Alterations of Immune Function in the DES Exposed

Diethylstilbestrol Revisited: A Review of the Long-Term Health Effects

1995 Research Abstract

Alterations of Immune Function

Speculation that prenatal exposure to DES may lead to an altered immune status is based on observations that mice exposed perinatally to DES show reversible thymic and splenic atrophy, decreased T-helper cell subpopulations, and impaired natural killer-cell activity. Interestingly, two small case series have shown altered T-cell and natural killer-cell function in women exposed to DES in utero.

In reviewing data from the DESAD cohort, Noller and associates observed that reporting of a lifetime history of autoimmune diseases was increased among persons exposed to DES in utero compared with unexposed controls. Overall, the rate of any autoimmune disease was 28.6 cases per 1000 persons among the exposed daughters and 16.9 cases per 1000 persons among the unexposed women, resulting in a relative prevalence rate of 1.8 cases per 1000 persons (CI, 0.99 to 3.1). Although no individual autoimmune disease was significantly associated with exposure, Hashimoto thyroiditis was reported by 10 of the 1711 women exposed to DES compared with 1 of 922 controls. No other clinical manifestations of immune dysfunction have been established. On the basis of the results of animal studies, however, Blair has hypothesized that immune dysfunction in exposed offspring may only become clinically manifest with aging.



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