Exploring immunomodulation by endocrine changes in Lady Windermere Syndrome

Holt, Michael R., Miles, John J., Inder, Warrick J., and Thomson, Rachel (2019) Exploring immunomodulation by endocrine changes in Lady Windermere Syndrome. Clinical and Experimental Immunology, 196 (1). pp. 28-38.

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Lung disease due to nontuberculous mycobacteria (NTM) occurs with disproportionate frequency in postmenopausal women with a unique phenotype and without clinically apparent predisposing factors. Dubbed “Lady Windermere Syndrome”, the phenotype includes low body mass index (BMI), tall stature, and higher than normal prevalence of scoliosis, pectus excavatum and mitral valve prolapse. Although the pathomechanism for susceptibility to NTM lung disease in these patients remains uncertain, it is likely to be multifactorial. A role for the immunomodulatory consequences of oestrogen deficiency and altered adipokine production has been postulated. Altered levels of adipokines and dehydroepiandrosterone have been demonstrated in patients with NTM lung disease. Case reports of NTM lung disease in patients with hypopituitarism support the possibility that altered endocrine function influences disease susceptibility. This article catalogues the evidence for immunomodulatory consequences of predicted endocrine changes in Lady Windermere Syndrome with emphasis on the immune response to mycobacteria. Collectively, the data warrant further exploration of an endocrine link to disease susceptibility in Lady Windermere Syndrome.

Item ID: 57233
Item Type: Article (Research - C1)
ISSN: 1365-2249
Keywords: nontuberculous mycobacteria; hormones; immune response; adipokines; estrogen
Copyright Information: © 2019 British Society for Immunology
Date Deposited: 27 Feb 2019 00:04
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3204 Immunology > 320499 Immunology not elsewhere classified @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920199 Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified @ 100%
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