journal of Immunology. 2024;27(4):853–858 (In Russ.) https://doi.org/10.46235/1028-7221-16954-SOC.Альбанова ВИ, Петрова CЮ. Особенности ведения атопического дерматита у беременных. Вестник дерматологии и венерологии. 2023;99(5):29–40. https://doi.org/10.25208/vdv13279.Albanova VI, Petrova SY. Features of management of atopic dermatitis in pregnant women. Vestnik Dermatologii i Venerologii. 2023;99(5):29–40. (In Russ.) https://doi.org/10.25208/vdv13279.Mulac-Jericevic B, Conneely OM. Reproductive tissue selective actions of progesterone receptors. Reproduction. 2004;128(2):139–146. https://doi.org/10.1530/rep.1.00189.Mulac-Jericevic B, Conneely OM. Reproductive tissue selective actions of progesterone receptors. Reproduction. 2004;128(2):139–146. https://doi.org/10.1530/rep.1.00189.Mulac-Jericevic B, Mullinax RA, DeMayo FJ, Lydon JP, Conneely OM. Subgroup of reproductive functions of progesterone mediated by progesterone receptor-B isoform. Science. 2000;289(5485):1751–1754. https://doi.org/10.1126/science.289.5485.1751.Mulac-Jericevic B, Mullinax RA, DeMayo FJ, Lydon JP, Conneely OM. Subgroup of reproductive functions of progesterone mediated by progesterone receptor-B isoform. Science. 2000;289(5485):1751–1754. https://doi.org/10.1126/science.289.5485.1751.Arruvito L, Giulianelli S, Flores AC, Paladino N, Barboza M, Lanari C, Fainboim L. NK cells expressing a progesterone receptor are susceptible to progesterone-induced apoptosis. J Immunol. 2008;180(8):5746–5753. https://doi.org/10.4049/jimmunol.180.8.5746.Arruvito L, Giulianelli S, Flores AC, Paladino N, Barboza M, Lanari C, Fainboim L. NK cells expressing a progesterone receptor are susceptible to progesterone-induced apoptosis. J Immunol. 2008;180(8):5746–5753. https://doi.org/10.4049/jimmunol.180.8.5746.Szekeres-Bartho J, Schindler AE. Progestogens and immunology. Best Pract Res Clin Obstet Gynaecol. 2019;60:17–23. https://doi.org/10.1016/j.bpobgyn.2019.07.001.Szekeres-Bartho J, Schindler AE. Progestogens and immunology. Best Pract Res Clin Obstet Gynaecol. 2019;60:17–23. https://doi.org/10.1016/j.bpobgyn.2019.07.001.Зайдиева ЗС, Прозоров ВВ, Карапетян ТЭ. Прогестероновая поддержка при планировании беременности у женщин с высоким инфекционным риском. РМЖ. 2006;(1):25. Режим доступа: https://www.rmj.ru/articles/obshchie-stati/Progesteronovaya_podderghka_pri_planirovanii_beremennosti_u_ghenschin_s_vysokim_infekcionnym_riskom.Zajdieva ZS, Prozorov VV, Karapetyan TE. Progesterone support for pregnancy planning in women at high risk of infection. RMJ. 2006;(1):25. (In Russ.) Available at: https://www.rmj.ru/articles/obshchie-stati/Progesteronovaya_podderghka_pri_planirovanii_beremennosti_u_ghenschin_s_vysokim_infekcionnym_riskom.

The authors declare that there are no conflicts of interest present.