Cytokines, such as interleukin‐1 (IL‐1) and tumor necrosis factors (TNF), produced by cells of the monocyte‐macrophage lineage in the local bone microenvironment, are potentially important local regulators of bone turnover. To investigate whether the protective effects of estrogen against postmenopausal bone loss may be mediated by inhibition of cytokine release, we studied the effects of 17β‐estradiol, dihydrotestosterone, and hydrocortisone on TNF release from human peripheral blood mononuclear cells (PBMC) in vitro. In unstimulated cells derived from eight postmenopausal women, seven of whom had osteoporotic vertebral fractures, 17β‐estradiol inhibited TNF release in a dose‐dependent manner between 10⁻⁶ and 10⁻¹² M but had no consistent effect on cells derived from men or premenopausal women. Dihydrotestosterone in concentrations of up to 10⁻⁶ M had no effect on TNF release in any patient group, whereas hydrocortisone at 10⁻⁶ M was a potent inhibitor of TNF release in all groups.

Since TNF is a potent stimulator of bone resorption, the inhibitory effect of estrogen on TNF release may be part of the mechanism by which it exerts a protective effect on the skeleton in postmenopausal women. These observations may also be relevant in other inflammatory diseases of connective tissue, such as rheumatoid arthritis, in which disease activity may fluctuate as estrogen levels change — during the menstrual cycle, in pregnancy, and after the menopause.