Abstract
Menopause, probably the most important natural change in a woman’s life and a major component of female senescence, is characterized, inter alia, by cessation of ovarian estrogen and progesterone production, resulting in a gradual deterioration of the female immune system. Hormone replacement therapy (HRT) is used in postmenopausal women to relieve some of the peri- and postmenopausal symptoms, while there is also evidence that the therapy may additionally partially reverse menopausal immune senescence. Flavonoids, and especially isoflavones, are widely used for the treatment of menopausal symptoms, although it is not at present clear whether they can reverse or alleviate other menopausal changes. HRT reverses the menopausal CD4/CD8 ratio and also limits the general peri- and postmenopausal inflammatory state. Moreover, the increased levels of interleukins (IL)-1β, IL-6, and IL-8, as well as of tumor necrosis factor-α (TNF-α) are decreased after the initiation of HRT. However, some reports show no effect of HRT on IL-4, IL-10, and IL-12. It is thus evident that the molecular pathways connecting HRT and female immune senescence need to be clarified. Interestingly, recent studies have suggested that the anti-inflammatory properties of isoflavones possibly interact with inflammatory cytokines when applied in menopause treatments, thereby potentially reversing immune senescence. This narrative review presents the latest data on the effect of menopausal therapies, including administration of flavonoid-rich products, on age-associated immune senescence reversal with the aim of revealing possible directions for future research and treatment development.
Highlights
Menopause, which is characterized by the termination of the ovarian production of estrogen and progesterone and is considered to be the most important natural change in a woman’s life, is accompanied by a large number of correlated changes
We present the most recent data concerning the impact of hormonal menopausal therapies and isoflavones on the immune system and potential, resultant senescence reversal with the aim of revealing possible directions for future research and treatment development, while we discuss flavonoid-rich products that may be used for pharmaceutical purposes or as functional foods
The above-reported data reveal that the impacts of Hormone replacement therapy (HRT) on the immune system and its senescence remain to date unclear in many respects
Summary
Menopause, which is characterized by the termination of the ovarian production of estrogen and progesterone and is considered to be the most important natural change in a woman’s life, is accompanied by a large number of correlated changes. Recent in vitro studies have revealed the anti-inflammatory effects of isoflavones, mentioned above, as evidenced by a reduction in the levels of inflammatory cytokines [11,12,13] Since it is well-known that ovarian steroids modulate the immune response, it could be suggested that HRT may possibly reverse immune senescence. Given that reduction of inflammation shows clear improvement in certain cases, deeper insight into the molecular pathways of the inflammatory cascade may well offer highly promising options for future treatments [21] In this narrative review, we present the most recent data concerning the impact of hormonal menopausal therapies and isoflavones on the immune system and potential, resultant senescence reversal with the aim of revealing possible directions for future research and treatment development, while we discuss flavonoid-rich products that may be used for pharmaceutical purposes or as functional foods
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