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Editor's Correspondence
December 13, 2004

Postmenopausal Asthma: The Estradiol 11β-Hydroxysteroid Dehydrogenase Connection

Arch Intern Med. 2004;164(22):2500-2509. doi:10.1001/archinte.164.22.2501

Barr and colleagues1 reported that postmenopausal female hormone therapy is associated with an increased rate of onset of asthma. They noted that the incidence of asthma usually decreases with the onset of menopause and that estrogens may exert proinflammatory effects.

In their discussion, their comments on common proinflammatory mechanisms that activate asthma failed to include the possibility that a decrease in the anti-inflammatory protection provided by cortisol might allow asthma to develop. Cortisol is an extremely powerful anti-inflammatory agent that may be protective against the development of chronic inflammation.2